Jan 21 2010
Victory Against Homeopathy in Australia
My skeptical comrades down under have been kicking A and taking names. They demonstrate that skeptical activism can have concrete positive effects. Most recently they issued a complaint to the Therapeutic Goods Administration (the Australian equivalent of the FDA) about the claims being made on two homeopathy websites (“Homeopathy Plus!” and “www.d-n-h.org”). Specifically the cites claimed that homeopathic immunization (there is no such thing) was as effective as real immunization for the prevention of infectious diseases. They report:
Dr Ken Harvey, a lecturer at Latrobe University School of Public Health, who authored the complaint, objected to claims on the website that “homeopathic immunisation is effective against poliomyelitis, chicken pox, meningococcal disease, hepatitis (all types), Japanese encephalitis, HiB, influenza, measles, pnuemococcal disease, smallpox, typhoid, cholera, typhus whooping cough, rubella, mumps, diptheria, malaria, tetanus, yellow fever, dysentery and many other epidemic diseases”.
To support these claims the research of Isaac Golden was referenced, but the study referenced was in fact negative – without statistically significant results.
The panel who heard the complaint came back with a favorable finding:
The findings from The Complaints Resolution Panel stated that although the complainant cited references for homeoprophylaxis, they “did not provide complete copies of the papers cited” and that the material was “misleading”, “unverified” and “abused the trust or exploited the lack of knowledge of consumers”.
That last bit could apply to just about all of so-called “alternative” medicine.
The ruling is another hopeful sign that we can turn the tide against pseudoscience in medicine and the legitimizing of health fraud through clever marketing. Homeopathy is pure bunk and has no place in a science-based health care system. But the promoters of dubious health claims have been successful in distracting the public, regulators, and even some academics with pleasant sounding but ultimately misleading rhetoric.
Here is a recent example – a press release about what is ultimately a worthless study.
The team of UCLA and UC San Diego experts in the fields of CAM, integrative medicine, Western medicine, medical education and survey development created a novel 30-question survey and sent it to 126 medical schools throughout the United States. In return, the team received 1,770 completed surveys from a pool of about 68,000 medical students nationwide, roughly three percent.
Three percent – that means that the results of this survey are uninterpretable – worthless. This is such a highly self-selective response that it tells us nothing statistical about the attitudes of medical students toward CAM. Further, the questions asked in such surveys can be phrased to produce a positive result – and in this case ambiguity as to what is considered “CAM” makes the questions themselves almost too vague to be of any use. This study is so bad that it should not be publishable in the peer-reviewed literature. However, CAM proponents now have their own journals in which to publish worthless studies that are only useful for propaganda purposes. This one will be published in Evidence-based Complementary and Alternative Medicine.
From the press release:
“Complementary and alternative medicine is receiving increased attention in light of the global health crisis and the significant role of traditional medicine in meeting public health needs in developing countries,” said study author Ryan Abbott, a researcher at the UCLA Center for East-West Medicine. “Integrating CAM into mainstream health care is now a global phenomenon, with policy makers at the highest levels endorsing the importance of a historically marginalized form of health care.”
I disagree with just about every assertion in this statement – this is the cover, the distraction, the equivalent of “ignore that man behind the curtain.” The first sentence begs the question as to whether or not CAM in any way will be helpful to the global health crisis. The World Health Organization recently had to admit that homeopathy, for example, has no role in the real health crises faced by third world countries. Unscientific medicine is a sure way to waste resources and worsen the global health crisis.
Then there is the attempt to portray CAM as “traditional” and “marginalized” – appealing to cultural sensitivity.
Then the press release dives into the core CAM propaganda:
CAM, which includes therapies such as massage, yoga, herbal medicine and acupuncture, is characterized by a holistic and highly individualized approach to patient care. It’s emphasis is on maximizing the body’s inherent healing ability; getting patients involved as active participants in their own care; addressing the physical, mental and spiritual attributes of a disease; and preventive care. While interest in these fields has increased dramatically in the United States in recent years, information about such therapies has not yet been widely integrated into medical education.
CAM is not “holistic”. Most CAM modalities take a very narrow view of health and illness by focusing on the “one cause of all disease” or a simplistic philosophy-based notion of health. Treating all illness as if it were a deficit in the flow of life energy does not treat a person as a whole biological organism. Most CAM treatment is also not individualized – but rather applies cookbook style remedies.
The press release also repeats the common canards that CAM is preventive medicine and patient-centered medicine. These concepts, however, have their origin in mainstream medicine. It is simply historical revisionism for CAM to claim that they innovated the notion of prevention. It is also simply not true that CAM treatments are truly preventive of anything. Of course, if you are willing to simply make up claims, like homeopathy can be used as an effective vaccine, then you can claim to be preventive.
But scientists and skeptics can resist this trend by refocusing attention on what really matters – what are the claims, and what is the evidence. We would also like scientific plausibility restored to its proper place, but that is a larger battle.
In the meantime, we can at least encourage existing regulatory agencies to do their job – police fraudulent health claims. This is where skeptical activism comes in, and has been increasingly successful. The WHO statements were in response to a complaint by Sense About Science, a UK skeptical group. The Australian Skeptics have successfully opposed anti-vaccination campaigns, and now have scored against homeopathy quackery.
Our core premise is hard to argue with, and is the premise of much existing regulation – health claims should be backed by sufficient evidence. In fact, it is easy to promote this premise when dealing with mainstream medicine – the claims of physicians and “big pharma”, for example. All we want is for the same standards of evidence to apply to all claims. CAM is about creating a double standard – it is the curtain behind which unscientific remedies are trying to hide.
Almost daily I get e-mails from readers and listeners who are faced with a situation in which unscientific medicine is being promoted at their workplace, at their school, in their family, on the web, or elsewhere, and they want to know what to do. For a long time many skeptics felt as if they should just keep their head down, lest they be accused of being closed-minded, culturally insensitive, or even a shill for some evil industry. CAM proponents have become very aggressive at silencing their critics – as they must if they are to promote their pseudoscience.
This is where culture comes into play – pseudoscience in medicine will be tolerated as long as we tolerate it. But if we stand up for science and reason in medicine whenever and wherever necessary I think most people will find that most people agree with the basic principles of science-based medicine, and they too were just keeping their head down because they were unsure about what was actually being claimed.
So speak up. Don’t be afraid to ask questions and defend science in medicine. And take advantage of the regulatory agencies that already exist (in the US that’s the FDA and FTC). Governments will respond if the public demands that they do their job.
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30 Responses to “Victory Against Homeopathy in Australia”
Mr. Novella,
I wonder if you might comment on this?
http://www.sciencedaily.com/releases/2010/01/100118091808.htm
It never fails to amuse me that the principle of “like cures like” gave birth to both homeopathy and vaccines.
It also never fails to bother me that all complementary and alternative medicine is tarred with the same brush. This is why people don’t take the skeptics seriously – because they don’t deserve to be until they can differentiate between the useful and the bogus amongst the thousands of CAM treatments.
MW – I saw that also. Not sure why the press release was so delayed – this came out over the summer.
This is not new research – just a review of previous research, and again it is in a dedicated homeopathy journal, the editor of which (Fischer) is embarrassingly pseudoscientific.
The bottom line is that there is no consistent biological effect from homeopathic potions. What we are seeing is the scattered positive results due to chance, fraud, and poor study design selected by cherry picking and the file drawer effect.
A more detailed analysis will follow, if not here than on SBM.
Dr. Novella, I’ve been following your blog for a few months now and I just want to say thank you. It is frustrating to see pseudoscience everywhere these days. I don’t mind the late night absurd supplement infomercials so much, but when CAM cracks into our academic medical institutions, then you know something has gone wrong.
At the hospital I work at, most of the doctors look down at the integrative medicine department, but few are bold enough to speak out against it. Hopefully, we will continue to see CAM defeats.
As a side note, I remember you quoted Mitchell and Webb’s sketch on homeopathy some posts ago. Did you see the nutrition sketch they did?
http://www.youtube.com/watch?v=SavsJYXWgm8
john – vaccination is not based upon the principle of “like cures like” – that is just homeopathy propaganda. Vaccination is based upon an understanding of the immune system – triggering an immune response with a weakened virus or part of a virus or bacteria. Like cure like is sympathetic magic.
And I do not paint CAM with one broad brush – I am specifically against that false dichotomy. It is the CAM proponents who create and perpetuate the false category of CAM. I use it only reluctantly to refer to their use of the term.
I advocate completely eliminating the very concept of CAM – it serves no purpose other than to create a double standard. Rather – each modality should be judged on its own merits of evidence and plausibility.
There is only medicine, and it either works or it doesn’t.
Read what skeptics actually write and say and your opinions may change.
Steven,
I think we’re arguing semantics on that one, the mechanism might be different, but both were born of a similar belief at a time when we didn’t have the technology or understanding of immunity to fully discern why the principle seemed to apply. One survived scientific analysis, the other doesn’t seem to have fared so well.
I’m glad you recognize the diversity amongst CAM. It’s fascinating that you think that it’s a collective paradigm applied by its proponents, I’ve always seen it as a collective label applied by proponents of conventional medicine.
I agree totally though, there is only medicine.
@johnc,
Perhaps you can enlighten us and differentiate between the useful and the bogus amongst the thousands of CAM treatments. Which ones are the useful ones? What criteria do you use to determine which ones are useful?
As seemingly useful and convenient as the term CAM is, I grudgingly have to admit it tends to be a counter productive term.
There really is no such thing as complimentary or alternative medicine; those terms imply actual medical/therapeutic value There is medicine that has been scientifically validated as safe and effective, and there is everything else. The scope of everything else ranges from things simply not yet validated to unscientific/prescientific, made up nonsense to outright fraud. Most of what is commonly called CAM falls under the latter two categories.
Here is an editorial in JAMA from 1998 by editors Marcia Angell and Jerome Kassirer:
“It is time for the scientific community to stop giving alternative medicine a free ride. There cannot be two kinds of medicine — conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work.”
This has pretty much been the party line of defenders of science-based medicine.
The terms “alternative’, “complementary”, and “integrative” were all coined and promoted by proponents in order to market their methods. We have consistently opposed them.
And here I am, also voicing my opposition to the use of the term. Either it works, or it doesn’t.
And “CAM” isn’t a monolithic entity except in one regard: They’re all sloppy to various (but still unacceptable) degrees in their research.
If they were otherwise, they wouldn’t need to call themselves “alternative” or play their never ending rhetorical games.
Excellent post, Dr. Novella, with one criticism. The headline makes it seem like the post is homeopathy winning in Australia (and it is being twittered just that way).
Better:
A Victory for Science in Australia
A Defeat for Homeopathy in Australia
I could not believe that Science Daily article. I think my jaw literally dropped open. I use that site quite a bit to look for things to write about. I guess I’d better start being a little more skeptical about it!
Very interesting discussion about mainstream and homepathic medicine. I believe that this phenomenon of medicine and alternative, homeopathic etc medicine should be viewed as any other phenomenon. Basically, medicine we need. It evolved after many centuries of effort using trial method, scientific method etc. Now! What would be the reason for alternative medicine. I think there are many but basically people combined religious beliefs shifted to an unreligious subject using all the frustrations with absence of success of the so-called traditional medicine. We should not forget that traiditional medicine was pouring boiling oil and melted lead in the wounds, giving purgatives and blood letting for everything etc. Eventually we came to the stage of scientific medicine which is still prone to media-type hystery like we had with a recent swine flu epidemic.
On the other hand alternative medicine was using a smokescreen of some useful and some at least not harmful treatments to cover all sort of hoax and quackery. This is indeed pitiful because it somehow stiffles the possibility of finding something new and efficacious etc. On the other hand a division line is being drawn between people – on one hand you have those that believe in the traditional medicine, in the government, in “normal” food, vaccinations, etc and on the other hand you have the alternative crowd who believe that vaccinations are harmful, that only vegan or at least vegetarian diet is good, etc.
Like that famous division in the functional left and right side of the brain!
liz – you are right, the title was unintentionally misleading. I changed it.
I actually used the Science Daily comment widget on the right side of the window to ask them if they were a real science site or some kind of overly-subtle parody site after I read that stupid article a couple of days ago.
Dr. N. wrote “homeopathy is pure bunk and has no place in a science-based health care system [...being] pseudoscience”.
Well, just this hour I’m reading the expert advice / wisdom of a CT and NY ND-homeopath [an NCNM grad.] concerning artificial sweeteners as reported in a Danbury, CT Hearst newspaper
(see http://www.newstimes.com/news/article/What-you-should-know-about-sugar-substitutes-328182.php ).
He tells us “it is always best to err on the side of nature.”
Per ‘erring’, this ND is killing me with irony, because on his web page (see http://home.earthlink.net/~ofgang/health/ ) he writes:
“the highly sophisticated science [!!!] of homeopathic medicine treats people through the use of safe, natural [!!!] remedies that stimulate the indiviual’s [sic.] own healing processes [vitalism coded!] while avoiding potentially harmful side effects.”
Surely it is appropriate for science-based medicine to have this ‘natural science’ a.k.a. homeopathy within it, Dr. N.!!!
The ND [and NCNM] told me so.
-r.c.
Nice article, Steve. Homeopathy is one of my pet peeves as it is so popular here in Germany. Some of my scientific colleagues even use it, and they should know better. As mentioned by others, ridicule is often the best way to tackle this sort of thing, so I thought you might be interested in the ‘10:23 event’ on January 30th in which skeptics throughout the UK will be committing homeopathic suicide outside branches of the biggest pharmacy chain there (Boots).
http://www.1023.org.uk/the-1023-overdose-event.php
Perhaps Rebecca will be taking part?
SteveN
JOhnC “It never fails to amuse me that the principle of “like cures like” gave birth to both homeopathy and vaccines.”
You could say that the first vaccinations used the ‘like cures like’ principal. People would be exposed to ‘mild’ forms of smallpox in the hope that this would prevent them catching a more dangerous form later. It worked for some, but in many cases ‘mild’ was not mild enough and lots and lots of people died. Which is why it never caught on, and why homeopaths are forced to dilute their (often extremely toxic) cures to the nth degree to avoid killing people and had to make up the idea of ‘water memory’ to justify their ridiculous treatments.
The pioneer of vaccination was Edward Jenner who noticed that people who had contracted cowpox rarely, if ever, contracted smallpox. He exposed people to non-lethal cowpox and found they were then immune to the often lethal smallpox. Which is where we get the name ‘vaccination’ from, ‘vaccinia’ being Latin for cow.
Now you might say that smallpox is ‘like’ cowpox. No, they just have similar-sounding names. Smallpox is like smallpox, and if you treat people for smallpox with smallpox, they catch smallpox and a lots of them die of smallpox.
SteveA.
I know how vaccines work, and how they were discovered.
Smallpox IS like cowpox, its a very weak relation, making it ideal for vaccination.
It’s very important to trick the body into producing the right immune response which means you have to get as close to the real thing as possible without causing any danger.
Hmmm…vaccination has NOTHING to do the homeopathic law of similars?
Who are you going to believe, Steven Novella or Dr. Emil Adolph von Behring (the “father of immunology” who was the FIRST person to get the Nobel Prize in medicine) who directly pointed to the origins of immunizations when he asserted, “(B)y what technical term could we more appropriately speak of this influence than by Hahnemann’s word “homeopathy” (Von Behring, 1906). And are you familiar with von Behring research on homeopathic doses? Probably not. He himself didn’t want to make it public until after he won the Nobel Prize (for good reason…some people are more bigoted about medical issues than racial ones).
Steven seems to be a doctor of spin. When will Fox News begin to use your expertise?
Dana,
Unlike the homeopaths, medical scientists have discovered a few things about how vaccines work in the last 104 years.
Homeopaths still can’t tell a real homeopathic medicine from plain water.
More material to send to a colleague who asked me “if I knew of a good homeopath” – because her doctor said she could do no more for the patient and she should try homeopathy!!! even going to the extent of asking the patient to report back on the homeopathic treatment! Why won’t Licensing/Qualifying/Regulatory boards speak out against this stuff once for all?
Dana Ullman:
Actually, I am more inclined to listen to Dr. Novella, and the historical writings of the 18th century. Dr. Edward Jenner worked on the method of infecting persons with cowpox (a similar but weaker pox virus) several years before Hahnemann wrote about his homeopathic “laws.”
Without any kind of reference, there is no way we can tell if Emil Adolph von Behring actually said what you claim. I have read elsewhere that you tend to mis-interpret writings or selectively quote them in order to skew their meanings to something else.
There is more on Mr. Ullman and his tactics here: The Dull-Man Law. Enjoy.
KathyO, I have read several articles on Science Daily that caused my BS meter to twitch — this one, however, was the most over the top.
I don’t believe the editors of the site vet the material. It’s kind of a clearing house for ’scientific’ news releases. Since CAM has wriggled its way into respectability, if not with the scientific community at least among the public and with the government, the editors of Science Daily just posted what they believed to be another news release.
I’m looking forward with interest to Mr. Novella’s in-depth review of the ’study’ results.
I have no idea if Dr. Emil Adolph von Behring researched or believed in homeopathy or not and it’s largely irrelevent. Linus Pauling won a Nobel Prize and all that Vitamin C stuff turned out to be rubbish. Winning a Nobel Prize does not make you an ultimate authority on everything, and if the research doesn’t support your claims – and homoeopathy’s claims have been trashed by research not name-calling – then your opinions aren’t worth any more than any other Joe Sixpack.
There always seems to be confusion between the terms alternative, complementary, pseudoscience and effectiveness.
Theoretically there can be effective treatments that are pseudoscientific. i.e. they show effectiveness above placebo in clinical trials but the theory does not generate falsifiable hypnotheses.
Theoretically there can be effective treatments that are based on “alternative medicine” – i.e. on a theory that is not in alignment with mainstream science.
Evidence-based medicine in it’s purest form has no interest in the theoretical basis or the current form of accepted scientific knowledge.
Clinicians will primarily be concerned with effectiveness. Researchers with science.
Evidence for treatment effectiveness that is outside of mainstream scientific knowledge will need to pass very high levels of scrutiny.
Evidence for treatment effectiveness that is within mainstream scientific knowledge will generally have much lower levels of scrutiny (and let’s acknowledge it… much better funding).
e.g. surgery for example (Moseley et al 1996, on arthroscopy – the surgery was, it turns out, a placebo).
My POV is that as the whole SSRI debate unwinds we will look back in a few years in shock at the way the scientific and medical community lost their critical faculties and ended up drugging vast sections of society.
I am pretty sure that homoepathy is nothing more than a very elegant placebo. But I can be only pretty sure. I can be sure that in 50 years time many medical treatments practiced today will be looked on with the same derision as we look back on medical treatments of 50 years ago. So let’s not be too derisive.
Dana wrote: “Hmmm…vaccination has NOTHING to do the homeopathic law of similars?”
Well, no, it doesn’t.
The “law of similars”, as applied in homoeopathy, involves administering a remedy that is supposed to produce the same overall symptoms as those exhibited by the patient. Not just the symptoms of a specific disease, indeed, but any and all symptoms, feelings etc. they report. It will not necessarily be (and in fact will almost certainly not be) anything to do with the actual cause of the condition being treated.
Vaccination uses the infectious agent of the specific disease concerned, or preparations of it bearing the relevant antigens, to provoke a response from the immune system. The important factor, the thing that makes it work, is the involvment of the specific antigens, and the important property of the vaccine is its ability to produce a specific immune response, not its ability to produce symptoms similar to those of the disease. We’re not talking about just something that will produce similar symptoms.
i just found this site. its incomprehensible to me that you claim CAM has propagandists when if you have that rationale, you are clearly printing propaganda on your site. if you are going to argue that promoting or defaming anything is propaganda, then please have some basis for your claim.
secondly, I have read a few of your posts on acupuncture. Basically, there are some points where I agree with you and others where I don’t think you’re being logical.
you have said that CAM/acupuncture/alternative therapies are psedo-scientific and that studies in the field are weak:
i wholeheartedley agree w/you. At the present time, it is difficult to find a reputable study on the above mentioned topics. Perhaps because we need better tools and funding to study these areas?
There are some MDs out there who readily believe in acupuncture; I have no idea about how many because the sad fact of it is that they are usually publicly silent.
Then you have some MDs who completely degrade/criticize any alternative therpaies and “warn” the public against them. You fall into this category, non?
I am sure your intention is good. You want to protect people from something which you think is wrong.
I, on the other hand, want to promote something which I think is right.
So you see, we’re really in the same boat. We both want to better the healthcare system.
you can call me a propagandist. I could do the same about you. But lets not go there. There’s no time for name-calling. From this point forward…
You said in another post that many people who try CAM are Older, richer people who believe in paranormal activity. Paranormal is a large term. It could include ESP, UFOs, magic, harry potter, and the like. Most people would agree that ESP and UFOs are false. Others would say, they really don’t know. Furthermore, other people would claim that of course they exist.
Maybe it would help to clarify what you meant exactly by people’s beliefs. ARE you SAYING that people who spend time/money on CAM are crazy? Not rooted in logic? believing in paranormal activities?
Or, were you saying that many people who get acupuncture believe that paranormal activity might be possible? Because they really don’t know.
This point is very pseudo scientific because you don’t provide the exact details of these people’s beliefs.
And, not to kill a dead horse, but do you consider astrology part of paranormal belief? and, do you know your sign?
I am pleased to have found your blog. I am a skeptic, but to be a skeptic like the conventional medical profession, bought and paid for by Pharma, that is to be skeptical to the point of having a closed mind. Anecdotal evidence is evidence. Bought studies are absurd. I would like you to address the Zamboni procedure for MS, as it is difficult to obtain financing for it, and the neuros and big Pharms are distressed by it putting them out of business. Dr. Michael Dake at Stanford is trouble getting financing for his program, I sent him $10,000. My wife who has MS very predictably demonstrated blockages and malformations to the extent of over 80% on MRV. Why does John McCain want to block use of Vitamins and Nutritionals? MS is in much higher incidence in northern climes, practically unknown in equatorial zones. Vitamin D is foolish? C is foolish? Who is foolish. The medical profession has had MS wrong for 150 years, and they are skeptical because they don’t like the truth. The right studies and abstracts can be found on the internet for those whose minds are not blinded by too much skepticism. I have to fight to get this procedure for my wife, and I am forced right now to use LDN, an off-label use of naltrexone, which has been helping her.Too much skepticsm is as much of a blindfold as what is worn by true believers. It takes Keplers, Newtons, Galileos, and people with common sense like myself, a very successful businessman who would not be successful if I was not a practical dreamer. Do discuss Zamboni, and if you don’t know about it, you should. It’s being pursued now at Stanford, University of New York at Buffalo, and at Georgetown. Always against the resistance of paid skeptics. I’m in Santa Cruz, California and I’m in the phone book, and will be happy to talk with anyone who wants to know what I’ve learned about MS.
Very truly yours,
Louis Bartfield
As I said, I am pleased to have found your blog, but did the above letter on the wrong thread, first time on the site and navigation issues. Can you put my letter on an appriate site, I
don’t know which one to go on? I see no discussion of CCSVI.
Very truly yours,
Louis Bartfield
Use the search box which is at the top of the page to the right of the article title. Also click on the category you are interested in, which is to the right of the search box under the word “Categories.”