World Homeopathy Awareness Week 2011
This week has been designated as “World Homeopathy Awareness Week” (WHAW). This is a rather odd title, as we shall see later, but the gist of it is that it is a PR exercise by the homeopathy community, designed to increase sales of their treatments.
There’s a hashtag for it on Twitter: #WHAW. The amusing thing is that the vast majority of tweets using that hashtag are from non-homeopaths, pointing out how utterly bogus homeopathy is.
Anyway, in the spirit of raising awareness, I’d like to share a couple of facts about homeopathy. First I’m going to explain the important, but often misunderstood, difference between homeopathy and herbal medicine, and then I’m going to look at the motivations of homeopaths who put their clients’ health at risk.
It’s a surprisingly little known fact that homeopathy and herbal medicine are two completely different things. Regular readers of this blog are doubtless well informed about such things, and may find it surprising that anyone could confuse the two, but they frequently do.
Herbal medicines contain extracts of herbs. They are quite interesting. Many are pretty much worthless, but some have reasonably good evidence of efficacy. St John’s Wort is a good example, which was found to be more effective in the treatment of depression than placebo in a Cochrane Review. Because many herbal medicines are pharmacologically active, they can of course have side effects. Most commonly used herbal medicines are reasonably safe if taken as directed, but fatal side effects have been known, particularly when the manufacturing process was not well controlled.
Many modern pharmaceuticals are, of course, simply adaptations of herbal medicines. Some medicines, such as digoxin, are simply the purified active ingredients of medicinal herbs, while others, such as aspirin, are simple chemical modifications of those ingredients.
Homeopathy is completely different. Although some (but not all) homeopathic treatments are prepared from herbal treatments, homeopathic treatments are diluted so comprehensively (typically by a factor of 1030, or to put it another way, a trillion trillion times) that not a single molecule of the original herbal (or other) substance remains in the finished product. The finished product is therefore completely pharmacologically inactive. It is literally nothing more than a sugar pill.
Homeopathic treatments, where they appear to be effective at all, therefore do so entirely by the placebo effect. This is not only what would be expected based on the fact that they contain no active ingredients, but it has also been demonstrated clearly in a vast body of clinical research.
So, by now you’ve realised that the distinction between herbal medicine and homeopathy is pretty important, haven’t you? However, one thing I have learned in WHAW is that even some professional homeopaths are apparently unaware of the difference. “Fact” number 19 on this page, maintained by a professional homeopath, states that an arnica gel product “was the first homeopathic product to be registered by the MHRA”. In fact, the arnica gel product in question is a herbal product, not a homeopathic one. If homeopaths themselves are not aware of the distinction, there must be many others out there who are similarly confused.
Another thing I have learned this week is something about the motivation of homeopaths. It’s something that has always puzzled me. Why would someone want to recommend ineffective treatments to people who are ill?
Now, I’m not saying homeopathy is all bad. As I’ve argued before, although homeopathy is nothing more than a placebo, there are plenty of minor, self-limiting conditions for which placebo is actually quite a good choice of treatment. Yes, there are ethical problems with that approach, but those problems are not necessarily insurmountable. And many homeopaths practice homeopathy responsibly, limiting their practice to non-serious conditions, and making sure patients are encouraged to seek proper medical help if they are actually ill.
However, not all homeopaths are that responsible. Some behaving shockingly irresponsibly. For example, some offer homeopathy as alternatives to vaccines for potentially fatal diseases,and others offer it for malaria prophylaxis. I recently came across one particularly harrowing account of a woman who died a prolonged, painful, distressing, and probably unnecessary death from bowel cancer, after a homeopath had convinced her to use homeopathy instead of potentially curative conventional treatment.
Why on earth would anyone behave in such a despicable and frankly evil manner?
There are really only two possible explanations: that the homeopaths are ignorant of the science of homeopathy, and genuinely believe that their treatments can cure real diseases, or they are acting in bad faith, and despite being aware that homeopathy cannot cure cancer, prevent malaria, etc, are putting their own desire to make money from homeopathy ahead of their responsibility to care for the health of their clients.
So we have 3 categories of homeopaths: responsible ones who understand the limitations of their treatment and refer to real medicine when necessary, irresponsible ignorant ones who attempt to treat real diseases in the mistaken but genuine belief that they can, and those who callously and knowingly offer ineffective treatment for real diseases.
I do not have any statistics for the proportion in each category, but one thing I have learned this week is that there do appear to be considerable numbers of prominent homeopaths in the last, and most worrying category.
WHAW has a Facebook page. I thought it would help to raise awareness (that’s the point, isn’t it?) by posting a link to a systematic review of homeopathy on the page, which points out that homeopathy is no more than a placebo. That link was promptly deleted. A post later appeared on the page pointing out that they were not interested in any contrary opinions, and would simply delete them.
This appears to be quite common practice in blogs maintained by homeopaths. Comments left pointing out that good quality research evidence shows homeopathy to be ineffective are frequently deleted. It’s also clear from following the exchanges on Twitter that many of the opinion leaders of homeopathy are simply not interested in actual research evidence.
Does that sound like a good way of promoting awareness?
No. It sounds like a way of attempting to suppress awareness. These do not look like the actions of people ignorant of the facts but acting in good faith. These have every impression of being the actions of people who are cynically trying to create a misleading impression to protect their own business interests.
I am actually quite shocked by this clear evidence of bad faith among many members of the homeopathic community. Until this week, I was not really aware of the extent to which that bad faith appears to exist. I suppose that in that sense, WHAW has been successful in raising my awareness of homeopathy.