Despite mounting evidence

“I don’t know how, but homeopathy really does work”, says Rachel Roberts in today’s Comment is Free, with the tagline “More of a mystery is why scientists continue to debunk it despite mounting evidence that homeopathy is effective“. Now, CiF is The Guardian‘s opinion section, and is known for giving some particularly controversial viewpoints a platform, so some sort of devil’s advocacy about homeopathy is to be expected. Okay, it would still hardly be a debate so much as just blind contrarianism, but that’s about par for the course of modern journalistic “balance”. This however goes way beyond that, into out and out nonsense on an actually epic scale.

This will be a paragraph by paragraph takedown, so it’ll get a bit long, but if you want a summary, the article takes place in topsy-turvy world where nearly every scientific study proves homeopathy works, and yet no scientist believes in it. Roberts then tries to claim that because scientists in topsy-turvy world are blinded and ignorant, scientists in the real world must be equally stupid.

Here we go:

I was a dedicated scientist about to begin a PhD in neuroscience when, out of the blue, homeopathy bit me on the proverbial bottom.

Science had been my passion since I began studying biology with Mr Hopkinson at the age of 11, and by the age of 21, when I attended the dinner party that altered the course of my life, I had still barely heard of it. The idea that I would one day become a homeopath would have seemed ludicrous.

That a biologist in the third year of their degree had never heard of homeopathy kind of boggles the mind – it’s like the strawman atheist from a Chick tract who’s ignorant of the very concept of Christianity. For a scientist to be unaware of homeopathy indicates complete lack of interest in contemporary issues in popular science – not perhaps something you’d want in someone writing about contemporary issues in popular science.

That turning point is etched in my mind. A woman I’d known my entire life told me that a homeopath had successfully treated her when many months of conventional treatment had failed. As a sceptic, I scoffed, but was nonetheless a little intrigued.

She doesn’t mention what the condition the homeopath treated was, which makes it hard to comment on this. Nevertheless, I should point out that many chronic disorders do last several months. That a change of treatment regimen coincided with an improvement can be exactly that – a coincidence.

She confessed that despite thinking homeopathy was a load of rubbish, she’d finally agreed to an appointment, to stop her daughter nagging. But she was genuinely shocked to find that, after one little pill, within days she felt significantly better. A second tablet, she said, “saw it off completely”.

One pill cured her in a couple of days? That’s just silly. Misrepresenting homeopathy is one thing, but claiming a single pill cures you within days turns it into the Mary Sue of medicine. Although… perhaps, homeopathically speaking, it makes sense. After all, according to homeopaths, greater dilution equals greater clinical effectiveness. So of course just one pill will cure you!  In fact, for even faster relief, she should have taken half a pill, or a quarter of a pill; though for maximum effectiveness she should have diluted it in her body to the greatest extent possible and taken 1/ of a pill – i.e., no pill at all.

I admit I ruined that dinner party. I interrogated her about every detail of her diagnosis, previous treatment, time scales, the lot. I thought it through logically – she was intelligent, she wasn’t lying, she had no previous inclination towards alternative medicine, and her reluctance would have diminished any placebo effect.

The placebo effect does not work like that: it’s a deep, subconscious process affected by conditioning as much as expectation.For example, for all your life, you’ve been conditioned to have a subconscious connection between healthcare – doctors, clinics, medicines – and health. If you walk into a homeopathy centre, all those things will seem to be present – there’ll be people dressed in white coats with “Dr.” in front of their name (regardless of whether that’s Dr. as in M.D. or Dr. as in Ph.D.), off-white painted rooms with examination beds and anatomy posters, and of course, tiny glass bottles of overpriced pills and syrups. Is it any surprise that in such an environment, the body thinks “I’m going to be cured!”, even when it’s not the case?

Scientists are supposed to make unprejudiced observations, then draw conclusions. As I thought about this, I was left with the highly uncomfortable conclusion that homeopathy appeared to have worked. I had to find out more.

Scientists are also supposed to understand basic statistics, know fundamental scientific principles, and think rationally. Entire scientific community vs. unqualified person at a dinner party?

So, I started reading about homeopathy, and what I discovered shifted my world for ever. I became convinced enough to hand my coveted PhD studentship over to my best friend and sign on for a three-year, full-time homeopathy training course.

Do postgraduate courses work like this? I mean, as much as I’d love such an easy route into doctoral research, I’m not sure I can just ask someone else to give me theirs, right? Oh, and thanks for not telling us anything about what it was that “shifted your world forever”!

Now, as an experienced homeopath, it is “science” that is biting me on the bottom. I know homeopathy works, not only because I’ve seen it with my own eyes countless times, but because scientific research confirms it. And yet I keep reading reports in the media saying that homeopathy doesn’t work and that this scientific evidence doesn’t exist.

This should be good.

The facts, it seems, are being ignored. By the end of 2009, 142 randomised control trials (the gold standard in medical research) comparing homeopathy with placebo or conventional treatment had been published in peer-reviewed journals – 74 were able to draw firm conclusions: 63 were positive for homeopathy and 11 were negative. Five major systematic reviews have also been carried out to analyse the balance of evidence from RCTs of homeopathy – four were positive (Kleijnen, J, et al; Linde, K, et al; Linde, K, et al; Cucherat, M, et al) and one was negative (Shang, A et al). It’s usual to get mixed results when you look at a wide range of research results on one subject, and if these results were from trials measuring the efficacy of “normal” conventional drugs, ratios of 63:11 and 4:1 in favour of a treatment working would be considered pretty persuasive.

One more thing scientists are supposed to – identify sources of bias. In particular, research handpicked by the British Homeopathic Association may not represent the whole range of research out there! A quick Google scholar search for “homeopathy randomised controlled trial” – a pretty specific search term – finds 9,190 papers. Not all of these will be trials, but it’s clear the 142 trials found by the BHA are a drop in the ocean.

Secondly, to be considered a medicine, you have to show that it works; you can’t just show that it doesn’t not work. 63 positive results for homeopathy from 142 trials is a poor showing.

Thirdly, they don’t seem to provide a list of what the papers they analysed were (not a good sign), but most of the papers cited in that report are from journals like British Homeopathy Journal, Complementary Therapies in Medicine, Homeopathy, and Forschende Komplementärmedizin. Not really an unbiased lot, and, I’d wager, a group with a strong tendency towards pro-homeopathy publication bias. “Homeopathy works! You can keep your jobs!” is a far more arresting headline for the readers of the British Homeopathy Journal than “Homeopathy doesn’t work! Quit now!”

Finally, they blantantly misrepresent the findings of the systematic reviews: Kleijnen, Linde and Cucherat all found that the evidence was weak, and strong connections only appeared in papers with obviously flawed methodologies. They are only positive about homeopathy to the extent that they say more research should be done – none of them even comes close to suggesting that homeopathy should actually be used clinically. Incidentally, the recent Evidence Check released by the government, which she’ll quote later, cites 18 systematic reviews, only 2 or 3 of which found even tentatively positive results (pp. 88-91).

Of course, the question of how homeopathy works is another matter. And that is where homeopathy courts controversy. It is indeed puzzling that ultra-high dilutions of substances, with few or no measurable molecules of the original substance left in them, should exert biological effects, but exert biological effects they do.

Or don’t. But whatever.

There are experiments showing that homeopathic thyroxine can alter the rate of metamorphosis of tadpoles into frogs, that homeopathic histamine can alter the activity of white blood cells, and that under the right conditions, homeopathic sodium chloride can be made to release light in the same way as normal sodium chloride. The idea that such highly-diluted preparations are not only still active, but retain characteristics of the original substances, may seem impossible, but these kinds of results show it’s a demonstrable fact.

(The links were the wrong way around in the original article – I’ve fixed that here) The first two papers appear to be typical publication bias – a result that occurred by chance. The last paper is a result from physics paper from many moons ago (New Scientist pointed out a couple of possible flaws in it way back them), of which I can’t find a single repetition, and which, even if the result is true, only indicates a homeopathic effect in radiation from interatomic bonds of salts dissolved in deuterium at low temperatures, possibly due to the way ice crystals are seeded. This is not a mechanism which the body can exploit!

Also, none of these show any beneficial clinical effect. Even if we assume that the findings of these papers are repeatable and flawless, all that would tell us is that a dilute chemical has the same effect as a concentrated one. That’s not what homeopaths claim. If homeopathic histamine behaved like an antihistamine, then they’d have one piece of evidence for clinical homeopathy.

Surely science should come into its own here – solving the riddles of the world around us, pushing the frontiers of knowledge. At least, that is the science I fell in love with. More of a puzzle to me now is the blinkered approach of those who continue, despite increasing evidence, to deny what is in front of them.

That is some delightful hypocrisy. The science I fell in love with, incidentally, is the science that says extraordinary claims require extraordinary evidence.

In the last few years, there has been much propaganda and misinformation circulated, much of it heralding the death of homeopathy, yet the evidence shows that interest in complementary and alternative medicine is growing.

Interest is growing in all sort of areas. For example, psychic octpodes. That doesn’t make the field of cephalopod clairvoyance a legitimate science.

In February, the “sceptics” campaign had a breakthrough – a report from the House of Commons Science and Technology Committee recommended no further NHS funding for homeopathy, despite a deeply flawed hearing.

The Society of Homeopaths – the largest body representing professional homeopaths – was refused permission to give oral evidence. Also notable by their absence from the panel were primary care trusts who currently commission homeopathy and representatives of patients who use homeopathy. Yet oral evidence was heard from a journalist previously investigated by the Press Complaints Commission for unsubstantiated criticism of homeopaths, and a spokesperson for a charity that has long publicly opposed homeopathy. It is significant that one of the four MPs asked to vote on the report abstained due to concerns about the lack of balance in the evidence heard.

This nameless journalist she mentions is the one and only Ben Goldacre (who is in fact a fully registered and accredited doctor). “Investigated by the Press Complaints Commission” is kind of meaningless – presumably this just means a homeopath complained about him, and the complaint was thrown out, since I can’t find evidence of any case against Dr. Goldacre on the PCC website. The charity that has long publicly opposed homeopathy meanwhile was the group Sense about Science, who were explicitly there in a pro-science capacity – that fact that they have been critical of homeopathy is no more an issue than the British Homeopathic Association supporting homeopathy.

As far as I can tell, the reason that the SoH wasn’t represented was because the British Association of Homeopathic Manufacturers, the Royal London Homeopathic Hospital (which, incidentally, is part of a PCT that currently commissions homeopathy), the British Homeopathic Association and the pharmacy Boots (which sells a wide range of products marketed as alternative medicines) gave oral evidence instead, and a number of unaffiliated homeopaths, as well as the Northern Irish Association of Homeopaths, gave written evidence. That seems like a pretty rigorous group of pro-homeopathy representatives. The fact that none of them happened to be there specifically representing the Society of Homeopaths is beside the point.

Homeopathy is well-established in the UK, having been available through the NHS since its inception in 1948. More than 400 GPs use homeopathy in their everyday practice and the Society of Homeopaths has 1,500 registered members, from a variety of previous professions including pharmacists, journalists, solicitors and nurses.

Thalidomide was also available on the NHS. There are more than 40,000 GPs in the UK who don’t use homeopathy. The Royal Pharmaceutical Society has almost 60,000 registered members without bulking out its numbers with journalists.

And yet the portrayal of homeopathy as charlatanism and witchcraft continues. There is growing evidence that homeopathy works, that it is cost-effective and that patients want it. As drugs bills spiral, and evidence emerges that certain drugs routinely prescribed on the NHS are no better than placebos, maybe it’s time for “sceptics” to stop the witch hunt and look at putting their own house in order.

“Some drugs don’t work! Homeopathy doesn’t work! Therefore homeopathy is a viable clinical treatment!” Wait, what?

It’s all a far cry from the schoolgirl biologist who envisioned spending her life in a laboratory playing with bacteria.

Sadly, yes. It just shows what a waste a career in homeopathy is. The idea that homeopathy prevents a career in the laboratory is, ironically, perhaps the the truest fact in the article.

  1. #1 by ukenagashi on Thursday, 15th July 2010 - 19:43 GMT+0100

    I just want to tell you that I love you.

    Also, cephalopod clairvoyance doesn’t need to be a science because we all know it are fact.

  2. #2 by wickedday on Thursday, 15th July 2010 - 23:15 GMT+0100

    CiF’s open-door policy is one of the thing that makes me roll my eyes on a regular basis precisely because they publish things way out of (even the Guardian’s) normal journalistic discourse – but in both directions. I love that they’ve given space to some of my favourite feminist bloggers, and have strong atheist and sceptic voices. And then they also let through drivel like this. Oh CiF, you are infuriating.

    Excellent takedown. Thanks.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: