Ben Goldacre
Saturday May 27, 2006
The Guardian
“I hope you get cancer and then look in the mirror.” That’s a pretty representative sample from the Bad Science mailbag last week, so I shan’t be writing about mobile phone masts again until you all calm down. But it’s in the backlash that you can find the truth. This week, some fabulous elderly scientists came out loudly against homeopathy on the NHS. A maelstrom ensued, and critics focused mainly on the failures of modern medicine: the side effects, and the disappointments, as if these problems could somehow be subtracted from medicine and given to alternative therapies as a benefit. In that backlash, you can see a whole century of medical history.
Before 1935 we were basically useless. Then suddenly, between about 1935 and 1975, science poured out a constant stream of miracle cures. Everything we associate with modern medicine happened in that time: antibiotics which could save you at 21 and let you die at 70; dialysis; transplants; intensive care units; CT scanners; heart surgery; almost every drug you’ve ever heard of, and more. As well as the miracle cures, we really were finding those hidden killers that the media still desperately pine for in their headlines. Smoking, in the 1950s, to everybody’s genuine surprise, turned out to cause 97% of lung cancers.
Then, rather suddenly, for the most part, the breakthroughs stopped, and the subtle refinements began. We can shave percentages off here and there, but it’s marginal. Maybe things will pick up again with the human genome project – who knows – but medical stories certainly lack pace these days.
And so you get dogged headlines like “Is This The Cure For ME?†in the Daily Mail, last week. This was apparently based on a conference presentation, not a published paper, reporting just 12 people treated for chronic fatigue syndrome with an antiviral drug, apparently without a control group, although you can’t read it, of course, or critique and assess the methodology, because it’s not published. It feels pretty wet alongside, say, the invention of the coronary bypass: but the media haven’t found a way to cope with the change of pace. They still want the miracle cures and the hidden threats. They try to convince you that one glass of wine a day can prevent a heart attack.
But we want perfect health, which is where homeopathy comes in. The World Health Organisation define health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmityâ€. Now that is a tall order, and the desire to make it a biomedical issue, and pretend that science and medicine can serve up your immaculate physical, mental and social well-being, will create nothing but disenchantment.
We will have back ache. We will get colds. We will get tired, sometimes cripplingly, without explanation. We will be shy, and sad. And that is where homeopathy is valuable: often, medicine can do little for these problems, which have become the focus of our health worries; and where medicine can do nothing, it should step aside. We may be tempted to offer drugs, as placebos at least, but drugs have side effects, and sometimes they’re not worth it.
During the Cholera outbreak of 1854 surrounding the Broad Street Pump, where John Snow famously removed the pump handle and stopped everyone drinking poo water, the London Homeopathic Hospital had a death rate of 13%, rather better than the Middlesex Hospital’s death rate of 53%. Neither medicine nor homeopathy could really do anything to treat cholera then, just like neither can really give you perfect health now; but medicine’s attempts – with bloodletting, for example – had dangerous side effects, and it’s the same bargain today.
To stop your transplant being rejected, you want big pharma. But if you’re treating the untreatable, if the NHS is there to serve up WHO’s modern definition of immaculate well-being in a pill, then that’s like trying to cure cholera in 1854: at least with homeopathy, the side effects only effect our intellect. Bring on the placebos.
detly said,
May 27, 2006 at 12:19 am
[Starts countdown until BG massively misinterpreted and heralded on homeopathy websites as "supporting homeopathy for maladies untreatable by modern medicine".]
That line was shorter in my head.
Ithika said,
May 27, 2006 at 12:42 am
That was a good laugh, and I only hope that your estimation of the average Guardian reader proves accurate — otherwise there’s going to be a helluva a kerfuffle over this one!
David Colquhoun said,
May 27, 2006 at 5:46 am
Oh my god!
“We will have back ache. We will get colds. We will get tired, sometimes cripplingly, without explanation. We will be shy, and sad. And that is where homeopathy is valuable”
I see that line being cited on every crackpot web site.
Yes by all means bring on the placebos, but dispense with the lies and intellectual dishonesty that accompany homeopathy, reflexology and a myriad of others.
David (fabulous elderly scientist)
jeremymiles said,
May 27, 2006 at 8:54 am
Reminds me of an episode in the Simpsons:
An angry crowd has gathered outside the Hibbert Medical Clinic…
Crowd: We need a cure! We need a cure!
Hibbert: Ho ho ho. Why, the only cure is bedrest. Anything I give you would be a placebo.
Woman: [frantic] Where can we get these placebos?
JM
Ben Goldacre said,
May 27, 2006 at 10:54 am
ha! absolutely, people are of course more than welcome to take placebos and say that they find them enormously helpful. what bothers me is the intellectual dishonesty, the flaky reasoning and the pseudoscience: being told that a customer satisfaction survey is more important than a large meta-analysis, for example.
maybe it’s an aesthetic issue. i have been to see lots of homeopaths talk, and they were sanctimonious and wrong; i went to see david colquhoun talk, and he was funny and right.
dbhb said,
May 27, 2006 at 10:57 am
And then last night on Have I Got News For You we got Phil Hammond, practicing doctor / stand-up comedian, bigging up NHS complementary therapy because it mean’t fewer patients ‘on pills’, lambasting the anti-complementary therapy ‘idiots’, and getting a righteous cheer from the audience.
He made a fair argument, actually, similar to Ben’s above: if the Placebo effect does some good then we should exploit it.
And boy are there people out there exploiting it.
Now, after HIGNFY last night, and this article, it just got a massive boost in credibility over the last 24 hours.
Ben Goldacre said,
May 27, 2006 at 11:07 am
sure, we just have to remember that alongside the placebos, clear thinking is still important, otherwise you get this problems like this.
and the funniest thing of all, of course, is the role of the intelligent homeopath: they know, really, that it’s about the consultation, and the chat, and the ritual, but they have to keep alive for their customers the dream that the pills really do do something, so when cornered, they’ll tie themselves up in some fabulous knots.
amoebic vodka said,
May 27, 2006 at 11:14 am
“Now, after HIGNFY last night, and this article, it just got a massive boost in credibility over the last 24 hours.”
Then 8 out of 10 cats restored our faith in humanity. Phew.
dbhb said,
May 27, 2006 at 11:16 am
Yes, that was something!
Ben Goldacre said,
May 27, 2006 at 11:22 am
nice to see the guardian getting avogadro’s number wrong today by a factor of 1,000,000,000,000,000,000,000,000:
The dilution varies. Dr Fisher picks up one labelled 6c – that is, 600 parts water to one part active substance. Another is 9c – 900 parts water. “As near as dammit there is no molecule in that one,” he said. “But it works – absolutely.”
Diotima said,
May 27, 2006 at 12:03 pm
Dr Phil Hammond no doubt suggests the homoeopathic option when a woman presents in his surgery with a large breast lump?
As for the Dutch, it seems a National delusion. Anyone who followed the dire medical history of Sylvie Millecam (a Dutch TV personality who tried more than 30 alternative healers for her untreated breast cancer and died in agony) will shudder at the spectacle of her last ‘healer’, a qualified GP, who tried ‘music therapy’ on her when she was already in a moribund condition. All the alternative healers had insisted that ‘this is NOT cancer’ which was what she wished to be told. One healer contacted her on the astral plane after death and told the world that it had not been cancer which killed her.
Tessa K said,
May 27, 2006 at 12:50 pm
I’d much rather get a placebo from my doctor than pay some quack for ten ‘therapeutic’ sessions and some overpriced sugar pills. Just teach GPs to make sympathetic noises as they write the ‘prescription’.
Ben Goldacre said,
May 27, 2006 at 12:52 pm
the trouble with that is, then doctors would have to lie to their patients, which we don’t like to do.
Michael Harman said,
May 27, 2006 at 1:15 pm
Re Ben’s post 10, the reporter failed to grasp the basic point about c6, c9, and so on. C6 is dilution by a factor of 100 six times in succession – ie 1,000,000,000,000 times. A good chance for a sneer – arts graduate type, maybe? Or perhaps belief in homeopathy tends to reduce comprehension and/or arithmetic skills?
stnemmoc said,
May 27, 2006 at 4:45 pm
If placebo can be effective because people think it works, then it seems like someone could get the same effect by realizing that others on placebo are just really confident that they will get better. Couldn’t I just keep telling myself that if I think I’m going to get better I might actually feel better? Does everyone just need a little bit of cognitive restructuring, or am I horribly confused?
FlammableFlower said,
May 27, 2006 at 9:05 pm
That’s the big conundrum, how to stop the quakery and fraudulent costs, but allow people to benefit from the palcebo. Would it be as effective if homeopaths (who I consider to be quacks) admitted it was all a pack of lies but carried on as normal? Probably. A public who are willing to believe that there’s truth behind the Da Vinci Code and “Holy Blood, Holy Grail” and read the Daily Express (it’s all a conspiracy you know to take away the People’s Princess) and Daily Mail will refuse to believe that homeopathy is placebo even if practitioners had big banners declaring, “IT’S ALL PLACEBO AND I’M A FRAUD” just above them on their walls….
Robert Carnegie said,
May 27, 2006 at 10:28 pm
I didn’t see the show, but Dr Phil Hammond has claimed in previous recent broadcasts that he loves it when patients go to homeopaths instead of him, and die. He’s a GP, he gets paid whatever happens.
I suggest that as an effective placebo for self-limiting illnesses, you could have an electronic black box, with electrodes and flashing lights, that monitors your wellbeing and automatically phones the doctor if you aren’t getting better as expected. For complete effectiveness, it should be capable of actually doing this when circumstances justify it.
I don’t recall ever getting to the bottom of – although I may have mentioned here – occasional claims that (1) the Nazis believed that smoking was unfavourable to good health and (2) they had scientific evidence. For instance, a play on Radio 4 some years ago was set in some kind of Nazi healthy-living laboratory. Some of us vaguely understand that captured Nazi records included data from some of their horrible experiments, which might or might not be valid, but in any case was suppressed or even destroyed. And the words “did Hitler smoke” bring only a few, unhelpful pages from Google.
JQH said,
May 27, 2006 at 10:54 pm
Not only did Hitler not smoke, he didn’t drink AND he was a vegetarian.
Useful anecdotal evidence next time you’re harangued by a health fascist.
He was against testing new medical procedures on animals too ……
Frank said,
May 27, 2006 at 11:09 pm
Ballsy.
AitchJay said,
May 28, 2006 at 1:41 am
I liked the response to one of BG’s posts (last year?) from a guy in America – he mixes his own homoepathic placebos using diluted kitchen herbs, and tells himself that it will cure him. Laughing the whole time. But, from what he said, it seemed to work.
kim said,
May 28, 2006 at 8:45 am
Hitler wasn’t a vegetarian – that’s just one of those daft myths (see e.g. http://www.veg.ca/living/p-hitler.html).
About the placebo effect. Ben’s article was fascinating, but I thought the most interesting statement was this: “London Homeopathic Hospital had a death rate of 13%, rather better than the Middlesex Hospital’s death rate of 53%.” That suggests that, if cholera patients are left untreated, then 87% will simply get better of their own accord. If true, that’s quite startling. Perhaps that’s why placebos often seem to work – a lot of the time, the body just heals itself.
raygirvan said,
May 28, 2006 at 9:45 am
If true, that’s quite startling
Simple rehydration (ie replacing fluid and salts) works seriously well with cholera.
billgibson said,
May 28, 2006 at 9:59 am
Did anyone hear about the homeopath who forgot to take his tablets and died of a massive overdose?
Diotima said,
May 28, 2006 at 10:23 am
Kim,
Evidently you don’t have first hand experience of cholera (rice water faeces and all). Left to itself the body does not heal itself. You die of massive dehydration and mineral deficiency. Not a pretty sight, I can asure you. During the great irish cholera epidemic of 1831 whisky enemas were tried—with what effect I don’t know.
kim said,
May 28, 2006 at 11:14 am
True, I don’t have first hand experience of cholera, Diotima, but I’ve always understood it to be pretty nasty. This is why I used the word “startling” to describe Ben’s statement that only 13% of the cholera patients in the homoeoapathic hospital died. Either the homoeopathy made the other 87% better, or they got better themselves. Or Ben has got his facts wrong. Or, I suppose, a fourth option is that something completely different that we don’t know about made them better.
terry hamblin said,
May 28, 2006 at 11:37 am
I believe the National Cancer Research Institute (NCRI) has a section of complementary medicine. I object to public money being spent on the myth of alternative therapy. If anything works it isn’t alternative; doctors will make it mainstream. Placebos work, at least to begin with, and we should be able to make use of the placebo effect, but we don’t have to buy in to the monstrous lies that the alternative practitioners propogate. I also object to these lies being endorsed by the Royal Family so that they gain a spurious authority. This more than anything makes me a Republican.
Doctors need to know when to do nothing and let the body heal itself. Being expected to see a new patient every 6 minutes doesn’t exactly lend itself to spending time listening, being sympathetic and reassuring, and getting to the bottom of the sort of illness associated with normal blood tests and normal X-rays.
kim said,
May 28, 2006 at 12:03 pm
Just to add to my last post: there is an option 5, which is that when Ben referred to a “death rate of 13%”, he meant 13% of the patients in the hospital at the time of the cholera outbreak, not 13% of the cholera patients.
Fyse said,
May 28, 2006 at 3:35 pm
terry hamblin –
I couldn’t agree more about our berk of a Prince Regent. While his mother is largely inoffensive, he is an ignorant fool who mouths off on subjects about which he knows very little. Since many people still attach a sense of authority to having ‘royal’ status he wields considerable influence, yet has no mandate from the population at all. His ill-informed ramblings are viewed by the press as a legitimate counter to the reasoned arguments of fabulous elderly scientists. In my opinion this makes him downright dangerous…
JQH said,
May 28, 2006 at 3:47 pm
Kim
If citing websites is proof of anything, how about http://www.geocities.com/hitlerwasa vegetarian/
Not that its actually relevent to the merits of vegetarianism. I was just making the point that this is the level of argument that the complementary/alternative medicine crowd make, so it’s nice to have one to throw back at them.
Fyse
I think that Charles Windsor actually believes that being “royal” places him above us mere commoners in all things and therefore he knows more than anybody about everything, so obviouly he knows more about medicine than someone who’s been researching it for half a century.
kim said,
May 28, 2006 at 6:02 pm
JQH – you said : “Not that its actually relevent to the merits of vegetarianism. I was just making the point that this is the level of argument that the complementary/alternative medicine crowd make, so it’s nice to have one to throw back at them.”
Sorry, you’ve completely lost me here. If someone says “Smoking, drinking and eating meat are bad for you,” how does saying “Hitler was a non-smoking teetotal vegetarian” in any way act as a counter-argument?
Fyse said,
May 28, 2006 at 8:52 pm
Quick correction – Obviously I didn’t mean Prince Regent. Must have meant ‘Heir Apparent’. Always get my royal terminology mixed up…
Why Dont You…Blog? » Had BadScience Gone Soft? said,
May 28, 2006 at 9:08 pm
[...] Well, readers of Saturday’s newspaper (or the website http://www.badscience.net) may be forgiven for thinking that Ben Goldacre, scourge of the charlatan, has gone soft. (Read the article online) [...]
JQH said,
May 28, 2006 at 11:03 pm
Kim
I’ve met far too many vegetarians who say that as Ghandi was a vegetarian and that he was indisputably a good person, vegetarianism makes you a good person. I’ve given up trying to argue this point and just counter with the fact that Hitler was a vegetarian.
The fact is, BOTH arguments are fallacious (or complete bollocks) and have nothing to do withe the health issues involved.
Filias Cupio said,
May 29, 2006 at 12:56 am
The Ghandi/vegetarian argument as expressed above is a “post hoc ergo propter hoc” fallacy. However, there is a possible valid argument available.
Consider this argument:
My friend, Ty Coon, has made a fortune on sharemarket speculation. He spends a great deal of time investigating companies before deciding where to invest. He has just started buying lots of shares in Acme Corp. Therefore, I should buy Acme shares also.
Now consider:
Ghandi has, in my opinion, a very strong record for making correct moral choices. The morality of vegetarianism is too difficult for me to come to my own conclusion, but he thought deeply on it and chose to be vegetarian. Therefore I should be vegetarian also.
Or indeed:
Ben Goldacre has the training (which I lack) to evaluate the evidence for the efficacy of various medical interventions, and has taken the time to do so. His advice has proven reliable in the past. Although I can’t evaluate the claims for and against homeopathy, he says it is not a good treatment for cancer. Therefore I will not rely on homeopathy to treat my cancer.
This is argument from well founded authority. (That is my invented term – there may be a recognized technical term for it.)
Agema said,
May 29, 2006 at 1:15 am
“the trouble with that is, then doctors would have to lie to their patients, which we don’t like to do.”
But, surely lying to the patient is part of a placebo? Or if not lying, then deceiving – you can hardly tell them it’s actually a Tic-Tac and expect there to be a benefit. On the same grounds, you could theoretically send a patient off to a complementary therapist.
Arguably, as the patients are almost certainly made better by being happily chatted to for a while by someone they think cares and knows what to do, it’d also make economic sense to hire a complementary therapist than a doctor, as the former will have on average a much lower salary and be cheaper to train. (And I’m tempted to think that’s a large part of why it looks quite attractive to politicians.)
Thirdly, supporters of complementary medicine do have a ‘point’ that it makes some people feel better, even if it is entirely in their heads.
Now I don’t personally believe the NHS should provide unproven therapies, as it makes a mockery of intellectual rigour and the advances made by scientific method over the last few centuries. But is that enough for the people holding the national health system’s purse strings?
kim said,
May 29, 2006 at 8:35 am
JQH – you wrote: “I’ve met far too many vegetarians who say that as Ghandi was a vegetarian and that he was indisputably a good person, vegetarianism makes you a good person.”
It’s odd. I’m a vegetarian, and I know lots of other vegetarians, yet I’ve never come across a single one who’s made this argument. You must be mixing with the wrong sorts of vegetarians.
John A said,
May 29, 2006 at 9:14 am
The arguement that CAM on the NHS is valid since we should “use the placebo effect” presupposes that it has some cost effective benefit. As far as I know this has never been tested.
How much better is it than the ultra low cost version of a GP handing out a sugar pill and saying (without lying to the patient), “try this placebo pill, it is 100% natural, has no side-effects, has been used by xxxxx exotic culture for centuries and has been shown to produce amazing results in some individuals”. I’m sure homeopathy (for example) is more effective what with the long consultation and the apparent confidence of the practitioner. But how much better and how much more does it cost?
Sadly, I doubt that even doctors “lying” would do the trick. I think the strong placebo effect from “naturopathic” treatments is a reflection of our modern distrust of (and lack of understanding of) science. In earlier ages, electricity or radium were placebos of choice. Perhaps it will go full circle but right now I suspect the most effective lie would be for a doctor could to say “I forbid you from taking this (placebo) remedy. My medical and scientific colleagues and I are well against it. Pah how I scoff at cultures different from mine with my giant intellect. Mark my words it will never work”.
Coobeastie said,
May 29, 2006 at 10:29 am
About the deat rates – what were the criteria for entry to the hospitals? We’re talking about private hospitals here. Googling brought me this: http://www.homeoint.org/morrell/londonhh/outbreak.htm
which has a quite revealing bit;
“The whole of the wards of the London HomÅ“opathic Hospital were devoted to the treatment of the epidemic, and 64 cases of cholera and 331 of choleraic and simple diarrhÅ“a were treated. Of the 61 cases of cholera treated, 10 died, a percentage of 16.4; of the 331 cases of choleraic and simple diarrhÅ“a trated, 1 died. The neighbouring Middlesex Hospital received 231 cases of cholera and 47 cases of choleraic diarrhÅ“a.”
The LHH had a majority of patients who were (relatively) mildly ill; the Middlesex had a majority of patients who had the major illness. The latter therefore, will have had greater pressure on resources, nursing, hydration etc. No wonder that their death rate was higher.
Diotima said,
May 29, 2006 at 10:45 am
When GPs say ‘Would you like to try homoeopathy?’ they are not striclty speaking lying. Although faced with a heart sink patient the London HH might seem an oasis in the desert. It is always up to the patient to reply ‘No, I’d prefer proven treatment’.
j said,
May 29, 2006 at 11:09 am
If we are going to prescribe placebos on the NHS, couldn’t we pick, well, nicer placebos than homoeopathy. Things like massage or reflexology might at least least be more enjoyable for patients (and have more physiological effects than homoeopathy); or how about starting ‘chocolate therapy’, where a ‘trained’ therapist tells patients to eat 5g of different types of chocolate per day instead of sugar pills. If the NHS will prescribe placebos, surely it may as well choose relatively pleasant ones; I don’t like the taste of plain sugar pills
Delster said,
May 29, 2006 at 2:27 pm
as has been pointed out a good deal of the effectiveness of homeopathy comes from the “Doctor” spending time with the patient going through things and only then giving them the sugar pill. In the time taken for one consultation a regular GP would probably be expected to do at least 5-10 consultations…. so cost effective it’ll never be.
billgibson said,
May 29, 2006 at 5:57 pm
I would be very interested in seeing a well-designed RCT comparing GPs with 30-minute appointment times, and homeopaths. Anyone got an enourmous research grant I can use?
Evil Kao Chiu said,
May 29, 2006 at 8:36 pm
I appreciate this is completely off point but did anyone just see Dr G. McTeeth ‘singing’ on Celebrity Simon Cowell Pop Star Factor?
Dr G., I think she may have done for her reputation what all the patient and sober analysis in the world could not.
Normal service resumes…
Ben Goldacre said,
May 29, 2006 at 8:41 pm
bugger, missed it, is it repeated on any channel?
billgibson said,
May 29, 2006 at 9:52 pm
Joy of joys, everyone’s favorite corpophilliac can be seen again on ITV2 at 17:55 tomorrow (tuesday)
WaveyDavey said,
May 30, 2006 at 8:19 am
Um, looky here : McTeeth ‘Celeb’ Biog.. Ugh. And she was crap. Really, really crap. Unfortunately Paul Daniels and Debbie McGee were voted off first, according to the site.
superburger said,
May 30, 2006 at 8:54 am
Has nobody ever done the really simple experiment of letting homeopaths give the full experience to each patient, then providing them with either a homeopathic sugar pill, or a ‘real’ sugar pill. All double blinded with suitable population sizes and randomisation.
The experience for each patient is the same, only the treatment varies, so if there is any pharamacological effect from the homeopathic treatment it could be detected. It would be east to compare results with people who’d been to the GP and been prescribed conventional medicine.
Given that we have homeopathic NHS hospitals, surely the medics there would be thrilled to take part in some cutting edge research that would show the true reasons for the effectivness of homeopathy. The cost to the taxpayer would be close to 0.
or would that reveal the emperors new clothes?
Kess said,
May 30, 2006 at 11:16 am
“Gillian feels that singing feeds and nourishes the soul. Therefore, music is just as essential to your good health as the right foods, exercise and a positive attitude.”
Uh-oh. Look out for the Gillian McKeith Song Book at a store near you soon…
Kess said,
May 30, 2006 at 11:20 am
“Has nobody ever done the really simple experiment of letting homeopaths give the full experience to each patient, then providing them with either a homeopathic sugar pill, or a ‘real’ sugar pill. All double blinded with suitable population sizes and randomisation.”
Sounds reasonable. Conversely, if the full experience is an essential factor then how can drugstores justify selling homeopathic medicines over the counter? Surely their effectiveness will be compromised unless administered by a qualified homeopathic practitioner?
terry hamblin said,
May 30, 2006 at 1:15 pm
Homeopathy might be cost effective if the NHS paid the therapist one tenth of what it pays the GP. Six minutes with the GP or one hour with the homeotherapist; which would you choose? Remember the homepathy person would not have to diagnose or explain the technicalities of the disease. He would not need to know any medicine or pathology. Anyone who could listen sympatheically, talk incomprehensibe jargon convincingly and keep a straight face could do it. Might be a job for out-of work actors.
Delster said,
May 30, 2006 at 3:15 pm
Terry,
well the consultation costs would be the same per appointment…. however it has to be remembered that if the placebo effect did not work for the patient who saw the homeopath then your looking at repeat visits, certainly more repeats than with standard treatment options.
just a thought…. would the placebo effect be boosted by making the “sugar pill” taste bitter? after all everybody knows that if it tastes bad then it has to be good for you!
superburger said,
May 30, 2006 at 4:17 pm
I’m sure there is a study which shows that if patients are given a big green sugar pill then the placebo effect is stronger than with a little white one.
Evil Kao Chiu said,
May 30, 2006 at 4:29 pm
Has nobody ever done the really simple experiment of putting all the homeopaths in a sports stadium and beating them with big pointy sticks until they stop moving. And then laughing and laughing and laughing?
‘Cos I’d be willing to give that one a go.
kim said,
May 30, 2006 at 6:03 pm
Six minutes with the GP? Surely it doesn’t take that long for the GP to say, “It’s probably a virus, it’ll probably go away of its own accord?”
JQH said,
May 30, 2006 at 9:28 pm
Evil Kao Chiu
That really creased me up.
Kim
I mixed with the wrong sort. Don’t now, doesn’t stop them from existing (unless you’re a solopsist.)
terry hamblin said,
May 30, 2006 at 11:19 pm
The homeopathy option is instead of saying, “It’s probably a virus; it will go away of its own accord.”
It probably will, but trust me, patients enjoy the experience more if there’s mumbo-jumbo. Although for enjoyment nothing beats a cofee enema. Especially a Starbucks coffee enema.
pv said,
May 31, 2006 at 12:21 am
Isn’t a problem with Homeopathy on the NHS that it is defrauding the tax payers. The real cost of homeopathic medicine is £0.00, or pretty close to it. There is absolutely no pharmaceutical research to fund. There’s no research of any kind. So what is the NHS paying for, apart from dispensing obscene amounts of money for the benefit of liars and con artists?
Over here (Italy), where hypochondria is the second most practised religion after football, homeopathy too has its following. But the fans of homeopathetic medicine have to pay for their own delusion. The state contributes bugger all, I’m very pleased to say.
sockatume said,
May 31, 2006 at 8:02 am
Meanwhile, the NHS is limiting the use of Alzheimer’s medication until patients have experienced more severe symptoms, in order to save money.
Suffice to say, homeopathy can stuff it.
terry hamblin said,
May 31, 2006 at 8:03 am
It wouldn’t be the first time that we pay the government to lie to us.
pv said,
May 31, 2006 at 11:16 am
“Meanwhile, the NHS is limiting the use of Alzheimer’s medication until patients have experienced more severe symptoms, in order to save money.”
Yes. To save money so it can be spent of flakey homeopathists – so they can dispense illusions to their desperate and deluded clients. We should be mean and cruel to people in desperate need of real treatment and care (such as Alzheimers sufferers) in order to satisfy the needs of the deluded and the charlatans who feed off them.
It’s criminal.
Ben Goldacre said,
May 31, 2006 at 1:21 pm
i just had a quick chat with richard peto about this column. he points out that although the individual marginal breakthroughs of the past 30 years may have been less dramatic, the effect in the aggregate over the past 30 years has been a stunning reduction in mortality, which is, for example, roughly halved in first half of life.
this is the power of being actuarial about health outcomes of course, even if the rolling figures on life expectancy year on year (and the development of medical statistics) don’t make for a desperately interesting news story.
Robert Carnegie said,
May 31, 2006 at 3:55 pm
I think small placebo tablets are more effective than bigger ones. If the pill is that small then it must be extra strong stuff?
Colour is another matter.
baldywilson said,
May 31, 2006 at 6:14 pm
The problem with the “if it’s as good as a placebo, then use it as a placebo” argument is that it legitimises con-artists. Homeopathy is a con act – even when performed by people who believe that the homeopathic ‘cures’ they’re offering work, they’re still involved in a con act. It may be okay to hand someone suffering from, for example, a cold to a homeopath simply to use that homeopath to provide what you know is merely a placebo, but that homeopath may well believe – much like prince Charles – that homeopathy has a real medicinal effect and can cure cancer and can – as Charles has frequently stated – cure asthma, or other life-threatening diseases.
And this is the core problem: medical science knows that it cannot cure all diseases, it admits as much even though the public may not get this message from their doctors. Homeopathy is bound by no such honesty. It can make any outrageous claim that it cares, and then state that it can’t be tested with normal clinical methods. This is patent nonsense, but the patient doesn’t know this. The patient – with a cold – would have been sent to a homeopath with a cold to get a placebo, and believe that where medical science failed to provide a cure, homeopathy “worked” – because they believe that correlation is causation. They will refuse to recognise that the cold went away of its own accord, so they will – loudly – proclaim that homeopathy works.
Yes, sometimes the best thing to do with a patient is to give them a placebo, knowing full well that it in and of itself will do nothing. But don’t hand them over to the charlatans, because when it’s a life-threatening problem, they’ll turn to the people who they believe cured their cold first.
three tigers said,
June 1, 2006 at 6:33 am
The problem is that many diseases have a variable course and acute ones like respiratory viral infections do, for the most part, get better on their own. So sometimes the quack therapies called homeopathy, acupuncture, etc., do seem to work.
I know it’s not actually a disease, but I’d really like to see a quack practitioner try to suppress graft rejection in a transplant patient. Somehow I suspect “thinking yourself adequately immunosuppressed” wouldn’t work as well as “thinking yourself well” when you probably already are anyway.
Just shows when your immune system is really challenged, drugs are the only thing.
Ho, hum…
AndrewT said,
June 1, 2006 at 11:06 am
A couple of cents worth:
Ok homeopathy is placebo. But is it good placebo? We know that some placebos are more powerful than others, so how does homeopathy measure up? Surely Bach flower remedies should work much better, as they have soothing overtones of classical music and pretty flowers?
More to the point, if the benefit of homeopathy is that somebody listens to your problems, surely homeopathic training should focus on how to be a counsellor, rather than learning about 200 yr old books of nonsense voodoo that is the materia medica, Hering’s law of cure etc etc
sockatume said,
June 2, 2006 at 8:13 am
You know, I could make money by producing “Homeopathically equivalent” solutions containing nothing, and undercutting the real homeopathers with prices while selling directly to the NHS. They save money, I get money, real homeopathy dies a death and everybody wins. Especially me.
AJH said,
June 2, 2006 at 12:04 pm
Problem with that is, sockatume, is the Placebo Paradox (TM) which says that if you KNOW it’s placebo it won’t work!
AJH said,
June 2, 2006 at 12:14 pm
Hey! I got a superscript (TM)! There it is again! Let’s try some more: (C) (R) Yay!
AJH said,
June 2, 2006 at 12:15 pm
Boo. they didn’t work. Move along now, nothing to see here.
JQH said,
June 2, 2006 at 12:27 pm
Sockatume, how can you tell that that’s not what the homeopaths do anyway?
Delster said,
June 2, 2006 at 1:26 pm
JQH,
you can’t… thats the beauty of it!
sockatume said,
June 2, 2006 at 2:43 pm
I just won’t tell anyone it’s a meta-placebo. After all, the product’s identical to the homeopathic form down to the subatomic level, so I can’t exactly be sued for misleading advertising.
JQH said,
June 2, 2006 at 9:03 pm
Some punters are starting to catch on. One of the Daily Mail message boards contained a posting from someone who had read the ingrediants list on her homeopathic remedy and realised that it contained nothing but lactose!
I had trouble posting replies but one of them eventually stayed up. The secret is to sound like you’re one of them but sneak in some doubt in a seemingly innocent comment.
PatriciaKane said,
June 3, 2006 at 8:42 am
What on earth is best science? Is it just research dominated by an outdated research mindset?
I find it galling to hear reputable scientists launching an attack on Homeopathy when good scientifically backed? best medical practice includes pumping incurable, dying patients with chemotherapy [which has proven to be ineffectual for the patient in question [ proved because they are dying]] during the last weeks of life. Perhaps we really are not too far from the cholera epidemic of 1854 when patients were adversely affected by conventional treatment.
I’m not advocating Homeopathy as best medical practice but feel `scientists’ should back off until they can come up with an appropriate research paradigm.
I was diagnosed with breast cancer three years ago and was shocked to discovery pretty shaky and limited research. The research industry controls a great deal of money but is dominated by one very powerful research paradigm which by definition restricts pursuing non conforming avenues of research. One such avenue is the cognitive effects of chemotherapy which if one is going through chemo is very significant but which doesn’t have any place in so called scientifically back knowledge. `Best practice scientific research’ does not recognise this therefore it doesn’t exist even though most people going through chemo has this. Also at the very heart of the cancer research industry is the effectiveness of chemotherapy – just how effective is this?. We are told that chemotherapy is the remarkable scientifically proven weapon against cancer but how valid is this? When I pursued this question the statistics did not make much sense to me as a person and when I pursued it with my oncologists the best answer I received was `well it’s all a bit of a crap shoot really. If it doesn’t recur in five years you’re cured. If it does then it’s incurable’ – is this an answer based on good science??
JQH said,
June 3, 2006 at 11:44 pm
PatriciaKane
To answer your final question, it sounds to me like your doctors were being honest with you rather than make promises they might not be able to fulfil
EVERYBODY
Did you see Emma Mitchell’s column in Guardian Weekend? She told someone who wrote in that her body was suffering from a ‘memory’ of having had chickenpox and that this could be cured by homeopathy. So your body has a ‘memory’ of infections which can be cured by a sugar pill with the ‘memory’ of a drug!
God that is such a good scam!
pv said,
June 4, 2006 at 2:36 pm
“`scientists’ should back off until they can come up with an appropriate research paradigm”
What kind of conceit is that?
Patricia Kane, what exactly is there to research with regard to homeopathy? It’s a bit of a problem when there isn’t anything to research. It’s rather like researching the Emperor’s new suit of clothes. It might be of some value if there were any evidence that homeopathy actually cures anything. But there isn’t, because it doesn’t. There are only “claims” for made homeopathy, none of which stand up when prodded – just like the Emperor’s new clothes. Coincidentally, the material used to make the Emperor’s suit of clothes is the same as that used by homeopathists to treat their patients.
The Emperor has been told he is wearing the finest suit of clothes, and he believes it. Homeopathists dispense “medicine” that has no side effects (no effect, therefore) and tell their patients that their ailments (real or fictitious) will be cured. They believe that. Each appeals to credulity, vanity and, sometimes, desperation.
Homeopathists know there is no scientific explanation, because there is nothing to explain (apart from the deception) – which is why, for the benefit of the credulous, they keep playing on the notion that science can’t disprove it, or they produce their own bogus “scientific” results. It’s all part of the deception. Science has no part to play in homeopathy because it is neither scientific nor medicine.
What has this to do with the cholera epidemic of 150 years ago? Or bubonic plague, even? The sum of human knowledge has moved on somewhat in the last century and continues to do so.
sockatume said,
June 4, 2006 at 6:26 pm
PatriciaKane: read up on just what the scientific method is, then come back. Also, read up on the success rate of chemotherapy. And the success rate of homeopathy at curing cancer. In fact, just read up on the subjects you’re attempting to comment on before you comment on them, that would be a start.
CB said,
June 6, 2006 at 4:34 pm
Patricia,
Chemo’s not great, but its the best we’ve got. As far as I’ve been able to tell, it works mainly on the basis of poisoning you, and hoping that the cancer is more likely to die than the rest of you.
This is the reason that a truly mind boggling number of different ways have and are being researched, by scientists, to find a better way of treating cancer. Most of them have not yet been succesful which is why cancer is still so nasty and you’re left with chemo.
If you can find a better way, then be my guest – but don’t think that scientists aren’t giving it their very best shot in as many different ways as they can think of. Maybe they’ll eventually crack it.
alangdon said,
June 14, 2006 at 1:59 pm
Just in case there is anyone here who has been tricked , sorry I mean treated, by a homeopath (or any other practicioner of alternatives to medicine) could you try reading John Diamond’s ‘Snake Oil’ ?
Nurn said,
June 21, 2006 at 10:03 pm
A (deluded) friend of mine did a homeopathy course years ago. She used me as a guinea pig during her training, despite my disbelief. I didn’t have any health problems at the time, but she still “prescribed” me a “remedy”.
I’m not sure what the remedy was supposed to be for. It seemed as though the idea was that you should be taking some kind of homeopathy remedy whether there was anything wrong with you or not – to balance your psyche, or something such twaddle.
It reminds me of “social phobia” (otherwise known as shyness or introversion) and other such personality traits needing pharmaceutical treatment, when there is nothing actually wrong with you. Snake Oil Salesmen will always find a way to sell you something.
wotsisnameinlondon said,
July 5, 2006 at 3:07 pm
I do not object to homeopathy in much the same way as I do not object to people killing themselves while trying to climb Mt. Everest. What I do object to is money raised through public taxation being used to fund either of these daft activities.
The correct way of going about addressing this issue is that which was adopted by the group of eminent doctors recently i.e. to prevent NHS funds being spent on this quackery. Companies selling these treatments should be subject to the same checking procedures as the big drug companies and to be sued for compensation when their treatments don’t work.
In many ways, the energetic attacks by the orthodox medical establish only serve to strengthen the resolve of homeopathy adherents. When asked by patients about “alternative treatment”, Doctors should respond by saying that “while it won’t do any harm, it won’t do any good either. If you want to clutch at straws then be my guest.”
In the long run, the early demise of these people will strengthen the gene pool. It should be remembered that there is not exactly a shortage of Homo Sapiens on this planet and the concept of free choice must always include freedom to make the wrong choice. Sadly, the best argument for real medicine is more publicity on the failure of the alternative variety (see Comment 11).
Dorktor said,
August 4, 2006 at 3:32 pm
Even though homeopathy is utter nonsense, I can sympathize with PatriciaKane regarding the efficacy, or lack thereof, of chemotherapy. When my wife developed aggressive cancer, I spent much time reading the peer-reviewed, medical literature on chemotherapy trials. This proved to be very dispiriting reading, indeed. Chemotherapy, at least for breast cancer, seems to shift the survival curve to by a few months to the right, indicating a prolongation of life for 3 to 10 months, but does not significantly change the shape of the curve. This interpretation was confirmed by her consulting oncologist from Johns Hopkins University. When I asked him why he recommended this very unpleasant, very expensive treatment when statistically the expected life extension is no greater than the treatment duration, he replied that “Patients and their families want to feel that everything possible is being done.” Incidentally, she died five years and two months after diagnosis and treatment, so she is yet another ‘successful’ chemotherapy treatment.
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Homeopathic overdoses are homeopathically dangerous | Hurtling Through Space said,
January 30, 2010 at 12:18 pm
[...] you think that homeopathy has helped someone you know, then neither of you understand the importance of the placebo effect. Please learn about it — it’s a very real effect with measurable positive results. [...]