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.
Delster said,
June 2, 2006 at 1:26 pm
JQH,
you can’t… thats the beauty of it!
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??
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. […]
Homeopathic overdoses are homeopathically dangerous « Hurtling Through Space said,
September 16, 2011 at 4:29 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. […]