Despite some £4m a year being spent on homeopathy, the House of Commons Science and Technology Committee said today that using public money on the highly diluted remedies could not be justified. The cross-party group said there was no evidence beyond a placebo effect, when a patient gets better because of their belief that the treatment works.
It seems reasonable that people should have the freedom to buy these remedies and pay for these alleged treatments if they wish to. However, it also seems right that any government should examine the science behind any medical claims, direct limited funding towards remedies that have credible theory and demonstrated effectiveness, and that they should remove any government-backed badge of respectability from those that don’t.
On the World at One on Radio 4 today, Phil Willis MP (Chairman of the Commons Science and Technology Committee) and Dr Michael Dixon (a homeopathic practitioner) were debating the Committee’s findings, which can best be summed up in the words of Phil Willis:
“This was a challenging inquiry which provoked strong reactions. We were seeking to determine whether the Government’s policies on homeopathy are evidence based on current evidence. They are not.
“It sets an unfortunate precedent for the Department of Health to consider that the existence of a community which believes that homeopathy works is ‘evidence’ enough to continue spending public money on it. This also sends out a confused message, and has potentially harmful consequences. We await the Government’s response to our report with interest.”
I was interested in the two points that Dr Dixon made in response to the above devastating conclusions.
First, he tried to make out that the committee looked at the wrong evidence and suggested that evidence for the effectiveness for homeopathy was there if you could only see it. What he challenged was the committee’s requirement that evidence should be produced from randomized trials, the only sure way of measuring effectiveness.
Qualitative evidence may be useful in the human sciences where there often isn’t clear links in the physical causation chain, but in hard science (described by Dixon as ‘fundamentalist’) it is reasonable to expect credible theory and hard evidence, and the only source of hard evidence is randomized trials. Claims that people get better may be real for the people concerned, but in terms of the science, there is no credible theory why they may do so, and nothing to distinguish their improvement from chance or placebo effect. If homeopathy works, where are the randomized trials demonstrating that it does? Surely someone could have done some by now?
And doubtless, Dixon requires evidence from ‘fundamentalist’ science before trusting his life to an aeroplane. Why should anyone else be expected to accept a lower standard of ‘evidence’ as far as their own health is concerned?
Dixon’s second line of ‘argument’ was then to make a semi-emotional plea by describing the many patients who had come to his homeopathy clinic that morning, and asking Willis, “What should I tell them?” The implication was that it is somehow ok to tell people a lie if it makes them feel better. Of course, many people will be hindered in seeking professional medical help by the false belief that they can be cured by homeopathy, but regardless of this, it seems immoral to con people.
Until presented with a credible theory and credible evidence to the contrary, the government should stop funding supposed health care solutions that lack efficacy and direct the money elsewhere. If people want to buy their placebos, let them, but they shouldn’t expect the taxpayer to contribute to them, or use the government to bolster up a crumbling reputation.
And of course, similar arguments to the ones above could be used for the government ceasing to pay for hospital chaplains - but that’s another story …
The whole subject of what receives or is entitled to receive public funding seems fraught and confused. I suppose I agree re public funding of homeopathy. I don’t agree with the campaign against Boots.
The whole issue of relying wholly on evidence-based control trials is also not as straightforward as it always seems. Did you read the spoof article a few years back in the BMJ - where they tried to prove the effectiveness of parachutes for preventing death using scientific trials? It was very amusing and worth a read. Although you may have to be a subscriber to do so. Let me know if you want to read it as I have a copy somewhere.
My own feelings about homeopathy and other seemingly “quack” remedies are that they should be available to those who wish to use them. Personally I think they lose their efficacy if people do not believe in them. They may well be placebos but there is no way people can get placebo treatment (and often it is enough or helps when nothing else is available) really is there? If people go gung-ho and destroy people’s faith in quack remedies then they are left with nothing in many cases. It would be interesting to know how many people would suffer more for having the placebo taken away as opposed to those who are harmed because they had faith in the placebo and didn’t therefore seek the help of conventional medicine.
It would also interest me to know (and this data must be available) what kind of people mostly turn to homeopathy. I would have thought most of them were educated, middle class people who know full well that the treatment is “alternative”. But perhaps I am wrong?
But on your point about public funding I do, I think, agree.
Reluctant Blogger
Thanks for your comments. I’m glad that we are agreed that public money should only go where there is reasonable justification and evidence - after all, that is how research grants are handed out - you don’t want to waste limited resources. And we are both agreed that individuals should be free to spend there money in whichever way they want to (given the usual provisos about avoiding public harm etc.)
In your further comments I hear (perhaps incorrectly) two arguments that I still disagree with:
1) If it helps them, let them have it, even if there is no truth in it.
2) The fact that there is a body of people who believe it means that it can’t be wrong.
In reply to the first, fine if they want to pay for it, but I also feel that human beings deserve truth, and I don’t apologise for arguing against something which (until I see evidence to the contrary) seems so patently wrong. I don’t think the end justifies the deception.
In reply to the second, a large body of people believing something to be true and efficacious doesn’t make it so. Millions of people are arguably ‘helped’ and believe that the world is changed by regular chats with invisible friends, but that doesn’t make the process efficacious or true, and any resources spent in doing so could arguably be more productively used elsewhere.
I’d be one of those quacks. No wait, I am a quack. It’s not easy being green. Quack.
I usually say nothing about this. What can I say? I have used homeopathic remedies for oh I don’t know, about 15 years or so, on and off. I don’t preach it. I don’t teach it. I just use it. Is it placebo? Could be. A lot of conventional meds could be said to be placebo as well. Heck, just having someone listen to you is probably the best medicine and likely the best placebo.
I’m only speaking up because I respect you A Thinking Man and think know less of you for your position. I just know a lot of us out here keep our mouths shut on the issue because we hate being called Quacks. I’m also a Registered Nurse, but that doesn’t account for much I know. The sad thing is, there are many main-stream medical professionals who do use homeopathy and alternative medical options, but as I said, most of us keep our mouths shut.
I’m not saying I can defend my position. Just letting you know I’m a quack.
Zoe
Thanks for your comments. I respect the rights of individuals to do whatever they want (within some limits).
I hope that I would be open to new evidence, and am slightly puzzled why the homeopathy camp don’t produce the convincing evidence if they have it, or set up the studies to produce it in order to look for it. The Commons Science and Technology Committee studied the evidence base, and found none. Until the homeopathy camp can produce a scientific explanation for, and evidence of effectiveness that goes beyond the anecdotal, or beyond that which could be explained by chance, or by placebo, I think the government are wrong to fund it. In my view, apart from being an unjustified use of public money, it gives it a badge of credibility that, to date, it doesn’t deserve. If it changes, I hope I will be willing to change my mind, eat my words, and take the arnica
I actually used a dose of Arnica two weeks ago after our rear-end collision with a vehicle that decided to run into us at a traffic stop in the city.
I understand you regarding government funding. In Ontario it’s not funded in any way. I think in Nova Scotia it is and perhaps another province in Canada as well. Not entirely sure.