It hardly seems possible that so much has happened since I first started writing about the deteriorating situation in the UK. It’s not possible in this short article to do the subject justice, so I’m limiting myself to a thumbnail sketch of the latest news and a little historical context from the last three years. If you’re interested in reading more I’ve written fully referenced articles about the subject; who the players are; how it all fits together, and the possible implications for CAMs in general. I have included some excerpts from the articles in this piece, but you can download the full articles as pdfs at the end of this discussion.
Homeopathy: Edzard Ernst’s delusion.
Professor Edzard Ernst is the UK’s first university Chair of Complementary and Alternative Medicine (CAM) who, in a few short years, has gone from a self-confessed user of homeopathy to one of its biggest critics. The more Ernst has criticized homeopathy, the more respect he has received from his peers and the higher his profile has become. The UK media now refer to him as the world expert on the scientific evidence for CAMs, “faith-based medicine” has become a descriptive for CAMs in general and homeopathy in particular and the convention for the critics to refer to the ‘delusion’ of homeopathy.
It’s more comforting to think that the current situation has evolved via a series of random if unfortunate events, but I have traced the sudden escalation of the anti-homeopathy movement since the coup that was The Lancet’s “End of Homeopathy?” issue of August 2005. It’s my opinion that there is organization and an orchestration to the timing of events – and that it is another aspect of a much larger anti-CAM legislative trend that seems to be gaining ground.
The Royal London Homeopathic Hospital, an international touchstone for homeopathy and the UK National Health Service (NHS), where homeopathy has been sanctioned since 1948, was the perfect place to start. That provision of homeopathy on the NHS would be seen to be withdrawn, not because of lack of funding, but because it had been proven not to work, could be guaranteed to have far-reaching effects on the rest of the homeopathic world.
Having said that, I also think that there has never been a more exciting time to be a homeopath! The recent changes and challenges present the biggest opportunity that the CAM world, and homeopathy in particular, has had for maybe a hundred years.
As a profession we are being called to step up to the plate, to take ourselves seriously and to walk our talk. We need to be informed, to stay informed and to collaborate on pro-active responses. This is not a time for keeping our heads down and hoping we won’t be noticed. This is a time for Big Ideas and Bold Action! (BIBAs)
Some background: A coup of the highest order
“The End of Homeopathy?” issue of The Lancet, August 2005 included: the infamous fundamentally flawed Shang et al. meta-analysis, which purported to “prove” once and for all that homeopathy is no better than placebo; an anonymous editorial, “The End of Homeopathy”, which implored doctors to be “honest with patients about homeopathy’s lack of benefit”; and a fierce criticism of the leaked pro-homeopathy World Health Organization (WHO) draft report, which was later withdrawn for revision and to date has still to be published.”
Shang et al. took 110 trials of homeopathy that matched the study’s criteria but drew the conclusion for the meta-analysis from just eight of the trials – and in the published paper, neglected to identify the eight they had used! At the insistence of the homeopathic medical community, the eight trials were eventually revealed, and it was easy to understand why they had not been identified. Extreme “cherry-picking” had transpired; only these eight particular trials would produce a negative result and a meta-analysis using other combinations of the 110 trials available would all weigh in favor of homeopathy. (To see just how flawed the “science” is, see the “Proof against homeopathy does in fact support homeopathy”, a detailed critique of the Shang paper (3); and “The growth of a lie and the end of “conventional” medicine”, by two Italian physicians, which lays out the vested interests at work (4) in the full Similia article.)
Needless to say both Shang and Richard Horton, editor of The Lancet, are openly critical of Homeopathy and Shang was part of the group who provided another highly criticized meta-analysis which led to the withdrawal of homeopathy from Swiss health insurance.
The WHO report which described homeopathy as the world’s fastest growing modality, now used by some half a billion people, was leaked by Renckens, a gynecologist and chair of the Dutch Union Against Quackery and another vocal critic of homeopathy. Professor Ernst, Chair of Alternative and Complementary Medicine at Exeter University (as late as 2003, a supporter of homeopathy) called for the report’s revision including a full disclosure of names of authors and any conflicts of interest. In an interesting Freudian slip, the same Lancet article states: “Renckens argues that it is wrong that such reports should not be prepared in secret behind closed doors…” (my italics). The irony surely won’t be lost on the homeopathic community.
The Lancet put out a disingenuous press release describing the meta-analysis as having reviewed all 110 trials to draw the conclusion that homeopathy performed no better than placebo. This conclusion, promoted by critics and media alike has now been accepted as fact. As we say in mathematics: homeopathy = placebo Q.E.D. (point proved) so no further discussion is necessary.
Following the August issue of The Lancet and in a series of apparently unrelated yet perfectly timed events in different formats, high-ranking medical professionals in the UK demanded that public money not be spent on an ‘ineffective, impossible, implausible’ therapy. Strategically leaked reports; letters from 13 of the U.K.’s most eminent medical professionals to funding Primary Care Trusts (PCTs) across the nation, insisted that they stop providing homeopathy as a patient option; and a plethora of newspaper articles served to keep homeopathy in a negative spotlight.
Predictably, the Shang meta-analysis quickly became the defining proof of homeopathy’s ineffectiveness, while the dilution issue continued to make it “scientifically impossible” and the subject of derision. The critics claim they merely want evidence, but what has become clear is that when the evidence they call for has been provided, they claim it scientifically impossible (on the basis of Avogadro’s number) and dismiss it!
In June 2006, the BBC conducted a “sting” of homeopaths for its TV program News Night, exposing the “threat to public health” posed by homeopaths who suggested homeopathic prophylaxis for malaria. Simon Singh at Sense about Science, an openly anti- CAM organization established to “educate the public”, led the sting in which a reporter posed as a patient and asked for homeopathic advice about protection against malaria for a forthcoming overseas trip. The media had a field day. (Several of the major drug companies are listed as funders of this group.)
The main critics began to describe homeopathy variously as: “like drinking a glass of water” (Ernst), “gobbledy gook” (Professor Colquoun, high ranking pharmacist) “worse than witch craft” (Professor Baum, leading oncologist and professor emeritus of surgery). Many of the published articles are astonishing in their ignorance of homeopathy and ferocious in their attack.
In November 2007 enough signatures were finally collected to table a parliamentary debate about the provision of NHS homeopathy. In the same month The Lancet put out another anti-homeopathy issue with three articles, two without a single reference, all slamming homeopathy.
You might be well advised to check your blood pressure before reading some of the most frequent writers. It’s important not to take it personally but to be reassured we are in good company: imagine Hahnemann facing his opposition, he was in the company of one! Let’s be true to our healing philosophy, employ our unprejudiced observer and feel compassion for the opposition’s confusion and fear. The very bedrock of their belief system must change in order for them to embrace homeopathy.
Who are these people?
I have researched the main critics in this movement and found them to be a small but powerful and media savvy group, closely related not least by their common anti-CAM stance. They take turns to write inflammatory articles, to quote each other, endorse each other, award each other prizes and then use them to add authority to their writing. All are connected directly or indirectly with Quackbuster organizations. Some, it seems, have made it a badge of honor to engage unsuspecting homeopaths in apparent debate, only to use the homeopath’s own arguments in ridicule against them. (A serious downside of online debating is the risk of a typo that leads to an ambiguity of meaning. If we are to do it we need to write with precision, with every word considered. I recommend taking a deep breath before drafting your response outside the Comment box, cut and pasting it into the box, re-reading it from their point of view and taking another deep breath before pressing Send.)
Have you heard the one about the homeopath who…….