{"id":149,"date":"2010-04-19T12:38:47","date_gmt":"2010-04-19T12:38:47","guid":{"rendered":"http:\/\/tomsalinsky.co.uk\/blog\/?p=149"},"modified":"2010-04-29T21:37:35","modified_gmt":"2010-04-29T21:37:35","slug":"talking-to-my-gp-father-about-homeopathy-3","status":"publish","type":"post","link":"http:\/\/tomsalinsky.co.uk\/blog\/index.php\/2010\/04\/19\/talking-to-my-gp-father-about-homeopathy-3\/","title":{"rendered":"Talking to my GP father about homeopathy #3"},"content":{"rendered":"

Part two is here<\/a><\/p>\n

TOM<\/strong><\/p>\n

I\u2019ll keep this as brief as I can.<\/p>\n

Parts of your reply misrepresent my position slightly. I\u2019d like to clear up any misconceptions.<\/p>\n

I don\u2019t equate evidence with certainty. Absolutely, we can be less sure than we would ideally like that a given intervention will be effective in a given case, but we always have an evidence base on which to make such judgments \u2013 even if the best we can say is \u201cthis is a wildly experimental treatment which stands as good a chance of curing your cancer as it does of killing you on the spot, but we\u2019ve run out of other things to try \u2013 what do you say?\u201d If this is a lottery, it\u2019s one where we can often buy an awful lot of tickets.<\/p>\n

Thus, I continue to insist that everything is split into two categories. A physician can recommend a treatment because there is evidence to suggest that it will be effective or can ignore the evidence which shows that a treatment is no better than placebo and prescribe it anyway. A physician can honestly tell a patient that the evidence is inconclusive, or dishonestly claim results which are not supported by data of any kind.<\/p>\n

The other slippery issue is that of false claims. You approve of the wording on the Homeopathic Hospital\u2019s website regarding Iscador, but I\u2019m not sure you are looking at this website the way a patient might. Here\u2019s a page from a website all about Iscador<\/a>.<\/p>\n

Here we read that \u201cone of the primary functions of Iscador\u00ae<\/sup> is that it stimulates parts of the immune system that can slow the growth of cancer cells\u201d. This, as we know, is rubbish. On the same website, there is a link to a single study, published in a Complementary Medicine Journal which purports to show a significant benefit to cancer sufferers using this preparation. However, as we have already seen, a review of all the available literature shows that overall there is no good evidence that Iscador has this effect. This is the usual pattern. Evidence-based (or science-based) medicine which reviews all the available evidence, and people with a pill to sell (herbal or pharmaceutical) who pick only the studies they like and ignore the rest.<\/p>\n

Now consider the effect on a patient who may have seen these other claims made for Iscador\u2019s magical cancer-healing powers, coming across Iscador on a National Health Service website. It isn\u2019t the details of the mode of action that stick in the mind \u2013 it\u2019s the key message MISTLETOE CURES CANCER. And this message is reinforced, not contradicted, by the product\u2019s availability through an apparently prestigious and trustworthy source. So while the NHS might stop short of actually saying \u201cmistletoe cures cancer\u201d, it ends up delivering that message just the same.<\/p>\n

It is at least partly for this reason that the Ten23 campaign is targeting Boots. When homeopathic preparations are seen side-by-side on the shelf with active pharmaceuticals in the country\u2019s largest and most-trusted pharmacy, it is almost inevitable that patients will get the wrong impression (this is reinforced by dire warnings on the sides of the bottles). So, it becomes impossible to clearly send a message that homeopathy will not cure your cancer, is not a suitable defence against malaria, will not cure your child of eczema and so on, and the result is that people believe the hype, and sometimes that belief turns out to be deadly.<\/p>\n

My feeling is that placebo cures possibly do have a role in treating chronic conditions such as back pain, may even have a role in treating minor self-limiting conditions although this is more likely to be simply a waste of everyone\u2019s time,* but are a danger as soon as they are let near anything remotely life-threatening. With a powerful lobby that can\u2019t bring itself to say \u201cfor god\u2019s sake get proper medicine if you feel really poorly,\u201d the only answer is to try and destroy the credibility of these interventions as much as possible, or stand by as greedy corporations and misguided practitioners continue heedless of the harm they cause.<\/p>\n

So it isn\u2019t that homeopathy on the NHS is itself prescribed in a cavalier or life-threatening way, rather that this activity is an enabler,<\/em> enhancing the credibility of others with fewer ethics or less regard for evidence, and also fuelling the fires of hysterical media coverage of things like Andrew Wakefield\u2019s infamous MMR paper. Is public demand for medicalised quick-fixes a good enough reason to accept this corrosion of public standards of evidence? I don\u2019t think it is.<\/p>\n

You asked the excellent question \u2013 can you have medicine without quackery? I don\u2019t know if you can. But I do know that mainstream medicine has no business flattering the quacks.<\/p>\n

One final question for you. Many churches pray for people with life-threatening illnesses and many people feel happy that people are praying for them. What if this were offered as a service on the NHS? Is government-sponsored prayer also something you would endorse?<\/p>\n

* Caveat \u2013 when I have a sniffle, I\u2019m perfectly well aware that no matter what I do it will probably last 3-4 days, but I prefer Lemsip to a homebrewed hot lemon drink because the fact that Lemsip tastes a bit medicine-y<\/em> makes me feel better. The placebo effect is also present with pharmaceutical interventions of course.<\/p>\n

\n

JOHN<\/strong><\/p>\n

I don’t see complementary medicine (or if you prefer ‘placebo medicine’) as competing with\u00a0scientific medicine. I think most people are aware that they are different in conception and that for some major illnesses or accidents only science will deliver. Very few people put herbs on broken legs these days. There would be no demand for it on the NHS.<\/p>\n

Whether there would be a demand for prayers for healing on the NHS I don’t know but it might catch on and save a lot of money currently spent on visits to A and E.<\/p>\n

When I was in China last year, I was interested to see that some of the hospitals and clinics we visited\u00a0 had Western scientific medicine\u00a0 and TCM ( traditional Chinese Medicine) departments running side by side. The patients chose which one to go to, but if the doctor they went to initially thought they had got it wrong they were cross-referred to the other wing.\u00a0 So the two approaches can co-operate.<\/p>\n

That’s all I\u00a0 have to offer for now. I hope I have muddied the waters a bit so you can get to work clearing them again.<\/p>\n","protected":false},"excerpt":{"rendered":"

Third in a series of exchanges regarding homeopathy and other modes of alternative medicine.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"jetpack_post_was_ever_published":false},"categories":[14],"tags":[15,17,16,462],"class_list":["post-149","post","type-post","status-publish","format-standard","hentry","category-skepticism","tag-homeopathy","tag-medicine","tag-science","tag-skepticism"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p5JY5l-2p","jetpack-related-posts":[],"_links":{"self":[{"href":"http:\/\/tomsalinsky.co.uk\/blog\/index.php\/wp-json\/wp\/v2\/posts\/149","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/tomsalinsky.co.uk\/blog\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/tomsalinsky.co.uk\/blog\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/tomsalinsky.co.uk\/blog\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/tomsalinsky.co.uk\/blog\/index.php\/wp-json\/wp\/v2\/comments?post=149"}],"version-history":[{"count":5,"href":"http:\/\/tomsalinsky.co.uk\/blog\/index.php\/wp-json\/wp\/v2\/posts\/149\/revisions"}],"predecessor-version":[{"id":168,"href":"http:\/\/tomsalinsky.co.uk\/blog\/index.php\/wp-json\/wp\/v2\/posts\/149\/revisions\/168"}],"wp:attachment":[{"href":"http:\/\/tomsalinsky.co.uk\/blog\/index.php\/wp-json\/wp\/v2\/media?parent=149"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/tomsalinsky.co.uk\/blog\/index.php\/wp-json\/wp\/v2\/categories?post=149"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/tomsalinsky.co.uk\/blog\/index.php\/wp-json\/wp\/v2\/tags?post=149"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}