Puffs and huffs of homeopathic smoke

In which Dr Aust ponders whether recessions are good for scepticism. Or at least bad for homeopaths.

The sceptical blogosphere has been afire this weekend with the (presumably) leaked news that the  House of Commons Science and Technology Commitee were not terribly impressed with the homeopaths, and that the Committee’s report – to be released Monday morning – will reflect this. Almost makes it worth going to bed early so that I will be awake enough to have a good giggle tomorrow.

My only sadness is that, as far as I can tell from a long “tweet-up” on Twitter, none of the sceptical “citizen-journalists” seems to be able to get into the press briefing tomorrow morning, not even cyber-geek turned Blogzirkusmeister turned 10-23 press supremo turned impressively-bearded U-boat-commander-lookalike turned Guardian freelancer Martin Robbins.

It would be a shame if we have to rely entirely upon mainstream press coverage, since bloggers like Ben Goldacre, Prof David Colquhoun, Le Canard Noir, and Gimpy (see blog sidebar for links) have played a critical part in lighting the fuse under homeopathy’s shaky foundations.

Take that together with the late-breaking (at least for MPs, though better late than never) insight that NHS money you spend on homeopathy cannot be spent on other more sensible things, and you have a recipe for a spotlight finally being turned on the surreal daftness of having an eighteenth century superstition enshrined in Act Of Parliament, and endorsed by the NHS.

Now, I did have a post on homeopathy about three-quarters written, penned two weeks ago as a retrospective muse on the brilliant 10-23 campaign. But it never got finished, largely because I got derailed by a deadline crisis and then by a debate I got involved in under my real-world identity. And  I don’t have time to finish it now.

However, I do have time to quote a bit of it – which is actually itself a quote from what I wrote about homeopathy in a comment on Jack of Kent’s blog about a month back. The trigger for this little summary was that someone asked why sceptics tended to highlight homeopathy’s intrinsic scientific impossibility, rather than talking about the clinical trials.  I reproduce it here because it is perhaps as close as I have come to a reasonably concise explanation of my personal reasons for finding homeopathy risible.

—————————————————————

“The point about homeopathy is that the two approaches [to deciding what is a useful treatment] mesh – the “prior plausibility” approach (aka incomprehensibility, or impossibility) and the “lack of real evidence” detailed-forensic-scientific-analysis-of-the-trials approach.

To scientists, homeopathy serves as a kind of sine qua non demonstration of the way implausible / mystical / belief-based therapies are both clung to (all evidence notwithstanding) and promoted.

As a sub-set of this, homeopathy also shows what happens if you take a completely placebo therapy and feed it into the arena of medical trials, where biases of various kinds are undoubtedly present, and indeed are well-described.

The first point is that most of the studies will be done by enthusiasts / advocates for homeopathy. So you get enough random false positives, people fooling themselves through the psychological need to believe or through lack of technical know-how, finagling of results, over-promotion of wholly inadequately-controlled “positive” studies, “file drawer” burying of the results of negative studies, etc etc. that the homeopaths can always find SOME positive results in the literature.

And all the detailed meta-analysis of the trials which shows that the positives are illusory (essentially, as the study design and size, and hence reliability, improves, the “positive effect” of homeopathy beyond placebo tends inexorably to zero) cannot “unconvince” them.

Coming back to the point [about why scientists tackling the issue in public fora tend to concentrate on talking about how intrinsically silly homeopathy is] we basically default to incomprehensibility because the scientific argument is won, to the satisfaction of all but the homeopaths, who are utterly beyond all convincing (cf the anti-vaccination nuts and MMR).

And… the incomprehensibility argument is quicker, pithier, and easier for a layman to grasp.”

————————————————————–

Meanwhile, how have the homeopaths responded to the last few months’ events?

They have circled the wagons. They have made lots of loud noise about all this being unfair. They have started a snide letter-writing campaign about Dr Evan Harris, one of the very few MPs that actually understands science and medicine. This last one is particularly revealing. Essentially the homeopaths feel it is unfair to have scientifically or medically literate MPs like Dr Harris on the Science and Technology Committee, because such folk seem unusually likely to see homeopathy clearly for what it is. They think that MPs should be selected for a lack of any relevant prior knowledge, presumably because as it would then be easier to bullshit them.

[It is so important not to let that mean old knowledge get in the way of being "open minded"]

Anyway, for a full chronicle of the spasms of nastiness, frivolous complaints and persecution mania over the last few weeks, Gimpy’s blog is a must.

So, if the report is indeed as widely expected, what next?

Probably little, this side of any election.

But that is fine. At least it will be another, and very clear, public statement that faith-based “magical” quack therapies should not be given a special and privileged place in a modern medical system where we strive towards the goal of there being sensible evidence behind what doctors do.

To repeat an old line, if you can show that something works, then it is neither “mainstream” nor “alternative”. It is just “medicine”.

The playing field should be equal for mainstream and alternative “treatments”, in terms of having to demonstrate that they work.

Once that principle is firmly established, we can move forward.

And if you can’t show it works, then your Alternative Therapy of choice can still be your personal luxury –  if you want.  And if you are prepared to pay for it. Though I suspect that in the current economic climate there will be less people wanting to pay than a few years ago.

Which brings me to a final question:

I wonder what the other careers of choice are for an unemployed homeopath?

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15 Responses to “Puffs and huffs of homeopathic smoke”

  1. Teek Says:

    I’m not sure about how many votes there are for politicians if they were to endorse the findings of the SciTech report and commit to getting rid of homoeopathy from the NHS – however many there are, it would still be the right thing to do, IMHO this side of the election, as it’s topical and current.

    Other than that I do like the implausibility argument, given that so much of the so-called ‘evidence in favour’ of ultra-diluted nothing is such poor quality…!

  2. pv Says:

    Is there any evidence “in favour” of homeopathy that isn’t of poor quality? Most of it surely wouldn’t even be described as evidence in any sphere of real science.

  3. XtalDave Says:

    I do think that the homoepaths have played this whole thing incredibly badly, and this latest letter writing campaign again Dr Harris is just (IMHO) another example of extremely poor PR and reasoning.

    Had the homeopaths swallowed a touch of humble pie at t=0, and admitted, “yes, evidence is shaky, but in some circumstances, giving patients a placebo can be a good thing, and this is what we do”, then they might have got an easier ride through the S&TC evidence check. I suspect their pride would have gotten in the the way if such a suggestion had ever been made.

    As it stands, their claims of efficacy, backed up by woefully misrepresented data, have brought them to the pickle they currently find themselves in (See http://www.layscience.net/node/932 ). Whoops.

    High profile “circling of wagons” such as the attacks on Dr Evan Harris have also been mirrored lower profile, but unusually prolific and astoundingly moronic “astroturfing” of certain internet fora with pro-homeopathic statements (more often than not – completely unsupported).

    Also, your quote “It is so important not to let that mean old knowledge get in the way of being “open minded”” – serves as an excellent cue to post Tim Minchin’s song “If You Open Your Mind Too Much Your Brain Will Fall Out (Take my Wife)”

  4. batarista Says:

    Regarding your question “what the other careers of choice are for an unemployed homeopath?”

    Perhaps, for the genuine homeopaths, those that really are interested in helping people, they might do worse than:

    * train for a proper medical career,
    * train as councillors, advisors (i.e. talk-cures),
    * coach doctors in how to “charm” patients,
    * learn to do science properly & tackle their perceived excesses of “BigPharma”.

    However, as homeopathy becomes more and more discredited in the first world, some homeopaths seem to be becoming more active in the developing world. Perhaps it is easier to operate there, and easier to make their extraordinary claims unchallenged.

    Debby Bruck’s attempt to establish a “Homeopathic Clinic in Haiti” (http://twitwall.com/view/?what=0600000E02) is one example, James Pannozzi’s tacky gambit for funding here (http://www.thesundayleader.lk/2010/02/07/cancer-and-homeopathy/) is another.

    It is also surely, easier to undertake ethically dubious studies in such countries, for example the University of Washington trials of homeopathic remedies for acute diarrhoea in Honduran children (http://www.ncbi.nlm.nih.gov/pubmed/17034278) which, by the way, failed to find any benefit beyond placebo.

    We should keep a watch on these activities, which remind me somewhat of the tactics used by the Tobacco industries once they realised that their game was up.

  5. Michael K Gray Says:

    “what the other careers of choice are for an unemployed homeopath?”

    Used car sales?
    Labour Politician?
    Pope?
    Creationist?
    “Sun” reporter?

  6. draust Says:

    Yes, I find it hard to see any of the lay homeopaths taking any of the paths suggested by Batarista. They are convinced they have the One Revealed True Answer to all the ills of the body and soul, so I can’t see them wanting to retrain as psychotherapists. Not many of them, anyway.

    I suspect that if the demand for homeopathy falls, many of them will simply add a few more daft things to their grab-bag of nonsense to try and have a greater variety of pick-your-own Woo to lure the customers with. Don’t fancy homeopathy? Try diagnosing your “intolerances” with Applied Kinesiology. Not keen? How about a Radionic machine that tunes into your energy vibrations? Or what about some Reiki healing?

    PS Re Michael Gray’s suggestions, it has been the experience in the UK that Pseudomedical Nonsense is politically neutral. Thus we have Labour’s Peter Hain and his longstanding enthusiasm for homeopathy. And we also have bonkers Tory David Tredinnick and his desire for people to have astrology on the NHS, and surgery at the right phase of the moon.

  7. Martin Robbins Says:

    “…cyber-geek turned Blogzirkusmeister turned 10-23 press supremo turned impressively-bearded U-boat-commander-lookalike turned Guardian freelancer Martin Robbins.”

    Best. Description. Ever.

  8. draust Says:

    Thanks Martin. Glad you liked it.

  9. Cybertiger Says:

    What a brilliant letter to the BMJ!

    http://www.bmj.com/cgi/eletters/340/feb23_3/c1091#232122

    What say you, Herr Draust? And what would Frau Draust think?

  10. draust Says:

    Well, I have repeatedly stated my view that classical homeopathy essentially constitutes a kind of “stealth psychotherapy”, so in that respect I largely agree with the BMJ letter writer. Of course, the ethical difficulties with deception remain, if people are being told the pills are a medicine. See what I wrote in this comment on the previous thread:

    “I actually have an open mind on the topic of placebo therapies, or “stealth psychotherapy”. I can see the ethical problems with dishing out dummy pills, but I can also see why some doctors think there are settings where placebo interventions, or stealth psychotherapy, might be useful. But we cannot have a sensible discussion about this until folk like Peter Fisher and Jonathan Davidson stop refusing to engage sensibly with the idea (though it is far more than that) that homeopathy is a placebo.”

    Re. what The Boss might do with her patients, I have said a little bit about that over on David Colquhoun’s blog.

  11. Cybertiger Says:

    I loved this response from Dana Ullman in the BMJ today,

    http://www.bmj.com/cgi/eletters/340/feb23_3/c1091#232179

    And she finishes with,

    “Finally, when science gets smug, it gets sloppy, and science and medicine wilts.”

    Now I realise why Droopy Draust is such an apt name for this splenetic, anti-homeopathic blogmeister supremo.

  12. draust Says:

    Goodness, Shabby, if you are quoting Dana Ullman approvingly (or “DUllman” as he is universally known in the blogosphere outside of his own self-promoting website), then you really are out of touch. Dana is a he, BTW.

    To paraphrase:

    “Finally, when Dana spouts smugly, everyone else laughs so hard they spill their beer sloppily”.

    DUllman is a tediously tireless booster of homeopathy, from which he presumably makes his living via sales of his books and videos. He is not a doctor, or a scientist, though he proudly tells us he has “a Master’s Degree in Public Health”. I can’t be bothered de-constructing what he says, as (i) many other people have done it elsewhere and (ii) it is the proverbial game of Alt.Reality whack-a-mole. Personally I would say the best analogy for what Dana does is that he is like one of those people who try and sell you motivational videos by mail-order or over the net.

    More about Dana can be found at Science-based Medicine in the post:

    The Dull-Man Law

    I feel sure DUllman would be delighted to know you are an admirer.

  13. Cybertiger Says:

    No doubt Mr Ullman understands that micro-molecular tincture of wilted violet is really no cure for smug gits like Goldacre & Draust.

  14. Cybertiger Says:

    Colquhoun, Ernst and that vile harridan, Caroline Richmond, are all there to have a go at Michael Dixon.

    http://www.pulsetoday.co.uk/story.asp?sectioncode=19&storycode=4125317&c=2

    They’re a disgraceful crew but then I have this feeling that Dreadful Draust will love them drearily.

  15. draust Says:

    Good guess, Shabby. I thought Michael Dixon’s comments were completely ridiculous (and totally inaccurate), and the commenters did a great job of “taking him to school”.

    May pen a short post on it tonight if I have a moment.

    Edit: Managed to find some time so it is now up

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