The following is an email I’ve just sent to the Daily Telegraph. They posted this article on their website today, which Ben Goldacre alerted me to on Twitter earlier, and it inspired me to another rant about what rubbish homeopathy is. Quite possibly it’s all rather petty and pointless, but I’ve decided I’m going to try and err on the side of over-eager zealotry for a while, when it comes to skeptical activism, at least until I get better at it.
Dear Sirs, Madams, and so forth,
I’m writing about the article posted in the Health section of the Telegraph website today, the 22nd June 2009, titled: “Annabel Croft: Why I have come to rely on homeopathic medicine”. (http://www.telegraph.co.uk/health/wellbeing/5576901/Annabel-Croft-Why-I-have-come-to-rely-on-homeopathic-medicine.html)
I think Frances Glover has done the Telegraph’s readership a substantial disservice in her portrayal of homeopathy in this piece. I won’t get into how newsworthy it may or may not be, that someone who used to play tennis has expressed a view about a thing – I like hearing celebrities gab on about whatever inconsequential thoughts happen to be passing through their heads as much as anyone. But this article became little more than an advertisement for a selection of products which, although marketed as health treatments, have a track record of showing absolutely no pharmacological benefit whatever.
Ms Croft’s basis for recommending homeopathy seems to be entirely one of personal anecdote, but this is a notoriously unreliable way of distinguishing genuinely useful medicines from bogus ones. It may have seemed to her at the time that the progression of events – pain from the cyst, taking the homeopathic remedy, and relief from the pain – was proof of a causative link, and provided a demonstration of the power of the remedy, but we simply can’t establish such facts with any certainty from such a limited data sample.
Ovarian cysts are surprisingly common, and pain does not typically last very long anyway (http://www.emedicinehealth.com/ovarian_cysts/article_em.htm has more information). It is entirely possible that Ms Croft’s condition may have been of a sort which would have got better over time anyway.
Because we can’t go back in time, and see what actually would have happened if she had made a different choice, we can never know for sure. But what we can do is run large clinical trials, in which hundreds or thousands of patients are given homeopathic treatments, and their results are compared against hundreds or thousands of other patients with similar backgrounds, who are given a placebo remedy – pure water, for instance, or a sugar pill. These trials can rule out any alternative explanation for the rate of recovery, and are far more effective at establishing whether a treatment actually works, or whether it just happened to be taken by a patient who was getting better anyway.
Rigorous clinical trials of homeopathy have repeatedly failed to find any evidence that it has any effect beyond that of a placebo. This isn’t to say it has no effect at all – people may often benefit from the reassurance, comfort, and attention provided in a homeopathic consultation, as the practitioner may be able to provide a longer and more personal session than a GP, which can itself do some good. But decades of scientific study shows that people taking homeopathic solvents might as well be taking nothing but water.
In fact, they generally *are* taking nothing but water. The article states that the active ingredient is “diluted down to microscopic quantities”, but this is usually not the case. The solvents are more commonly diluted to such an extent that there does not exist even a single particle of the active ingredient in the final solution. Rather, it is claimed that the water retains a “memory” of the particular ingredient which it once contained. It’s never been explained how this could be possible, given our modern understanding of the laws of physics. Given such an implausible basis, the evidence would have to be overwhelming before we should give this idea credence. It is not; the evidence consistently implies that homeopathy has no effect beyond a placebo.
Many of the uses Ms Croft describes are exactly the sort of thing where a psychological effect might be enough – if you really believe you’re taking something that will calm your nerves, you may find yourself actually calming down – or where people will often recover in good time anyway, and may be tempted to attribute this to the homeopathic treatment. Children get minor colds and sniffles all the time, and tend to get over them pretty quickly – it’s very easy to decide after the fact that a particular intervention is what made it happen. This kind of subjective, amateur assessment can often provide misleading conclusions; when it comes to giving advice on people’s health, we need to take particular care in testing a theory before accepting and promoting it.
The whole article takes a tone which isn’t just reporting facts, but gives homeopathy a strong and unequivocal endorsement, in a way which really concerns me. Anecdotal evidence is offered as conclusive proof, and the purchase of various types of treatment from specific vendors is actively recommended in the final paragraphs. It seems irresponsible to encourage people to invest their time and money in “remedies” which have been demonstrated not to work, and to sing the praises of a strategy which involves deciding to actively avoid consulting a GP (someone with actual medical qualifications). People reading articles like this may well assume that there is sound data behind these treatments, and good reason to believe they actually work; it’s not obvious at all from the way they’re discussed here that the evidence suggesting that they’re any good at all is non-existent.
You have my compliments on running an often fine newspaper, but this was a disappointingly slack piece of journalism. I hope I don’t have to see too many more stories in the news about uninformed people off the telly grandly espousing inane positions which could easily be refuted by a few basic facts if you asked anyone who actually knew what they were talking about.
P.S. Gosh, I sounded rather bitchy and smug towards the end there, on reflection. Sorry about that – it’s almost certainly nothing personal at you, dear reader, wherever on the hierarchy of newspapering you happen to be – but this does bother me, and I had to say something in support of skepticism, critical thinking, and science-based medicine.