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243 thoughts on “Placebos as Medicine: The Ethics of Homeopathy

  1. JPZ says:

    @libby

    “So you have no problem prescribing drugs made by a rogue company who’s actions have killed people? That IS ethical in your opinion?”

    I think several people (including myself) made very cogent arguments as to why refusing to prescribe life saving drugs (regardless of the source) is unethical. I would welcome a discussion of the comparitive ethics of these two points of view, and I am sure many of the physicians in this audience could offer personal insights. Simply stating your point of view and not recognizing counterpoints is not going to encourage discussion.

  2. west says:

    @ Libby, continuing our back and forth…

    “Doctors could and should as a group demand that the products they administer have not had safety information suppressed by the companies or the regulatory bodies.”

    One thing I never understood about alternative medicine, in this case homeopathy, is how you can assume it is so safe. I mean if you have real faith in homeopathy you would think it to be a powerful treatment. Why you would think any treatment that can resolve any symptom would be without side effects is very confusing to me. It suggests a severe lack of chemistry/biology knowledge or just an incredible level of blind faith or wishful thinking.
    Why would you assume homeopathic corporations to be above brushing relevant information under the table because its convenient for them?
    I would say that homeopathic companies display a lot more “corruption” than normal pharmaceutical companies do.
    Consider all of the very good scientific studies that get refuted or ignored by homeopaths. Then consider all of the horrible inexcusable studies that they support without question. (this seems to be universal across all alternative fields).
    I’m not saying you are like this but it is a disturbing trend I notice. Sure you could say that the results of homeopathic corruption is not usually fatal, unlike some pharmaceutical corruption, but then you would be ignoring everyone who needed real medical help but instead chose to waste very valuable time trying these alternative treatments out. I may be a little off topic with that point.

    I suppose I assume a lot about your side of the argument however I still feel that homeopathy has as much evidence as leprechauns.
    I would consider investing money in faith healing a bad decision for the exact same reason. Until homeopathy can distinguish itself from other woo type things it will not be worth researching. This may seem harsh but you have to have some standard which you would apply to all potential treatments.
    Why would you support homeopathy and not faith healing or voodoo or other non-science based alternatives? (I’m assuming you don’t support the examples I listed)

    I don’t consider myself to be an expert but to my understanding most people justify homeopathy with something like “science has yet to discover the means to measure its mechanism or actual affect in an empirical way”.
    Well that same justification would hold true for people seeing ghosts or UFOs. You could say that for faith healing and all kinds of silly things.

    So again, why would you recommend homeopathy for study above treatments in which there basic mechanism is understood?
    How exactly would you distinguish homeopathy from other alternative treatments like faith healing and such?
    To me that is what this issue boils down to.

    PS: My opinions on ethics and such are just that, I’m not expert. I do however feel strongly about homeopathy and it having no place in science based medicine (at least until someone gives me a decent explication for “water memory”).

  3. libby says:

    vicki

    “Following your line of reasoning, I would like to know how much time you spend working to eliminate police departments, given the record of corruption in many of them?

    No time at all, because I don’t want to eliminate any police dept.”

    “If you report a crime in Cleveland, will you be upset that the desk sergeant doesn’t tell you about cases of corruption in the Los Angeles or New York Police Department?”

    Corruption in a LA or NY police dept has no bearing on crime in Cleveland.

    “Do you sleep under the stars rather than give money to the building industry, in which there is proven corruption?”

    You don’t have to. There are a few honest contractors but even then, I would be looking over their shoulder to make sure. But in most cases I do my own stuff.

    “How do you feel about imported goods, given the history of organized crime involvement in the loading and unloading of goods?”

    I don’t like it.

    “Corruption is, alas, a thing that happens among humans. Boycotting large industries or fields of endeavor because of it will leave you with little or nothing.”

    True but if you’re serious about discouraging it you have to change the model.

    The reason drug companies are corrupt is because the structure promotes it. Companies even build into their budgets payments for fines if caught, which are often much less than the profits from any transgression.

    Doctors aren’t interested unfortunately in changing the structure and as you can see on this board, they can’t even say the word “corruption”, let alone devise a strategy to control it, even though its existence is not debatable.

    Drug companies compete with each other to some degree, not as much for product marketing as for investors. Corruption increases profits attracting more investors. Within any pure capitalist system that’s the structure. Investors can bury a company by leaving en masse. If a company decides to be ethical and disclose all negative effects of a drug they produce, the investors will airlift out.

    Cuba does not operate on that principle, and the results of infant mortality and morbidity significantly decreased after the Revolution of 1959, in spite of US attempts to the contrary and in spite of massive poverty, disease, illiteracy, prostitution, etc.

    We call THEM corrupt and not deserving of a look BUT we can’t say WE are corrupt. That would be disobedient to OUR system

    That’s why our doctors don’t make waves by trying to eliminate corporate corruption in the drug industry. Our system would punish them for it. That’s why I suggested they do something as a group. Predictably, it was rejected.

  4. west says:

    forgive my spelling errors please :_)

  5. JPZ says:

    @libby

    “Companies even build into their budgets payments for fines if caught…”

    That is not corruption, it is what investors require if a drug company enters into a settlement over a lawsuit, i.e. does the company have enough money to pay the settlement without putting the company at overall financial risk. Companies do not set aside money before a lawsuit is filed. If they do not set aside enough money, the investors pull out. And, while some lawsuits are due to misconduct, many more are due to previously unrealized adverse effects of drugs or nuisance lawsuits.

    I can hear your moral indignation, but I would encourage you to better understand what you criticize.

  6. libby says:

    JPZ:

    It’s amazing that you can paste a quote and then misread it.

    At what point did I say setting aside money was corruption?

    I would encourage you to read what I said rather than what you think I said.

  7. Harriet Hall says:

    @libby,

    JPZ did not say you said setting aside money was corruption. He simply said it was not corruption. I would encourage you to read what he said rather than what you think he said.

  8. Libby “That’s why our doctors don’t make waves by trying to eliminate corporate corruption in the drug industry. Our system would punish them for it. That’s why I suggested they do something as a group. Predictably, it was rejected.”

    Yes, you suggested that doctor’s as a group, withhold prescriptions based on their opinion of the behavior of the manufacturer. That would include something along the lines of depriving a good number of children with type 1 diabetes of the medication that keeps them alive. Those slacker doctors, predictably, rejected it.

    Like I said, the CAM proponents seem to be their own worst enemies.

  9. daedalus2u says:

    Libby, do you boycott all drugs made by corrupt pharmaceutical companies? If you don’t, then why do you think that doctors should? If your default is that all pharmaceutical companies are corrupt, why do you use any of their products at all? Why are homeopaths immune to corruption?

    Compartmentalized thinking is better than flawed thinking.

    If you look at the wikipedia entry on the test you refused.

    http://en.wikipedia.org/wiki/Dilated_fundus_examination

    It cites a paper showing that the dilated examination is significantly better at finding anomalies. 51% of patients had anomalies that were detected following dilation that were not detected without dilation. You have no way of knowing if you had anomalies that would not be detected without dilation.

    You are exhibiting the Dunning-Kruger effect.

    http://en.wikipedia.org/wiki/Dunning%E2%80%93Kruger_effect

  10. libby says:

    “One thing I never understood about alternative medicine, in this case homeopathy, is how you can assume it is so safe. I mean if you have real faith in homeopathy you would think it to be a powerful treatment.

    I don’t know of any side effects or deaths from homeopathy. I could be wrong.

    “Why you would think any treatment that can resolve any symptom would be without side effects is very confusing to me. It suggests a severe lack of chemistry/biology knowledge or just an incredible level of blind faith or wishful thinking.”

    I think you’re saying if a remedy helps it must also be able to hinder. Is that correct? So since homeopathy encourages the immune system to respond to problems, I’m not sure why that would ever have a bad effect. Perhaps the immune system might respond in the wrong way. I believe when provings are done that is what happens, the body reacts when there is no condition, but I am not the person to discuss that with because I don’t know how it works. I’m relying only on results.

    “Why would you assume homeopathic corporations to be above brushing relevant information under the table because its convenient for them?”

    I don’t. I’m vigilant re any malfeasance.

    “I would say that homeopathic companies display a lot more “corruption” than normal pharmaceutical companies do.
    Consider all of the very good scientific studies that get refuted or ignored by homeopaths. Then consider all of the horrible inexcusable studies that they support without question. (this seems to be universal across all alternative fields).”

    If you are referring to the famous meta-analysis in Lancet (2005), I’ve already discussed that. It appears Richard Dawkins also sees the failings of that study as he is now calling for one that uses proper homeopathic protocols.

    “I’m not saying you are like this but it is a disturbing trend I notice. Sure you could say that the results of homeopathic corruption is not usually fatal, unlike some pharmaceutical corruption, but then you would be ignoring everyone who needed real medical help but instead chose to waste very valuable time trying these alternative treatments out. I may be a little off topic with that point.”

    No that’s not off topic. It is a good point. People have died when taking a remedy that didn’t work. However it is incorrect to claim that they would have been saved had they used conventional medicine. Conventional medicine cannot guarantee success either. Further, if you were in a head-on collision and grabbed a homeopathic remedy instead of going to emergency that would not be wise in my opinion. Or if you needed a prosthetic arm, homeopathic drops won’t help you.

    “I suppose I assume a lot about your side of the argument however I still feel that homeopathy has as much evidence as leprechauns.
    I would consider investing money in faith healing a bad decision for the exact same reason. Until homeopathy can distinguish itself from other woo type things it will not be worth researching. This may seem harsh but you have to have some standard which you would apply to all potential treatments. Why would you support homeopathy and not faith healing or voodoo or other non-science based alternatives? (I’m assuming you don’t support the examples I listed)”

    The Cuban health system does not use faith healing nor do they engage the help of leprechauns or extra-terrestrial travelers or ghosts, but they do use homeopathy. If we don’t think they deserve a look, as one doctor here has said, then our collective lack of curiosity will likely keep us in the dark for a long time.

    “I don’t consider myself to be an expert but to my understanding most people justify homeopathy with something like “science has yet to discover the means to measure its mechanism or actual affect in an empirical way”.

    Since I have gotten results from homeopathy this quote seems accurate. It makes no sense to me to vilify something I haven’t tried.

    “Well that same justification would hold true for people seeing ghosts or UFOs. You could say that for faith healing and all kinds of silly things.”

    One difference to consider. Few people on this planet consult a ghost or an alien to cure a medical condition, however there are millions who consult homeopaths. I actually have difficulty getting an app’t with mine because she is so busy, and, here’s the important part, it is not covered under government insurance so these patients are paying out of their own pocket. For me it’s ends up to be cheaper when I consider the cost of antihistamines and the fact that my one bottle, which only lasts 2 weeks, can be extended by ‘topping it up’. It’s not quite that simple but I can do it on my own.

    “So again, why would you recommend homeopathy for study above treatments in which there basic mechanism is understood?
    How exactly would you distinguish homeopathy from other alternative treatments like faith healing and such?”

    I don’t have any authority to recommend homeopathy to anyone, and I never do. If asked, I tell people I use it.

    “To me that is what this issue boils down to.
    PS: My opinions on ethics and such are just that, I’m not expert. I do however feel strongly about homeopathy and it having no place in science based medicine (at least until someone gives me a decent explication for “water memory”).”

  11. libby says:

    Harriet Hall:

    “JPZ did not say you said setting aside money was corruption. He simply said it was not corruption. I would encourage you to read what he said rather than what you think he said.”

    That’s quite a statement coming from someone who is unconcerned about rogue pharmaceutical companies.

    1. Harriet Hall says:

      libby,
      “That’s quite a statement coming from someone who is unconcerned about rogue pharmaceutical companies.”

      This is not only a non sequitur, but a defamatory misinterpretation of what I said. This is the second time you have misrepresented my words and accused me of being unconcerned about pharmaceutical company malfeasance. Please do not do so again.

  12. libby says:

    micheleinmichiganon

    “Yes, you suggested that doctor’s as a group, withhold prescriptions based on their opinion of the behavior of the manufacturer. That would include something along the lines of depriving a good number of children with type 1 diabetes of the medication that keeps them alive. Those slacker doctors, predictably, rejected it.
    Like I said, the CAM proponents seem to be their own worst enemies.”

    A little thought will go a long way.

    It is likely impossible to withhold prescribing ALL drugs from one company, but it is likely possible to use alternatives to the rogue company on occasion. Even small attacks on corporate profits can result in large changes.

    There are of course other ways to pressure drug companies. How about SPEAKING UP for a change instead of falling silent when malfeasance occurs. Does this ever happen? Do doctors ever take a stand against companies that engage in deadly corporate decisions?

    It’s as rare as a 3 dollar bill.

  13. libby says:

    daedalus2uon 13 Jun 2011 at 10:33 pm

    “Libby, do you boycott all drugs made by corrupt pharmaceutical companies? If you don’t, then why do you think that doctors should? If your default is that all pharmaceutical companies are corrupt, why do you use any of their products at all? Why are homeopaths immune to corruption?”

    I’m not authorized to write prescriptions. As for over-the-counter drugs, I lost interest when I realized at the age of 20 that Contac-C wasn’t curing my cold but suppressing my body’s attempt to fight the disease. That was just nuts to me, and I was as dumb a 20 year old as you’d ever meet.

    “Compartmentalized thinking is better than flawed thinking.
    If you look at the wikipedia entry on the test you refused.
    http://en.wikipedia.org/wiki/Dilated_fundus_examination
    It cites a paper showing that the dilated examination is significantly better at finding anomalies. 51% of patients had anomalies that were detected following dilation that were not detected without dilation. You have no way of knowing if you had anomalies that would not be detected without dilation.
    You are exhibiting the Dunning-Kruger effect.
    http://en.wikipedia.org/wiki/Dunning%E2%80%93Kruger_effect

    Well the decision has to be made then, do I accept a better quality exam and subject my healthy eye to a drug that might have side effects that some rogue company produced but withheld safety issues, or to I get a poorer quality exam and avoid a possible iatrogenic condition? If I ran into problems later from the drug, we do know that no doctor would have the slightest concern. That we do know.

    In the exam, I asked the doctor to confirm the drug was safe, and can you guess what he said? He didn’t offer a study or data or anything scientific but TESTIMONIAL evidence – he hadn’t heard any complaints from his other patients. Isn’t that rich? All of a sudden testimonial evidence was all the proof necessary.

  14. JPZ says:

    @daedalus2

    Wow, Dunning-Kruger effect. I thought learning about the Gish Gallop was an amazing insight into argumentative technique, but Dunning-Kruger is seriously helpful. Many thanks for that new bookmark!

    @libby

    “Do doctors ever take a stand against companies that engage in deadly corporate decisions?”

    You continue to lump doctors together for acts you think they commit. To make that larger assumption requires data not personal experiences. Based on my personal ethics, a doctor who allows a patient to die because the doctor hates a pharmaceutical company that makes the drug that could save them is horribly unethical if not criminal (but I am not a lawyer nor a physician). Examine your argument in light of the impact of your recommendation on patients totally removed from the supposed misconduct of a pharmaceutical company. Forcing someone else to die for your own principle is not something to be undertaken lightly.

    @anyone

    I’ve trained a couple of Cuban public health workers, but I did not want to speak up in case there were Cuban health care workers in the group. Can anyone else shed light on that system?

  15. pmoran says:

    Thanks for answering my query Libby. I said I would explain.

    Studies support the notion that most CAM users use them with a modicum of discrimination and safety, and mainly when conventional medicine has failed to satisfactorily resolve medical problems.

    This seems to apply to you, but with some reservations that I will refer to later.

    You are also well aware that your experiences don’t translate into secure scientific knowledge. To quote you: “Again the remedy could be nonsense but it did seem to work. ” — and — ” It could be placebo and I can’t rule that out –”

    So what is the problem here?

    I think it would be rather nice if we physicians could simply wish you well, pleased that you have found something that has helped you with problems mainstream medicine was unable to resolve at the time, even if the excellent outcomes are “merely” the result of placebo influences, other non-specific responses and phenomena peculiar to medical interactions.

    Or should we continue to try to poison that well for you, persuading you into a different way of thinking about homeopathy and by inference other CAM modalities, potentially denying you this kind of help forever? We could almost certainly do that, given a long enough dialogue — this one has barely started.

    Other skeptics may ask themselves this question, but within a microsecond will have reassured themselves with some reasonably plausible presumptions — that any misunderstanding of your experiences to date may make you prone to more dangerous misuse of “alternatives” on other occasions, — and that the failure to aggressively attack pseudoscience wherever we find it helps expand its hold upon society generally, with potentially serious consequences for science and medicine at both collective and individual levels.

    There is actually no solid evidence that any of this is so, but they are reasonably plausible concerns.

    In your case, the worry I have is not so much anything that you have said about homeopathy, but the serious mistrust that you have expressed of the medical profession generally. I would be very concerned at the impact of this on your treatment choices if you had a serious illness.

    Should I be? What is your own aseessment?

    As an example I cite your absurd reaction to a one-time dose of a mydriatic (probably atropine which is actually from the herb belladonna and has been studied and used intensely in medicine for over a century).

    This does suggest an irrational fear of pharmaceuticals and an unsafe level of mistrust in the medical profession. Should I be worred? Convince me.

  16. JPZ says:

    @pmoran

    That is a very nicely structured query! I concur with your logic.

  17. pmoran says:

    Apologies — not atropine, because of its long duration of action, but one of the same class of well-studied pharmaceuticals.

  18. west says:

    @ libby

    Nice post, I only have one real gripe about it:
    “…however there are millions who consult homeopaths…”

    There are billions of Christians, Muslims and Jewish people. They can’t all be correct yet they are all very popular. I don’t agree with the justification that popularity implies validity.
    I still fail to see how homeopathy can be distinguished from other alternative treatments like faith healing.

    Without proof you are basing everything on faith and for me that isn’t enough (for things like medicine). But if you want to use homeopathy or support its research I wont tell you that your wrong.
    But I still disagree with you about it.
    : )

  19. Libby, “A little thought will go a long way.
    It is likely impossible to withhold prescribing ALL drugs from one company, but it is likely possible to use alternatives to the rogue company on occasion. Even small attacks on corporate profits can result in large changes.”

    As a consumer, you are perfectly capable of talking to your doctor about your desire to use a generic brand drug whenever possible. If you chose to express your concern in a friendly, rational way, you might be able to engage other consumers in an effort to switch to generic brands as a protest against pharmaceutical corruption.

    But, instead, you go on a comments board and attempt to manipulate a bunch of doctor’s into withholding prescriptions that possibly allow me (the patient) or my children to live a normal life without disability or pain.

    I’ll ask you more directly, don’t you think it should be MY choice, not my DOCTOR’S choice whether I want accept the risk of a medication change or discontinuation to protest pharmaceutical industry behaviors?

  20. libby says:

    Harriet Hall:

    I’m pleased you are concerned about rogue drug companies.

    Please point me to articles on this website that discuss corporate corruption in the drug world because I can’t seem to find any.

  21. libby says:

    micheleinmichigan

    “As a consumer, you are perfectly capable of talking to your doctor about your desire to use a generic brand drug whenever possible. If you chose to express your concern in a friendly, rational way, you might be able to engage other consumers in an effort to switch to generic brands as a protest against pharmaceutical corruption.”

    I think that is a great idea. If consumers, supported by their doctors, pressured rogue companies to put the safety of their products over profits it could make quite a difference.

  22. Libby, you didn’t answer my question. Do you think it should be the patient’s choice or the doctor’s choice?

  23. daedalus2u says:

    Libby, you report that you have never heard reports of adverse side effects from homeopathy. What reports of adverse side effects from pupil dilating drugs had you heard of prior to your refusal of them?

    The absence of anecdotes of adverse effects from untested homeopathic drugs is good enough for you, but anecdotes of the absence of adverse effects from drugs that have been tested and approved for use in humans isn’t?

    No one is saying you can’t use your own idiosyncratic decision making process to decide about your own health. Just don’t pretend that your idiosyncratic decision making process is consistent or makes any sense or is something that people who want good health should emulate.

    If you want to fight and have an adversarial relationship with your health care provider, go right ahead. Why you think that will somehow get you decent health care is not something I understand. If you like the Cuban health care system so much, why don’t you move to Cuba?

    Homeopathy is faith healing. All of the CAM treatment modalities that are placebos are variants of faith healing. That placebos do work on some things is about the physiology of the placebo effect, much of which is mediated through nitric oxide. That is why placebos work on fibromyalgia, fibromyalgia is largely due to low nitric oxide and the placebo effect raises nitric oxide levels.

    Anger and hatred lower nitric oxide levels too, so getting angry at health care professionals and hating and blaming them will tend to reduce their effectiveness in treating what ever health problems you have. But that is what you want, isn’t it; someone to hate and then blame your problems on. Hate and anger all by themselves cause health problems

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3019061/?tool=pubmed

    Health problems you can’t blame on anyone but yourself. Is that why you like homeopathy? Because you find their holistic mumbo-jumbo empowering?

    Parental attitudes can make children’s asthma worse too.

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2959059/?tool=pubmed

  24. Harriet Hall says:

    @libby,

    “I’m pleased you are concerned about rogue drug companies.
    Please point me to articles on this website that discuss corporate corruption in the drug world because I can’t seem to find any.”

    Here’s one that even mentions your target of choice: GSK:
    http://www.sciencebasedmedicine.org/index.php/medical-science-and-public-opinion-the-avandia-story/

    I don’t know what “rogue drug companies” even means. The industry in general has many failings as described in Marcia Angell’s book “The Truth About the Drug Companies: How They Deceive Us and What to Do About It.” The industry has also been responsible for developing lifesaving drugs, so any harm must be balanced against the benefits.

    I am concerned about a great many things that have not appeared on this blog at all. It’s a blog, not a comprehensive analysis of all that is wrong in this world.

    The subject of this article is the ethics of placebo with homeopathy as an example. It would be appropriate to comment on that subject. It is not appropriate to hijack the comments to express poorly informed opinions about other subjects.

  25. Du2′ From a quick read over, I don’t think much of that asthma report. It seems they are suggesting causation while only finding some correlation on reporting of symptoms. The results seem based entirely on parent reporting of the child’s condition and their stress levels.

    From a laymen’s point of view, it seems very plausible that stressed out parents tend to report higher severity of symptoms, rather than stressed out parents cause higher symptoms. Also of course, a parent stressor (such as a big move, family wide viral illnesses, or death of a family member) could also be stressing the child and possibly acerbating asthma symptoms.

    My favorite line is “Clinicians know that there are children, whose symptoms are improved by a “parentectomy”, i.e., putting an asthmatic child in a hospitalized setting to separate them from home”

    Imagine that, when you hospitalize a child for asthma, their symptoms get better. Apparently, removing the parent is the only factor for consideration in that equation. :)

  26. daedalus2u says:

    Michele, this was a prospective replication of multiple retrospective studies. I liked the term “parentectomy” too. Family dynamics and stress imposed by parents is an important part of children’s health.

    It isn’t a surprise that parent induced stress makes asthma worse. Essentially every other source of stress make it worse, why wouldn’t parental stress?

    “Stress” is like the opposite of a placebo. Instead of a non-pharmacological treatment that makes you better, it is a non-pharmacological treatment that makes you worse. There has to be physiology that does that too. That is my conceptualization of the opposite of the placebo effect, something that triggers the “fight or flight” state. Placebos trigger the opposite of the fight or flight state.

  27. Yes Du2, stress can make asthma worse, as can the humidity level, allergens, exercise, lack of exercise, temperature, eating, medications, exposure to a virus or bacteria…in fact maybe it would be easier to list what doesn’t make asthma (if you have it) worse.

    On the other hand, here’s another interesting paper that says “We conclude that dysfunctional family interaction seems to be a result rather than the cause of wheezing in infancy.”

    http://www.ncbi.nlm.nih.gov/pubmed/8071765

    Funny how causation can be really difficult to pin down in parenting research.

    Which is one reason I usually balk at suggesting (how ever subtlety) another poster’s attitude may be making their child sick.

    You want to complain about a parent with-holding needed medication or treatment, fine, good. But let’s not go around dissecting the personality of a poster you never met and pointing to soft evidence in the attempt to make them look like a bad parent, because you’re pissed off at them.

    I can read that kind of…stuff on any mommyboard online, I expect better here.

  28. libby says:

    Harriet Hall:

    Thanks for the link. I will have a close look at it when I get a chance.

    A rogue is someone who has no respect for the law or rules of any kind. The term is often applied by the US Gov’t to any State that the it doesn’t like, but Noam Chomsky applies it to the US itself, a State that will often disregard International Law and flout the Rule of Law.

    I used the term against any pharmaceutical company that would suppress safety issues and put the public at risk to augment profits.

    Re your statement: “The subject of this article is the ethics of placebo with homeopathy as an example. It would be appropriate to comment on that subject. ”

    I have been commenting on the subject numerous times, usually with those who steered away from the bullying tactics.

  29. libby says:

    daedalus2u

    I don’t believe in the concept that a drug is safe unless proven otherwise. People have died thinking they were taking a safe tested drug. I however am not a guinea pig for GSK.

    Re the dilation drug, remember I asked the doctor about its safety record and he could only give me testimonial evidence from his other patients. All on this board have been emphatic that testimonial evidence is of no use, so it cannot now be deemed worthwhile when convenient for your arguments.

    Homeopathy to my knowledge has never harmed anyone, but if you have evidence to the contrary I would be most interested and more vigilant in the future.

    I’m pleased you label my thinking as idiosyncratic. All of us should strive for that. I’m assuming you do know what that word means.

    The rest of your post deteriorates into puerile arguments beginning with “move to Cuba” through nonsense about my hate issues and desires to empower myself through homeopathy etc, none of which merit any response.

  30. libby says:

    micheleinmichiganon

    “Libby, you didn’t answer my question. Do you think it should be the patient’s choice or the doctor’s choice?”

    That’s not the right question. If you are serious about fixing the problem you have to fix the model. Having created an economic structure that promotes corporate corruption, we are reaping what we have sown.

    The pharmaceutical industry should be nationalized (along with energy, but that’s another topic) because health care should never be in the hands of a capitalist trying to maximize profit. Profit and health are a perilous mix.

    But in the short term, patient’s could affect some change but that is a very tall order because most patient’s are obey they their doctor and will take whatever is prescribed, and will not listen to an activist who is trying to organize a boycott against some rogue drug company. Doctors, however, already have a network in place (this board for instance) and even the threat of action by a group of doctors would make a difference.

    Now doctors might have to give up some percs. They might not receive that new computer network for the office from the drug company(ies), or receive any cash payments as their consultant, or be asked to speak at their conferences, but I think the knowledge that they would be making things safer for their patients would more than offset these material gains.

    http://abcnews.go.com/Health/Wellness/drug-companies-payments-doctors-revealed-database/story?id=11929217

  31. libby says:

    west:

    You state: “There are billions of Christians, Muslims and Jewish people. They can’t all be correct yet they are all very popular. I don’t agree with the justification that popularity implies validity.
    I still fail to see how homeopathy can be distinguished from other alternative treatments like faith healing.”

    It depends on why these religions are popular. Most of the devout are that way because of their location and culture. These people are not trying to seek immediate relief from some spiritual agony that has been thrust upon them. They are following the traditions of family members and friends and their society.

    That’s quite a different dynamic to someone seeking immediate answers for health issues, which has nothing to do with any of the elements connected to religion.

    You’re absolutely right though. Popularity does not mean correct.

    In my case had it not worked the first time, I would be telling everyone here what an important service they are providing for society by dispelling the myths of woo health care. I just can’t do that given my repeated success with homeopathy.

  32. libby says:

    pmoran:

    Your post deserves a better and more thoughtful reply than the short note below. I will try to respond as soon as I am able.

    If a serious disease came along I would at that point weigh all the options, including conventional medicine, talk to doctors and other health care providers, talk to my family and friends for their input, acquaint myself with every facet of the disease or condition, and then select a course of action.

  33. JPZ says:

    @libby

    I would encourage you to learn more about the things you criticize from people who know the field well. As I cannot engage you in thoughtful debate (reference previous posts), I will move on to more fruitful discussions. And, as always, please continue to be a skeptic! :)

  34. Libby “That’s not the right question”

    It’s the right question to answer if you are suggesting that doctor’s alter their prescribing behavior in anyway that could possibly be a detriment to the patient.

    Since you won’t answer the question, I will just assume that you are happy to undermine the rights of the individual patient in order to accomplish your goals. You basically acknowledge that is the case when you suggest that regular citizen would not make the choice to boycott the pharmaceutical industry.

    Apparently you want to make this a political discussion. This isn’t the place for that. I usually reserve my political comments for huffpo, nytimes, wall street journal, so I’ll be moving on.

  35. libby says:

    JPZ:

    Please explain to me how the statement, “If you like the Cuban health care system so much, why don’t you move to Cuba?” is in any way an attempt to have a thoughtful discussion.

  36. libby says:

    micheleinmichigan

    Actually your insistence on asking a simple question to elicit a simple answer to a complex issue is a favourite tactic of the ‘pundits’ on Fox News.

    Your implication that doctors NEVER have an option when it comes to prescribing drugs is an absurd premise designed to elicit an absurd response.

  37. Libby – yes, of course, me and Beck are tight.

    Good luck selling your plan to patients and doctors. It sounds very appealing.

    Sorry, I have to go now. I’m anxious to run out and get myself some of that intelligent water and successful communism!

  38. libby says:

    micheleinmichiganz:

    Re what appears to be sarcasm on your part, “successful communism”:

    If you want to discuss the state of Cuba under foreign domination prior to 1959, when, after expelling the Spanish, the US had 60 years to create a free market paradise but instead spent most of the time exploiting Cuban resources for the benefit of a few rich barons state-side while maintaining high levels of infant mortality, prostitution, street drugs, poverty, and illiteracy among the Latino masses, I would be happy to engage in that discussion.

    That does not mean their totalitarian system is a desirable place to live, where personal freedoms have been seriously curbed, but they do do some things right, and health care and education are on that list.

  39. Harriet Hall says:

    @libby,”they do do some things right, and health care and education are on that list.”

    Even if we accept that they “do health care right” that doesn’t mean everything in their health care system is right. I don’t think offering homeopathy is right and you haven’t presented any evidence to support your perception that homeopathy benefits the Cuban population.

  40. libby says:

    Harriet Hall:

    “Even if we accept that they “do health care right” that doesn’t mean everything in their health care system is right. I don’t think offering homeopathy is right and you haven’t presented any evidence to support your perception that homeopathy benefits the Cuban population.”

    http://www.ncbi.nlm.nih.gov/pubmed/20674839

  41. libby says:

    pmoran

    Thanks for your patience.

    First let’s examine what is disquieting about conventional medicine. My overview might be partly inaccurate and I don’t mind being corrected.
    Drug companies spend billions developing products, performing the required studies on them. These studies are then submitted to a governmental regulatory body for approval. Once approved, the drug can be marketed. Drug companies have entire divisions set up of people who have no expertise in medicine but an expertise in developing strategies to convince regulatory bodies to approve their product. As well it is highly unlikely a company will spend billions and then be completely honest about the safety of their product, a conflict of interest situation. Not that that always happens, but the structure in place, tying health products to free market profit, encourages this. And this is what happened with GSK and Avandia, where people died. Add to this the sometimes occurrence that doctors have a relationship with drug companies: receiving cash awards for speaking at conferences, or being a consultant, or simply receiving gifts for the office like a computer system, creates a too close connection between the care giver (doctor) and the profit machine.
    The University of Stanford is so concerned with the relationship between doctors and drug companies that they have severely limited drug company access to the university.
    http://med.stanford.edu/news_releases/2006/september/coi.html
    From the Stanford website:

    QUOTE:
    Philip Pizzo, MD, dean of the School of Medicine, said he has been concerned for some time about the pervasive presence of the pharmaceutical industry in the medical profession, an issue that’s been highlighted in recent years in news articles, books and the medical literature. He began a discussion in the Stanford medical school community on the issue through his “Dean’s Newsletter” in the summer of 2005; last fall, he asked Greenberg, who is senior associate dean for research, to convene a task force to draft a policy.
    “In recent years we have witnessed an erosion of the public trust in the profession of medicine and even in the value of science,” Pizzo said. “Part of that is related to the market forces that have increasingly converted medicine from a profession to a business, but a significant factor has also been the perception that physicians and scientists may be accepting gifts and gratuities from industry at the very time that the cost of drugs is skyrocketing.
    “It is essential that medical professionals and scientists reclaim the moral high ground and avoid the appearances of conflict of interest that can otherwise cloud or alter the trust of the American public. It is my hope that the stance being taken by Stanford will serve as beacon of responsibility for the medical and scientific professions.”
    Stanford’s policy is broader than those of its counterparts in that it regulates devices, the biotech, hospital and research equipment and supply industries, as well the pharmaceutical industry throughout the medical center including laboratory research facilities.
    David Magnus, PhD, director of the Stanford Center for Biomedical Ethics and a member of the task force, said studies suggest that small gifts can have as much of an influence on physician thinking, prescribing and purchasing habits as large gifts.
    “Gift giving creates a reciprocal obligation that is a powerful force, and pharmaceutical companies know this very well,” he said. “So we’re discouraging it from happening anywhere at the medical center.”
    Larry Shuer, MD, chief of staff at Stanford Hospital and a professor of neurosurgery, said he’s “certain that most medical staff would feel that they are not influenced in their medical decision-making by free pens or doughnuts from an industry representative. However, we all agree that the appearance of possible conflict is what we must try to avoid, as the public perception may be different from that of the physicians.”
    END OF QUOTE

    So I am not alone in thinking that a conflict of interest is a serious problem within the conventional medical field.
    I am also concerned with the method on the recall of drugs. I myself was given Zomax, a pain killer, after a dental operation. The drug was recalled one month later because of deaths. Now this is for pain, not for some critical situation where you could rationalize risking side effects.
    What is the process whereby drugs are recalled? If a side effect occurs with a drug, a patient might or might not mention this to his doctor. If he does then the doctor has to be convinced that there is a causative link between the drug and the effect. Likely this will not occur the first time, but only after several patients or more have the same issue. He then has to take the time to contact a regulatory body to tell them. If enough doctors carry this out, then the regulatory body starts the ball rolling on a recall. That appears to be the reason that dangerous drugs can be out on the market for years before a recall occurs.
    My career was saved not by conventional medicine, but a collaboration of conventional medicine and alternate care. A doctor, who had no strategies himself on my problem, referred me to a coach, who contacted a dentist who came up with a theory. An acupuncturist came into the mix and suggested a specialized collagen drug that, in combination with calcium and glucosamine, solved the problem. Compare that situation to doctors who base ALL of their actions on RCT’s. In my experience they seem to lack the will to solve problems, simply relying on the science performed by the profit-motivated drug company. Earlier to all this, I even had a conventional medicine specialist tell me my career was over, better make other plans.

    Given the lack of success I have had with conventional medicine, the safety issues, the profit gained even from dangerous drugs, the idea of turning to something that is completely safe is attractive. But what turned out was something that seemed to make a difference where conventional medicine failed. I am now well into my hayfever season and am doing very well, and without any worries that what I’m taking will be eventually recalled because it strains the liver or creates heart palpitations or clogs arteries, etc.
    My concern with the power of drug companies is that they are likely using their influence to carve out a bigger share of the profit pie for themselves by doing what any good capitalist would do, eliminate the competition. To do that, you have to have some connection with Government Health Depts and their regulatory bodies. You also have a lot of money at your disposal so a nice contribution ‘to the cause’ wouldn’t hurt. You can also fund studies which might play a role in the outcome. So is homeopathy being victimized by the powerful for financial gain? The Lancet meta-analysis (2005) might be just that. One entry on this thread lied about the its funders, and after a better look I discovered that he had not found who funded it, only that it was done by those connected with various universities. The information on its funding is unknown – was it public tax dollars or GSK. The meta-analysis appeared to be designed to create failures by selecting studies without any regard to whether homeopathic protocol was used. I can easily destroy my hayfever remedy by misuse.
    Go back to the Health Canada inspectors who were fired for trying to protect public safety. They claimed they were being pressured, but by whom. It was the work of this team that earlier had kept rBGH out of Canadian milk products, a substance banned in Britain, but was approved by the FDA. Two Fox News reporters (Wilson & Acker) had documents handed to them by a Monsanto insider about the serious health effects of rBGH, but were ultimately fired over threats from the company, denied whistleblower status, and lost a lawsuit to Fox News. That’s what our capitalist society does to the ‘disobedient’. Now I admit that this is not a case of a prescribed drug, but there is no reason to believe that the pharmaceutical industry doesn’t work under the same banner, and that is disquieting.
    The reason I have infused Cuba into the argument is because here we have a health system that is not connected to free market profits. It is a glorious opportunity to access their work on homeopathy, and in fact their work in all medical fields, in a real situation. But the hatred of Cubans in the US is at such a high level that it makes cooperation very difficult.
    Here is their work, albeit not a complete document for which I am still searching, on leptospirosis using homeopathy: http://www.ncbi.nlm.nih.gov/pubmed?term=20674839

    1. Harriet Hall says:

      @libby,
      Your comments are a mix of fact, misconceptions, important concerns, paranoia, conspiracy theories, and political opinions. I’d just like to point out a few things.
      1. The principles and validity of science-based medicine are in no way discredited by reports of errors or malfeasance in applying it. If someone drives a car recklessly and has an accident, that doesn’t mean the car is defective, and it doesn’t mean we should give up cars and walk.
      2. Personal experience, no matter how compelling, commonly generates erroneous conclusions. You believe homeopathy has helped your allergies. Would any kind or amount of evidence ever be capable of convincing you that your belief is wrong? I asked this before and didn’t get an answer.
      3. Your example of Cuba is not so pristine: Cuban doctors prescribe the same medications that were developed by capitalist drug companies. They benefit from the results of the capitalist system while contributing little or nothing to new drug discovery and medical progress. Incidentally, I bet Cubans don’t reject dilation for eye exams like you did.
      4. You have cited the leptospirosis study again after I provided a link showing why it is not credible evidence for homeopathy.

  42. Trod says:

    Libby,

    From your third or so comment in you stopped discussing the merits of homeopathy and started attacking medicine and those disputing your points. The last dozen or so comments go off the deep end on this. So I’m limiting myself to these following points. In your response, limit yourself to answering these bullet points.

    For discussion:
    1) No properly done scientific study has ever shown homeopathy to be more effective than placebo. Poor studies have been done without proper blinding, without placebos, or with cherry-picked data that show them more favorably, but when Homeopathic remedies are subject to the exact same standards as drugs and medicine these favorable results vanish.

    2) Homeopathy works on laws that are counter to common sense. Water dosen’t have a memory; if it did, you’d be diseased because the water we drink has had innumerable substances in it. Why does it remember some things and not others? Is it in the shaking of it? Throughout all of mankind’s history, no one accidentally shook drinking water in such a way to trigger the wrong memory?

    3) If you were to take the homeopathic remedy home and put it under any number of tests, it would be: water. Given your criticisms of corruption in medicine, why do you trust homeopaths so? You are literally taking their word that the water you are buying is different in a way that can’t be verified through any means.

  43. weing says:

    ” One entry on this thread lied about the its funders, and after a better look I discovered that he had not found who funded it, only that it was done by those connected with various universities. ”
    What are you talking about? The funding for the study is clearly stated in the article. Just look it up.

  44. libby says:

    Trod:

    I agree with you.

    My attraction to homeopathy is likely more a disapproval of the corruption within conventional medicine and its ineffectiveness from my experiences than the amount of science supporting homeopathy.

  45. libby says:

    Harriet Hall:

    I agree also with you.

    I don’t believe a structural analysis of conventional medicine would reveal it to be a conspiracy.

  46. libby says:

    Can anyone explain to me what drug companies hope to gain by gifting doctors?

  47. libby says:

    micheleinmichigan

    Very good read and funny as well.

    Thanks.

  48. pmoran says:

    Libby:Can anyone explain to me what drug companies hope to gain by gifting doctors?

    Something for you to think about with respect to this and other questions.

    Truly major medical breakthroughs are infrequent. Most of the time physicians, researchers and drug companies, with only partially overlapping motives, strive for small, incremental gains in patient care. These often teeter on the edge in terms of cost, risk and effectiveness, thus also lying close to the limits of detection within clinical studies of affordable size.

    This why it doesn’t take much to make the whole system look bad, or corrupt, when it isn’t, really, at heart.

    It is why a measure regarded as good for you this year may not be next year. Further studies have simply suggested less benefit or higher risk.

    This is why approved drugs sometimes have to be withdrawn.

    It is also why there are so many imitative drugs on the market — drug companies can make fortunes by producing drugs that are almost the same molecule as existing drugs, but which may have minuscule advantages. — that is, so long as they can be marheted as such.

    So it looks very bad when those “small gifts” to doctors appear to be influencing their prescribing habits. All that has usually happened is that a recently visiting drug company representative has suggested to a doctor that his company’s brand of a product is superior in some small way e.g. a little less of a minor side effect, and has left a little gift as a reminder for the next time the doctor reaches for his prescription pad.

    Patient care has not changed in any major way. To the extent that the information supplied to the doctor is accurate (never certain, unfortunately, and why the practice is being stopped in most countries) it may have improved slightly.

    But it is wasteful of resources. It is why health care systems like the Cuban one can get away with limited access to the latest, and thus more expensive, drugs, and even with replacing treatments for innumerable minor and self-limiting conditions with dirt-cheap homeopathic preparations. The money thus saved can be huge, enabling a high standard of hospital care and better services for the poor, with little if any impact upon major health care indices.

    The main problem is that it is not possible to ensure prior to obtaining marketing approval that a new drug pr medical device is definitely safer than older ones. To some extent we always have to rely upon post-marketing surveillance.

    It follows that it is reasonable to be cautious about novelty in medical care. Generally speaking, treatment programs, drugs and devices that have been around for a long time will be reasonably trustworthy, or at least any ill effects will be better known.

    (The Leptospirosis study IS poor. There is no way of knowing that the populations being compared actually had comparable levels of exposure.)

  49. libby says:

    I’ve read your thoughtful posts several times and appreciate them.

    Those who suggest that I should eschew homeopathy, something that is effective within my experience, and move back to scientifically proven conventional medicine that is less effective within my experience, cannot mean what they say. If I were to follow that advice, I would have to be insane.

    Basing one’s views on a scientifically proven approach is sound thinking, but it can also be a ball and chain. The restriction is seen with 2 examples. In my case, there is no one who appears interested in observing me or anyone else using homeopathic remedies except within a double blind, peer reviewed, science based study. There is also no attempt to observe anyone with cancer who chooses a non-conventional approach. A pat on the back and a “good luck” is about it.

    This is striking in its lack of curiosity. If I were in the medical field, I would need to know, whether I could convince my colleagues or not, what the truth is at least for myself, not what I could make palatable to those within my field, not what always fits into the structure set up by medical science. The mind-set appears to be “I don’t want to observe something that I cannot explain, because I wouldn’t know what to do with a positive result”.

    It’s important to make a distinction between what is proven within the confines of science and what is fact. What is proven is a fact, but not all facts are proven. Facts are not things that exist only within the scope of human experimentation. The relativity of time has always existed, it didn’t begin to exist because Einstein discovered it.

    British Journal of Cancer (2007) 97, 440–445. doi:10.1038/sj.bjc.6603880 http://www.bjcancer.com
Published online 10 July 2007
    Prospective study of grapefruit intake and risk of breast cancer in postmenopausal women: the Multiethnic Cohort Study
    K R Monroe1, S P Murphy2, L N Kolonel2 and M C Pike1

    British Journal of Cancer (2008) 98, 240–241. doi:10.1038/sj.bjc.6604105 http://www.bjcancer.com
Published online 20 November 2007
    A prospective study of grapefruit and grapefruit juice intake and breast cancer risk
    E H Kim1, S E Hankinson1,2, A H Eliassen2 and W C Willett1,2

    These 2 studies published in the same journal one year apart came to opposite conclusions about grapefruit and cancer. That probably tells scientists that this is an example of how science works, the ability to falsify.

    But another conclusion can be drawn. If we have double blind, peer reviewed, science based studies that come to opposite conclusions, how do we ever know for certain when a study proves a fact, and when a study ‘proves’ a non-fact? And how can we be so arrogant as to assume that since we can’t determine with certainty any medical fact scientifically, that we can discard other methods for determining effectiveness of substances on health, like field tests or a vast amount of testimonial evidence, which admittedly could also lead to incorrect assumptions.

    Thanks for your time and good luck in your endeavours.

  50. Scott says:

    Those who suggest that I should eschew homeopathy, something that is effective within my experience, and move back to scientifically proven conventional medicine that is less effective within my experience, cannot mean what they say. If I were to follow that advice, I would have to be insane.

    I am interested to understand how it can be “insane” to recognize that an individual is not infallible, that it’s possible to learn from things other than personal experience, and indeed that personal experience is highly unreliable for answering certain questions.

    In my case, there is no one who appears interested in observing me or anyone else using homeopathic remedies except within a double blind, peer reviewed, science based study. There is also no attempt to observe anyone with cancer who chooses a non-conventional approach.

    This is because the best quality evidence shows very firmly that homeopathy does not have any effect beyond placebo. Overturning this conclusion requires contrary evidence of strength and quality comparable to that supporting the conclusion. Such uncontrolled observations as you advocate would constitute at best extremely weak evidence, and therefore have insufficient power to change the conclusion. Accordingly, it would be a waste of the time and money and everyone involved to do so.

    The mind-set appears to be “I don’t want to observe something that I cannot explain, because I wouldn’t know what to do with a positive result”.

    We know full well what to do with a positive result. If it is contradicted by a large amount of superior-quality results, then the positive result may be considered an error and discounted. That is in fact the only logical thing to do with it.

    If we have double blind, peer reviewed, science based studies that come to opposite conclusions, how do we ever know for certain when a study proves a fact, and when a study ‘proves’ a non-fact?

    We never claim that a “fact” is “proven.” We draw provisional conclusions based on the best available data. If further data shifts the weight of evidence to support a different conclusion, we draw that conclusion instead.

    What your example completely fails to appreciate is that there are degrees of evidence. When the evidence is weak and contradictory, only weak conclusions may be drawn (e.g. “maybe this works”). The stronger the evidence, the stronger the conclusion, and the more contrary evidence must be amassed to overturn it.

    Do we know anything for certain? No. Do we know some things to a very high degree of confidence? Yes. Is one of those things that homeopathy has no effect beyond placebo? Yes. Could anything other than the very highest quality of evidence contribute to overturning that conclusion? No.

  51. libby says:

    Scott:

    I would find conventional drugs more palatable if the drug companies were honest.

    I was given Zomax for pain relief after a dental operation. One month later it was recalled. Since McNeil Pharmaceuticals knew there were problems with the drug, they should have said something like:

    “Zomax will take care of your pain. Then again it might kill you. Either way, your pain will be taken care of.”

    But if you’re comfortable with the safety record of drug companies, by all means use them.

    Good Luck!

  52. Harriet Hall says:

    libby,

    The Zomax manufacturer DID say something like that. In pre-marketing studies they found that aspirin-allergic patients could have anaphylactic reactions to Zomax. There was a warning in the package insert telling patients who were allergic to aspirin not to take Zomax. After getting an alarming number of reports of patients who had anaphylactic reactions to Zomax but were not allergic to aspirin, the company voluntarily recalled the drug. The company can certainly be criticized for being too slow on the uptake and for waiting for better confirmation before acting on initial reports. But that doesn’t mean every drug sold by every manufacturer is unsafe. Would you throw out an entire barrel of apples just because a few of them were rotten?

    Are you sure you can trust homeopathic manufactuers?
    (1)There was a recent report of babies developing symptoms of belladonna poisoning from taking a not-very-dilute homeopathic teething remedy. The FDA, not the company, tested the product and found inconsistent amounts of belladonna. The FDA, not the company, recalled the remedy. The company tried to do damage control with a poorly argued defense.
    (2) I read one confession from a technician who prepared homeopathic remedies: he admitted that he and his co-workers got tired of all the dilution/succussion work and just filled some of the bottles with tap water.

    Zomax was recalled because of a small risk of serious side effects and even death; but it was an effective product that had advantages over other painkillers. Homeopathic remedies may be entirely safe, but science has not shown them to be more effective than placebo.

    If you are convinced a homeopathic remedy has helped you, it is rational to keep using it. Consistently choosing homeopathic remedies over prescription drugs because of a fear of drug company malfeasance is not rational.

  53. libby says:

    Harriet Hall:

    The story about McNeil Pharmaceuticals and Zomax is a little more complex.

    From the New York State Trial Lawyers Association:

    http://webcache.googleusercontent.com/search?q=cache:4cgOoa_v_7UJ:www.nystla.org/index.cfm%3Ffuseaction%3Darticle%26articleID%3D1143+zomax+washington+post&cd=3&hl=en&ct=clnk&gl=ca&source=www.google.ca

    The article deals with secrecy agreements and I have pulled a number of sections from it (in quotes):

    “…secrecy agreements have caused a broader harm to society because they are “increasingly being used to prevent debate about critical problems of public safety and policy”.

    “Secrecy agreements are used in a wide variety of civil actions for personal injury and wrongful death compensation.”

    During pre-trial, trial and post-trial periods, secrecy mechanisms can be invoked in spite of the impact on public safety:

    “During the pre-trial discovery phase, a judge may be asked to issue a protective order which forbids the plaintiff from sharing information disclosed during the case with anyone, even government regulators.”

    “At the conclusion of a trial, a defendant can request the plaintiff to agree to an order to seal all records in a case, including all exhibits and transcripts. Sealing orders can go so far as to remove all trace that a lawsuit even existed.”

    “After a trial, a defendant can ask for a confidentiality agreement that prohibits victims from saying or revealing anything publicly about the case. A confidentiality agreement can prohibit a victim from cooperating with government safety regulators and even law enforcement agencies.”

    “Secrecy agreements can also help a manufacturer of a defective drug, medical device, auto, or other consumer product to “hide” information from a federal regulator with the authority to ban or recall the product.”

    Drug companies along with other corporations have fought the Sunshine in Litigation Act that would prevent secrecy if in the public interest.

    And Zomax is one of the examples used in the article:

    “In an article on the use of secrecy agreements to settle claims against McNeil Pharmaceuticals for injuries linked to its painkiller Zomax, the Washington Post quoted an attorney for one of the patients candidly summing up the dilemma lawyers confront: “The problem is that they have a gun to your head. The client is concerned about being compensated in full. The lawyer must abide by the concerns and wishes of his client….not the fact that [information will remain secret or] other victims may be injured.”

    “Another attorney told the Post, “What they [McNeil Pharmaceuticals] are trying to do is not be accountable to the vast majority of the public for what they’ve done…. They paid my clients a ton of money for me to shut up.” …..

    “When it was withdrawn from the market in 1983, Zomax had been sold for only 28 months, yet its manufacturer, McNeil Pharmaceutical, had received hundreds of reports of severe allergic reactions from this prescription painkiller. The FDA believes that Zomax was probably a factor in 14 deaths. Seniors who were suffering from arthritis were the main users of this drug.” 





    “The company used protective orders and confidentiality agreements to prevent disclosure of information the company had given during numerous lawsuits filed by Zomax victims. A Washington Post article published several years after the recall noted that documents that were still being kept secret included “indications during pre-marketing that Zomax might cause a severe allergic reaction…which can lead to seizures and respiratory failure.” The Post reported that, while notice about the danger was included nine months after the drug went on the market, “one internal memorandum to the company’s president criticized the company for not acting sooner”. The wife of one person who died said she had settled her case without knowing about a meeting where McNeil doctors had “declared their lack of confidence in Zomax’s safety”.

    So when you say that “The company (McNiel Pharmaceuticals) can certainly be criticized for being too slow on the uptake and for waiting for better confirmation before acting on initial reports. But that doesn’t mean every drug sold by every manufacturer is unsafe. Would you throw out an entire barrel of apples just because a few of them were rotten?”

    I agree with you that not all drugs are dangerous. But when you refer to a few bad apples, how would you know that? Since courts can muzzle any information at the bequest of the defendant, there is NO WAY YOU CAN KNOW what or how many drug companies have been through litigation and managed to keep things quiet, AND continue to sell the product in question.

    There are protective orders, the sealing of records, secrecy agreements, confidentially agreements, and protective orders that protect the industry.

    My question is why have drug companies fought to maintain secrecy if public safety is a priority? That makes no sense.

  54. libby says:

    Harriet Hall:

    I cannot check your sources on the belladonna remedy because you left no link nor did you mention the company in question. And what was the recent report from?

    More info please.

  55. daedalus2u says:

    Libby, if you do a google search on

    belladonna homeopathic teething

    6 of the 10 links on the first page are to the recall of the teething tablets due to dangerously inconsistent levels.

  56. Harriet Hall says:

    @ libby,
    Here is the FDA consumer update about the belladonna incident: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm230762.htm

    “why have drug companies fought to maintain secrecy if public safety is a priority?”

    Because, of course, companies want to make money and avoid lawsuits whenever possible. The other side of the litigation coin is that the courts have awarded huge damages to patients where science could show that the product was not at fault, and publicity about an ill-advised verdict could lead to copycat suits that would bankrupt the company.

    Companies may get away with doing bad things in the short run; but in the long run, it is always in their own best interests to sell safe products. Over the long run, if a company covered up facts and kept selling a dangerous product, people would die and no matter what the company did, the truth would come out eventually. Rather than assuming all the apples are bad, I think there is reason to assume most of them are good. The longer a drug has been on the market, and the larger the number of people who have taken it, the less likely it is that it will turn out to be unsafe. I certainly agree with you that coverups and abuses should be stopped, but I think you are over-reacting.

  57. Chris says:

    I remember those homeopathic teething tablets! I used to see flyers for a student study on those things.

    Perhaps Libby would be interested in making her own homemade homeopathic remedies. That way she can make sure Big Pharma outfits like Boiron Homeopathic Medicines do not profit any further.

  58. libby says:

    I think you are all missing the point.

    We cannot expect that all drugs that are marketed are harmless. That would be an unreasonable demand.

    It’s the methods by which pharmaceutical companies COVER UP, or SUPPRESS safety information, by legal means, through the courts in an attempt to protect profits. Their options are many as noted before: protective orders, the sealing of records, secrecy agreements, confidentially agreements, and protective orders. According to the NYSTLA in my previous post, this has become a considerable problem within the drug industry among others.

    In the Hyland belladonna matter, I did not see where the company intervened through the courts to subvert attempts by the FDA to step in and handle the matter. In fact it appears that the FDA had free reign to deal with the issue to protect the public. That is what should happen. Regulatory bodies should be able to act unfettered.

    That in no way let’s Hyland off the hook for being sloppy about their product.

    The FDA stated that there were “serious adverse events”. But they also reported that “children…..consumed more tablets than recommended, because the containers do not have child resistant caps.” The FDA also said that belladonna is “a substance that can cause serious harm at larger doses” By the way carrots are toxic in high doses, just put it in perspective.

    If that’s the worst case that could be dug up, that’s hardly a condemnation of the safety of homeopathy in general.

  59. libby says:

    Chris:

    I am always in favour of self-reliance when possible. As far as I know there are no patents on homeopathic products so there are no legal barriers.

  60. weing says:

    “It’s the methods by which pharmaceutical companies COVER UP, or SUPPRESS safety information, by legal means, through the courts in an attempt to protect profits. Their options are many as noted before: protective orders, the sealing of records, secrecy agreements, confidentially agreements, and protective orders.”

    So, your beef is with the legal system that allows this? Most of the members of congress are from the legal profession. Look, we all want transparency in the system of drug testing and approval. Doctors do not have the financial wherewithal to influence senators and congressmen like big pharma or big homeopathy even. If we did, you wouldn’t have the waste of taxpayer dollars on CAM, never mind reliable safety and efficacy data on pharmaceuticals. We have to take the results of the studies given us with a grain of salt. When it comes to homeopathy, with a salt mine.

    BTW, I never prescribed zomax. Patients seemed to like it too much and would ask for it by name. That has always been a red flag for me.

  61. libby says:

    weing:

    “So, your beef is with the legal system that allows this?”

    I know the NYSTLA article is long but it is worth a read.

    Drug companies have not been in favour of the Sunshine in Litigation Act and have LOBBIED against it. The Act would create transparency within the system in the interests of public safety, allowing gov’t regulators to do their job unhindered.

    Clearly that is not what drug companies want. Are they interested in the safety of their products or maintaining the legal protections of secrecy in place that inhibit transparency?

    Here are their complaints with the Act by the drug companies, etc:

    - The Act will have a chilling effect on parties who might otherwise wish to settle (There is no evidence for this);

    - The Act would result in an influx of cases into an already overburdened judicial system (The opposite is true in the few States that have passed the Act);

    - The Act would allow sensitive trade secrets to be revealed to competitors (The Act deals with that issue);

    - Secrecy agreements are private matters (The public’s right to know overrides this. Profits are less important than public safety).

    Given this stance by the drug companies, there is little room for concern over public safety.

  62. libby says:

    weing:

    “Doctors do not have the financial wherewithal to influence senators and congressmen….”

    Let’s think outside the box a little bit.

    Doctors don’t have to spend millions lobbying politicians behind closed doors. As a group they could influence policy by making their views known to the public, demanding that companies be transparent by supporting the SLA.

    If you say nothing then nothing will happen. The worst case scenario: no more gifting from the drug company.

  63. Chris says:

    libby:

    I am always in favour of self-reliance when possible. As far as I know there are no patents on homeopathic products so there are no legal barriers.

    So you are going to make your own Nat Mur. More power to you!

    I understand that the sugar pills used by Boiron are the same as the little white non-pareils used in cake decorating. Once you have finished diluting and shaking to a 30C dilution, you don’t even have to sprinkle the little sugar balls with the stuff. It apparently works if you just set the bottle next to the container of cake decorating sugar balls, apparently mysterious “quantum forces” transfer the healing powers to the sugar.

    Good luck. And do tell us how it works the next time your child has a high fever and/or strep throat.

  64. weing says:

    “Doctors don’t have to spend millions lobbying politicians behind closed doors. As a group they could influence policy by making their views known to the public, demanding that companies be transparent by supporting the SLA.”

    How quaint! You still believe in the system.

  65. libby says:

    Chris:

    As Noam Chomsky says, the mud-slingers always win.

  66. libby says:

    weing:

    “How quaint! You still believe in the system.”

    I used to say stuff like that until someone told me to stop whining, relating a story about migrant farm workers in California working under horrendous conditions. They organized and eventually got better pay, better working conditions, and benefits.

    And these were poor, uneducated Latinos who didn’t even speak English.

  67. weing says:

    “They organized and eventually got better pay, better working conditions, and benefits.”
    Anti-trust laws forbid us from organizing.

  68. Chris says:

    Perhaps you would prefer the Benveniste’s method where the homeopathic remedies are literally phoned in.

    Where have I slung mud? How does it compare to your comments on doctors, pharmaceutical companies and others?

    Absolutely everything I said is true. I showed you how the remedies are made, and I have seen actual homeopaths claim you can create the sugar pill remedies by setting them next to the bottles on forums like hpathy. I have seen the teeny tiny pills in little bottles sold by Boiron, and they are just like stuff sold to decorate cookies and cakes.

    Do you still not understand how homeopathy and its industry are so ridiculous? It is not “herbal” medicine. It is “western medicine, because it originated in Germany (unless it got moved elsewhere). It has not changed in two centuries, while real medicine constantly changes (example: one of Hahnemann’s “miasm” is “syphilis”, how is that disease presently treated?). And companies like Boiron and Hyland are raking in cash just as much as “Big Pharma.”

    Earlier you said:

    I don’t know of any side effects or deaths from homeopathy. I could be wrong.

    Oh, you are very very wrong. The harm comes from using homeopathy instead of real treatments. Like treating syphilis with homeopathy instead of antibiotics. Or treating diabetes,epilepsy or severe eczema with homeopathy instead of real medicine. You should look up where a homeopath ended up after trying to treat his daughter for eczema. You will find little Gloria’s story here:
    http://whatstheharm.net/homeopathy.html

    Claiming that certain parts of medical industry is bad, does not in any way prove homeopathy works. In order to prove homeopathy actually works better than placebo, you have to prove it. You have to show that it works for non-self-limitiing conditions, and not with anecdotes.

    One way would be animal testing for a bacterial infection. Divide them into three groups, give one group your favorite homeopathic medicine, give another group antibiotics and then nothing for the final group. Record the results. One homeopath, Andre Saine, claims homeopathy works better for rabies than convention methods. That is one condition you can try in an animal study.

  69. libby says:

    weing:

    “Anti-trust laws forbid us (doctors) from organizing.”

    The anti-trust laws you refer to only concern independent contractor physicians, and deal with the restriction on collective bargaining for medical services.

    It is sheer confusion to mix anti-trust laws designed to promote competition with the doctors constitutional right of free speech to collectively express concerns about transparency within their field.

  70. weing says:

    It sure is. (sigh)

  71. libby says:

    Chris:

    I think you misunderstand me.

    By resorting to mud-slinging, you have eroded the position of those in your camp.

  72. Chris says:

    I am sorry, how is explaining what homeopathy mud slinging compared to you denigrating the entire medical and pharmaceutical community?

    You really don’t know what homeopathy is, do you?

  73. weing says:

    “As Noam Chomsky says, the mud-slingers always win.”

    Is that prescriptive or descriptive? It would explain the bashing, i.e., mud-slinging of science based medicine by the CAM artists, Fox News by liberals, etc. Personally, ad hominems don’t work for me. I need evidence.

  74. daedalus2u says:

    Chris, you are slinging homeopathic mud. To a homeopath, that is the worst kind of mud. So powerful that it will always win. ;)

  75. Chris says:

    I suspect that libby really does not know much about homeopathy. She has claimed it is not part of “western” medicine, so she does not know it was thought up by Samuel Hahnemann in the early part of the 19th century in Germany. Last I checked, Germany is considered a “western” country (and I should note that “western” medicine is a silly term considering all of the modern advancements from places like Japan).

    I have read part of Hahnemann’s Organon (it is available online in several places) where he says that even though it does not make sense, the remedies get stronger when they are diluted more. He did not know about Avogadro’s number, so he would have had no idea that anything past 24X or 12C would not contain one molecule of the supposed healing substance.

    I think it is fascinating that Hahnemann had a theory about miasms, some with names like “psora”, “gonorrhea” and “syphilis.” There are probably more, but what I find interesting is that these “miasms” are recognizable conditions: a skin problem and what we now know are a pair of bacterial infections. One of those bacterial infections, syphilis, is not self-limiting, and actually causes severe mental deterioration after a long while.

    Hahnemann claimed his homeopathic methods worked better for syphilis, which is probably true for his time. Two centuries ago mercury and other odd things were used for syphilis, and perhaps brought on neurological symptoms and death quicker than the bacteria. But medical science advances, and antibiotics are now the first line treatment for syphilis, not homeopathy.

    I sincerely believe that libby did not realize the most common homeopathic dilution, 30C, is one part remedy to 10^60 parts of solvent. By the way 10^60 is a one with followed by sixty zeros, or all the water in our solar system. Or that between each dilution the remedy must be succussed by banging on a leather bound book, usually a Bible.

    But if she really really believes that homeopathy is real, and not placebo or a form of sympathetic magic: there is prize of one million dollars to anyone who can take two unmarked bottles of homeopathic remedies and figure out which is which. She can find out about the challenge, and discuss the issues of homeopathy with folks who are much more knowledgeable than me at in this forum.

    Otherwise, she can read more here.

  76. Chris says:

    Or libby could read the article by Scott Gavura with a bit better comprehension, where he also describes homeopathy, but with terms like “absurd” and “impossible.”

    I merely tried to show how it is made in a tongue in cheek manner, which she seems to think is “mudslinging.” But a similar, and done very seriously, article is up by a homeopath: How To Make Your Own Remedy. It clearly shows how silly the stuff is. The author, Elaine Lewis, was the subject of many discussions on the JREF forums.

    Now I must go back to putting nylon footies on my apples and pears to keep the apple maggots and coddling moths away.

  77. libby says:

    Chris:

    I enjoyed your link to whatstheharm.net, not for any information it provided but for the entertainment value.

    The case of Susannah McCorkle was the most stirring. Battling cancer and depression, and having a father and sister both dealing with depression as well, she went on pharma antidepressants, but stopped because of side effects. She consulted a homeopath and then decided to “redo her apartment”. But then she fell on further hard times: mother had a heart attack, record label cut her back, a promised loan never materialized, lost her long-term singing job at a venue. In this environment she decided to take “Tegretol just prescribed by a psychopharmacologist.”

    Four days later she committed suicide.

    Cause of death according to this esteemed website? – Homeopathy of course. The Tegretol had no bearing on her death even though she took that only days before. Nor did anything else in her life. Had to be homeopathy.

    Very funny stuff.

  78. libby says:

    weing:

    I totally agree with you. I’m not a fan of bashing even when it’s coming from my side of the fence.

    I suspect people resort to it when they can’t present a cogent argument. It’s a short cut to win applause from their peers.

  79. Chris says:

    libby, an interesting personality if you thought the deaths of small children who had real medical treatment withheld is entertaining. There were reports that nine month old Gloria Thomas was screaming in pain on the airplane between Australia and India (where her father consulted more homeopaths, and her mother sought real medical treatment for herself).

    You cannot prove homeopathy by telling us over and over that real medicines don’t work or that pharmaceutical companies are corrupt. You must prove it by showing that it works.

    Show us the real data that shows a homeopathic remedy works for a bacterial infection, which is what eventually killed the baby. Or show us that homeopathy works for seizures, because they did not work for Isabella Denley. Make it clear you know something about homeopathy.

  80. libby says:

    Chris:

    “There were reports…..”

    Really? Must be true then because everybody knows that hearsay is always true.

    “You cannot prove homeopathy by telling us over and over that real medicines don’t work or that pharmaceutical companies are corrupt. You must prove it by showing that it works.”

    Already provided. You didn’t bother to read the thread that you joined did you?

    In any case as entertaining as you are with your rubbish website links, it’s time to move on.

    Good Luck!

  81. libby says:

    General Comment:

    Would the people on this board please discontinue providing links to specious websites. Those such as whatstheharm.net are just atrocious.

    As well, Wikileaks is adequate to give someone an overview on a topic, but it is of no value as a legitimate source to prove a point. The authors are anonymous and often the information is suspect.

    All of my links were from bona fide sites but in many cases I was sent on ridiculous journeys through mountains of nonsense. Not all as Harriet Hall and pmoran only presented worthwhile material, and that is much appreciated.

    Hopefully this will save my time in the future.

  82. libby says:

    Correction:

    Sorry. Wikipedia, not Wikileaks

  83. For readers who are interested, this is the newspaper article outlining the trial of the parents of Gloria Thomas who died from an eye infection and eczema that the parents repeated refused conventional medicine for until it was too late.

    http://www.smh.com.au/national/parents-guilty-of-manslaughter-over-daughters-eczema-death-20090605-bxvx.html

    Libby seems think that the testimony in court of witnesses to the child’s pain and condition is “hearsay” or mudslinging. It appears that the Australian court did not agree.

  84. libby says:

    micheleinmichigan:

    “Libby seems think that the testimony in court of witnesses to the child’s pain and condition is “hearsay” or mudslinging. It appears that the Australian court did not agree.”

    That is one of the most confused statements I’ve seen in a long time.

    The courts make a clear distinction between hearsay and testimony. When you relate what someone else said that is hearsay. When you relate what you experienced or saw, that is testimony.

    Back to your belief that doctors have no choice in prescribing medicine and therefore cannot steer their prescriptions away from rogue companies. Apparently JAMA is on my side, so that argument has no basis.

    Doctors who are gifted by drug companies are prone to prescribe more medicines from that company over others, even if it costs the patient more money. As you will see below, not only do doctors have a choice in prescribing, in contrast to your unsupported statement that they don’t, gifting affects the prescribing.

    What I was saying to you was why don’t doctors prescribe in support of more honest companies that don’t suppress safety concerns rather than according to which companies gift the most.

    http://jama.ama-assn.org/content/283/3/373.abstract?ijkey=a7b027dcab3a4d2c18c5cfaf8fd2b924f979cfdc&keytype2=tf_ipsecsha

    Highlights from above link:

    QUOTE

    Data Synthesis

    …..Attending sponsored CME events and accepting funding for travel or lodging for educational symposia were associated with increased prescription rates of the sponsor’s medication. Attending presentations given by pharmaceutical representative speakers was also associated with nonrational prescribing.

    Conclusion

    The present extent of physician-industry interactions appears to affect prescribing and professional behavior and should be further addressed at the level of policy and education.

    UNQUOTE

  85. Libby, I think it’s important that people who read this comment thread have access to reports of the trial regarding the death of the infant Gloria Thomas. I posted the link.

    You may read the report or not.

    You and I both have had adequate time to discuss issues of a patient rights to access the most appropriate medication for their condition. I see no reason to take further time or bandwidth rehashing.

  86. WilliamLawrenceUtridge says:

    “Real medicine is corrupt therefore homeopathy works.”

    Hm…argument fail.

    “Real medicine is corrupt therefore I prefer to take homeopathic preparations because of the lack of effects.”

    That’s more of a valid argument, even if it’s a logic fail.

    Medicine has effects; the ones we don’t like are “adverse effects”. Homeopathy has no effects, therefore is much safer than medicine. Unless you’re talking about medicine that prevents you from dying. Though in that case, you die from the condition/disease/whatever rather than the side effects, but whatever.

    If you really want to prevent companies from corrupting medical practice, should we support state-sponsored drug development? Use taxes and any profits from drug sales (if any) to fund further research. Of course, this would probably slow the development of new drugs considerably, and reduce innovation a fair bit. The balance between safety, profit, effectiveness and adverse effects is not an easy one, and will always be fraught with flaws, reactionary policies, regulatory burden and liars (unlike homeopathy of course, with its perfectly safe, dubiously effective products that completely lack direct-to-consumer marketing and political influence issues Harkin).

    Libby appears to be asking for some sort of platonic ideal of medicine where all treatments are risk-free and no company ever puts profit ahead of customer health. Sadly, that’s not reality. About the only thing that would work would be a thousand years of intensive breeding programs to eliminate genetic susceptibility to disease followed by mandatory exercise programs.

    So I guess what Libby is arguing for is the Third Reich.

    And I’ll be damned if I argue with a Nazi.

  87. libby says:

    WilliamLawrenceUtridge:

    You state: “So I guess what Libby is arguing for is the Third Reich.
    And I’ll be damned if I argue with a Nazi.”

    Well I guess that’s the death knell for critical thinking on this board.

  88. libby says:

    micheleinmichigan:

    “You and I both have had adequate time to discuss issues of a patient rights to access the most appropriate medication for their condition. I see no reason to take further time or bandwidth rehashing.”

    That’s because I proved your point wrong. Doctor’s do have a choice and you claimed that was incorrect.

  89. Chris says:

    libby, the paper titled “Physicians and the Pharmaceutical Industry” does not show that homeopathy works.

    Please provide the evidence that homeopathy works for non-self-limiting conditions. And just to be consistent, do it for the miasms that Hahnemann wrote about. Please post the journal, title, date and authors of the papers that prove homeopathy is effective for:

    1) psora, like the eczema that caused the bacterial infection that finally killed the nine-month old baby.

    2) syphilis

  90. Chris says:

    libby:

    Already provided. You didn’t bother to read the thread that you joined did you?

    I did read the entire thread. Uh, no. You pointed a paper that was already dismantled by this blog. Try harder, and answer my specific questions.

  91. Libby, I’ll try to be clear. I think it’s creepy that you commented that you found entertainment value in the story of a child’s death.

    I have no stomach for pursuing a discussion with someone who would write that.

    I wanted readers to know about the facts of the case, so I posted it.

  92. Chris says:

    You did read the article you were pointed to, right?

    And leptospirosis is not syphilis. Nor is it the bacteria that killed the baby with eczema.

    So please, answer my question with real evidence. And then you can explain to us exactly how something diluted to where only the solvent (water, alcohol, sugar) can actually be effective outside of placebo effects. Use real evidence not cries that something else is corrupt.

  93. WilliamLawrenceUtridge says:

    Libby, the death knell was signed when you thought that the failings of modern medicine somehow justified homeopathy.

    Homeopathy either works, or it doesn’t.

    The whole “modern medicine is flawed therefore homeopathy FTW” approach didn’t work when creationists attempted to use the same flawed argument to justify biblical literalism by criticizing (and really just misunderstanding) the alleged failings of evolution.

    If homeopathy really works, then it should be easy to demonstrate it. The results should replicate 19 times out of 20 (the current results are perhaps 1 time out of 20, and those numbers are meaningful if you understand statistics). We should see a consistent, positive pattern. The research should converge towards a single, unarguable finding that is demonstrated in nearly every study. After 200 years, the Cochrane review should be debating which variations, combinations and permutations work best for specific conditions, not wondering whether there is actually a result.

    Pharmaceutical companies are flawed (for the purposes of making perfectly safe, evidence-based medicines) entities driven by profit. No-one here argues that point. But they are also required to demonstrate their products work. In the United States, homeopathic preparations are not. They were grandfathered into the current regulatory system with a free pass. Since they’re worthless and therefore do no harm, they’re never going to be pulled due to adverse effects (and they shouldn’t be – it is like banning sugar because they are just sugar).

    But if you want to test out your anecdote, the next time you go to see a homeopath, maybe you just have a nice little talk and don’t fill their “prescription”, and see if you get better despite not dissolving some sugar under your tongue.

    If you’re looking for ancient medical systems of deep wisdom, I suggest you try Egyptian. It’s older, there’s some meaningful interventions in there, and you can impress your friends with your home-made crocodile dung prophylactics. Plus, you get to chant.

    But whatever you do, don’t bother trying to justify your decisions through science. You’ve clearly made a political, Noam Chomsky-based, anticapitalist, Naomi Klein-inspired decision. You’ve chosen the answer you want to arrive at, damn the evidence. Stick with it! Why bother pretending this has anything to do with clinical trials? They’re confusing, and it’s much simpler to make your decisions based on a heuristic and a slogan. Now can you go away? We’re trying to talk about real science, and that requires dealing with reality.

  94. WLU – “Since they’re worthless and therefore do no harm, they’re never going to be pulled due to adverse effects (and they shouldn’t be – it is like banning sugar because they are just sugar).”

    except in the cases when an item is labeled homeopathic, but has actually has active ingredients, such as the zinc in Zicam, which the FDA recommended be recalled. The company declined.

    “An F.D.A. warning letter sent to Matrixx on Tuesday states that Zicam Cold Remedy intranasal products “may pose a serious risk to consumers who use them” and are “misbranded.” Such language would normally describe a recall alert. The products have no proven benefits.

    Matrixx has received more than 800 reports of Zicam users losing their sense of smell but did not provide those reports to the F.D.A., said Deborah M. Autor, director of compliance in the agency’s drug center.”

    http://www.nytimes.com/2009/06/17/health/policy/17nasal.html

    here’s the best part “Matrixx had $101 million in sales last year, of which $40 million came from Zicam products. Because Matrixx has called Zicam a homeopathic product, the company was not required to seek agency approval before selling it.”

  95. Chris says:

    libby has also decided to play arbitrator of what evidence can be used with her telling us (!) not to link to “whatstheharm” for no apparent reason. Perhaps because, even though it is a flawed collection of anecdotes, it does show real harm from eschewing real medicine for homeopathy.

    libby, you might like this website:
    http://www.howdoeshomeopathywork.com/

  96. weing says:

    “Attending sponsored CME events and accepting funding for travel or lodging for educational symposia were associated with increased prescription rates of the sponsor’s medication. Attending presentations given by pharmaceutical representative speakers was also associated with nonrational prescribing.”

    I remember that article. I couldn’t figure out what rational prescribing was supposed to be. Does it have anything to do with rationing? Anyway, since I read that article, I have told the pharma reps that I refuse to be bought for pens, notepads, etc. If they want to buy my prescriptions, it’s going to cost them. I want a mansion in the Hamptons and cash payments of $1million a year. Haven’t had any takers yet. I keep hoping though.

  97. yeahsurewhatever says:

    “empirical evidence in support of homeopathy would have to be particularly robust”

    I don’t think Smith goes far enough here, really. Given that, for homeopathic logic to be true, the current concepts of evidence and reason would have to be more or less scrapped and rewritten, I think it’s literally true that there is no possible evidence which could vindicate the homeopathic principles of similars and infinitesimals. Even if their treatments were found to work quite well and consistently, despite having no active ingredient, those principles could not be the reason why.

  98. pmoran says:

    Libby, it is impossible for those studies to distinguish between doctors prescribing a certain way because of the “bribe” and doctors doing so because they have been supplied with false information.

    In the latter case the doctors are choosing one of many almost identical drugs because they have been led to beleive it is better, or one that is not sufficiently well established to have the effects claimed, but which fills a hole in the medical needs of the doctor’s patients.

    It is not a desirable thing in either case, but I think the implications are invariably overstated. The doctors I know are more ethical than this implies.

  99. pmoran and weing – I’m curious how current the information in the paper is. I notice that it is from 2000. In 2003 and 2005 our family hospital implemented a policy that banned gifts, “souvenirs”, food, drink, etc to clinicians from drug reps as well as other policies that are modeled after the AMA opinions on ethics and drug companies representation.

    It seems to me that I have heard of other hospitals in the area taking up similar policies.

    It seems stuffed animals with medication emblems may be becoming a thing of the past.

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