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

  1. WilliamLawrenceUtridge says:

    MIM – thanks very much for correcting me, if that weren’t the most depressing thing ever, that’d be awesome. The thing is, if homeopathy were a rational system or approach, that would lead to a recall of at least a subset of products. However, since homeopathy is an inherently irrational system, there’s no way of “rationally” recalling it or enacting safety precautions.

  2. weing says:

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

    They are becoming collector’s items. I plan to sell off all my pens and stuffed animals on eBay at some time in the future. That’s my retirement plan. :)

  3. “They are becoming collector’s items.”

    hmm, I used to have a green parrot stuffed animal with some sort of unpronounceable drug name embroidered on it that my son was given after his first surgery. I kept it because it was so funny. I wonder if it’ll be worth anything.

    Of course, the hospital discontinued accepting that stuff, so now the kids are given small toys from the non-profit that collects for the kids and handmade blankets from local crafters.

    Better watch out for big grannie, she exerts undue influence.

  4. libby says:

    micheleinmichiganon

    You state: “Libby, I think it’s creepy that you commented that you found entertainment value in the story of a child’s death.”

    If you can’t win the argument on its merits, then start slinging mud.

    Goodbye and Good Luck!

  5. libby says:

    WilliamLawrenceUtridge:

    You are bringing up interesting points, the most important being that the system must not be challenged. In fact I believe you called me a Nazi and supporter of the 3rd Reich, or something like that.

    if I say that physicians prescribe in favour of companies that gift them, and reference it with JAMA, I’m a Nazi.

    If I tell you that I was given Zomax, a drug from McNeil Pharmaceuticals, a company that had been in litigation and fought to have the payments to victims concealed from federal regulators and doctors and purposefully exposed me to a dangerous drug, and reference that with the NYSTLA, I’m a Nazi.

    If I follow the trail of Avandia which led to 14 deaths and discover that safety information was suppressed, I’m a Nazi.

    If I ask why doctors do not support the Litigation in Sunshine Act that would prevent drug companies from using the courts to hide safety concerns, including death, I’m a Nazi.

    If I question the conclusions of the Lancet study of 2005 on homeopathy that found it no better than a placebo, I’m a Nazi.

    If I question our lack of knowledge of the Cuban health system, I’m a Nazi.

    The only way I can avoid being a Nazi is to say that drug companies are doing the best they can but sometimes errors occur, that gifts to doctors from drug companies are just one of those things, and that doctors are too tired to overworked to be expected to demand drug companies be better at what they do, that the Lancet is always right, and that Cuba is full of a bunch of lying Communists.

    The problem is, I don’t believe any of that is true.

    So I guess that makes me a Nazi.

  6. libby says:

    pmoran

    Thanks again for your post.

    Since you are involved in the medical field there is some comfort in what you say, that doctors are minimally affected by gifts.

    But there still remains the question as to why the drug companies spend $21 billion dollars a year (from memory so is only approxiamate) in the US. It’s hard to believe that companies will spend that kind of money with the expectation of nothing in return. That’s a lot of investor money.

    The University of Stanford medical department has abolished all gifting (except small items) claiming that even if there is no influence from gifting the perception by the public is that there is.

    What are your thoughts on the Sunshine in Litigation Act? I believe it has been passed in only a few States.

  7. Harriet Hall says:

    libby,

    You have hijacked this thread for your own purposes. Do you have anything to contribute about the homeopathy/placebo question?

  8. Chris says:

    She obviously has nothing to say about how homeopathy works. She only says she questions a study that says it works, but does not show any evidence it does work (other than a very flawed paper).

    By the way, my brother is moving to Cuba next month for a year. It should be interesting.

  9. libby says:

    Harriet Hall:

    Sorry but I don’t really respond well to bullying tactics.

    I also notice you have no problem with a lack of civility (Nazi references) as long as it is directed towards someone you don’t agree with. Apparently your view of a “civil discussion” (your words) only applies to your opponents and not to your jingoistic minions.

    You have made no attempts to demonstrate why my references about homeopathy didn’t live up to your standards other than to make Papalesque decrees that they were worthless.

  10. libby says:

    Let’s look at the Zomax issue:

    No one on this thread has responded to the Sunshine in Litigation Act in any positive way, although I am waiting for a response from pmoran on the topic. He is a special case, being a critical thinker.

    Do you not understand how important this Act is? It will prevent companies, any company, pharmaceutical, homeopathic, auto, electronic, from concealing safety information about their products through the courts.

    Now if this Act had been in place, I wouldn’t have been given the dreadful and dangerous drug Zomax, AFTER McNeil Pharmaceuticals had found out that there were safety issues that could lead to death, AFTER successful lawsuits had already taken place, AFTER payouts had already been made to victims and AFTER McNeil Pharmaceuticals had legally sealed all information about the litigation.

    Do I sound pissed. Well I am. I could have died from a god damned pain-killer. Sadly some people did. We’re not talking about risking side-effects to deal with a critical condition, we’re talking about pain.

    How many drugs are out that have had successful litigation against them and are still being prescribed by doctors? The fact is, no one knows, not doctors, not even federal health officials.

  11. Chris says:

    What does that have to do with homeopathy? What evidence do you have that diluting a substance to a level where none of the original material is present actually does anything?

  12. pmoran says:

    No one on this thread has responded to the Sunshine in Litigation Act in any positive way, although I am waiting for a response from pmoran on the topic.

    Sorry, I know nothing about the act you mention. It sounds like a reasonable idea.

  13. libby says:

    micheleinmichigan:

    Response (part 2)

    You stated “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.”

    Let me respond to this post because it is important.

    When I found it amusing that someone would blame homeopathy for a death when it was a pharma drug, not a homeopathic remedy, that was taken before the suicide of the adult musician Suzannah Chortle living in New York, micheleinmichigan makes the incredible claim that I was entertained by the death of an Australian child named Gloira Thomas.

    It’s hard to imagine what could possibly be going on in a mind that concocts such folly.

    It is not rocket science to distinguish between laughing at the tenuous attempts to blame homeopathy for a death, and laughing at the misery someone must have gone through that ended in death.

    To follow that logic, anyone who laughed at the folly of Bush’s attack on Iraq was not laughing at an ill-conceived policy by a man with limited intellectual ability, but was actually laughing at the thousands of people in Iraq along with US soldiers who were killed or maimed or dispossessed.

    Or again, anyone who laughed at the Monty Python skit involving cannibalism in the British army was actually laughing at the hapless victims of cannibalism practiced by the Korowai, Kombai and Asmat tribes of Papua New Guinea where this is still practiced.

  14. libby says:

    pmoran:

    “Sorry, I know nothing about the act you mention. It sounds like a reasonable idea.”

    I agree, although corporations are generally not too thrilled about it.

  15. libby says:

    Chris

    What does that (the fact that I was prescribed a proven dangerous drug by a conventional doctor) have to do with homeopathy? What evidence do you have that diluting a substance to a level where none of the original material is present actually does anything?

    Your lack of concern over the risk I took taking a prescribed pharma drug that was proven dangerous is duly noted.

  16. Chris says:

    It is not rocket science to distinguish between laughing at the tenuous attempts to blame homeopathy for a death, and laughing at the misery someone must have gone through that ended in death.

    Fortunately for you I used to be an aerospace engineer. I still don’t see how your statements on the failure of certain pharmaceuticals or the legislation surrounding them have anything to do with homeopathy.

    Your lack of concern over the risk I took taking a prescribed pharma drug that was proven dangerous is duly noted.

    You are using one anecdote of the Whatstheharm website, and ignoring the those who died from epilepsy, cancer, diabetes, sepsis and other conditions that real medicine actually works for. That is called “cherry picking.” Plus you are amused at the death of children due to not using proven medical interventions instead of homeopathy. At least irony meters are fictional.

    Your distaste of real medicine is duly noted. But in no way does that show that homeopathy is of any use other than placebo.

    If you have real evidence that homeopathy works for non-self-limiting conditions like syphilis and epilepsy, please present the journal, title, date and authors of the papers that support your opinion.

  17. Chris says:

    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 homeopathic drugs work for dental pain?

    We have noted in this thread that two so-called homeopathic drugs have been recalled for having ill effects on people, the one with that caused the loss of scent and the one that caused belladonna poisoning in children (neither one was truly “homeopathic”).

    I suggest the next time you have real pain, take some Nat Mur (salt) or Nox Vomica (strychnine plant). Personally, I prefer ibuprofen.

  18. weing says:

    “Now if this Act had been in place, I wouldn’t have been given the dreadful and dangerous drug Zomax”

    And you were damaged by zomax? In what way?

  19. libby says:

    weing:

    I stated “Now if this Act had been in place, I wouldn’t have been given the dreadful and dangerous drug Zomax”

    Your response: “And you were damaged by zomax? In what way?”

    This is a non sequitur. You seem to not understand the meaning of the word “danger”.

  20. WilliamLawrenceUtridge says:

    libby:

    Actually my overall point was the absurdity of your arguments – the only way your demands of risk-free treatments with zero chance of profit-based influence on medicine would be through an intensive eugenics program and an iron-fisted control of the economy and pharmaceutical industry by government. Please, read more closely.

    I don’t think the system should not be challenged. I just don’t think you’ll ever get the perfection that you seem to think is possible. I’ve actually said, on this board, that a better way of testing medicines would be to have pharmaceutical companies to deposit the funds needed to research their drugs into a neutral third-party (in my mind a separate government agency dedicated to just funding clinical trials) who would distribute the funds to independent researchers who are then free to publish their results without bias.

    You, on the other hand, are advocating homeopathy as if it were an alternative. Which shows an astonishing ignorance of science, a blind acceptance of pretty feel-good lies, an incredible lack of self-awareness in your criticism of drug companies because the spin study results while ignoring the fact that homeopathic manufacturers don’t have results at all. I mean, on one hand you say “wah, drug companies don’t tell the truth” while missing the fact that homeopaths blatantly lie.

    Yeah, drugs have side effects. Deal with it. Feel free to use homeopathy as a form of unqualified mental health care and a form of emotion-focussed coping. But don’t pretend that you care about science. You don’t, you’ve made up your mind, divided the world into good, happy homeopathic manufacturers and nasty, evil drug companies, when the real world is more complicated. We’re trying to deal with the real world here, where nothing is perfect.

    Have fun in lala land, and I look forward to the results of trying to treat a real illness with homeopathy instead of medicine.

  21. weing says:

    libby,

    You can have a potentially fatal allergic reaction to any, and I mean any, drug. So if you want to eliminate this danger, take no meds. Use plain water drops. Hope it works for you.

  22. libby says:

    weing:

    You state “You can have a potentially fatal allergic reaction to any, and I mean any, drug. So if you want to eliminate this danger, take no meds. Use plain water drops. Hope it works for you.”

    That’s why when problems arise there should be transparency. I would never have taken Zomax if the conventional medical field had been honest.

    Then again its hard to make mega-profits when you’re honest.

  23. libby says:

    WilliamLawrenceUtridge:

    You post is so full of lies and misrepresentations that it would take an hour to respond. Not worth the trouble.

    By the way, how’s the Nazi hunting going???

  24. weing says:

    “I would never have taken Zomax if the conventional medical field had been honest.”

    Since any medication has the potential to kill you, why would you take any medication? To enrich the pharmaceutical companies? Stick to drops of water for pain. You should have told your doctor that you refuse any medication and just want a few drops of water for the pain.

  25. weing says:

    libby,

    I am honest with my patients. I tell them that any and all medications have the potential to kill them. They also can help them with their symptoms or disease. I cannot tell them, in all honesty, that a homeopathic drug, i.e. drops of water, will help them. That would be a lie.

  26. WilliamLawrenceUtridge says:

    libby:

    Substitute “ignorance” and “illogic” and you’ve got my feelings on the matter. Good luck bringing about your perfect medical system where drugs have no risks or adverse effects. Please demonstrate your results through randomized, controlled trials, so the rest of the world can benefit from your brilliance. In the mean time, I’ll stick with what medicines exist now, which offer me true hope for cure or at least symptom alleviation, even if they are accompanied by side effects.

    Medicines aren’t perfect but at least they work. Homeopathy is just the most expensive sugar you’ll ever buy.

  27. libby says:

    WilliamLawrenceUtridge:

    I would use “feckless”.

  28. libby says:

    weing:

    “I cannot tell them (patients), in all honesty, that a homeopathic drug, i.e. drops of water, will help them. That would be a lie.”

    That is correct. That would be a lie.

  29. Harriet Hall says:

    libby,

    “I cannot tell them (patients), in all honesty, that a homeopathic drug, i.e. drops of water, will help them. That would be a lie.”
    That is correct. That would be a lie.”

    So did the person who recommended homeopathy treatment for your allergies lie to you?

  30. libby says:

    Harriet Hall:

    “So did the person who recommended homeopathy treatment for your allergies lie to you?”

    No

  31. WilliamLawrenceUtridge says:

    Libby, in what sense, lacking efficiency or irresponsible? Medications can lack efficiency in that their risk to benefit ratio is high. Depending on the condition this could result in the medication being scrapped – minor pain meds for instance. In other cases, such as chemotherapy, it may have a very close risk:benefit ratio, but if there are no other choices, you take the risk.

    If you are speaking of irresponsibility, then again drugs are at an advantage to homeopathic remedies if we’re still talking about them. Promoting homeopathic remedies is irresponsible since there is no evidence, or reason to believe, there is any effect beyond a mental one (mostly that long, lingering, heartfelt consultation with the practitioner; if you buy them off the shelf, you’re wasting your money because the benefit is from the unconditional positive regard of the practitioner, perhaps with a soupcon of emotion-focussed coping).

    Drugs, meanwhile, must demonstrate their effectiveness, and log side effects. There is extensive after-market testing. There are voluntary and involuntary recalls of drugs, and careful monitoring. The process to get approval is extensive and thorough, but imperfect. There’s a balance between profits, effectiveness, safety and patient need that is very difficult to manage. Your simple “drug companies are liars” critique acknowledges essentially none of this.

    Your example of Zomax doesn’t really help your case. It’s an NSAID, a highly effective one, but still ultimately a reliever of minor pain. A subset of patients showed unpredictable side effects, and it was withdrawn. I fail to see how this does anything but demonstrate the system worked – a drug was effective, it was released, rare side effects were acknowledged and it was withdrawn. What else do you want? If you demand perfect safety, or a profile that includes extremely rare adverse effects, then you must be prepared to pay a lot more for all medications. You’ll need much, much larger clinical trials, much more careful monitoring, and that means more expensive drugs as well as fewer drugs.

    So what do you want? Do you want even fewer new drugs arriving on the market? How much more are you willing to pay for medications? How long do you want it to take for a new drug to become available for cancer patients, or new antibiotics for infectious diseases? It’s not simple, it’s a trade-off. And all the buzzwords, all the snappy slogans, all the CAM apologetics, tu quoque and false dilemmas you offer are not solutions. It sounds good, but it’s shallow thinking, it’s not evidence, it’s not a solution and it doesn’t make homeopathy or any other CAM more effective.

  32. Harriet Hall says:

    @ Libby,

    “So did the person who recommended homeopathy treatment for your allergies lie to you?”
    No

    I’m intrigued. What did the person say? How did you decide to try it?

  33. libby says:

    Harriet Hall:

    “I’m intrigued. What did the person say? How did you decide to try it?”

    She said to try it and see if it works.

  34. libby says:

    Any decision to treat various medical conditions should be taken on an ad hoc basis, and that is how I deal with conventional medicine, homeopathy, and other fields.

    For example, our son was given homeopathy for asthma when the side effects from conventional medicine (cortico-steroid puffers) were severe enough to move away from it. Result: remarkable recovery over 2 weeks – condition never returned.

    My daughter took homeopathy for fibromyalgia because conventional medicine has no strategies for the disease other than emotional support. Result: no pain even after intense physical activity.

    I took homeopathy for hay fever because the side effects from conventional medicines were undesirable. I could also afford to deal with a number of failures knowing that I was risking nothing. Result: 95% effective over 6 seasons.

    I took homeopathy for kidney stones when conventional medicine strategy was pain killer and anti-inflammatory medicines. The condition of kidney discomfort remained with conventional medicine. Result: After 3 days discomfort vanished.

    Would I take homeopathy when a condition is outside its compass? Of course not. A good homeopath will tell you that certain conditions do not respond well to homeopathy. Is homeopathy always the first answer to a condition. Of course not. But after its success I certainly include it as an option.

    To show me studies about its ineffectiveness in double-blind, peer reviewed, science-based studies is unimportant to me personally because they must be wrong. If they were right, I would be experiencing NO benefits whatsoever.

    When I looked at the Lancet study of 2005, characterized by Richard Dawkins as the meta-analysis of meta-analyses on homeopathy, I realized that the methods of treating patients in the studies would result in failure because protocols were not followed. They didn’t even use homeopaths to evaluate which remedy should be used in each individual case. They used one remedy for all test subjects. That’s not science. That’s sheer confusion through ignorance. Richard Dawkins is now calling for a study that uses homeopaths where they evaluate each individual patient and assign an appropriate remedy. A study like that has NEVER been done.

    By showing me websites of people who abused their sick child through malnutrition, flights across the globe and back totaling 48 hours, and selecting homeopathy for a condition that didn’t respond to it, is not relevant to me, because I would never do that. No sane person would.

    Rather than establishing websites that set up battle lines and carrying on with endless YouTube style debates about why conventional medicine is the only path to health and everything else is snake oil, what would be beneficial for a patient would be a more cooperative environment. When conventional medicine fails (and within my family this has been common), admit the failure without vilifying other fields.

    Thanks for your time and good luck to everyone.

  35. weing says:

    “To show me studies about its ineffectiveness in double-blind, peer reviewed, science-based studies is unimportant to me personally because they must be wrong. If they were right, I would be experiencing NO benefits whatsoever. ”

    Your conclusion does not follow. You could still experience placebo benefits, your condition could resolve spontaneously too, it may have just run its natural course as most self-limited conditions do. You are then free to mistakenly attribute your recovery to homeopathy, prayer, or even science based medicine. You know the old canard? Without treatment your cold will last 7 days, with treatment only a week.

  36. Harriet Hall says:

    @libby

    “She said to try it and see if it works.”

    What if she had said to try bloodletting and see if it works? What if she had said to try a restrictive diet? What if she had said to try a tea made from dandelions? What if she had said to try standing on your head and see if it works?

    Surely you don’t just accept all recommendations; you clearly reject even science-based recommendations like dilating the pupils for an eye exam. So what are your criteria for deciding what to try?

  37. Harriet Hall says:

    @libby,

    You never answered my earlier question about whether any evidence could ever change your mind. What if the best possible kind of rigorous studies of individualized homeopathy you recommend were carried out and definitively showed that homeopathy didn’t work? Would you change your mind? Would you accept that your observations of improvement after homeopathy were due to factors other than the remedies themselves?

  38. WilliamLawrenceUtridge says:

    Libby:

    Asthma is frequently a self-limiting condition whose severity is strongly impacted by emotional arousal. Asthma can also appear and disappear over time, and can also be controlled by avoiding triggers to attacks. Two weeks is a long time for a result to appear, how do you know it didn’t just resolve on its own?

    Fibromyalgia has an unknown aetiology with a significant psychological component. In addition, pain is one of the most placebo-friendly symptoms around.

    Hay fever is an allergy, and allergies also come and go unpredictably. Try not taking homeopathy and see if your allergies have simply spontaneously resolved.

    Kidney stones also resolve on their own; for small stones treatment consists of pain management and drinking a lot of water.

    Every condition is compatible with homeopathy being a form of emotion-focussed coping; making you feel like you are in control while the disease spontaneously resolves itself. If you really want to know if homeopathy “works”, you can set up your own challenge-dechallenge-rechallenge clinical trial – have someone label and separate “real” homeopathic remedies and either water or sugar pills. Alternate the treatments on a weekly or daily basis, tracking symptoms as you go, then unlabel the two bottles at the end. If homeopathy is genuinely effective, then you should see a 1:1 correspondence. Submit your results to the James Randi million dollar challenge.

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