Guy, you have put your finger right on the button. It is fraud. Nothing else, just fraud. If we seriously want to get rid of these companies, all that is needed is for someone with deep pockets to file a complaint with the police. The simple way to prosecute the fraud case would be to get them to produce evidence of independent double blind trials showing that it works. Placebo effect is not proof that these so-called medicines work. Double blind trials were done some years ago in England and France by the Skeptics Society and as I remember, the placebo effect was considered the only active ingredient. We need to get rid of these pseudo-scientific leeches.

It shouldn't take deep pockets of an individual to prosecute fraud because it is a criminal matter, it should simply be the relevant level of policing (state or federal) doing their job.

Mike McRae - your cultural model doesn't excuse a huge multinational company form marketing littel bottles of water as "remedies" for children.

I don't see any "unsupported assertions on what needs to be done". I see general agreement that the scam should stop.

"... but medical subcultures determining what serves as adequate evidence in support of their respective views."

In Salem Massachusetts 1692, nineteen men and women, all having been convicted of witchcraft, were carted to Gallows Hill, a barren slope near Salem Village, for hanging. Another man of over eighty years was pressed to death under heavy stones for refusing to submit to a trial on witchcraft charges. Hundreds of others faced accusations of witchcraft; dozens languished in jail for months without trials until the hysteria that swept through Puritan Massachusetts subsided.

If you were accused, and you plead innocent, you'd have to face trial without a lawyer and without the ability to call witnesses on your own behalf, answer unanswerable questions ("If you're not a witch, how do explain the fact that these afflicted girls fall into fits the minute you enter the room?")--all before a court that unanimously believes in witchcraft and believes that you're guilty. (Even in the one case that the jury came back with an acquittal, the trial of Rebecca Nurse, the court sent the jury back to reconsider the verdict. The second time around, the jury found Nurse guilty.) You'll face spectral evidence--and how do you propose to convince the court that your apparition was not doing all this work on the part of the Devil? Just exactly what was your apparition doing on the night of April 23 while you were sleeping, anyway?

This was subculture that happily determined it's own version of "evidence", and the results spoke for themselves. Subjective culturally determined evidence and scientifically demonstrable evidence are two COMPLETELY different things - the former is open to interpretation, and the latter is not.

Now, I'm not comparing people who peddle homeopathic crap to the neurotic puritans of 1692 - this is an example of how things go wrong when you can't be unbiased and rely on evidence determined by a biased subculture.

Excusing implies moral judgment. You're welcome to do that, but I'm more concerned with the pragmatics of finding ways to reduce the negative impacts of poor medical decisions. That requires understanding why alternative medicine persists and what cultural forces are at work.

You don't see unsupported assertions in any of the comments? I see it asserted as fraud and a scam. These terms imply that the sellers of these products recognise it's ineffective but sell it anyway. Quite an assertion based on nothing more than incredulity (a logical fallacy in that regard).

There's also an assertion that merely complaining to the police should be sufficient to dissuade the sale of homeopathic remedies. Lastly there's an assertion that criminalising such claims will have an impact. I've never seen any evidence backing these suggestions up. If anything, the very prevalence of alternative medical practices and treatments is a response to seeing science not as a useful system, but as an oppressive one.

Of course, distinguishing between a scam and a genuine belief in a non-scientific claim is nigh impossible. But in science, those who make the claim are also obliged to convince others with their evidence.

So again, you're welcome to your moral indignation. But if you're really concerned about the impact of alternative medical treatment, thinking about it critically and scientifically is a better option than crying scam and fraud.

"Now, I'm not comparing people who peddle homeopathic crap to the neurotic puritans of 1692."

Yet oddly you just did.

Nonetheless, if you seriously think science is an unbiased culture, I'm not sure what I can say. The difference is that science holds values in place that permit rigorous criticisms of ideas. I happen to think science is an immensely useful, pragmatic system. I write science education resources for a living. So I don't need to be sold on its uses.

However, my point is not that we should or should not rely on the evidence produced by any one subculture. My point is to promote a scientifically informed view of health and medicine, we first need to understand why people behave as they do. Assumptions of criminality and fraud have been thrown about, yet do little to address the fundamental causes. If anything, they ironically worsen them, further making science seem like the oppressive enemy.

So to return to your analogy, evidence isn't an objective concept - scientific or otherwise. Science simply happens to offer a democratic context for evidence which applies logic, empiricism and skepticism. Useful, absolutely. But promoting its pragmatic benefits by labeling those who oppose it as criminals probably won't win many fans.

"Yet oddly you just did."

No, I didn't. Pay attention, because I'm only going to explain this once more.

I can compare the physical motion of a rock to the physical motion of a jet plane, but that doesn't mean I'm comparing a rock to a jet plane.

In this case, I'm giving you an example of why evidence needs to be determined without a bias. In other words, you cannot state your evidence that homeopathy works proves that it works just because you have a biased preference for homeopathy. Homeopathy doesn't work, because under scientific test conditions, it has not demonstrated any efficacy as a medical treatment or intervention.

Therefore, homeopathy doesn't work, regardless of whether you like it or not before the fact.

Now, we move on to science being a culture - you seem to be missing the fact that, while there is a scientific culture, science itself is a method for learning. The scientific method was established by Islamic scholars during the "Dark Ages" while Western Europe was arguing about how to enforce people's beliefs and generally running the world backwards.

Now, I know there are different kinds of evidence, I am well aware of that - I am also aware of science's pitfalls, and where it has gone wrong over the centuries. The difference is that science is capable of learning from its mistakes, and making new discoveries as a result of them.

But what you're saying is that someone might consider they have evidence that homeopathy works, which justifies their belief that it works. I understand this, I really do - and this is where science comes in, because science comes along and says, "no, homeopathy doesn't work, and this is why," and it provides the demonstrable, repeatable, and indisputable evidence to back up its claim.

Here, the homeopath has two options - 1) "ah! I see! well, you learn something new everyday, I'd better stop trying to sell this stuff and get into some REAL medicine then. Perhaps I'll do some experiments of my own to confirm or even refute your findings." <-- this is called the "scientific method", accepting when one's own findings are a mistake, or a possible mistake, and going from there. If someone can prove indisputably that homeopathy works, then I'll put my hand up the moment the situation calls for it.

2) "rubbish, i don't care what evidence you have, i have my evidence which while it may not be scientific, it proves you wrong..." <-- this one is called willful ignorance, and regardless of the cultural or psychological subtext, ignorance is not a defence in a court of law, and it makes them a criminal.

If they have a third option, I'd love to see it.

Thank you Mike McRae, That was well put. We need more upstanding defense of the scientific method like yours, from more scientists in every field, enlightening the general public through the media and schools. Maybe then we, as a species, might get a bit ahead of the game.

Mike - a civil society requires a set of (largely agreed) moral values.

So, for example, you might be interested in looking at the reasons why vistims of domestic violence stay in abusive relationships, but, at the same time, our society makes interpersonoal violence illegal.

You might want to know why the structures of some churches and their priesthood have allowed the practice of sexual abuse of children to take place, but our society also calls for that behaviour to be illegal.

We can have moral indignation about certain practices, and regulate them at the same time, so that the vulnerable are less exposed to them.

The moral test for these "remedies" is not just whether the people selling them think they work, but whether they are making claims that they cannot substantiate. That is a general principle for the sale and promotion of products in general - you have to be able to show that they do what you claim they do - whether it's a washing machine or a remedy.

Regulation and cultural understanding are not mutually exclusive.

While I don't disagree with your examples, Sue, medical pluralism isn't quite the same thing as washing clothes. Cultural identity and scientific values aren't built up around laundry beliefs. Clearly the very fact that its easier for unsupported washing machine claims to be dealt with by consumer affairs than medical claims demonstrates this is a vastly more complex issue. The toothlessness of the TGA isn't arbitrary - there is a significant counter-culture reacting to the sense of science being an oppressive, authoritarian threat.

My attitude to domestic abuse, theft, or any other 'immoral' act is little different. I'm less concerned with retribution, and more interested in a utilitarian, evidence based approach to changing a culture to reduce its negative impact on individuals.

"Medical pluralism"? I might understand that term if the competing models were equally valid, but they are far from it. You do understand, don't you, that homeopathic "remedies" don't contain any of the alleged therapeutic substance? The are either water or water-alcohol mix, in a glass bottle, bashed on a hard surface, and sometimes dropped onto sugar or lactose "pillules".

OK - I'll enter the discuss about why so many people in our society spend money on so-called "CAM". Interestingly, the spending on CAMs has grown during a time that medicine has moved to become less paternalistic, to communicate better and to express doubt. Medicine now has a much more feminised workforce, doctors are taught about communication skills and how to respect patient choices. Paradoxically, some people are made more uneasy by this style - there may be an innate human need for a simple answer, or a confident therapist giving firm advice.

In homeopathy, for example, the practitioner always sells you a "remedy". You don't have to accept simple reassurance, or be given just a diet or an exercise programme - you get some "medicine". The, if it doesn't work, you get another one. The person selling you the remedies may also be a good communicator, develops a trusting relationship, and makes you fee in control. IN a sense, this person is a new form of paternalist - they don't express doubt, and they always have a remedy.

Does that mean that medicine should go back to simple answers and miracle cures? Further improving communication and counselling skills would be good, but, unless patients are prepared to spend out of pocket they way they do for the homeopath, they aren't likely to get enough time with their GP for a satisfying interaction.

Yes, I do understand (not wishing to plug my book, but I devoted a fair bit of a chapter on homeopathy and why it is a 'bad idea'). I've delivered talks in pseudoscience, and developed educational resources explaining how alternative medicine is not scientifically valid by definition. I'm very familiar with homeopathy and its incompatibilities with science. And I'm a science writer and educator by trade, writing and editing for a major science education resource. I'm a big fan of it myself. :)

I've also worked in pathology, where I saw first hand the effects of a parent delaying treatment thanks to homeopathy. It was shocking enough I went into science education to see what I could do about it. Fifteen years later, and after post grad research in medical culture researching medical pluralism, I don't have a lot of answers. But it's clear how complex the problem is, and how much the perception of science as an authority is responsible.

You point out a correlation in medical communication and diversity increasing in the medical workforce, and increased spending in CAM. While that's true, I doubt you'd accept a mere correlation as evidence for complex systems in medicine. Indeed, that's one of the criticisms levelled at alt med - flimsy evidence without investigating their own claims in depth. Advocates of alternative medicine are a diverse bunch, with some areas of science rejected while others are embraced. Increased spending on CAM, for instance, is not in exclusion to using conventional medicine. These practices are typically made for social reasons rather than because science says so.

You have touched on a significant point of short consultations and poor communication playing a role. That is not the same as consumer behaviour regarding treatments such as those in the above article (which in spite of being homeopathic, is culturally different in how people go about engaging with it), but with the 'traditional' homeopath, it is a factor.

What's the answer? No single thing will do it. After fifteen years of looking, i never found a silver bullet. But potential answers will be clearer if the discussion is informed, evidence based, and objective rather than moralistic, assumption and has claims made without relevant expert opinion or supporting reasoning.

Why do you assume that you occupy the moral high ground?

I believe this connects precisely with what Mike is trying to say in using the phrase 'medical pluralism'.

Too often within these conversations people co-opt science as if it's some kind of sacred belief system, and use the kind of language associated with the Salem witch hunt to describe 'the heathens' who subscribe to anything that cannot be seen by the scientific eye.

Open dialogue, open minds, require opening. Describing homeopathic practitioners as being people who simply sell remedies and NOT seeing that this is exactly what many if not most conventional doctors do shows a closed mind, unable to make an observation because of bias.

Again, I believe this exemplifies a point made by Mike earlier about the way science, when co-opted (by narrow mindedness for example), is viewed as 'an enemy' by those who have, in most cases, had experiences which led them away from the dominant paradigm to seek what they couldn't find there.

Most people won't get what they want from a GP, unless all they want is a script for another round of "remedy" (officially acceptable as medicine).

Craig, I had a look but couldn't find the comment page. I may have started at the wrong place. Could you please give me the web address? Thanks mate.

It's a the bottom of each image on their webpage. For example:

http://www.kidssmart.com.au/kids-smart-products/kids-smart-natural-medicine-pain-fever/#comments

Stephen - you misunderstand the significance of placebo-controlled trials. Yes - placebo effect works with all therapies. That's why an effective therapy has to be shown to be BETTER than placebo (or the existing therapy).

You may have personally met people who take other remedies because medicine hasn't helped them. The fact that you have not met those - like the tragic Penny DIngle - who forgo medicine for the scam remedies does not mean they dont exist. This is where the harm lies, quite apart from the ethical issues of deception and withholding effective treatment.

No I don’t Sue, your missing my point. The placebo effect is active in medicines of any description - including drugs. So to claim that alternative medicine works only from the placebo effect is very misleading.
You mentioned Champix (in a previous post) has a success rate of 20%. Assuming a placebo responce of say 15%, (I know there is no exact figure for it) the success of Champix is only 5% more than the placebo. That is a tiny success rate. That would mean that Champix relies for most of it’s successes on the placebo response. That’s a common story in many drug trials.
I expect and achieve success ninety percent of the time with any alternative remedy I take.
The point I made is still valid. Alternative medicine is resorted to most often - after western medicine has failed. So the argument of delaying “life saving treatment" is invalid. Whether you reckon it works or not it is still ludicrous to harp on about a medicine with no side effects. Many others (including me) reckon it does work.
Concerning Penny, to be sure there are unwise people in all human activities, and I would say there is more to the story than has been made public.
The dangers from drugs still dwarves any risks from alternative medicines, to such a degree, that it is a craziness to harp on about a medicine that has no side effects.

Stephen Lehocz says "The dangers from drugs still dwarves any risks from alternative medicines, to such a degree, that it is a craziness to harp on about a medicine that has no side effects."

Apples and oranges, Stephen.

Effective pharmaceuticals absolutely swamp "alternative medicines" in efficacy. (The "altern tives" are called "altern tive" because the DON't work better than placebo. If they did, they would be called "medicines".) Effective medicines inevitably will have some degree of side-effects because they have pharmacological effects. That;s why they work.

When anyone sells a product that is claimed to contain therapeutic ingredients, but is found not to, that is both false advertising and fraud. Pure and simple. If any pharmaceutical was sold as containing an antibiotic, or beta blocker, or whatever, but didn't contain a single molecule of that substance, that would be false advertising and fraud too. Why is it accepted of the "alternatives"?

Sue, thank you for repeating my viewpoint which I still stand by.
But finally you bring up a very important point. Does it work?
Just because - you - can’t find any effective ingredients or any method by which something should work, does NOT mean it does not work. I would contend it’s a lack of ability to see other peoples viewpoints, except your own or you just believe what the “experts" tell you, without looking around and seeing what reality actually shows. Now that is very bad science. The reality from my experience is people actually getting better through alternative medicine, improvements actually occurring through the use of your so called useless alternative medicines with “no active ingredients.”
People keep going to these alternative therapies, mostly when western medicine and drugs have failed them.
I have found alternative therapies to work, personally for me. And apparently so have many, many others, as the number of alternative therapy practitioners keeps increasing. The numbers of times it works does not get explained by the placebo effect. That is why brought the placebo effect up.
A lot of drugs rely on the placebo effect for their gains. eg Champix - but looking at Champix the success rate is 44% and the placebo success rate is 18%. so Champix is actually affective 26% of the time, and 18% of the time it is the placebo effect in action through the application of Champix. Looking at the side effects it is a very dangerous drug, but it’s not bad, better than smoking.
Having found something to work far more often than 50% of the time would tend to make me think something has a workability, doesn’t that make sense?
And to find science says “it does not work,” “there are no active ingredients in it,” would strike me that someone is likely to be manipulating the science, or those particular scientists lack an ability to observe. I certainly question their science.
This statement of yours - “Effective pharmaceuticals absolutely swamp "alternative medicines" in efficacy,” I would most definitely dispute.
As to false advertising and pure fraud - I would say that the GSK case highlights a incredibly dangerous example of what you're talking about.
http://www.newscientist.com/article/mg21528723.800-glaxosmithkline-agrees-3-billion-fraud-payout.html

Here is another article on the type of false advertising and fraud you mentioned:
https://theconversation.edu.au/insight-into-how-pharma-manipulates-research-evidence-a-case-study-4071

Stephen - whatever "pharma" does or doesn't do still doesn't make water with no therapeutic ingredients any more effective.

You "definitely dispute" my statement "Effective pharmaceuticals absolutely swamp "alternative medicines" in efficacy,..."?

Go ahead - what is your contrary evidence?