Medicandus

Medicandus

Leave facts out of the ‘debate’ about homeopathy

Frequent commenter on this column and Friends of Science in Medicine (FSM) executive member Dr Sue Ieraci tweeted a link to this extraordinary defence of homeopathy in pharmacies, in the online pharmacy trade publication I2P. I find it genuinely gobsmacking that an otherwise sober and serious forum could erupt in such a febrile welter of muddled thinking.

I would encourage you to read it and make up your own mind whether the arguments are compelling. I’m not impressed by them so I can save you the effort if you’d rather just keep reading.

Here come the cliches….

it has an unrivalled safety profile when compared to mainstream medicine.

Well I’m not sure I totally agree. There are many tragic cases where consumers have been harmed or killed by placing misguided faith in homeopathy. Having said that, while it may be “safe”, it is also completely ineffective and based on provably mistaken beliefs about how chemistry works. It’s like comparing a car to a teleportation chamber. One is real, and the other… not so much.

a mischievous group called the Friends of Science in Medicine (FSM) who seem to have made it their objective to eliminate all forms of medicine other than mainstream medicine._

The aims and objectives of FSM are clearly stated on its website so Cluedo-style deductions are not needed if you want to clarify what their aims are. There is information about the organisation and its funding. It turns out some Friends are even pharmacists!

There then follows a confused accusation of FSM operating like a “military intelligence agency” to divert attention from some type of Big Pharma conspiracy. I know I am a bit thick, but I have trouble conceiving that there is really a group of homeopathy supporters who have an honest belief that FSM operatives are bugging phones, breaking into offices and recruiting paid informers for nefarious, not to say mischievous purposes. Really, truly? Does I2P stand by these claims? It’s their publication’s credibility which is at stake after all. I’d welcome any evidence of these covert operations since I’m a supporter of FSM and haven’t yet been approached to activate my sleeper cell from their deep cover and undertake any black ops. I’d look great in a black cat-burglar costume though. The claims regarding fraudulent research by FSM members are seriously repugnant and should be retracted if they cannot be supported by plausible evidence.

Patients must be allowed to take control of their own health, not have a restricted version foisted upon them.

This really is ethically bankrupt. It’s not as though there is any controversy at all that homeopathy is a placebo. Simply by its presence in pharmacies, the average layperson who knows little or nothing about health science will assume they can trust what is being sold in a pharmacy to do as it claims to. For a truly fair choice to exist, there should be valid benefits on both sides of the choice. I agree that patients should collaborate with their health-care choices, but this does not mean that I should willingly provide a completely futile treatment as an option alongside effective ones just because it is requested. As the professional in that relationship, one has a duty of care to give the best possible advice based on one’s expertise. Letting the patient choose without my expert advice, and then offering to provide anything they ask for is an abdication of my professional responsibility and duty of care. It pains me to see that some retail pharmacists are so slow to get how serious this point is.

Homœopathy has been practised by individual practitioners throughout Australia since the 1840s. The history of medicine during the formative years of the Australian colonies revolves around the fact that, apart from in the main cities, there were very few people who had formal qualifications as medical practitioners.

Complete with a superfluous “o” to make it look more “olde worlde”, it seems homeopathy has been failing to work for a long time in this country. It doesn’t follow that just because there were well-intentioned amateurs (and probably a lot of spivs and hucksters as well) 170 years ago, that this somehow makes it honourable or ethical for pharmacists nowadays to sell it. We don’t sell ice chests or Coolgardie safes any more because we have proper fridges. We get around in cars now instead of horse-drawn carts. Times change. Stuff gets better. The Australians of the 1840s would love to have what we have now and would probably be gobsmacked to see homeopathic hokum still kicking around.

The subsequent revival of homœopathy in Australia over the past 50 years is part of a story of world-wide changes in spiritual values and public perceptions regarding health.

Whatever has been responsible, it certainly hasn’t been robust scientific plausibility that’s for sure.

I2P has no agenda in providing reportage for homeopaths other than a sense of fairness, because their voice is drowned out through FSM influence and the political agendas of mainstream and medical media.

The arguments of the Australian Homeopathic Association get six paragraphs of direct quotation and several more of discussion while the NHMRC report is airily dismissed as being biased, unfair and subject to “FSM interference” of some sort. The effusive and entirely uncritical history of homeopathy in Australia, as well as the unbalanced accusations about FSM make this a thoroughly specious and disingenuous claim.

Because they represent a small market segment generated mainly by patient requests and take up a small section of shelving, I see no problem in this if actual display is not in a prime position and that these products do not appear in pharmacy catalogues.

Translation – “I get that it’s embarrassing in public but we do make some money out of them, so if we do it quietly in the corner will you leave us alone?”

Retail pharmacists I suspect know deep down that what they do outside of dispensing prescriptions is akin to selling cosmetics. They provide low-risk products and friendly advice to the general populace which make them feel temporarily better about themselves and how their life is going. Perhaps some have status envy without understanding the hard work, stress and responsibility that clinical health care, whether provided by doctors, nurses or allied health professionals, entails. They would do better to respect that when it comes to peoples’ health, there are serious responsibilities you can’t just wish away when you become a front-line clinician. It might help them refrain from conspiracy-mongering and cheap-shot mischaracterisations of the people who will always be there to get their customers out of trouble.