The Wounded Homeopath

The other day, in a social context, I got into a conversation with a very nice chap who turned out to be a homeopath. You know how it is, he asked me what I did, and I explained that I am a freelance clinical science consultant. He said he is a retired GP who spent his whole professional life practising and researching homeopathy. I suppose I could have expressed horror at how someone could waste their professional life, but I restrained myself. He immediately launched into an attack on Professor Edzard Ernst, and asserted that randomised controlled trials could not test homeopathy because the treatment had to be individualised. This was before he knew my opinions on the subject. At this point I put my cards on the table, and said that at a more appropriate time and place I would be delighted to debate homeopathy with him or anyone, as I had done this many times including on radio and TV. Anyway, I mentioned that trials of individualised homeopathy have been carried out, with the usual lack of positive results.

He then changed tack, and started talking about “you know, when they combine the results of several trials”. Meta-analysis, I helpfully prompted. “Well” said he, “when you do that you get a positive result for homeopathy”. Now the interesting point about this statement is not that it isn’t true if you exclude the rubbish studies, but that suddenly RCTs are OK when they appear to support what the homeopaths say. This is why it is almost always a waste of time debating with homeopaths, because they choose the evidence to suit what they assert. And assert is what they do – which I’ll come on to in a minute.

The conversation took the usual course:

“But the patients get better.”

“They get better anyway, whatever you do.”

etc

Now we get to the pathetic bit. With a very pained expression, he then asked “But why do you want to destroy it?”

“Because you are lying about what homeopathy does, and it’s not on to lie to your patients.”

“Well you won’t win you know”.

“Oh we already are, the NHS is de-funding homeopathy”.

Rarely have I seen someone so deflated. I don’t take pride in that, it was quite pathetic really. But should I be sympathetic? On reflection I think not. I have in front of me as I write two homeopathy textbooks, one on the philosophy and the other is a materia medica. I have to read them sitting down or I fall over laughing. The philosophy book starts by saying that homeopathy is supported by science, and then fails to cite any evidence for that. The introduction is basically just an evidence-free set of assertions, which later chapters then refer to as facts. I was sort of expecting a lot of skillful selection of data from crappy RCTs, but there is none of that. The references are entirely for other intellectual flights of fancy.

Simply asserting something as fact, irrespective of the evidence, has been done in politics (well I suppose it still is), and it got us into a great deal of trouble 70 years ago. The Nazis were terribly good at it, when they re-engineered German science in the 1930s. The Soviets destroyed much of their food production by supporting Lysenko because his ludicrous ideas suited their political agenda, in the absence of evidence. No doubt you can think of many other examples, but this is why it’s important to stand up for arrogant claims such as homeopathy. Josef Goebbels said that the more often a lie is repeated the more it will be believed, so why should we tolerate even small lies?