Wednesday, 19 June 2013

Freedom of Choice and Pseudomedicine

As the demand for evidence-based medicine gathers grows, especially in the NHS where many so-called Complementary and Alternative Medicines (CAM) are being re-examined for efficacy, the CAM proponents are increasingly declaring that their particular "health modalities" should be available on the NHS as a matter of "freedom of medical choice". It is reasonable to ask what the implications of this are.

Freedom of choice is a laudable thing, provided that it is informed and responsible. Choosing something about which we know nothing is potentially as stupid as choosing to walk across a motorway -- and it can have similar consequences. The tragic example of Penelope Dingle is a case in point, but she is only the tip of a huge iceberg of harm caused directly or indirectly by pseudomedicine. As in Ms Dingle's case, she was not directly killed by homeopathy (clearly, that which has no pharmacological effect can, by definition, have no adverse pharmacological effect), but because reliance on ineffectual pseudomedicine caused her to reject conventional interventions that would have prolonged her life and which may have cured her.

I should be clear that I am not claiming that conventional medicine never gets it wrong or that it is squeaky-clean in its methodology. It isn't; there have been some appalling errors and frauds. However, using that as a reason to use something of unknown or unproven efficacy is about as illogical as using a fatal motorway pile-up as a reason to leave the car at home and choose to skate-board in the middle lane instead! The blogger Guy Chapman puts it rather more eloquently: "Problems with medicine validate homeopathy in precisely the same way that plane crashes validate magic carpets."

Making an uninformed choice for yourself is one thing. It is another to make such a choice for those for whose health you bear responsibility. Parents who, for example, make an uninformed -- or, as in the case of MMR vaccine refusal, misinformed -- choice are unwittingly putting the health of their children at risk. This is one reason that it behoves the sceptic community to contest unevidenced claims for pseudomedicine, wherever they occur.

The beneficial claims made for a number of pseudomedical practices effectively boil down to an "argument from tradition", i.e. that they have been used for centuries or millennia. Apart from the inherent illogic of this (as David Colquhoun says of herbal medicine, it is "giving patients an unknown dose of an ill-defined drug, of unknown effectiveness and unknown safety") there is also the question of harm to those species whose body parts are used for pseudomedical practices. The "traditional medicine"-induced demise of the Amur tiger and poaching of rhinoceroses for their horns are both well known and well documented, but this is merely the tip of another iceberg. According to the Smithsonian, other animals that are endangered because their body-parts are used in traditional medicine include water buffalo, the Chinese alligator, the Asian elephant, musk deer, the sun bear, Grevy's zebra, wild banteng, and the hawksbill sea turtle. This is by no means a comprehensive list of animal species that are killed or maimed in order to meet a selfish demand for "freedom of choice in medical modalities".

Some may object that the use of animals for testing conventional medicines is equally cruel. That is a matter of opinion and individual judgement (and a tu quoque fallacy to boot), but the two things are not equivalent. The one is experimenting animals to establish whether there is robust evidence of efficacy for pharmaceutical substances for whose efficacy there is already some evidence. The other is killing and maiming animals to satisfy a demand for a product for whose efficacy there is no robust evidence.

As I write this, it is "Homeopathy Awareness Week", so where does homeopathy fit into this? According to the principles of homeopathy, "Medicines derived from the animal kingdom act energetically and rapidly" and "are especially indicated in potentially fatal crises or acute disorders as well as chronic diseases that have the character of the rapid destruction of organic tissue". Amongst the animals used by homeopaths are the medusae (e.g. jellyfish), various arthropods (insects, arachnids, etc.), and numerous reptiles, including snakes and lizards. There is a recent interest in the use of body-parts of birds, including those of humming birds, ospreys, herring gulls, pea-fowl and protected (in the UK) species such as the peregrine falcon and the golden eagle. Various mammals (or their body parts or secretions thereof) are also included in the homeopathic repertory, including bottlenose dolphin, badgers, beavers, cats, cattle, sheep, musk-deer, horses and skunks. And "testicular extracts of man" (i.e. semen to the rest of us. Please don't ask.).

Whilst we are on the subject of homeopathy awareness, any gay readers might be interested to know that, according to the principles of homeopathy as elucidated by James Tyler Kent, they suffer from "a sexual perversion caused by the miasms" . You would be forgiven for thinking that this is an archaic view that is no longer held in the 21st Century. You would be wrong.

Lastly, on this topic, I would not want to leave you with the false impression that homeopaths all exploit the animal kingdom for their remedies. This is simply not the case. In this Homeopathy Awareness Week it is my duty to give fair balance by ensuring that you are aware that they also use such diverse non-animal things as bacteria that don't actually exist, the light of the planet Venus or the star Polaris, various colours, a thunderstorm, the Berlin Wall, and water (which is dissolved in ethanol and - wait for it - water!). They have even outdone ordinary physics and managed to isolate a magnetic monopole for this gem.

So, please be aware and make informed decisions on your "choice of health-care modalities".

1 comment:

  1. Anyone who thinks that homeopathy is not a form of pseudomedicine should have a look at how some homeopaths have invented new and inventive ways to make money from the cohorts of the inanely credulous (which, ironically, probably includes those homeopaths who aren't knowingly deceiving their victims):



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