Friday 21 August 2009

Don't Throw Out The Baby!

A UN report today has condemned the promotion of homeopathic remedies to suffers of AIDS, malaria and TB. This is undoubtedly correct. There is no scientific evidence of the efficacy of these treatments as primary treatments for these conditions, and the claims made for homeopathy's methodology are unverified and illogical.

However, the baby should not be thrown out with the bath water, for this or other alternative therapies. Conventional medicine has achieved much and continues to offer the best hope for the sufferers of many diseases. There is evidence, however, that where conventional medicine has failed, and it does not work for everyone, then these therapies can be useful for some.

Scientists will assure us that this is purely a placebo effect. That may well be the case, but that misses the point. If people do believe in these treatments, as a last resort, than it doesn't actually matter if it is a placebo effect or not. What matters is that some of these people either recover, or have a better quality of life in their remaining time. Too often professionals lose sight of this.

There should be no false claims for the treatments, but as a secondary treatment option, then they certainly do no harm. By their own definition, and the analysis of scientists, they can not. Are they cost effective? In a community treatment setting, then they undoubtedly are. In hospital, that may be questionable. However, when all else has failed, can we deny people the possibility of a treatment that works for some, placebo or not?

Sometimes, in life, we lose sight of the ends, the goal, and concentrate solely on the means. If the means are harmless, and the ends are laudable, then why not?

2 comments:

  1. A recently published scientific paper has shown that the placebo effect can still occur even when the participant knows that they are being given a sugar pill instead of the real treatment. I look forward to this result being replicated, in view of which I would be able to withdraw my objections to the debunking of homeopathy and similar "alternative therapies". I don't think we should ban them, unless there is demonstrable direct harm (that is already the case), but, subject to that research replication, debunk away!

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  2. I was asked recently why I had left this post on my blog, despite changing my mind about some of what I had said. I think it is truly important that rational, critical thinkers are able to point to, and admit, their mistakes.

    That is the difference between those of us guided by the scientific method and rational analysis, and those reliant on blind and irrational faith; the rational review evidence, and when new evidence requires that we do so, we change our point of view accordingly, no matter how strongly the prior point of view was held.

    This was not a strongly held view for me. The substance was not as important to me as the call for reasoned analysis, rather than kneejerk antipathy. I would still not support a ban of those therapies that are inherently harmless. It is not our place to protect the gullible from themselves, unless they are likely to materially harm others or themselves. Being duped is a quick way to learn to think more critically.

    It has been suggested to me in discussions elsewhere that these therapies cause harm by diverting resources, and by reinforcing negativity towards conventional medicine. The first is true, though the resources are small in the scheme of things, and I did qualify that I thought them appropriate in a community, not a hospital setting, where they are largely patient-funded. I back the recent call to end NHS funding for homeopathic hospitals.

    The latter point is not a valid one to my mind, as at the point that people consider these therapies, they are generally either already closed-minded about modern medicine and open to "alternatives", in which case education has failed much earlier, or they have exhausted the possibilities that modern medicine offers.

    In this second option, then I see no harm. One correspondent told me that we should not be encouraging them to chase phantoms looking for cures that don't exist,and that they should spend that precious time with their loved ones and yet that is exactly what some conventional doctors do in trying out new treatments and drugs on the terminally ill, and those patients also chase the faintest possibility of a cure.

    It might be preferable if, as a society, we had a more mature attitude towards death, and allowed ourselves and others to face death with calm dignity. However, that is an individual choice, and if some can not do that, and prefer to chase phantoms, of whatever origin, I would suggest that it is entirely up to them to do so if they so wish.

    By all means debunk those therapies that have no scientific merit, but in doing so, do so with reason and evidence, and not vitriol. Make sure the criticisms are relevant to that therapy, and concentrate your fire primarily on those which cause actual, direct harm.

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