Homeopaths are crying into their infinitely watered-down beer about their treatment by the reality-based community, and the heartless refusal of the NHS, ASA and other TLAs to allow them to make incredible claims with no good evidence.
Part of this campaign is the endless rebunking of points refuted a thousand times. Here is their PRATT leaflet for people going to the demo outside the ASA at Mid City Place , 71 High Holborn, London WC1V 6QT at 11am on June 25. I sincerely hope no nasty skeptics turn up to mock them. Only nice skeptics.
The leaflet displays not just a misunderstanding of skeptic arguments but also fundamental dishonesty.
Rebutting skeptic arguments:
Homeopathy works by the placebo effect
The placebo effect depends on a person’s belief and expectations, so this cannot explain why remedies work on babies and animals or in provings, nor why they produce such a variety of other reactions apart from simply getting better. The mechanism of action of the placebo effect is also unknown – in fact less is known about how the placebo effect works than about how homeopathy works, so the “explanation” is less informative than what it claims to explain. This is not a scientific approach to knowledge.
Homeopathy is a placebo, but observations are also skewed by patient and observer expectations. That is why people falsely believe that it works on babies and animals. It is important to remember that not one claim for any mechanism by which the remedies could be anything but inert, has ever stood up to objective testing. In fact nobody has even produced a credible scientific proof that any effect remains after dilution, let alone that it is persistent, transferrable to an intermediary, and thransferrebale form there to a human.
There is no evidence for homeopathy
(see the sheet on Research)
When people talk about evidence they usually mean randomised control trials (RCTs), the method used to test individual drugs. 46% of conventional medical treatments in the NHS do not have RCT evidence of effectiveness, but these are not being attacked.
First, this is a straw man argument. skeptics do not say there is no evidence for homeopathy, only that there is no credible evidence (and certainly no proof). There is evidence for bigfoot, but it is junk. There is evidence for homeopathy, but it is junk.
Second, it is false to say that randomised controlled trials are the only form of evidence. Treatments used by medicine have a hierarchy of evidence: plausible mechanistic evidence, in the form of chemical and biochemical pathways; in vitro tests; perhaps animal tests; phase II and phase III clinical trials, and finally, after approval, clinical studies and meta-analyses. In the case of homeopathy, most of these forms of evidence are simply absent. The ones which are not (essentially equivalent to phase II trials in most cases) are prone to bias, and do not in any case provide any convincing evidence of effect. Meta-analysis, the most robust form of evidence, consistently shows that well-designed trials show homeopathy to be no more effective than placebo.
Third, for the treatments on the NHS which do not have RCT evidence, many cannot ethically be studied in this way. You cannot ethically compare surgery with placebo for cancer. There is no rational reason to conduct a randomised controlled trial to see whether broken limbs should be plastered or lacerations sutured or glued.
Fourth: mainstream treatments for which the evidence has been fudged or exaggerated are very much under attack – by much the same people as are criticising homeopathy, notably Ben Goldacre, co-founder of the alltrials initiative.
RCTs have weaknesses which can result in drugs being withdrawn because clinical use reveals serious side-effects. A a lot of the evidence for homeopathy is also from clinical use, and if this counts more than RCT evidence for conventional medicine, it should also count for homeopathy.
This is the distraction fallacy at work. Problems with medicine validate homeopathy in precisely the same way that plane crashed validate magic carpets. The “evidence” for homeopathy is not really from “clinical use” as such, it is due to confirmation bias. Homeopaths believe it works, when the patient gets better they attribute this to the remedies, when the patient does not get better they either rationalise it away or say it was the wrong remedy for that patient (so-called “individualisation”), if the patient gets worse they call it a “healing crisis”. There seems to be no outcome a homeopath will consider disconfirms the belief in homeopathy.
When a drug fails in an RCT or in clinical practice, doctors do not claim that conventional medicine does not work, but when a homeopathic remedy fails to produce a positive result in an RCT, it is claimed that the whole system of homeopathy does not work. The use of double standards like these is not scientific.
That’s because the tests of homeopathy are not designed to be specific tests of a remedy, but are instead designed to show that homeopathy itself is not a placebo.
Tests show convincing and specific effects for pharmaceutical treatments. There is no argument over whether administering measurable doses of substances with objectively testable pharmacological effects, will affect human physiology.
Tests show no specific effects for homeopathy. One of the things homeopaths bluster about is tests comparing different remedies; they assert homeopathy must be “individualised” (in practice, that the practitioner must be allowed to define success as whatever happened, good,bad or indifferent). Many poor quality trials assert that homeopathic remedies benefit X, Y or Z condition compared to placebo, but there are no robust studies which convincingly prove that only the right remedy has this effect. An effect which is non-specific, as homeopathy’s observed effects are, is much more likely to be an experimental error, bias or placebo effect.
What about the James Randi challenge?
James Randi is a magician, so he earns his living by fooling people into believing that something untrue is true. He has offered one million dollars to “anyone who can show, under proper observing conditions, evidence of any paranormal, supernatural, or occult power or event.” However, a “paranormal, supernatural, or occult power or event” ceases to be one the moment there is evidence of it. Instead it becomes a normal, natural, real, but unexplained event, so his money is safe. This is not a scientific challenge, but a stunt.
James Randi is not a magician, he is a conjurer. He cannot perform magic, and he will be the first to tell you so. He is, in his own words, an “honest liar” – an expert on deception and the mind tricks used by charlatans. Randi exposed Uri Geller, Peter Popoff, James Hydrick and many others, including of course Jacques Benveniste.
But this is again a distraction. Randi is a figure of legend in the skeptic community, but the scientific consensus that homeopathy is inert is not founded on Randi’s opinion. It’s founded on an extensive review of the evidence and, more to the point, missing evidence.
The person could have got better anyway
When you hold something in your hand and let it go, what happens next depends on lots of factors but the theory of gravity can explain why a helium balloon goes up, a ball-bearing goes down, and a feather may do either. If there is no certainty in the explanation of what happens after a treatment, it is because there is not a scientific theory to explain it, so anyone using this argument is actually admitting that they do not have a scientific theory of medicine.
Helium balloons rise because helium is less dense than air, so the balloon moves towards a point of density equilibrium (or until it bursts). A feather is denser than air and will always fall unless there are air currents; a ball bearing is denser still so normally not affected by air currents. There is a very high degree of certainty in the outcomes of dropping any of these three objects, as long as the environment is known (and the factors which affect the movement of the objects can of course be objectively measured).
There is no parallel between these and the stochastic nature of disease outcomes when treated with placebo.
We should not waste limited resources on unproven therapies
The object of medical practice is to help people get well, and until there is a system of medicine based on a theory which works 100% of the time, no therapy can be proven or unproven.
There is no reason to think homeopathy should work, no way it can work, and no good evidence t does work other than as a placebo. And it is an expensive placebo. It is medically and economically unjustifiable.
This also displays the classic SCAM double-standard. SCAM must be allowed, funded, and left to make whatever claims it likes until science can prove with 100% certainty that it is dangerous and ineffective Medicine should not be used until it can be 100% proved that it is safe and effective.
Skeptics, by contrast, think that all forms of treatment should be held to the same standard of evidence. No homeopath in the UK would allow this to happen, for obvious reasons..
Many patients have found that homeopathy benefited them when drugs did not, so this is an effective use of resources. Homeopathic remedies are also cheaper and do not produce side-effects or hospitalisations from overdoses, so their use may save resources rather than waste them.
This is an example of the fallacy of begging the question. Believing something is so does not make it so, especially if the belief is founded on the assurances of someone with a vested interest in selling you something.
People believe homeopathy helped them, but there is no good evidence to support this belief.
One of the reasons for resources being limited is the fact that the cost of health services continues to grow rather than shrink, suggesting that there should be an investigation into the effectiveness of both conventional and alternative medicine.
This is already going on. See for example House of Commons Science and Technology Committee Evidence Check 2: Homeopathy.
There is no credible reason to waste further resources investigating treatments that are not even remotely plausible.
Homeopathy has a long history of clinical success, so it is not a waste to spend money on research to discover why this might be the case, since the primary object of scientific research is to extend our knowledge.
Homeopathy has a long history of claimed success, but increasingly careful investigation has blown away the smoke, broken the mirrors and revealed the fundamental truth: it doesn’t work.
Scientific research is about proving the claims you make with objective tests that others can replicate. Homeopathy mixes religion with pseudoscience. Its doctrines are based on the word of Samuel Hahnemann and these are never questioned or tested, and all homeopathic “science” proceeds from the assumption that they are true.
Virtually every paper written by a homeopath starts with a preamble stating that homeopathy is a form of medicine whose mechanisms are strange and mysterious. This is false. As far as the scientific evidence goes, homeopathy is not a form of medicine, and its mechanisms are entirely mundane: placebo effects, cognitive biases, the natural course of disease.
If homeopaths want to do some real science, let them start with a generalised and robust proof of their core doctrines which accounts for the many inconsistencies with every scientific finding to date.