It’s been pumped in many quarters that we are presently in the middle of World Homeopathy Awareness Week. At this time, a great deal has been written, much of it on blogs such as this one, and much of it critical of homoeopathy’s persistence despite its counterfactual and anti-scientific nature (Part deux here). It is not our purpose to rehash the very many fact-based reasons why homoeopathy is, to a high degree of certainty, a load of undiluted bunk. It should be sufficient to consider just how convoluted and contrived are the “reasons,” “facts” and “arguments” of its proponents in order to set off a strident clamour of alarm bells.
Rather, the aim of this entry is to examine a few of the ethical issues attending the application of homoeopathy and how these often play out in practice.
If one were to Google the phrase “good intentions are not enough,” a plethora of hits would be returned. This signifies, above all, that it is a familiar phrase, something that is no doubt also true of many other phrases, be they English or of a different language. However, the phrase’s popularity cannot be taken to mean that it’s well understood what the phrase (or dictum if you like) intends to convey.
There are numerous stories and anecdotes about preventable harm and death at the hands of homoeopaths. Admittedly, these are just that – anecdotes, even if, in many cases, they are well-documented ones, and homoeopaths will claim the obverse, i.e. that homoeopathy could have prevented harms inflicted through conventional medical endeavours. But conventional practices are continually reassessed and improved whenever possible. It is astonishing, then, that homoeopaths do not seek, with appropriate and comparable vigour, to advance their “science” past the clearly outdated and counterfactual notions of Samuel Hahnemann. The fundamental “science” of homoeopathy retains exactly the same basic nonsensical principles articulated by Hahnemann more than 200 years ago, and is today concerned only with manufacturing ever more elaborate excuses why these must be taken to be not only valid, but also – inconsequently, please note – supportive of homoeopathy’s effectiveness. As an exercise in ethics, it should be self-evident that the “good intentions” of defending – at whatever cost – Hahnemann’s outmoded thinking “are not enough” to justify either the potential or the actual harm resulting from “knowledge” derived from dubious or even bogus premisses.
As medical practitioners (if only so in name), homoeopaths have a clear ethical obligation to inform their patients of unknown aspects or uncertainties or potential failures of their methods. Homoeopaths are partial to citing Hippocrates at opportune moments, specifically his moral directives concerning patient care – more so than practitioners of conventional evidence-based medicine. In this light, it is, to say the least, surprising that homoeopaths, almost without fail, seem always to know exactly what ails a given patient, and how to go about curing the condition. This last observation is based on discussions with and personal experiences of several different homoeopaths, so it cannot by any means be taken to be authoritative. Still, it is interesting to note that not one of these homoeopaths ever recommended a visit to a specialist, or admitted to being baffled, or hesitated to commit to a diagnosis, prognosis and/or course of treatment. Indeed, their findings were pronounced with firm confidence, as were the prescriptions of “remedies.” Never once was a caution issued along the lines of, “This may not work. Come and see me in a week or two if you don’t improve and we’ll try something different.” Such self-assurance is not warranted when assessed against the facts of homoeopathy’s performance, but perhaps that is exactly how they dupe themselves and the majority of their patients. Who needs ambiguity when buoyant conviction can be had at the same price?
Many homoeopaths also include several other CAM modalities, such as aromatherapy, applied kinesiology, iridology, crystal therapy, naturopathy, etc., in their repertoire. Here, one should immediately feel pressed to ask a very urgent and insistent, “But why!?” After all, if homoeopathy is, as very often claimed, an essentially complete system with only a few minor details left to be sorted out, it is just a little seditious of any homoeopath to augment his or her range of offerings with “skills” or methods that do not fit the homoeopathic mould. It would be akin to a hydrogeologist who professes to use pendulum-on-a-map divination in addition to willow-twig dowsing and remote viewing techniques for the siting of wells. It should, rightly, arouse the thinking individual’s suspicions: If X promises a whole solution, why bother with Y and Z? Could it be that, despite its philanthropic pretensions, homoeopathy and its evidence-free inbred cousins are – O, mon cœur noir! Quelle squalid sordidness, quelle grimy grubbery! – a business!?
When examining the trading of homoeopathic remedies, two further moral aspects rear their hydrocephalic heads. There are many off-the-shelf preparations that sport labels prominently emblazoned with “Homeopathic” (preferring, oddly, the miscreant US spelling – it has little to do with “O homeo, homeo, wherefore art thou homeo” and lots to do with “homoeo—,” Greek homoios). Of these remedies, several turn out, on closer inspection, to be about as homoeopathic as a flamethrower, usually by reason of significant concentrations of active ingredients. That is, the label of “Homeopathic” has been abducted purely for marketing purposes because there is a major subculture out there that buys into the sham and is therefore easy to bilk and milk in perpetuity. However, what is truly telling is that not a single homoeopath, either individually or through coordinated effort, has ever made a fuss about such blatant misuse of their craft. In contrast, it would not take very long before a shaman who sold, say, powdered baboon brains as a “proven” antidepressant, will find him- or herself in heaps of trouble with an assortment of professional bodies over misrepresentation. Thus, one must ask how it is that homoeopaths are apparently quite content to permit the hijacking of their terminology and principles for someone else’s promotional purposes.
Of at least equal significance is the fact itself of the ready availability of off-the-shelf bona fide homoeopathic preparations. To understand this properly, it is necessary to remember that a central principle of homoeopathy, second in status only to Hahnemann’s two founding tenets, is that of the individualised remedy. That is, homoeopaths design a “treatment” after assessing “holistically” the afflicted individual, and this “treatment” is allegedly specific to the individual for whose purposes it was formulated. It should be obvious that there’s a fundamental disconnect between the idea of an “individualised treatment” and that of off-the-shelf preparations (often selling, almost needless to say, at prices a Croesus would find challenging, given what they are). Again, no homoeopaths appear overly concerned about this sort of manipulative misuse.
It is the deception inherent in an “individualised treatment” – a “deception” because as humans we are to the best of medical science’s knowledge biochemically too similar to one another to merit such fine-grained distinctions as homoeopaths would make – that facilitates a further homoeopathic subterfuge. “Randomised double-blind placebo-controlled clinical trials,” proclaims the committed homoeopath in a voice of solemn gravity, “are not a suitable tool for gauging the effectiveness of homoeopathy because treatments must be tailored to the individual.” Well, fuck. And now what? There is an easy way around this, one that no homoeopath has ever proposed. By all means, do the individualised assessments and prescriptions for a significant sample of patients, and only after this has been completed is it time to randomise and placebo-ise (to coin a term) via another independent party whose involvement, except for revealing the group assignments (placebo or prescription) at the conclusion of the study, ends at that point. It’s not by any stretch of the imagination rocket science, proverbial or otherwise, and it’s eminently feasible. But instead of working towards such earnest endeavours to assess the validity of their spiel, homoeopathic apologists offer only superficial pretext and feeble rationale – with homoeopathic dilutions of verifiable fact.
And by these various factors the innate hypocrisy of homoeopathy in its modern practice becomes explicit.