Monday, February 22, 2010

Homeopathic Nonsense

Medicine is fraught with difficulties. The case, currently before the Alberta courts, of the child on life support whose parents want to sustain but the doctors directly involved see no hope is one example of the ethical and moral hazard of medical practice. The case of Avandia – the diabetes drug now known to have strong side effects, including fatal heart attacks – was approved by a medical panel, indicating how difficult it is to see solid clinical evidence as a basis for decision making, despite randomized control trials and strict standards for drug testing.

But some decisions in medical science are relatively straightforward, especially for those whose task it is to determine which medical procedures get funded and which do not. No one should fund or indeed support homeopathy.

There are many who believe in homeopathy. The fact that there is a belief system and a group of people who are adherents to this belief system does not make homeopathy effective or an appropriate treatment. Indeed, no clinical evidence exists to suggest that homeopathy has any effects whatsoever.

Don’t take my word for it. A thorough review of homeopathy has just been completed by the Science and Technology Committee of the House of Commons in Britain. Their conclusion: “the evidence base shows that homeopathy is not efficacious (that is, it does not work beyond the placebo effect) and that explanations for why homeopathy would work are scientifically implausible”. Is that clear. It was clear enough when, following a similar review, public funding for homeopathy was withdrawn in both Germany and Switzerland.

Yet in British Columbia the Green Party has argued that it should be funded, despite the decision of the BC Government not to do so. Jane Sterk, leader of the Greens, has bought into the idea that if people want it they should be able to get it as part of a Provincial health plan, whether or not the treatments work.

We also have a Federal initiative which seems to take homeopathy seriously. The Natural Health Products Research Program (NHPRP) of the Natural Health Products Directorate within Health Canada has been consulting with homeopathic practitioners and developing a research agenda, as if if this branch of pseudo-science was to be taken as seriously as, for example, a pharmaceutical product or new medical practice. Homeopathic products, sold over the counter in drug stores, are regulated by this Federal body. In 2008 the federal government proposed Bill C-51, which contained the potential of restricting the availability of certain natural health products -- including homeopathic medicines -- except by prescription through practitioners who are authorized by their provincial governments. The reality is that many of the “medicines” labeled homeopathic contain no detectable amount of active ingredient, so it is impossible to test whether they contain what their label says. Unlike most potent drugs, they have not been proven effective against disease by double-blind clinical testing. In fact, the vast majority of homeopathic products have never even been tested; proponents simply rely on "provings" to tell them what should work. Its time for the a bill to ban their sale.

In June 2007, Ontario passed the Homeopathy Act, which regulates the practice of this pseudo-medicine. It establishes a College of Homeopaths, regulates entry to the profession and seeks to regulate practice, though not all aspects of the Act are fully in force. The problem here is that this gives credibility to a practice for which there is simply no substantive evidence to support its practice.

It is a sad commentary on our health care system in Canada where evidence and clear thinking give way to populism. Where is the politician demanding the removal of homeopathic remedies from drugstores and who also favours the prosecution of practitioners under fraud laws?

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