It is long past time to close the door on homeopathy. After thousands of studies, homeopaths are still unable to produce convincing evidence that homeopathy works for any indication. Multiple reviews of the evidence have come to this conclusion, and now we have one more to add to the pile – the Australian National Health and Medical Research Council (NHMRC) just published their report after reviewing the clinical evidence and have concluded that homeopathy doesn’t work for anything.
Homeopathy is a prescientific medical philosophy based upon the fanciful notions that like cures like (which is really an expression of sympathetic magic) and that extreme dilutions of a substance can retain the magical essence of the substance. These ideas were silly two centuries ago when they were invented. The scientific advances we have made since them have only deepened this conclusion. Homeopathy should have been tossed onto the scrap heap of history along with phrenology, humoral theory, mesmerism, and other quaint ideas. Its persistence is testimony to the power of cultural inertia.
Despite the fact that homeopathic potions have essentially zero scientific plausibility (as close to zero as we can get in science), a great deal of resources have been wasted testing homeopathy clinically. The recent NHMRC review identified more than 1,800 studies, of which 225 were of sufficient size and rigor to include in the review. They report:
The review found no good quality, well-designed studies with enough participants to support the idea that homeopathy works better than a placebo, or causes health improvements equal to those of another treatment.
Although some studies did report that homeopathy was effective, the quality of those studies was assessed as being small and/or of poor quality. These studies had either too few participants, poor design, poor conduct and or [sic] reporting to allow reliable conclusions to be drawn on the effectiveness of homeopathy.
According to CEO Professor Warwick Anderson, “All medical treatments and interventions should be underpinned by reliable evidence. NHMRC’s review shows that there is no good quality evidence to support the claim that homeopathy works better than a placebo.”
In 2013 the NHMRC published a review of the clinical evidence for homeopathy, and they broke this down by medical condition. Of the 68 medical conditions they examined, for 7 of them there was no quality evidence from which to draw any conclusions. For 61 of the conditions there was evidence for lack of efficacy – not just a lack of evidence showing that homeopathy works, but evidence showing that homeopathy does not work.
The NHMRC was not the first to review the evidence or come to this conclusion. In 2010 the UK House of Commons Science and Technology Committee published their own report, concluding:
In our view, the systematic reviews and meta-analyses conclusively demonstrate that homeopathic products perform no better than placebos. The Government shares our interpretation of the evidence. We asked the Minister, Mike O’Brien, whether the Government had any credible evidence that homeopathy works beyond the placebo effect and he responded: “the straight answer is no”.
In 2010 Edzard Ernst published a systematic review of systematic reviews of homeopathy and concluded:
The findings of currently available Cochrane reviews of studies of homeopathy do not show that homeopathic medicines have effects beyond placebo.
The Swiss also reviewed the evidence for homeopathy and came to a somewhat different conclusion. Their report requires some explanation, however. The review board was packed with homeopaths and conflicts of interest, and their review was obviously biased. However, it should be noted that they, in fact, also concluded that the clinical evidence does not demonstrate that homeopathy works. They therefore had to argue for a change in the rules of evidence. Shaw, who critically reviewed the report, concluded:
This paper analyses the report and concludes that it is scientifically, logically and ethically flawed. Specifically, it contains no new evidence and misinterprets studies previously exposed as weak; creates a new standard of evidence designed to make homeopathy appear effective; and attempts to discredit randomised controlled trials as the gold standard of evidence. Most importantly, almost all the authors have conflicts of interest, despite their claim that none exist. If anything, the report proves that homeopaths are willing to distort evidence in order to support their beliefs, and its authors appear to have breached Swiss Academies of Arts and Sciences principles governing scientific integrity.
This pattern is now clear – gold standard clinical evidence shows that homeopathy does not work. Homeopaths do not respond by either producing high quality evidence of efficacy or by changing their views to account for the evidence. Rather, they whine about the game being rigged against them and try to change the rules of evidence, so that weak studies that are almost guaranteed to be false positive are used, or studies that are not even designed to test efficacy.
The response to this latest systematic review has been true to form. Australian Homoeopathic Association spokeswoman Ana Lamaro has already condemned the report as biased. She says:
We’re applying the prism of [a] very, very narrow, restricted format of research that applies well to situations where you’re testing one drug against one pathological state…Homeopathy is a holistic form, meaning we are taking into account the psychosocial, the physical, the emotional state of the person in assessing what they might need medicinally.
This is nothing but special pleading. If homeopathic potions worked, then placebo-controlled trials should demonstrate it. Homeopaths have also had plenty of opportunity to conduct trials in which treatments are individualized, but still have not been able to come up with evidence that homeopathy works. After 200 years and hundreds of studies, homeopaths have not been able to demonstrate that any of the fundamental principles of homeopathy are true, or that homeopathic treatments have any effects beyond placebo. How much more time and resources do they want to suck out of our civilization before it’s enough?
Let’s also examine Lamaro’s statement a bit more. She is referring to the fact that the philosophy of homeopathy doesn’t really even recognize diseases, or standard knowledge about biology and pathophysiology. It is not based upon our modern understanding of how the body works and the nature of specific diseases. It is based upon a prescientific philosophy that is nonsensical to its core. Illness, according to homeopathic philosophy, has to do with the personality type of the patient. Do they cry when they hear classical music?
Here is a homeopathic questionnaire, containing such medically relevant questions as the shape of your face, the shape of your stool, and your personality disposition. This is tooth fairy science – it gives the impression of being thorough, but there is no rationale or evidence to any of it. This, however, is supposed to inform which remedy gets diluted out of existence before you are given an expensive sugar pill. Just like no two astrological readings are the same, no two homeopathic consultations are the same – there is no established standard, and the “experts” cannot agree with each other, because it is all subjective nonsense.
I also find it interesting that whenever clinical studies show that homeopathic potions are just expensive placebos, homeopaths immediately throw the homeopathic products industry under the bus. What Lamaro is saying is that homeopathic products do not work by themselves, they need to be part of a homeopathic consultation. She is therefore saying that every over-the-counter homeopathic product is fraudulent. I wonder what Boiron (the major homeopathic product producer) thinks about that.
Homeopathy cannot work. That is as reliable a scientific statement as any we can make. In other words, if homeopathy did work, we would have to rewrite major parts of basic science textbooks, including physics, chemistry, and biology.
When tested clinically, despite their utter lack of plausibility, homeopathic potions are shown to lack efficacy. So not only should they not work, they in fact don’t work.
Yet proponents of homeopathy would have the world believe that one man, Samuel Hahnemann, stumbled upon a fantastic secret two centuries ago (actually, multiple secrets) that defy scientific explanation, have been ignored by 200 years of scientific progress, and yet to this day would turn our scientific understanding of the world upside down. For some reason, however, believers just can’t seem to produce any convincing evidence for any of it, not even that homeopathic products have any properties at all, let alone clinical efficacy. After 200 years all they can produce are endless excuses and demands for more research.
For some reason we cannot summon the political will to do what reason demands (and what multiple systematic reviews by government bodies have recommended) and finally expel homeopathy from modern health care.
Still there are researchers, either because they are true believers or just naive, calling for yet more research into homeopathy, such as the proposed Toronto study of homeopathy for ADHD. The demand for more research will never end. The public, however, should no longer support this profound waste of resources.