Feb 26 2010

Homeopaths On The Run

It’s been a bad year for homeopathy, and it’s still February. The 10^23 campaign has been making a proper mockery of the magical medicine that is homeopathy, capped off with their mass homeopathic “overdose.” In Australia skeptics have been taking homeopathic websites to task for making unsupported health claims. And in the UK there has been increasing pressure to question NHS support for homeopathy – most recently the House of Commons Science and Technology Committee concluded that homeopathy is nothing more than an elaborate placebo and the NHS should completely defund and remove any support for homeopathy. This could be a death blow to homeopathy in the UK, and provide support for similar efforts elsewhere.

Last year was no better. Most memorable was this comedy sketch by Mitchell and Webb, who nicely skewered homeopaths and other cranks. When comedians are not ridiculing them, homeopaths were doing a fine job of lampooning themselves – the best is this video where Dr. Werner tries to explain how homeopathy works – pure comedy gold. Of course the best real explanation for how homeopathy works is here.

Even before the House Committee presented its final report, the embarrassing moments were being immortalized on YouTube, for example the head of a major UK pharmaceutical chain admitting that they market homeopathic products with full knowledge that they don’t work.

All of this has homeopaths a bit desperate, it would seem. They now realize that skeptics and scientists are starting to get traction with their criticism. This is good, because as I have argued before the more we get homeopaths and other pseudoscientists trying to defend themselves, the more they will do our work for us.

Thanks to commenter tl;dr for pointing out this video by homeopath, John Benneth. This is the best incoherent rant yet by a crank against skeptics. If I did not already know Benneth from his other videos, where he puts forward rambling technobabble trying to make homeopathy seem scientific, I could easily have believed this was satire. Benneth looks disheveled, distracted, and gets childishly sarcastic at one point. But that aside, the content of his rant is priceless.

Benneth decides to take on skeptics directly, and by name. He mentions Randi, Edzard Ernst, Simon Singh, Harriet Hall, Michael Shermer, and your humble servant (thanks for including me in such excellent company). He then proceeds straight to the logical fallacy aisle and fills his cart.

He does everything he can to smear our reputations – the video is mostly a giant ad hominem logical fallacy. He says of us:

Whose purpose is to destroy legal medical practice. They’ve made an industry out of libeling others and they’re getting sued for it.

He equates being sued for libel with lying, and mentions Singh and Randi specifically. Yes – being a public critic opens oneself up for being sued for libel as an intimidation and silencing tactic. In fact, this has gotten so out of control, especially in England, that the scientific community (such as this editorial in the British Medical Journal) have called for keeping libel laws out of science. Let us have open debate in the public interest – and not abuse the courts to silence critics.

Benneth misses the fact (or I suspect just does not care) that Simon Singh’s case is still ongoing, and that his criticism of the British Chiropractic Association was completely legitimate – in my opinion and that of many others. Also, while Randi was sued (for example, by Uri Geller) he won those cases. So Benneth seems to be following the strategy – sue someone for libel, then claim they are not legitimate because they were sued for libel – no matter what the status of the case. The accusation of lying is equivalent to lying, for the individual and all of their associates – for reference, see “witch hunt.”

But it gets much worse. Benneth says:

Their action’s like a bunch of terrorists spreading lies and trying to discourage anyone who wants to get legal medical treatment.

I see your ad hominem and raise you a straw man. Wow – the terrorist card. Nice. Of course, our criticism has nothing to do with discouraging people from getting legal medical treatment. Rather, we are trying to educate the public about the scientific basis for treatments that are available, and also to lobby for rational and science-based regulation. Benneth, it seems, is taking the “restraint of trade” tactic that worked for American chiropractors against the AMA. In fact, he characterizes what we are doing as “not legal,” – he is accusing us of actually breaking the law by criticizing his nonsense.

He then returns for some more ad hominem, saying:

None of these people I’ve named, Randi, Ernst, Novella, Singh, are medical practitioners.

Harriet Hall’s not a medical practitioner. Oh, she might have been a flight surgeon at one time, but she’s not now. They’re always retired people, or they’ve been disbarred or defrocked or something, you know they have had some problems in the past. They can’t make it as real doctors or real scientists so they make their livings now by criticizing the works of real practitioners and real scientists, and then they try to run of their business is support. That’s called interference with trade. It’s a crime.

Edzard Ernst is a Professor of Complementary and Alternative Medicine. He is widely published in the peer reviewed literature, including many reviews of homeopathy. He has, by all accounts, a successful and internationally regarded academic career.

Harriet Hall is retired, after a full career as a primary care doctor. She was never “disbarred” or “defrocked” (probably because she was never a lawyer or a priest) – she simply retired. She decided to remain productive in her retirement, and so spends some of her golden years educating the public about science and medicine.

I work with many physicians who have decided to spend time defending the standard of science in medicine and educating our fellow professionals and the public about the relationship between science and the practice of medicine. Most are either actively practicing doctors and nurses or retired professionals. Some, like me, are academics. We also work at times with scientists and educators in other disciplines – such cross-fertilization in science can be very fruitful. We come together over a shared commitment to logic and reason.

Benneth, while ironically accusing us all of actual libel, has decided to slander us by making the demonstrably false accusation that we are all “failed doctors and scientists.” And I wonder what “problems” he is referring to.  I suppose Benneth is used to just making up his facts to suit his needs. After all – he is a homeopath.

Benneth apparently did not do his homework before switching on the video camera, and had to add this caveat in the middle of his video.

I have been informed that Stephen Novella [sic], a notorious self proclaimed “skeptic,” homeopathy basher and professor of neurology at Yale, does indeed qualify as a practitioner. However, I question whether or not he is really a practitioner of medicine, or is simply listed as such for political reasons; why is he thrusting himself into the limelight to pass judgment and argue on another medical doctrine which he denies? His involvement in strange activities have little to do with his profession. A good practicing physician would not take such an extensive, rancorous and defamatory political position against another modality that has support in the material sciences, debating the heads of departments from other universities, such as Professor Ruston Roy of Penn State, Professor William Tiller of Stanford and Professor Iris Bell, MD of the University of Arizona, calling their conclusions “nonsense.” so I question whether he can take on the heavy responsibility of being a competent practicing clinical neurologist while racing around the country to appear on TV shows, pursuing such comparatively frivolous and defamatory activities as organized “skepticism,” (not Pyrrhic skepticism, which demands withholding judgment in lieu of man’s inherent agnosticism.) The man is bizarre. President and co-founder of the New England Skeptical Society (NESS), he hosts their podcast, “The Skeptics’ guide to the Universe,” writes a monthly column called “Weird Science” for the New Haven Advocate, writes a blog and contributes to others. He has also appeared on several television programs, including an [sic] crude cable TV program hosted by abusive magicians. So where he gets time to be a good practicing neurologist is questionable.

Cranks really do not like to be criticized, especially by an academic with some credentials. It really irritates them. Recently on this very blog, naturopath Christopher Maloney, responding to criticism of the lack of science behind his claims and practices, took a similar approach in the comments to this blog. He went as far as to accuse me of neglect for spending my time in skeptical activities.

Maloney and Benneth appear to be blissfully unaware of the academic lifestyle. I have many colleagues who spend more of their non-clinical time than I doing things like maintaining websites, writing textbooks, doing research, or engaging in other academic activities. It’s pretty much expected. I do teaching, writing, and some research as well. But I have decided to spend much of my spare time pursuing public science education and advocating for high standards of science in medicine. All of this is in addition to a full time clinical schedule. Such are the realities of an academic medical career.

Benneth and Maloney are only interested in making a cheap (and naive) ad homimen attack – which basically amounts to saying “shut up.” They cannot deal with the substance of the scientific criticism aimed against them and their beliefs, so they try to make it seem like the entire endeavor of criticizing pseudoscience in medicine is not legitimate. It’s all quite childish.

I also like how Benneth says that my “involvement in strange activities have little to do with his profession.”  “That,” as Yoda once said, “is why you fail.” Skepticism is essential to being a good clinician. A clinician must understand how to read and apply the scientific literature, and how to be wary of the mental pitfalls that tend to lead us astray. Being a good clinician is partly being a good investigator, a Sherlock Holmes of medicine – which has everything to do with skeptical philosophy. Benneth rejects skepticism and practices homeopathy – it is easy to see how these two things are related.

Sprinkled throughout the video is also Benneth’s claim, implied or direct, that homeopathy works. He makes the astonishing claim:

Nobody would practice homeopathy unless there was clear evidence, clear evidence that it worked.

This is naive in the extreme, and by extension would mean that every medical practice must work, or else why would people use it. I guess this means that the bloodletting that was practiced in the West for two thousand years must have also worked. Throughout the video he also presents text from published studies which presume to show that homeopathy works. But as usual he is cherry picking and misrepresenting the evidence.

A thorough review of the homeopathic literature shows a clear pattern of no effect greater than placebo. In a systematic review of systematic reviews, Edzard Ernst concluded:

In particular, there was no condition which responds convincingly better to homeopathic treatment than to placebo or other control interventions. Similarly, there was no homeopathic remedy that was demonstrated to yield clinical effects that are convincingly different from placebo. It is concluded that the best clinical evidence for homeopathy available to date does not warrant positive recommendations for its use in clinical practice.

But of course, Benneth thinks Ernst is not an authority, even though he has more than 70 peer reviewed published articles on homeopathy.

After reviewing the evidence and testimony on both sides, the Science and Technology Committee also agreed that there is no plausibility to homeopathy and the clinical evidence shows it is no better than placebo. This accords with my own reading of the literature. And let us not forget that there is, for all practical purposes, zero plausibility to homeopathy. You don’t have to be a clinician to understand this – homeopathy violates basic principles of physics, chemistry, and thermodynamics. Homeopathic preparations are often diluted beyond the point where there is any active ingredient left, and this fact cannot be rescued by any hand-waving arguments about nanobubbles and radio waves.

Conclusion

The cat is clearly out of the bag. Homeopathy is a 200 year old pre-scientific system of pure pseudoscience. Modern attempts to explain how it might work have failed, and the clinical evidence shows (no surprise) that it does not work.

The public has been largely unaware of these facts, thinking that “homeopathic” was equivalent to “natural” and that they were getting herbs or some plant-based treatment. Like any cult, information is the enemy of homeopathy. The more the public, and regulators, understand about homeopathy the more ridiculous it seems.

Homeopaths are now in the desperate situation of shouting “ignore that man behind the curtain.” They have decided to attack the messengers – skeptics. But in so doing they are just making the situation worse for themselves, as their attempts to explain homeopathy and discredit their critics are indistinguishable from drunken rants.

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