iconimg Tuesday, April 21, 2015

Pratik Kanjilal
May 29, 2010
At its annual conference next Wednesday, the British Medical Association (BMA) could decide to lobby for homoeopathy to be banned from the UK National Health Service. The validity of the system has always been contested, and I am not naïve enough to take a position for or against the motion in a complicated debate in science and medicine — which are not the same thing, by the way. But I am disturbed by the intemperate dogmatism of the BMA, which has denounced homoeopathy as ‘witchcraft’. I wonder if it’s on a witch-hunt, a related activity which is just as benighted. Its vehemence suggests that the issue is not medical science but medical politics.

It’s an important distinction because the BMA is a reputed organisation and any campaign it takes up would influence opinion worldwide. But with respect to the question of homoeopathy, and with all due respect to the BMA, we should remember that contrary to the popular impression, it is not a scientific organisation. It is a trade union for doctors. That’s the first caveat.

The second: homoeopathy is routinely denounced because no one knows how it works. But a physician should be asking a simpler question: does it work for my patient? The doctor’s primary concern is to offer a cure, or at least comfort. Ruminations about its scientific basis come later. Many patients turn to alternative schools when mainstream medicine fails and leaves them facing chronic disability and pain, or the inscrutable mystery of death. Unless homoeopathy is unequivocally proven to be quackery, which is not the case, it is irresponsible of doctors to bar access to it. It smacks of scientific fundamentalism.

The third caveat: homoeopathy’s benefits are unproven because they can’t be tested by the method of science. Even the most diligently designed double-blind experiment must fail on one significant count. Science requires a valid experiment to be replicable. If Aconite 30 cures the sinusitis of Andy West of Tintagel, it must identically cure Judy North of Inverness. However, homoeopaths go by clusters of symptoms rather than the names of diseases. And, rejecting the egalitarianism of mainstream medicine, they believe that Andy and Judy are different people and should be treated differently. How do you design an experiment to accommodate that difference?

Homoeopathy is based on Hahnemann’s principle of ‘like curing like’. But in operation it is symptomatically statistical. It uses statistical shorthand like ‘miasm’ and ‘psora’ to cluster people and their symptoms into groups, which are mapped to cures. If one banned it, one should also consider banning other disciplines founded on statistics. Economics, a notoriously erratic discipline, immediately comes to mind. Should one ban economics? Maybe.

Maybe — it’s a power word for our times, when science has begun to question its dogmatisms. For instance, the thinking of Sir Martin Rees, astronomer royal of the UK and president of the Royal Society, raises questions reminiscent of intelligent design and The Hitchhiker’s Guide to the Galaxy. In comparison to his free thought, witch-hunts against unexplained phenomena like homoeopathy look positively medieval. I look forward to the day when a healthy agnosticism replaces our scientific fundamentalisms. And by the way, did I mention that Queen Elizabeth II has a personal homoeopath? Maybe I forgot. Yeah, maybe. I love that word.

Pratik Kanjilal is publisher of The Little Magazine, The views expressed by the author are personalAt its annual conference next Wednesday, the British Medical Association (BMA) could decide to lobby for homoeopathy to be banned from the UK National Health Service. The validity of the system has always been contested, and I am not naïve enough to take a position for or against the motion in a complicated debate in science and medicine — which are not the same thing, by the way. But I am disturbed by the intemperate dogmatism of the BMA, which has denounced homoeopathy as ‘witchcraft’. I wonder if it’s on a witch-hunt, a related activity which is just as benighted. Its vehemence suggests that the issue is not medical science but medical politics.

It’s an important distinction because the BMA is a reputed organisation and any campaign it takes up would influence opinion worldwide. But with respect to the question of homoeopathy, and with all due respect to the BMA, we should remember that contrary to the popular impression, it is not a scientific organisation. It is a trade union for doctors. That’s the first caveat.

The second: homoeopathy is routinely denounced because no one knows how it works. But a physician should be asking a simpler question: does it work for my patient? The doctor’s primary concern is to offer a cure, or at least comfort. Ruminations about its scientific basis come later. Many patients turn to alternative schools when mainstream medicine fails and leaves them facing chronic disability and pain, or the inscrutable mystery of death. Unless homoeopathy is unequivocally proven to be quackery, which is not the case, it is irresponsible of doctors to bar access to it. It smacks of scientific fundamentalism.

The third caveat: homoeopathy’s benefits are unproven because they can’t be tested by the method of science. Even the most diligently designed double-blind experiment must fail on one significant count. Science requires a valid experiment to be replicable. If Aconite 30 cures the sinusitis of Andy West of Tintagel, it must identically cure Judy North of Inverness. However, homoeopaths go by clusters of symptoms rather than the names of diseases. And, rejecting the egalitarianism of mainstream medicine, they believe that Andy and Judy are different people and should be treated differently. How do you design an experiment to accommodate that difference?

Homoeopathy is based on Hahnemann’s principle of ‘like curing like’. But in operation it is symptomatically statistical. It uses statistical shorthand like ‘miasm’ and ‘psora’ to cluster people and their symptoms into groups, which are mapped to cures. If one banned it, one should also consider banning other disciplines founded on statistics. Economics, a notoriously erratic discipline, immediately comes to mind. Should one ban economics? Maybe.

Maybe — it’s a power word for our times, when science has begun to question its dogmatisms. For instance, the thinking of Sir Martin Rees, astronomer royal of the UK and president of the Royal Society, raises questions reminiscent of intelligent design and The Hitchhiker’s Guide to the Galaxy. In comparison to his free thought, witch-hunts against unexplained phenomena like homoeopathy look positively medieval. I look forward to the day when a healthy agnosticism replaces our scientific fundamentalisms. And by the way, did I mention that Queen Elizabeth II has a personal homoeopath? Maybe I forgot. Yeah, maybe. I love that word.

Pratik Kanjilal is publisher of The Little Magazine, The views expressed by the author are personal