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Of homeopathy, witchcraft and the placebo effect

I’ve been following with amusement — and some exasperation — the debate in England about ending National Health Service funding for homeopathic medicines.

I’ve been following with amusement — and some exasperation — the debate in England about ending National Health Service funding for homeopathic medicines. I particularly enjoyed reading about the doctor who first compared homeopathy with witchcraft — only to quickly apologize to witches.

“Homeopathy is not witchcraft, it is nonsense on stilts,” he told a meeting of the British Medical Association last June. “It is pernicious nonsense that feeds into a rising wave of irrationality which threatens to overwhelm the hard-won gains of the enlightenment and the scientific method.”

“We risk, as a society, slipping back into a state of magical thinking when made-up science passes for rational discourse and wishing for something to be true passes for proof,” he added.

My sentiments exactly.

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At best, homeopathic medicines are placebos. And that’s exactly what a study published earlier this week in the journal Rheumatology has found.

Here are the details:

The study recruited 83 people with rheumatoid arthritis from three British clinics where they were receiving conventional treatment for that chronic and often debilitating inflammatory disease. (Rheumatoid arthritis patients were chosen for the study because homeopathy is often turned to by people desperate to get relief from their painful symptoms.)

Some of the study’s participants were then randomly assigned to five sessions of individualized homeopathic consultations, during which they received either actual homeopathic medicines or placebos. Neither the practitioners nor the patients knew which treatment was being handed out. The initial consultation was about an hour long. Subsequent ones ran about 30 minutes long.

Other participants were randomly assigned to receive either a fixed combination of homeopathic medicines for arthritis or a placebo, but without the consultations.

After 12 weeks, the 56 participants who remained in the study (the rest dropped out for a variety of reasons) used standardized assessments to self-evaluate their arthritis symptoms, including pain, inflammation, swollen joints and mood swings. Those who participated in the consultations — whether they received homeopathic medicines or a placebo — reported a significant improvement in their symptoms.

The participants who hadn’t participated in the consultations showed no improvement.

“Homeopathic intervention in patients with chronic, active but relatively stable [rheumatoid arthritis] has significant clinical benefits that are attributable mainly to the homeopathic consultation process. There appeared to be no specific benefit from the homeopathic remedies themselves,” concluded the study’s authors.

Or, as one of the authors told a British newspaper: “When you place the patient at the heart of the consultation you get a powerful effect. I think there are a lot of lessons here for conventional medics about the need for patient-centered care, instead of treating people as walking diseases.”

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True, true. Conventional medicine has a long, long, long way to go to becoming patient-centered.

But that still doesn’t lift homeopathy above witchcraft.