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Debating the Availability of Publicly Funded Homeopathic Treatment

by David Nortman
Topics: History of Homeopathy • Homeopathic Research • Homeopathy and Skepticism

In the recent article on skepticism about homeopathy we saw how we cannot ignore skeptical media reports because of their powerful influence on the acceptance of homeopathy in society. Well, if we cannot ignore them then let’s debate them!

In today’s article I present a video of a recent debate between physician and homeopath Peter Fisher, clinical director of the Royal London Homoeopathic Hospital (the same one who appears in Dawkins’ The Enemies of Reason) and Ben Goldacre, a physician and skeptical columnist for England’s Guardian newspaper.

The importance of debates such as this is that they influence not only the public but also regulatory bodies that rely on self-appointed experts on both sides of the debate in crafting their policies. In some cases their regulatory decisions exert a significant influence on the state of homeopathy locally and internationally.

Availability of publicly funded homeopathic treatment in the UK

Should homeopathy be available under publicly funded medical programs such as Britain’s NHS (National Health Service)?

Recently there has been a movement afoot to eliminate all UK government spending on homeopathy, after many decades of limited but significant support.

Thanks to the Royal family’s use of homeopathy over the past few generations, there happen to be four government-funded homeopathic hospitals in the UK, where patients can access a combination of conventional and homeopathic treatment along with other alternative services. These hospitals are now under risk of closure due to discontinuation of their government funding. (Incidentally, if you ever experienced the benefits of homeopathy you may sign the “‎Homeopathy Worked for Me‎” online petition which has been organized in response to this troublesome state of affairs — both UK and international residents may sign.)

By learning about this particular debate we can better understand the dynamics between supporters and opponents of homeopathy, and the social consequences of their interaction, wherever in the world these debates might take place.

The video’s total length is 1h33m, of which the following sections are relevant to us:

  1. 6m-26m: Peter Fisher (pro-homeopathy) retells some cases of ‘bad science’ that argue that homeopathy has no effect followed by ‘good science’ that shows that homeopathy has an effect.
  2. 30m-50m: Ben Goldacre (anti-homeopathy) presents the basic principles of skepticism, engages in “armchair skepticism” by declining directly to challenge any of Fisher’s positive evidence.
  3. 1h1m-1h30m: Audience debate, in which several interesting comments in favor of homeopathy are made (the audience in this case is made up mostly of supporters of homeopathy).

The present episode serves as an illustration of the ongoing dialogue between supporters and opponents of homeopathy.

Relevance to other countries

Legislative trends in certain countries often have worldwide implications. If homeopathy were to take a step backward in the UK then it might have less of a chance of being supported elsewhere in the near future, regardless of positive clinical outcomes and patient satisfaction.

Even detractors of homeopathy will admit that the homeopathic hospitals offer a valuable service to the community by striving to maximize patient choice through a broad selection of conventional and complementary treatments: external referrals from ordinary physicians are their main source of patients, and surveys show high patient satisfaction and positive clinical outcomes.

But despite this they consider any expenditure on homeopathy unjustified given, as they claim, its scientific implausibility and lack of demonstrated efficacy in randomized, placebo-controlled trials. In other words, they see any expenditure on unproven therapies as unjustified in principle.

So we see that the fact that there is demand for homeopathy and that homeopathic treatment likely saves health-care resources (by diverting patients away from more costly conventional care) is not enough for ensuring its ongoing, unhindered development. The debate on the status of homeopathy is thus a debate on the extent to which mainstream scientific opinion should determine which treatment choices we pursue.

It is difficult for skeptics to forbid everyone from pursuing homeopathic and other alternative treatments. But it is possible for them to make it more difficult and costly than it could otherwise be, and thereby to prevent from many people from experiencing the benefits of alternative medicine.

Further reading

You may explore the current UK situation in greater detail by following the links below. For a more general view of a typical debate on the scientific status of homeopathy see the lengthy discussion between myself and several defenders of Ben Goldacre’s position as mentioned below.

  1. Open letter calling for a boycott on homeopathy (see also the comments that follow it), written by a group of UK physicians and academics headed by Edzard Ernst (a physician who investigates alternative medicine), demanding that NHS support for homeopathy be stopped.
  2. Peter Fisher’s reply to the above letter.
  3. A recent editorial titled Benefits and Risks of Homoeopathy published in The Lancet (a British medical journal of worldwide influence) by Ben Goldacre, followed by a discussion between myself and Ben and several of his supporters on his site Bad Science. This discussion offers a lively illustration of how such debates are typically not resolved, because each side views the raw evidence through the lens of pre-existing assumptions.
  4. A more recent article about funding cuts for homeopathic services that are already taking place in the UK.

Again, please sign the online petition in support of government-funded homeopathy if you have experienced its benefits and wish to voice your support of it in the UK and beyond.

Have your say below: Should homeopathic treatment generally be funded by the taxpayer or financed privately?

Speak your mind: Share your thoughts on this article by publishing your comment below.

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3 Comments: (Click here to add a comment)

1
Clement on March 8, 2008 wrote:

It would be nice to have homeopathy available for free, but there’s also a good argument for keeping it outside of a government framework. This is a trend in regular medicine as well, where the best care is available privately in many cases.

I wouldn’t hesitate to go to a homeopath if I had confidence that I would be helped, and would be willing to pay from my own pocket, but I haven’t found a homeopath where I live. Perhaps instead of trying to convince governments to support homeopathy I believe homeopaths should concentrate on making their presence known by promoting their services directly to the population.

2
Celia Penderton on March 21, 2008 wrote:

We need to be careful not to show our own biases and not listen to the opposition. You describe Goldacre’s bit as armchair criticism whereas it is a straightforward discussion of evidence. If we are to engage we should not be dismissive. Also, Ben does not directly address Fisher’s points as that would break general debating etiquette of second speakers advantage. Being seen to be fair to our opponents is vital if we are to gain the upper hand.

3
David Nortman on March 21, 2008 wrote:

Celia,

The trouble with Goldacre’s speech is that it enumerated the standard tenets of the skeptical creed without addressing the fact that Fisher had just presented evidence that contradicted them. In other words, he used debating etiquette as a shield against confronting convincing evidence by hypothesizing rather than demonstrating that Fisher’s evidence was vulnerable to this criticism; this is what I meant by “armchair skepticism.”

I’ve debated Goldacre myself (see the link near the end of the article) and there, too, he repeated his points without confronting mine, and quickly bowed out of the debate once he realized that he had a knowledgeable adversary.

Being fair to our opponents is achieved, in my view, through integrity rather than timidity.

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