Trick or Treatment—The Undeniable Facts about Alternative Medicine (Electronic book text)

It was misguided at best, irresponsible at worst, for the Prince of Wales to suggest publicly that Gerson therapy might be able to treat cancer, when the evidence is to the contrary. And it would be arguably reckless for him to continue promoting alternative medicine in general when we have demonstrated in this book that very little benefit is derived from therapies such as acupuncture, homeopathy, chiropractic therapy and herbal medicine.

In short, the Prince of Wales ought to start listening to scientists rather than allowing himself to be guided by his own prejudices. Or, as Professor Michael Baum, a cancer specialist at University College, London, put it: ‘The power of my authority comes with a knowledge built on 40 years of study and 25 years of active involvement in cancer research. Your power and authority rest on an accident of birth.’

Placebos — little white lies or fraudulent falsehoods?

We have shown that the majority of alternative treatments are wholly or largely ineffective in treating the majority of conditions. The term ‘ineffective’, however, does not mean that such remedies are of no benefit to patients, because there is always the placebo effect, which we know can offer varying levels of relief. So, should doctors encourage the use of disproven alternative treatments, which on the one hand are nothing more than fake remedies, but which on the other hand can help those patients who have sufficient faith in them? Can large parts of the alternative-medicine industry justify their existence by offering relief through belief?

Of course, patients with life-threatening conditions cannot rely on the placebo effect to rescue them, but for patients with less serious conditions the issues are more complicated. Because of this complexity, we will explore the value of placebos by focusing on homeopathy, but everything that follows is also applicable to the placebo effect in the context of other alternative therapies.

Homeopaths will argue that their remedies are genuinely effective, but we know that the best scientific evidence concludes that homeopathic remedies are bogus and rely wholly on the placebo effect in order to benefit patients. For example, rubbing homeopathic Arnica cream on a bruise works only at a psychological level, so that a patient merely feels that a bruise is healing faster and that the pain is subsiding. Or a person with high blood pressure might take a homeopathic remedy, and the resulting sense of optimism might normalize his blood pressure. Similarly, a patient who uses homeopathy to deal with hay fever will expect the remedy to be helpful, hence the placebo effect may actually reduce the hayfever symptoms, or perhaps the patient tolerates the same symptoms with more fortitude — either way, the patient is happier. Some patients take homeopathy for self-limiting conditions, such as colds, which will clear up regardless after a week or so — in these sorts of cases, the placebo effect makes the patient feel better because he or she is given the illusion of taking control of the illness. For some conditions, such as back pain, conventional medicine struggles to offer a reasonably good solution, which means that a homeopathic remedy might be as good as anything else. After all, it will garner whatever psychological strengths the patient can bring to bear.

With all these undoubted benefits, it might seem that the use of homeopathy as a placebo is an obviously good thing, because it gives patients hope and relief. Many people might even argue that this is sufficient justification for homeopathy to be embraced by conventional doctors.

However, we take a different view. Despite the allure of the placebo effect, which is often (but not always) cheap, safe and helpful for patients, we strongly believe that it would be wrong for doctors and other healthcare practitioners to use homeopathic pills in this way. We base this stance on a variety of arguments.

One of our main reasons for discouraging the use of placebo-based alternative medicine is the desire for honesty between doctor and patient. For the last few decades, the consensus in medicine has moved very decidedly towards encouraging a doctor — patient relationship based on openness and fully informed consent. This has involved doctors using the principles of evidence-based medicine to offer patients those treatments that hold out the greatest likelihood of success. Any reliance on placebo treatments would undermine all these goals.