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

In fact, it is important to remember that the clinical trial is so effective at minimizing bias that it is also a vital tool in researching conventional medicine. This is a point that was well made by the British Nobel Prize-winning scientist Sir Peter Medawar:

Exaggerated claims for the efficacy of a medicament are very seldom the consequence of any intention to deceive; they are usually the outcome of a kindly conspiracy in which everybody has the very best intentions. The patient wants to get well, his physician wants to have made him better, and the pharmaceutical company would have liked to have put it into the physician’s power to have made him so. The controlled clinical trial is an attempt to avoid being taken in by this conspiracy of good will.

Although this chapter demonstrates that acupuncture is very likely to be acting as nothing more than a placebo, we cannot end it without raising one issue that might rescue the role of acupuncture within a modern healthcare system. We have already seen that the placebo effect can be a very powerful and positive influence in healthcare, and acupuncture seems to be very good at eliciting a placebo response. Hence, can acupuncturists justify their existence by practising placebo medicine and helping patients with an essentially fake treatment?

For example, we explained that the German mega-trials divided patients into three groups: one received real acupuncture, one received sham acupuncture, and one received no acupuncture at all. In general, the results showed that real acupuncture significantly reduced pain in about half of patients and sham acupuncture delivered roughly the same level of benefit, while the third group of patients showed significantly less improvement. The fact that real and sham acupuncture are roughly as effective as each other implies that real acupuncture merely exploits the placebo effect — but does this matter as long as patients are deriving benefit? In other words, does it matter that the treatment is fake, as long as the benefit is real?

A treatment that relies so heavily on the placebo effect is essentially a bogus treatment, akin to Mesmer’s magnetized water and Perkins’ tractors. Acupuncture works only because the patients have faith in the treatment, but if the latest research were to be more strongly promoted, then some patients would lose their confidence in acupuncture and the placebo benefits would largely melt away. Some people might therefore argue that there should be a conspiracy of silence so that the mystique and power of acupuncture is maintained, which in turn would mean that patients could continue to benefit from needling. Others might feel that misleading patients is fundamentally wrong and that administering placebo treatments is unethical.

The issue of whether or not placebo therapies are acceptable will be relevant to some other forms of alternative medicine, so this issue will be fully addressed in the final chapter. In the meantime, the main question is: which of the other major alternative therapies are genuinely effective, and which are merely placebos?

3 The Truth About Homeopathy

‘Truth is tough. It will not break, like a bubble, at a touch; nay, you may kick it about all day, like a football, and it will be round and full at evening.’

Oliver Wendell Holmes, Sr

Homeopathy

(or Homoeopathy)

A system for treating illness based on the premise that like cures like. The homeopath treats symptoms by administering minute or non-existent doses of a substance which in large amounts produces the same symptoms in healthy individuals. Homeopaths focus on treating patients as individuals and claim to be able to treat virtually any ailment, from colds to heart disease.

IN RECENT DECADES HOMEOPATHY HAS BECOME ONE OF THE FASTEST-GROWING forms of alternative medicine, particularly in Europe. The proportion of the French population using homeopathy increased from 16 per cent to 36 per cent between 1982 and 1992, while in Belgium over half the population regularly relies on homeopathic remedies. This rise in demand has encouraged more people to become practitioners — known as homeopaths — and it has even convinced some conventional doctors to study the subject and offer homeopathic treatments. The UK-based Faculty of Homeopathy already has over 1,4 00 doctors on its register, but the greatest number of practitioners is in India, where there are 300,000 qualified homeopaths, 182 colleges and 300 homeopathic hospitals. And while America has far fewer homeopaths than India, the profits to be made are much greater. Annual sales in the United States increased fivefold from $300 million in 1987 to $1.5 billion in 2000.