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Call for doctors not to practice homeopathy or refer
to homeopaths
The Medical Council of New Zealand (MCNZ) released their
Statement on Complementary and Alternative Medicine (CAM) in March 2011, in
order to inform doctors of the standards of practice that are expected of them
if they have patients who use CAM.1
The key principle is that the Council does not oppose CAM
use if it has "...demonstrated benefits for the patient...and patients have
made an informed choice". The Council state that they endorse comments made
in a Medical Practitioners Disciplinary Tribunal decision that "there is an
onus on the practitioner to inform the patient not only of the nature of the
alternative treatment offered but also the extent to which it is consistent with
conventional theories of medicine and has, or does not have, the support of the
majority of practitioners...". Further, the Council statement says that
patients "must be aware of the likely effectiveness of a given therapy
according to recognized peer-reviewed medical publications, notwithstanding your
individual beliefs".
Some CAM therapies have been shown to be safe and effective,
and others are scientifically plausible but only have weak evidence to support
their use. However, there is no grey area with respect to homeopathy, a practice
which involves diluting substances to such a degree that not a single molecule
remains. An example of a homeopathic product is "Berlin Wall", which consists of
dust from the Berlin Wall, diluted until none remains, sold to people to help
them stop feeling repressed. It is not hard to see why the British Medical
Association recently described homeopathy as
witchcraft.2
A 2006 survey found that around 15% of New Zealand GPs will
either administer homeopathy or refer patients to a
homeopath,3 but this would appear not to be
compatible with the Medical Council statement.
In terms of demonstrated benefits, there are none other than
placebo effects.4 A US $1 million prize remains
unclaimed for anyone who can demonstrate any in-vitro or in-vivo effects of any
homeopathic product. Therefore the "likely effectiveness.... according to
recognized peer-reviewed medical publications" is that there will be no
benefits beyond those of a placebo.
With respect to "the extent to which it is consistent
with conventional theories of medicine", this is also
clear—homeopathy is biologically implausible and completely inconsistent
with our understanding of medicine, biology, pharmacology and pathology.
Homeopathy does not have the support of the majority of
medical practitioners, as demonstrated by the British Medical Association
statement above and the 2006 New Zealand survey which found that most GPs say
that it does not have benefits.2,3
Therefore in order for informed consent to occur according
to the MCNZ statement, a doctor would have to say that:
The authors of this letter consider that
practicing homeopathy, or endorsing it by referring patients, is not consistent
with the ethical or regulatory requirements of practicing medicine, and call for
doctors to do neither.
Shaun Holt
Adjunct Professor, School of Biological Sciences Victoria University of Wellington, New Zealand Andrew Gilbey
Lecturer, College of Business Massey University, Palmerston North, New Zealand David Colquhoun
Professor of Pharmacology, Dept of Pharmacology University College London, England Michael Baum
Professor Emeritus of Surgery & Visiting Professor of Medical Humanities University College London, England Edzard Ernst
Director, Complementary Medicine, Peninsula Medical School University of Exeter, England References:
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