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DOI: 10.1055/s-0043-1762590
Against Arguments There Are No Facts—The Inconsistencies of Critics of Homeopathy
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“…a staged trial in which the verdict is known before the trial has begun”.
W. Heisenberg
Every homeopath at some point in his career faces negative or contrary opinions. Almost every year our profession is threatened by sceptics brandishing articles – with dubious methodologies to say the least – whose sole purpose is to declare ‘the end of homeopathy’.
When we examine the posture of these sceptics a little more carefully, it is possible to recognise a pattern: when the object of study is homeopathy, they pose as defenders of the scientific method at the same time that they condemn it.
I have selected three examples of this inconsistent and anti-scientific attitude. These authors span a spectrum from the most academic to the most popular.
Our first example is taken from an article of which one of the authors is Dr Guyatt, one of the fathers of evidence-based medicine (EBM), i.e., making medical decisions based on the best information available. In this text, considerations are made about the philosophical assumptions of this approach.[1]
Let's look at these two excerpts:
‘(...) what counts as “true” scientific knowledge is tentative and remains revisable as science progresses’.[1]
‘The emphasis of EBM on skepticism and uncertainty (...) agrees with the philosophical view that scientific knowledge is never complete and ultimately falible’.[1]
The main characteristic of science is brilliantly described there: our knowledge is provisional. In the human activity called science, we deal with hypotheses and never with dogmas. The confrontation of several hypotheses that can result in a change of understanding is what we call the scientific method.
The authors provide a didactic example:
‘... observations obtained in the clinical trial on hormone replacement therapy were accepted as accurate despite contradicting the prevailing theory of the day (resulting in the change of practice almost overnight)’.[1]
That is, despite the initial theory suggesting a type of treatment, the tests showed that the theory could be wrong, a fact that led to a change in conduct to adapt to the new evidence. In other words: facts trump arguments.
But see how, in the same article, the reasoning changes when it comes to homeopathy:
‘However, results from homeopathy trials that were obtained from RCTs [randomized controlled trials] were dismissed to a large extent due to the extreme skepticism regarding homeopathic theory’.[1]
What?!
In the case of hormone replacement, the best evidence has caused the medical approach to change overnight, even if it contradicts the theory. However, when it comes to homeopathy, the authors argue that, if the evidence contradicts the theory, we should continue clinging to the theory. That is, against the arguments, the facts do not matter.
And we are not talking about just any evidence, but exactly those obtained by the type of test that in EBM is considered of high quality. The authors themselves confirm:
‘Evidence obtained in homeopathy RCTs consists of high-quality placebo-controlled trials in that both patients and physicians were “blinded” to intervention’.[1]
So, what's the argument for snubbing high-quality tests? What is this powerful argument capable of making critics ignore the facts?
In debates about homeopathy, the topic that is always placed in the dock – and without the right to be defended – is the ultra-dilution.
‘However, homeopathic drugs are prepared by serial dilutions of remedy, the result of which is that the drug is diluted to the point that there is little to no likelihood that a single molecule from the original solution is present in the final product. As a result, the homeopathic solution is not believed to adhere to contemporary chemical principles, thereby making any claim about its effects pharmacologically implausible’.[1]
That is: what is valid for other fields of science is not valid for homeopathy. At this point in the text, the authors have already forgotten those important words with which they characterised scientific knowledge: revisable, uncertainty, never complete, fallible. It seems that in the case of ‘contemporary chemical principles’ the best adjectives to qualify them would then be: certain, absolute, complete, immutable.
Our second example is taken from one of the greatest authors in epistemology: Michael Polanyi. This philosopher of science was responsible for some of the most important insights for understanding the structure of scientific knowledge.
We read in his book called ‘Personal Knowledge’[2]:
‘Formal operations relying on one framework of interpretation cannot demonstrate a proposition to persons who rely on another framework. Its advocates may not even succeed in getting a hearing from these, since they must first teach them a new language, and no one can learn a new language unless he first trusts that it means something’.[2]
Nothing seems to better describe the situation of a homeopath vis-a-vis sceptics than these words. Homeopathy presents a new language and critics are unwilling to learn it. Therefore, the doors are already closed at the beginning of the debate, for them homeopathy simply has no right to exist.
Polanyi continues:
‘Proponents of a new system can convince their audience only by first winning their intellectual sympathy for a doctrine they have not yet grasped (...) Such an acceptance is a heuristic process, a self-modifying act, and to this extension a conversion (...) They think differently, speak different language, live in different world...’.[2]
That is, in science, new discoveries provoke a rupture, not only with the previous way of thinking, but also with the language itself. Polanyi calls this rupture a conversion: we abandon a hitherto accepted interpretation and commit ourselves to another interpretive system; we leave one world to enter another.
But let's see what the great philosopher says when the subject is homeopathy:
‘Take for example homeopathy. In this case the efficacity of an alleged art, still widely practised today, can be wholly refuted, in my opinion, by a mere analysis of its claims. Medicinal substances used homeopathically can be shown, on the evidence of homeopathic prescriptions, to be diluted to concentrations as low as, or below that, in which they are presented in ordinary food and drinking water; it seems impossible that an additional spoonful of them administered in a similar solution would be medically effective’.[2]
When faced with the other world of homeopathy, it seems that the author forgot that need for new interpretative frameworks that, in a moment of lucidity, he himself advocated for new scientific discoveries. Sticking to accepted theories, he claims that the practical result of homeopathy (its effectiveness) would be refuted by the simple rhetoric of its implausibility. That is, it seems that the philosopher does not have that ‘intellectual sympathy’ for homeopathy – against his arguments there are no facts.
The third example is taken from a popular book: Bad Science [3] by Ben Goldacre. Early in the book we have a passionate defence of EBM:
‘... evidence-based medicine, the ultimate applied science, contains some of the cleverest ideas from the past two centuries, it has saved millions of lives, but there has never once been a single exhibit on the subject in London's Science Museum’.[3]
And with beautiful words the author also reminds us of the importance of scientific knowledge:
‘... the very core of why we do science: to prevent ourselves from being misled by our own atomised experiences and prejudices’.[3]
The subject that occupies the largest chapter in the book is homeopathy (despite the author saying at the beginning of the book that it is not ‘important or dangerous’).
Let's see some of his considerations:
‘Homeopathy is perhaps the paradigmatic example of an alternative therapy (...) without scientific evidence to demonstrate its veracity; and its proponents are quite clear that the pills will make you better, when in fact they have been thoroughly researched, with innumerable trials, and have been found to perform no better than placebo’.[3]
If, for the author, the ultimate applied science is medicine based on evidence, then it is to it that we should turn to confirm these sentences: ‘without scientific evidence to demonstrate its veracity’ and ‘have been found to perform no better than placebo’.
For EBM, systematic reviews of randomised clinical trials with meta-analysis occupy the first place in the hierarchy of levels of evidence. A Brazilian review published in 2017 found seven studies of this type on homeopathy, six are favourable, that is: it cannot be said that the effects of homeopathy are exclusively a placebo effect. Only one study attributed the homeopathic clinical effects to the placebo effect and this one was severely criticised due to methodological flaws.[4]
Why consider just one of those seven studies? It sounds like a prejudice. But the author said at the beginning of the book that he studied science in order not to be deceived by his own prejudices.
Someone might claim that the book was written in 2008 and all these reviews did not exist yet. But four of them predate the book: Kleijnen et al (1991), Boissel et al (1996), Linde et al (1997 and 1998).[4] That is, the author simply ignores the evidences when he makes his claims. Where is the EBM he praised so much? His medicine seems to be based on the evidence that suits him. Here too we see that against the arguments, the facts do not matter.
If the ideal of science is to be a knowledge subject to constant revisions, a free field for investigations, an eternal search for the truth, then the truly scientific attitude should be a total openness to new discoveries, even those that challenge established knowledge and that for this very reason they tend to modify our understanding of reality. Science has been described as a tension between tradition and innovation, stability and change.[5]
The posture of all these authors who repudiate homeopathy is the same: they seem to represent the scientific spirit, they accept the fallibility of knowledge and the need to revise our beliefs, they pose as defenders of good science; but when the methods of that same science lead to evidence favourable to homeopathy, they quickly close their eyes, turn their backs on reality and, in a dishonest attitude, they forget the spirit they claimed to defend.
Publication History
Article published online:
05 April 2023
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References
- 1 Djulbegovic B, Guyatt GH, Ashcroft RE. Epistemologic inquiries in evidence-based medicine. Cancer Contr 2009; 16 (02) 158-168
- 2 Polanyi M. Personal Knowledge. London: University of Chicago Press; 1958
- 3 Goldacre B. Bad Science. London: Fourth Estate; 2008
- 4 Waisse S. Clinical research in homeopathy: systematic reviews and randomized clinical trials. Revista de Homeopatia 2017; 80 (3/4): 121-133
- 5 Kuhn T. The Essential Tension. Chicago: University of Chicago Press; 1977