Paul Benedetti is a journalist and author who taught journalism and critical thinking at the University of Western Ontario. Wayne MacPhail is a veteran journalist and emerging media consultant. They are the authors of Spin Doctors: The Chiropractic Industry Under Investigation. Timothy Caulfield is a Canada Research Chair in Health Law and Policy at the University of Alberta.
Belief in homeopathy simply won’t die. Despite the mountains of science that tells us it is bunk, advocates keep emerging – including, most recently, former federal NDP leader Thomas Mulcair, who wrote in support of it in November.
“In today’s world, people are more informed than ever and you need a compelling reason to remove their right to make decisions for themselves,” he wrote in an editorial in the Toronto Sun. “There are many alternative medical practices, old and new, that are providing treatment, comfort and relief to patients but that cannot be fully explained by science. They now need to be regulated in the public interest, not prosecuted on the pretense of protecting the public.”
That was an unfortunate and unhelpful misstep from a respected parliamentarian who, despite his reputation as a skilled debater and knowledgeable lawyer, has used a legalistic defence around “personal liberty” that puts vulnerable patients in harm’s way.
His appeal is a common refrain – not to mention an intuitively appealing one – in the alternative-medicine world. It seems logical: Consumers should have the right to choose whatever treatment they want for them and their children. Sounds reasonable.
First, homeopathy does not work. Period. It is a form of alternative medicine from the mid-19th century based on the law of infinitesimals. It claims that diluting a substance in water makes the substance more potent. In fact, many homeopathic remedies are so diluted that not one single molecule of the original substance exists in the product. There is not a shred of scientific evidence that supports the efficacy of homeopathic remedies and the laws of chemistry and physics make its claims impossible.
Second, this isn’t about freedom of choice.
Sick people are not like consumers shopping for a vacuum cleaner. They are ill, sometimes desperately so, and are faced with a decision based on complex medical and scientific data. They often have to trust health-care professionals and regulators, such as Health Canada, to help facilitate the provision of evidence-based information about risk and benefits. Informed choice is dependent on the availability of accurate information.
Unfortunately, there is currently a huge amount of misinformation circulating about many health products. Studies have consistently shown that online health information can be misleading, that people often do not access the most accurate and authoritative sites, and that many feel confused and frustrated about what health information to believe. It is no surprise that the World Health Organization has declared the spread of health misinformation, specifically around vaccines, a "major threat to global health.”
In the context of alternative medicine, people may be persuaded by dramatic testimonials, appeals to the naturalistic fallacy, fear-mongering about conventional medicine, false and misleading advertising and, unfortunately, personal endorsements by high-profile people. In addition, cognitive biases, such as an illusory belief in cause-and-effect, may influence how people evaluate the effectiveness of a therapy. People may believe it worked when, in fact, it was either the placebo effect or the simple fact that they would have gotten better on their own.
Yes, there are many problems with conventional medicine, including a lack of evidence for many commonly used therapies. But that is not a justification for an increased tolerance of other therapies that do not work. We need good science everywhere.
And good science proves that homeopathy simply does not work, because it cannot work. We don’t choose that reality; the laws of nature do. So contrary to Mr. Mulcair’s claim, the fact that homeopathy is still marketed as an effective therapy for a range of conditions highlights the need for stricter, rather than legitimizing, regulatory oversight. We need regulators and science-informed health professionals to ensure that people have access to accurate information and that unproven therapies are not inappropriately marketed to the public.
Indeed, allowing the provision of harmful, science-free, health misinformation erodes freedom of choice. The U.S.-based National Council Against Health Fraud has battled for years against the argument of “freedom of choice” being deployed around complementary and alternative medicine: "Consumers have only the illusion of free choice when they are led to make decisions based on false or misleading information that comes with quackery. There is no health freedom in what is based upon misinformed consent. When you’re being deceived, you’re not free to choose. And when your health is threatened, it’s especially difficult to be wary of quackery.”
People should have the right to choose the kind of care they want. But when a therapy is being represented in a manner that does not accord with the available evidence, or is harmfully misleading, regulators should step in to make sure that patients are protected from unproven therapies and misleading claims. Otherwise, their choice isn’t a choice at all.
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