Trick or Treatment

"I really like this book. It’s a modern classic of the sceptic movement. Simon Singh is an excellent science writer. Edzard Ernst is the world’s first professor of complementary medicine. Well he was, Ernst is retired now. He started out convinced that there was some truth to the claims made by homeopathy and some other alternative practices. He was trained as a homeopath and he was a practising homeopath. He believed homeopathy worked. He then decided to investigate the treatments scientifically, to show that they worked, and he found that they didn’t. The therapies that he practised didn’t come out well from this scrutiny. It turned out that the evidence didn’t support the beliefs that he previously held, and so he gave up those beliefs. Ernst thinks that some complementary medicine may work, but the vast majority of it simply does not. I like Tim Minchin’s question: What do you call alternative medicine that’s been scientifically proven? Answer: medicine. The problem with alternative ‘medicine’, very often, is there’s very little good scientific evidence for its efficacy. Very often, the ‘evidence’ is anecdotal. We’ve already seen two examples of how weak anecdotal evidence is – the story about the 1967 UFO, and the thousands of anecdotes collected by the Christian Science movement. If you want to know whether something works, don’t rely on the anecdotes which can seem very convincing, look at the data. Run controlled studies, and if those studies reveal that the therapy doesn’t work, then you really shouldn’t believe it does, notwithstanding the fact that you can point to those anecdotes. Yes, a placebo can be very useful, and it may be that some of the effect of conventional medicine is achieved through placebo. But, of course, we know that it’s not just placebo when we’ve done the science. We know that, in fact, these drugs really do have medicinal effects. You might think that it’s worth prescribing placebo just because it’ll make people feel better. Some doctors in the past have done precisely that: they have prescribed sugar pills to alleviate somebody’s depression, say, and the pills have worked just fine. But when it comes to other serious diseases which you want cured, a placebo is not going to work. It may improve your mood; you may feel happier; it may reduce the pain to some extent, if you believe it’s going to have that effect. But if you actually want somebody cured of a serious illness such as cancer, a placebo won’t work. There’s also the question of whether state funds should be given to fund placebo treatments. If lots of people believe blancmange head rubs cure headaches should the NHS then be funding that kind of blancmange treatment? I think the answer is: No, the NHS should not be funding that. If that’s so, then neither should it be funding these alternative medicines, even if they do work as placebos. In many cases it’s clear that that’s all they really are. What concerns me most is that in some cases people have forgone conventional medicine that works and instead chosen an alternative therapy that did not work. As a consequence, they died. For example, people have gone to areas in which malaria is rife, they’ve treated themselves with a homeopathic medicine to prevent them from becoming infected, and of course it doesn’t work, so they get malaria and die as a result. Yes, it’s your free choice. People can choose to rub blancmange on their heads too, thinking this will make their hair grow, if they wish; but nobody should be allowed to claim that blancmange makes your hair grow unless they can provide very good evidence it really does. That evidence is missing when it comes to many of these alternative approaches."