While musing on the nature of evidence, and what is or is not considered ‘evidence’ in all the various contexts evidence is used, I came across this excellent rapid response in the BMJ back in 2004 by Clifford Miller, “a practising English lawyer, graduate in physics and a sometime examining lecturer on law, standards and ethics (particularly, the law of evidence) to Masters student technologists at the Imperial College of Science Technology and Medicine”.
He writes, in the context of the imputed association between MMR vaccination and the onset of autistic states, on “The Unreliability of Scientific Papers as Evidence”:
“Reliable evidence is that which is authentic, accurate and complete. In short, scientific evidence is incomplete if used for purposes outside the strict confines of science because it fails to take account of evidence of lay witnesses of the facts and is hence only applicable to the narrow and specific confines of scientific enquiry and not the broader ones found in other fields of human endeavour.
“Examples in point include the parental evidence of symptoms in the MMR cases or that of Gulf War veterans about their symptoms. A court (or the Legal Services Commission in the case of MMR) in contrast, ought to take that oral evidence into account for the very reasons science dismisses it. The point, unfortunately is not as well taken by our legal system as it might be. We have seen this recently with the Legal Services Commission in the MMR cases and in the cases of Gulf War veterans.
“Science treats evidence of lay witnesses of fact as inadmissible (as ‘anecdotal’ only) for reasons which are inapplicable in Court, but science does so for two main reasons. The higher scientific standard of proof (in effect, irrefutability) only admits evidence which can be tested scientifically for reliability. Oral witness evidence is discounted by medical science because medical scientific method does not currently have or recognise a mechanism for testing oral evidence to the scientific standard and so, for the sake of rigour, excludes it.
“Neither of these propositions apply in Court. Evidence of the direct witness of the fact, whether oral, or more frequently now, by way of written statement, is always admissible and is, in fact, the keystone of the trial system of evidence and the primary source of information a court uses to make decisions of fact. The Court has and applies its own mechanisms for testing witness evidence (eg. cross-examination). Further, the Court applies a far lower standard of proof, namely a balance of probability and not the unnecessarily high one of irrefutability applied by science.
[…]
“Governments also take advantage of the confusion and often use the term ‘evidence’ interchangeably with ‘proof’ when dismissing evidence they choose not to agree with or set unreasonably high standards of proof for the kind of decision required. The press and public alike are continually hoodwinked by this approach.
“In law ‘evidence’ is nothing more than information. It is information which one party proposes in support of, or to undermine, a disputed proposition. ‘Proof’, however, depends upon the decision-making process concerned. For the public interest, the standard of proof is sometimes based on risk and sometimes on other factors. In civil courts it is ‘balance of probability’. In criminal it is ‘beyond reasonable doubt’. And science requires irrefutable proof: a remarkably high standard.
“It is a fundamental error to apply the wrong standard of proof to the decision making process concerned and yet it seems to happen regularly.
“For issues of public safety, such as medicines like MMR or vaccines in the Gulf War, or the BSE crisis, the risk standard ought to be applied.
“However, instead, we, the public, are told frequently by officials in government there is no scientific evidence of a causal link between one thing and another. Whereas, often evidence to the contrary does in fact exist, it is not evidence that the officialdom concerned may either choose to or sometimes be at liberty to accept as proof of the issue. This is much the same for the BSE crisis with the government as it was for the Courts in relation to Gulf War syndrome or the Legal Services Commission for MMR. Whereas in the case of courts, the court has to rely on the expert evidence presented, in the case of public health officials like the Chief Medical Officer, he is in a position to assess the reliability himself, with the aid of his own experts if necessary. However, in the latter case, the risk standard of proof ought to be applied to decision making in the public interest rather than the scientific standard, which is only applicable to proof in science.
“In the scientific context, the only answer to a scientific issue that scientific journals should involve themselves in is a scientific one and they should only trouble themselves with the scientific standard of proof. If MMR did not cause autism, or vaccines in the Gulf War did not cause other problems, then it is for scientific journals to publish irrefutable scientific proof of what ails the 1000 or so children and the numerous afflicted Gulf War veterans.
“The current political debates about these kinds of issues are ones science could answer, if only the scientists got on with it and stopped playing politics.
“It is, for example, no answer to Wakefield to claim there is no scientific evidence of a link between MMR and autism. That just shows science has not found one that it can accept as proven to its very high standard of proof. It does not prove there are none, nor that there is no proof to other more realistic and practical standards for day-to-day decision making. It also leaves the public confused and distrustful of science.
“Buried in the MMR debate and little known to the general public is formal confirmation of a link between immunisation and the so-called allergy epidemics in the developed world. According to the US National Academies’ Institute of Medicine (IoM) Immunization Safety Review Committee (1), for at least two years it has been known that current vaccination programmes can expose children to risk of various problems ranging from allergy to infection. The IoM have also confirmed (2) that reasonable theories exist to explain how too many immunizations can overwhelm an infant’s immune system.
“A clear indication of the possibility of the existence of a causal connection between vaccination and the emergence of the various allergy and other issues over the last 20 years is the contemporaneous substantial increase in vaccinations as reported by the IoM (3). This shows an increase from 4 vaccinations per child in 1980 to up to 20 now.
“Whilst the IoM considered (4), as regards asthma in particular, and allergies in general, it had inadequate evidence to accept or reject a causal relationship, it accepted there is cause to consider that there might be a connection. Effectively, all the IoM statement amounts to is an admission by the most authoritative governmental authority in the US that they will not accept any evidence unless it provides the answer to a scientific standard of proof, and until someone produces that proof, they will not apply a risk standard, such that it is immunization as usual for children.
“The IoM’s conclusion is also not a reliable one for government to apply to the risk standard of proof because the IoM rely upon the scientific standard of proof and that is the wrong standard to apply for a decision based on risk. Irrefutability is too high a hurdle. Similarly, parents taking practical day-to-day decisions risk their child’s health if they wait for scientific proof, because proof to such a standard also takes too long to be produced.
Quite. Yet note that the MMR vaccination was foisted upon the population at large on the basis of those same scientific standards of evidence. So scientific standards of evidence conclude the vaccine has “proven” efficacy and “safety”, despite the fact that trials of the vaccine are limited and have no long-term follow-up. Scientific standards of evidence also conclude that there’s no adequate association between MMR vaccination and autism, despite the fact that documentary evidence acceptable as prime evidence in a court of law presents compelling evidence to the contrary.
What’s wrong with this picture? The aim of science is to arrive at an explanation and understanding of observed phenomena and their causal mechanisms that is, above all, utterly faithful to those observed phenomena. Not politics, not commercial expediency, not pre-existing theories or biases. The observed phenomena. Full stop, end of story. Consequently any hypothesis that meets those conditions should be acceptable to anyone observing the phenomena under consideration because the degree of fit will be such as to render any alternative explanation superfluous and irrelevant.
But when there is such substantial variance between the observed phenomena according to day-to-day standards of evidence and the preferred ‘scientific’ hypothesis, then something has to have gone badly wrong, and the scientific process has become subverted by something other than the aim to explain the observed phenomena. If the two are not congruent, then the scientific proces has failed.
Laughing my socks off ... 
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December 18, 2007 at 1:29 pm
colmcq
“But when there is such substantial variance between the observed phenomena according to day-to-day standards of evidence and the preferred ’scientific’ hypothesis, then something has to have gone badly wrong”
Well, no. It just proves how open to bias and subjective appraisal anecdotal evidence actually is. In the case of MMR, rates of autism are the same in vaccinated and non-vaccinated populations; the theory that MMR causes autism is therefore false.
Anecdotal evidence can be used to form the basis of a testable hypothesis, but it is only with rigorous testing that this hypothesis can be proved true or false.
December 18, 2007 at 5:00 pm
Andy Lewis
Socks – I hope you or Clifford Miller are never falsely accused of a terrible crime. Let’s imagine there was excellent forensic evidence that you were not giulty but several people were testifying to your guilt – maybe maliciously, maybe by mistake. I bet you would be crying like a baby in your remand centre, hoping that the judge does not take your advice on discarding scientific data because it is not ‘utterly faithful’ to the testimony of witnesses.
And, is that the Clifford Miller who is a solicitor for the nuclear and oil industries and who also happens to be a prominent antivax advocate with his own full page on whate.to? And do you think he knows what ‘strawman’ means?
December 18, 2007 at 5:46 pm
yeshomeopathy!
Andy- You are talking about medicine as if it is a single scientific experiment by reducing the treatment of sick people to very narrow arguments and very weird analogies like your crime one.
But I see that also behind this is the threat and implication of crime which seems to fit into your threats about danger and doom concerning non-MD homeopaths treating sick people. This also then extends to the argument that homeopaths are killing the 50 million people in Africa suffering from AIDS who are not being given conventional medicine by the grace of pharmaceutical companies and governments. Somehow homeopaths are preventing this.
But back to the UK- consumer intelligence, preferences and experiences mean piss all to you.
From narrow arguments and assumptions you seem to have built up quite a bit of personal hysteria that you want to spread as far and wide as possible.
December 18, 2007 at 5:49 pm
laughingmysocksoff
Oh really? A new survey indicates a strong correlation between rates of neurological disorders, such as ADHD and autism, and childhood vaccinations. While this doesn’t point the finger specifically at MMR, it’s necessarily one of the vaccines implicated.
The survey, commissioned by Generation Rescue and modeled on the CDC’s own methodology for conducting similar surveys, compared vaccinated and unvaccinated children in nine counties in Oregon and California. Among more than 9,000 boys age 4-17, the survey found vaccinated boys were two and a half times (155%) more likely to have neurological disorders compared to their unvaccinated peers. Vaccinated boys were 224% more likely to have Attention Deficit Hyperactivity Disorder (ADHD), and 61% more likely to have autism.
For older vaccinated boys in the 11-17 age bracket, the results were even more pronounced. Vaccinated boys were 158% more likely to have a neurological disorder, 317% more likely to have ADHD, and 112% more likely to have autism.
(More on this and other studies done on the link between MMR and autism in my preceding post.)
Yes, this is true, BUT — and it’s a huge BUT that’s really the crux of this whole argument — you have to be extremely careful to make sure that the assumptions that underly your testing are not themselves predicated on bias and subjective appraisal, otherwise all you succeed in doing is filtering for mechanisms of action that conform to your bias and your subjective assessment of the fundamental nature of what you’re testing. I submit that this is the case here.
The fact that there is such implacable opposition between the conclusions drawn from hard and soft evidence for both these cases — MMR/autism and homeopathy — is a major red flag. If the hard evidence were as “true” as it sets itself up to be, then the soft evidence should also be demonstrably in agreement. The truth is the truth after all, surely? If it’s true we shouldn’t have any difficulty agreeing about it. But we are, because there are huge numbers of people convinced beyond all reasonable doubt (through a perfectly admissible form of evidence in law and any other circumstance in daily life) that the observations they’ve made are valid. If there were just one or two isolated cases, then it would be reasonable enough to assume unrelated coincidence, but the anecdotal evidence in both situations is substantial, consistent, convincing, and continually accruing.
In any circumstance where this is the case, then the reasonable step to take at this point would be to re-evaluate the assumptions that underly the scientific assessment, since any credible scientific hypothesis MUST fit the observed data. The null hypothesis in both instances is not credible to those who have given anecdotal evidence. It doesn’t fit the data.
As far as I can see, any hypothesis that has to rely on dismissing or denying a large body of evidence and ridiculing and vilifying those who bring that evidence to light is on very very shaky ground. Those are the principal tactics of the sceptic position. Where’s the actual science here? Most of what I’ve seen quoted is as flawed as you perceive the evidence in support of homeopathy to be, which equates to an equivocal status, not an incontrovertibly conclusive one. Meanwhile EBM is moving towards the definition and acceptance of an “evidence mosaic” comprising a number of different types of evidence all of which are required to be in agreement.
December 18, 2007 at 6:49 pm
laughingmysocksoff
Andy I’m not advocating discarding scientific data, I’m only saying it needs to be reassessed and thoroughly questioned in the context of its foundational assumptions. And your analogy is a bad fit for homeopathy’s case because the body of anecdotal evidence we’re talking about is considerably more substantial and robust than the word of a couple of witnesses, while the “forensic” evidence is wholly inconclusive.
What I principally object to here is:
a) the trumpeting of equivocal, inconclusive scientific evidence as “conclusive proof” (it’s nothing of the kind),
b) the denial of all anecdotal evidence and uncontrolled clinical data and its dismissal as “not one jot of evidence”,
c) the persistent self-righteous claims to represent ‘science’ when the science in question is flawed and open to serious challenge on valid scientific grounds, and
d) the continual knee-jerk vilification of anyone who speaks out in homeopathy’s favour.
This isn’t good science. This looks to me far more like a dogmatic insistence on clinging to the map rather than the territory. The thinking demonstrated is frequently black-and-white and I’ve yet to see much evidence of any appreciation of the subtleties of interpreting trial data and its essentially equivocal nature. It reminds me very much of the situation at the coal face now where machines and tests have assumed diagnostic responsibility and are relied on to the exclusion, frequently, of common sense. The same thing seems to be happening with trial data. Sophisticated statistical analyses mask the variability of the raw data and the biases applied in its interpretation and seem to give this aura of exactitude and incontrovertibility which is not borne out in the detail.
December 18, 2007 at 6:49 pm
Andy Lewis
yeshomeopathy! Hysteria? Narrow Arguments? Assumptions? Getting back to the post in question – the argument is made that personal testimony in MMR like court cases should be superior to scientific assessment. I simply make an analogy that the author would not be claiming this if his neck was on the line. The argument from Clifford is a nonsense. He makes claims for scientific evidence that are not true and he confuses proof (in the mathematical sense) with scientific notions of proof which are contingent and provisional.
The whole thrust of this argument is just plain wrong. Evidence rarely lines up like ducks in a row. Contradictory evidence is the staple of both legal and scientific investigations. The trick is not to attempt to shoehorn all the evidence into some sort of false agreement, but to weigh evidence and take into accounts its reliability and strength. To argue that simple testimony from fallible human beings is vastly superior to carefully collected, analysed and openly published scientific data from multiple independent sources appears to be an inversion of reality. And all Clifford can do is use daft straw man arguments to justify it.
We see on the web many personal testimonies from parents about how their child’s autism was caused. Some blame WiFi, diet, jabs (different sorts), mobile phones, heavy metals, genetics. We know they cannot all be right and yet each testimony is heartfelt and sincere. Most probably have made a sort of post hoc error of some sort. Their autism was diagnosed following some unusual event and that has latched in their minds as the reason. How do we find out true causes? Careful science. Do you really have a better way?
December 18, 2007 at 7:09 pm
Andy Lewis
laughingmysocksoff – a body of anecdotal evidence does not increase in strength according to the number of people making the claim. That is the meaning of the phrase “the plural of anecdote is not data”. It is possible for all anecdotes to be based on the same underlying false assumptions and so all to be wrong. It is quite possible for millions of people all to be wrong about the same things – you must agree with that – the financial strength of Northern Rock, the presence or weapons of mass destruction in Iraq, alien abductions, various religious beliefs – take your pick.
In short, it is only you who appears to shoehorning science into expecting certainty. You will find sceptics arguments much more subtle than that if only you stopped your bluster and settled down and listened, and then maybe answered some simple questions.
My first question would be: do you think my criticisms of homeopathy are sincere?
December 18, 2007 at 8:14 pm
M Simpson
If large amounts of anecdotal evidence constitute proof then what does that say about all the people who believe in ghosts, who put their faith in psychics or who claim to have met alien creatures? Are all these things, for which there is not one jot of actual evidence, also true simply because millions of people think so?
December 18, 2007 at 10:02 pm
yeshomeopathy!
M Simpsom: The woo factor argument- you had to get that in.
And there were many scientific studies and actual evidence that Vioxx was harmless or at the very least minimally harmful. Does that make it true?
Historically and currently, is there actual evidence that many pharmaceutical drugs and medical procedures are dangerous, not just minimally risky, but downright dangerous? Yes! Based on this track record is actual evidence or trials really all that effective in determining risk?
As much as you think discussing the deficiencies of conventional medicine is skirting the issue when someone is defending homeopathy, this has to factor into any argument or discussion of a viable medical treatment whether mainstream or alternative.
For what I see is your main concern is that homeopathy is dangerous.
Is there actual evidence that homeopathy is dangerous? No, just your opinion. I can feel your worry and sympathize. I’m hoping that you think woo thinking is simply stupid but not dangerous, otherwise we would have a thought-policing mentality here.
If you give an opinion that homeopathy is “dangerous” not based on actual evidence then you can’t have it both ways: i.e. give an opinion about its harm and even state it is dangerous based on that opinion and then ask homeopaths for actual evidence.
December 18, 2007 at 10:37 pm
M Simpson
Okay, let me put it another way. What is the difference (if any) between the vast amount of anecdotal evidence for the existence of alien visitors (and ghosts and psychics) and the vast amount of anecdotal evidence for homeopathy?
Let’s see if you can answer the question rather than answering several other questions that we haven’t asked.
December 18, 2007 at 10:39 pm
yeshomeopathy!
Well, are you saying that it is dangerous or harmful to believe in ghosts, psychics or dare I say it God?
December 18, 2007 at 10:48 pm
NJ
yeshomeopathy! Says:
“Well, are you saying that it is dangerous or harmful to believe in ghosts, psychics or dare I say it God?”
I you base your medical treatment on either ghosts, psychics or religion then yes that would be dangerous
December 18, 2007 at 10:54 pm
M Simpson
No, I’m saying “What is the difference (if any) between the vast amount of anecdotal evidence for the existence of alien visitors (and ghosts and psychics) and the vast amount of anecdotal evidence for homeopathy?”
If you don’t want to answer, just say “I decline to answer that.” (I’m tempted to ask where you’re reading these other questions you keep answering, but that really wouldn’t work here, would it?)
December 18, 2007 at 11:38 pm
Andy Lewis
And I am really keen to hear a yes/no/decline to answer to my question;
Do you think my criticisms of homeopathy are sincere?
it should take a few keytaps to answer.
December 19, 2007 at 2:01 am
yeshomeopathy!
Simpson and NJ: I’m a little confused- are we talking about your delusions that medicine is generally minimally harmless and scientific and your ignoring of the fact that the iatrogenic evidence proves danger? In other word, that your belief in and requirement that homeopathy prove itself in the same way that medicine does is similar to someone who believes in aliens?
Lewis: Yes, your questions are disingenuous. They are more statements of bravado and criticalness rather than real questions. They do not come from a place of inquiry rather a place of rigid pre-judgement. There are MANY answers to your questions right on this blog- but you brush them aside as if you had some sort of expert knowledge instead of the ignorance of real medicine that you exhibit.
So can you all provide me with evidence that conventional medicine is not dangerous when the rate of serious iatrogenesis is conservatively 3-4 % and some say 10%. We are talking 3-10 people out of 100 having serious side effects.
Can you prove to me that homeopathy is dangerous?
December 19, 2007 at 9:03 am
Andy Lewis
“Lewis: Yes, your questions are disingenuous.”
This was my question “Do you think my criticisms of homeopathy are sincere?” An answer one way or the other would be great.
As for harmful medicine. Real medical interventions carry risks – especially in life critical situations. Doctors take risks such that lives may be saved. That is real, difficult adult medicine. Sometimes those risks do not payoff and the patient is harmed. Absolutely. But if lives are saved and people are here now that would not be if lives were not saved then that is good.
Ambulances take risks by travelling at high speed. There is one accident per day in the UK. Should we introduce homeopathic ambulances that travel very gently and holistically? That is not a rhetorical question.
And yes, drugs have side effects. That is because they have effects too. Homeopathy has neither bar the side effects of misinformed patients – that can be very dangerous. Doctors and patients balance the side effects against the intended benefits. If they there is a net benefit then most people will take them. Some malaria tablets cause some people to have unpleasant side effects. The side effects of not taking preventions can be death. A choice.
Can I prove that homeopathy is dangerous? Well I think the question I should be asking is that can you prove that homeopathy is safe? It is your practice, you should be in a position to demonstrate safety of what you do. Checking up on your safety record is not others responsibility. If I was the owner of a business and did not take steps to demonstrate the safety of my production process, the HSE would be quite rightly down on me like a ton of bricks, even without ‘proof’ that I was doing harm. It’s called taking responsibility.
Can you show that people given malaria prophylaxis do not go on to contract malaria? Can you show that homeopathic AIDS clinics give better outcomes than conventional clinics? Can you show that homeopathic asthma treatment is effective over the long term? And if not, don’t you think these practices are just irresponsible?
December 19, 2007 at 2:06 pm
colmcq
“Oh really? A new survey indicates a strong correlation between rates of neurological disorders, such as ADHD and autism, and childhood vaccinations. While this doesn’t point the finger specifically at MMR, it’s necessarily one of the vaccines implicated.”
If you have time, please read over this excellent critique by Orac:
http://scienceblogs.com/insolence/2007/06/fun_with_phone_surveys.php
December 19, 2007 at 2:18 pm
yeshomeopathy!
Hello Andy,
Thank you for your response.
Again you use the “dangerous” word which has very significant consequences. It is a strong word for something that is your opinion- because I haven’t seen any evidence from you that it is dangerous except your argument that by seeking a homeopath you will not seek a conventional medical opinion or treatment. That is based on many assumptions about how the majority of consciencious homeopaths function.
You also have an opinion that it is not effective.
I am not suggesting that people should not seek conventional medical care especially in critical care situations and in an ongoing way.
I could also add in terms of your ‘something may be missed and death may ensue’ argument that medical doctors miss diagnosis more frequently than expected and that poorly mixed drugs also create mortality. But this is also an opinion- except I have evidence for it.
So I have an opinion based on evidence and you have an opinion based on conjecture. Well, I will stop here and enjoy Christmas- I hope you have an enjoyable one too.
December 19, 2007 at 2:56 pm
isaiah30v8
Actually this conversation reminds me of a bible verse:
1 Timothy 6:20
O Timothy, keep that which is committed to thy trust, avoiding profane and vain babblings, and oppositions of science falsely so called:
The reason this comes to mind is because I am presently having opposition from scientists in regard to the manifestation of Jesus Christ.
This is exactly what the scriptures immediately previous to this one discuss. I have done some research solidly based on eye witness testimony which scientists continue to overthrow with weak arguments.
You can read about my research here in an article I called “Armchair Archeology”
http://ablebodiedman.blogspot.com/
regards
Geoff
December 19, 2007 at 3:44 pm
Andysnat
How on earth did this post get onto the wordpress intro page in the “science” category.
I’m laughing my socks off at that irony.
December 19, 2007 at 4:38 pm
Rich Scopie
@yeshomeopathy! : If you’re suggesting that people should seek conventional medical care, “especially in critical care situations”, presumably that’s your admission that homeopathy doesn’t work? Or at least your admission that you’re not sure and so are hedging your bets? Or is it so you can claim a homepathic cure after conventional treatment?
December 20, 2007 at 12:02 am
laughingmysocksoff
Well, well, well … this is all very fascinating.
What started out as an argument for giving anecdotal evidence more than zero credibility has ended up being interpreted as an argument that anecdotal evidence should be raised above scientific evidence and taken instead of it, at which point everyone starts shrieking!! Amazing! It’s really quite hilarious what you lot talk yourselves into once you get going.
Perhaps they know something you don’t 😉
This is all so ludicrously polarised. How on earth can anyone turn what is essentially an argument supporting a pluralist approach to healthcare based on a pragmatic “evidence mosaic” into this ridiculous notion that any one therapy should be all things to all men, and that to concede one therapy is better in some situations and another in others is somehow an admission that one or the other doesn’t work at all?!!
A therapy is a tool for helping sick people get well, not a religion or a football team! The sole reason this blog came into existence was because of the lies and disinformation being spread by the sceptic camp in respect of homeopathy, specifically the factual inaccuracies cited in Ben Goldacre’s recent comment piece in The Lancet. And they are factual inaccuracies. The “hard” evidence for homeopathy is presently equivocal and inconclusive. It does not prove in any way conclusively that homeopathy is equivalent to placebo, or that it’s not. That’s just the simple fact of the matter. You can interpret that in any number of ways, precisely because the evidence is equivocal (d’oh …).
The mantra that “there is no evidence in support of homeopathy” is a lie. That’s the bottom line. If you were all shouting “there is no evidence in support of homeopathy that we accept” you’d be telling the truth and I’d have no problem with it, but that critical qualification is never there.
December 20, 2007 at 8:08 am
Andy Lewis
laughingmysocksoff
i>What started out as an argument for giving anecdotal evidence more than zero credibility has ended up being interpreted as an argument that anecdotal evidence should be raised above scientific evidence and taken instead of it, at which point everyone starts shrieking!!
let me remind you what you said…
But when there is such substantial variance between the observed phenomena according to day-to-day standards of evidence and the preferred ’scientific’ hypothesis, then something has to have gone badly wrong, and the scientific process has become subverted by something other than the aim to explain the observed phenomena. If the two are not congruent, then the scientific proces has failed.
That sound like to me a statement that says if testimony ad scientific evidence do not agree then it is the science that has failed.
In short, you appear to be saying that testimony has a superior status to scintific evidence otherwise why should be assume it is the science that has failed and not that we have suspect testimony on our hands.
Can you clear this up for us?
And – the avoided question:
Do you think my criticisms of homeopathy are sincere?
December 20, 2007 at 8:47 am
homeopathy4health
Yes Andy that’s it – science fails medicine as testified by many people who stop taking their drugs because of side effects, who have been damaged by vaccines, who die as a result of medication.
December 20, 2007 at 9:01 am
Rich Scopie
@Mr Socks Off:
“this ridiculous notion that any one therapy should be all things to all men, and that to concede one therapy is better in some situations and another in others is somehow an admission that one or the other doesn’t work at all?!! ”
Well, if it’s not an admission that homeopathy doesn’t work, could you perhaps draw a line for reference, indicating the kinds of illnesses and conditions that homeopathy does work for, and conditions that people should be treating with conventional medicine?
December 20, 2007 at 9:51 pm
Andy Lewis
homeopathy4health – so when parents are certain that MMR has caused their childs autism but tons of science says that it is almost certainly not true, you believe the parents I take it. How do they know?
And you ducked again…
Do you think my criticisms of homeopathy are sincere?
December 20, 2007 at 10:45 pm
laughingmysocksoff
OK. This is not going to be a short comment, and I make no apologies for that because the arguments need to be examined in depth, but hopefully it will make clear what I’m trying to get across from this.
Remember we’re talking about the specific nature of homeopathy and its evidence base here, so applications of general principles in relation to evidence must be appropriate to the context. For the purposes of trying to grasp what I’m saying, please put the whole implausibility issue to one side because what we’re concentrating on is a) the suitability of using controlled trials to test the validity of an individualised therapy as it stands, and b) where its body of clinical and anecdotal evidence fits into that assessment.
FACTS: Over the space of 200 years, homeopathy has been refined into what appears to be a subtle and finely differentiated individualised therapy, for which there’s a considerable body of clinical and anecdotal evidence showing efficacy. The therapy was founded on empiricism, derived through the classical observationalist-inductivist approach, and built on replicability. Responses to successful prescriptions show a lot of individual variation, but in well-established chronic conditions frequently involve a brief period of symptom exacerbation, followed by a general improvement in the way the patient feels in themselves. This often precedes measurable changes in the symptoms themselves which, with time, reduce and disappear. Partially successful prescriptions (close but not quite close enough) may result in some temporary amelioration of the presenting complaint, but generally a different prescription is required to obtain the desired reaction. Unsuccessful prescriptions may produce one or two temporary changes but nothing lasting, and the remedy generally has no other effect.
FACTS: Clinical trials have proven effective to a reasonably acceptable degree in establishing efficacy for pharmaceutical interventions which introduce large doses of biochemical agents into the body, producing a measurable effect in most people. It’s not particularly subtle: the higher the dose generally the less individual variation there is. Nevertheless, it’s clear that not all the effect of treatment resides in the agent itself, so the remainder is assumed to be almost entirely due to the psychosomatic impact of believing something helpful has been ingested, and this is controlled for in testing by giving dummy medication, randomising the administration of it amongst testers and blinding the administrators so no other subtle extraneous effects like administrator’s expectations can intrude. Data is gathered on testers’ responses and any effect over and above placebo is assumed to be a property of the pharmaceutical intervention. All well and good, if a bit crude and approximate.
One of the foundational requirements and assumptions underpinning this whole methodology is that the agent being tested has a common effect. The strength of statistical measures applied to the trial data derive from the assumption that you are measuring a pretty much identical process in a group of pretty much identical subjects, ie. that there is homogeneity. Otherwise, what on earth are you measuring? Of course, we recognise that there is individual variation in humans, but we accept the level of approximation in the testing because we’re working at the level of what is common.
But when you’re dealing with an individualised therapy, you tip the balance in the other direction. You’re emphasising the individual elements over the common. The whole basis of your approach has changed. You’re not bursting doors open now. You’re looking for the individual key for every lock. That changes the way in which you test for and interpret success in opening doors because there are different variables at play, and different ways of assessing whether or not the door is in the process of opening. Consequently, and in the light of the substantial and consistent clinical evidence for the therapy, you have to think very carefully about what results from these trials might be telling you before jumping to the same conclusions you would if you were testing an intervention designed to work at a common level.
If you say fine, let’s allow homeopaths to select an individual remedy for each tester, then run the test, you’re relying in large part on the skill of the homeopath to select the right remedy in the right potency first time, something which, in practice, probably only happens in around 50-60% of cases. In a clinical situation, first prescriptions would be reviewed at follow-up and the prescription adjusted accordingly until the desired reaction is achieved, but trials haven’t (to my knowledge) allowed for this. So at the very least you’ve introduced a variable into your test that’s not being adequately accounted or controlled for. If you then run the test and find the results don’t indicate the same efficacy or replicability rates as you’re seeing from complete case histories in practice, then it’s not appropriate to draw conclusions about the therapy as a whole and the reliability of its evidence base without taking this into account and running further tests to differentiate. From the perspective of the therapy, all you’ve really tested in this scenario is the abilities of the individual practitioners involved to get it right first time for that particular group of individuals enrolled for that trial. This doesn’t tell you very much about the effect of remedies, or the effect of the therapy as a whole.
If you say fine, let’s go the other way and find remedies which might have a more common action, then you inevitably end up in the realms of isopathy — treating with idem rather than similar (eg. a remedy prepared from an allergen identified as common to a group of people) — which is not homeopathy and has never produced as good results in a clinical setting even if it does have some impact on symptoms. It might be able to show that ultra dilutions demonstrate an effect beyond placebo, but it’s no test of homeopathy.
These are just two of many angles on the issue. In a lot of ways, testing an individualised therapy poses similar problems to undertaking meta-analyses of clinical trials. You’re comparing apples with oranges, grapes, pears, bananas and the whole contents of the fruit bowl. You’re no longer looking at the fruit as just fruit or subjecting it to tests that are designed to test the common properties of all fruit: you’re approaching it and treating it in all its individual variation, relating to apples as apples, oranges as oranges, etc, and maybe mistaking Asian pears for apples. The more subtle and individualised the process becomes, the more uncontrolled and unacknowledged variables are introduced, the more variable and equivocal the aggregate results will be. And this is exactly what the trial data show.
When you come to perform a meta-analysis of accumulated trial data, you’re compounding the problem all over again. You’re trying to draw conclusions from a bowl of mixed fruit each item of which is in itself a bowl of mixed fruit. You’re also (and this applies to other trials too) making generalised assumptions about bias and applying them to all trials regardless of the individual biases (which are enormously variable) in the researchers concerned. And you wonder why results are equivocal or merely end up echoing the biases of the researchers conducting the meta-analysis? Controlled trials have their limitations and it’s important to realise what they are.
Hence the conclusion from many researchers that this means of testing homeopathy is not a suitable research tool and that other forms of evidence are needed to establish efficacy to sufficiently rigorous standards. There is good and valid scientific reason for doing so. So the assumption that homeopathy is bogus because it doesn’t appear to measure up to the “gold-standard” is no more than opinion that’s failed to examine the underlying reasons why that might be so.
Not avoided — I thought you were addressing that to yeshomeopathy!.
Yes I think many of your criticisms of homeopathy are sincere. Some of them, from my perspective, are misinformed, others rather narrow in their logic, and most are overstated, which makes it difficult for homeopaths to accept them as they are. Yet there’s been many good points made which homeopathy as a profession needs to address. However, you also have a tendency to indulge in witch-hunts which makes it very hard to have a reasonable discussion about any of this. It blows all the sincerity clean out the window.
Despite this, I can see very easily how you come to the conclusions you do. As I’ve said before, many homeopaths know that only too well because they’ve been there, but their own explorations have taken them beyond that position and convinced them otherwise. This is why much of the sceptic reaction comes across as similar in many respects to xenophobia.
If there was less hysteria, vilification and deliberate attempts to trap homeopaths into appearing to say what they haven’t said at all in all of this, you’d probably find homeopaths willing to take part in your experiment. It’s not a bad test as these things go, though the strong suspicion remains that even if the results were sufficiently positive you’d find a way to discredit them. But in the present climate you’re unlikely to find anyone willing to climb onto what looks suspiciously likely to morph into a ducking stool.
December 20, 2007 at 11:47 pm
M Simpson
“you’re relying in large part on the skill of the homeopath to select the right remedy in the right potency first time, something which, in practice, probably only happens in around 50-60% of cases”
This is fascinating. After 200 years of refining this therapy, homeopaths are still making incorrect prescriptions 40-50% of the time? Has this figure changed over time? Is it an average, with inexperienced homeopaths getting it wrong much more often but experienced homeopaths getting it wrong much less frequently? Because surely any testing would need to be done using the most experienced homeopaths available, who one would hope to be able to correctly prescribe more than 60% of the time.
Also, and this really is something I don’t understand, what effect does an initial wrong remedy have on a patient? If you give a homeopathic remedy to someone for whom it is not appropriate, surely that is the same as giving it to someone in a proving. So if provings are replicable then surely the patients who receive a wrong remedy will develop, however mildly, the symptoms associated with that remedy when it was proved?
If I’m making a mistake at any step here, please correct me but if the above is true then it flies completely in the face of the claim that homeopathy has no side effects.
December 21, 2007 at 12:25 am
Andy Lewis
Thank you for answering my question.
What strikes me most about homeopaths is there incurious nature. So much breath on explaining why you cannot test it. So few homeopaths saying how you can test it. And the excuses for not testing tend to be weak.
First, even if you were, say, only getting it right first time in, say, 50% of cases, that should still show up above a placebo. Getting a 50% hit rate aint too bad, say, compared with some cancer treatments – if it were true.
Secondly, you must recognise the existence of problems such as the placebo effect, regression to the mean, misattribution of cure, wishful thinking etc. Don’t you? So, given these enormous problems, how do you know homeopathy works? How reliable is this ‘clinical and anecdotal’ evidence you speak of? You do recognise these problems, no?
December 21, 2007 at 12:38 am
homeopathy4health
Andy Lewis: I am sure that MMR caused my own child’s autistic behaviours (see Purpose of my blog) and that homeopathic MMR caused the reversal of this state.
Science’s ‘evidence’ does not always stack up in the real world (as I and laughing has said) and is subject to considerable bias.
I do understand your criticisms (I’m sure I’ve said that before) or maybe it was another pseudosciencer clone, you’re all starting to sound the same.
December 21, 2007 at 8:37 am
Andy Lewis
homeopathy4health – How can you be sure. Sure is a strong word.
December 21, 2007 at 9:05 am
homeopathy4health
I am sure. And this scientific ethos of ‘I don’t believe it’ creates a lot of uncertainty in the ordinary person to disbelieve their own senses about their own health and those of others. Of course this then takes them to highly paid ‘experts’ who may not have any relevant research to hand to confirm or deny. There is a lot of uncertainty in medical treatment and lack of direct experience due to the divorce between those who do the research and practitioners.
December 21, 2007 at 10:17 am
Andy Lewis
homeopathy4health – don’t you think that this might be the difference between us? Your willingness to be sure? But you did not say why you are sure – just that you distrust uncertainty in the scientific world.
This is interesting. One of my beliefs is that the reason why some people turn to ‘alternative’ medicine and seek strange explanations is that they have a low tolerance of uncertainty. They do not like the apparent lack of control that doubt and ignorance imposes. Scientists, on the other hand, live with uncertainty and except it – in fact uncertainty is what drives their inquisitiveness to discover. But for some people, there is a huge mental desire in many people to have explanations for all things. When real reasons cannot be found – as in the case of autism – alternative explanations on latched onto, no matter how little evidence there is for these beliefs.
Out of interest, are you the sort of person who believes ‘there is a reason for everything’?
Homeopathy, to me, looks to be a way for people with a low tolerance of uncertainty, to pretend to themselves they have control in their lives. Homeopathy pretends to provide an all-encompassing philosophy of health and a hope for cures, in the face of the massively complex and unknowable issues surrounding health, life and death. Real medicine cannot provide that comfort – it is a tricky, uncertain business. One piece of evidence I find to support this is homeopaths’ complete unwillingness to subject themselves to testing of their beliefs. I see no desire in the homeopathic community to really test fundamental aspects of the practice. Rather, the tiniest piece of confirmatory evidence, no matter how weak (like anecdotes) is used to bolster their current certainty. I have yet to see a homeopath answer a question like ‘what would it take to change your mind?’. This is an everyday question for scientists. I have answered that question myself with my challenge. If homeopaths could pass that test, I would change my mind. What would change yours? Or are you too afraid of the uncertainty that such a question brings?
To me, I live comfortably with the knowledge that we don’t know everything or can control every aspect of our lives. If no good explanation is available for an event, I don’t need a pretend one to fill that void. To me, the central gift that science gives us as a way of thinking is not just knowledge, but knowledge about what we can say with some certainty we know and knowledge about what we do not know. I would call this wisdom.
I would rather live not knowing than with pretend knowledge.
December 21, 2007 at 1:46 pm
John R
M Simpson raised a good question a few posts back, and one that I’ve never heard a homeopath answer, or even attempt to answer.
One of the main claims of homeopathy is that it is free from side effects. When homeopathic treatment fails due to incorrect remedy selection what prevents the proving process occuring in the patient? Have any case studies been published where the incorrect administration of a remedy has led to unwanted side effects, or does the patients body know that the remedy it is recieving is meant as a cure?
December 21, 2007 at 3:49 pm
lynne
Andy Lewis says:
“I have yet to see a homeopath answer a question answer a question like
‘what would it take to change your mind?”‘
I am a homeopath who has been in full time practice for 13 years in 2 countries and have been a homeopathic patient for 30 years.
For me, what would change my mind would be to see people no longer get better – often dramatically – in my prescription of homeopathic medicine.
Here are a few real life examples from my own practice:
– a woman who has just given birth rapidly and is in a state of shock – trembling uncontrollably, clinging to everyone around, and drinking glass after glass of cold water to cool her feverish anxiety, settle back onto the bed, release the vise grip on her attendants,stop trembling, stop drinking, suddenly return to herself and smile at her baby.
– a woman, who over a few months, has just been diagnosed with MS. – and is experiencing symptoms like ataxia, slurred speech, numb extremities – returned to a state of good health within a few days of receiving a homeopathic remedy. The MS symptoms have never returned.
– a child,who every night was subject to terrors, in which he screamed uncontrollably, knew no one and thrashed about in fear at his hallucinations, now able to sleep through the night, no more terrors, only good dreams.
– a man, with nightly insomnia and fiercely itching eczema on his face, arms and legs, with a wife and children ready to leave him he was so irritable and unpleasant to live with…….eczema completely gone, able to sleep restfully, peace restored in his family
– a teenager,at a family reunion, stung by a horse fly, his face swelling alarmingly, the inflammation moving by the minute toward his throat – literally within minutes of administering a remedy, the inflammation reversed its order, his family agape – antihistamines, epipen and escape car at the ready – all superfluous. There was no trace of any swelling or ill effects 5 minutes later.
– again, another event. witnessed by a crowd of previous homeopathic skeptics…… an artist, who had developped a ganglion on his wrist which had gradually increased in size to that of a golf ball. Last Christmas Eve, he took a remedy. By Boxing Day, it had shrunk to the size of a pea, to the astonishment of his family and friends, who monitored its progress.
A year now…..it has not grown back.
Shall I go on ? I could. on and on and on……..
NOT seeing these results from my own homeopathic practice- that is what it would take to change my mind.
–
December 21, 2007 at 4:29 pm
isaiah30v8
Accepting that we do not know all the answers is a very righteous thing to do.
I see most people standing hard and firm on what they are convinced is the right decision.
In fact when I look around at what is happening in the world does what I see measure the value of what the most intelligent people are thinking?
If what is happening in the world is not a result of what the most intelligent people are thinking then I guess they are not too intelligent then!
Even if the value of what I see happening in the world is not a result of what the most intelligent people are thinking then you must admit that it would be hard to argue that what is happening must be a result of decisions which people made.
These people must have thought they were making the right decision.
This reminds me of another bible verse:
Gensis 3
4 “You will not surely die,” the serpent said to the woman. 5 “For God knows that when you eat of it your eyes will be opened, and you will be like God, knowing good and evil.”
you will be like God, knowing good and evil.
………….. the original sin.
regards
Geoff
December 22, 2007 at 7:10 pm
laughingmysocksoff
It really is extraordinary how much mirroring is going on here between the two “camps” (for want of a better word). To homeopaths, this appears to be one of the principle reasons the sceptics cling so tenaciously to their perspective where deterministic predictability, determined materialism and linear logic seem to hold sway!! Speaking personally, I think life would be deadly dull if that were so. The fact that we know so little about ourselves, the world and the universe we inhabit is the source of enormous inspiration and an unrelenting curiosity to explore, to continually push the boundaries and see where it all leads.
No, because I don’t think much of what goes on in life is reasonable (in all senses of the word). If, as is postulated, individual awareness filters out around 95% of sensory input, then the data we’re basing our reasoning on, no matter how ‘scientific’, is ridiculously paltry. It seems that most of the time we’re merely looking in the mirror of ourselves and objectifying what we see. Is there really any “out there” out there? Who can tell for certain? Ultimately we can only experience life through our subjective experience of it. As Einstein is quoted as saying, “Reality is merely an illusion, albeit a very persistent one.” But damn! What an illusion!
You’re spot on when you say
It’s no different in homeopathy. It’s equally tricky and uncertain, precisely because that’s the nature of dealing with any one individual and their unique case of illness. If anything I think it can be more so: the level of differentiation required can sometimes be enormously subtle. Generalisations, averages and repeated demonstrations of replicability are all very well, but at the end of the day, we come down to the uniqueness of one person, with their particular illness in their particular circumstances and their particular environment, all of which play a part in their condition. Can we say with any certainty that our interventions — whether homeopathic or biomedical — are going to have the desired effect? Of course not. But we give them responsibly and in good faith, based on what we have assessed as reasonable probability, and hope for the best. And if the best doesn’t transpire, we do our utmost to find out why it didn’t work and to try something else which might make a difference. (And anyone inclined to scoff at this and bemoan the lack of certainty and “science” should stop mistaking the theory for the reality and spend a lot more time observing what goes on in conventional primary care settings and hospitals up and down the country.)
What inspires homeopathy’s practitioners is the discovery that its principles appear to hold good in the real world of medical practice and give us hope that, applied diligently, we can make a real difference to people’s suffering. One of the many reasons so many conventionally trained doctors and veterinary surgeons are seeking training in homeopathy is that it’s principles seem to fit what they are continually observing through interacting with their patients in practice. Yes, it involves a paradigm shift in the way we understand lifeforms in health and disease, but it’s one which people very rarely step back from once they’ve made that leap. And if it’s hard enough for non-biomedically qualified homeopaths to deal with the level of opposition and ridicule, it’s far worse for those within the biomedical community. Do you honestly think so many would follow this path if it didn’t have something going for it? Colquhoun may lament the fact to his heart’s content, but the fact is that demand for training in homeopathy is continually growing, and much of it from biomedically-trained individuals.
Homeopathy is a long long way from being perfect and homeopaths make no claim that it is, or that the profession doesn’t have some growing up to do and lessons to learn. All we claim is that homeopathy appears to be at least as effective in many instances as biomedical interventions, but without the crippling and lethal side-effects or anything like the astronomical cost. Time and again we witness dramatic cures that just aren’t amenable to any other explanation than that something in the remedial process had an effect.
The examples that lynne gave are very typical of all practitioners’ experience. If they weren’t, then to be honest there would be little point in continuing to study as hard as it takes to become a decent homeopath, especially in the face of so much opposition and ridicule and, it has to be said, no more than a subsistence level of income. These are the cases that keep our resolve intact through the long hard slog of the more deep-seated chronic conditions that can take months or years to unwind. Homeopathy is no magic bullet, even though there are many cases in which it seems to act like that, and chronic cases can present in a layered fashion where it’s necessary to, in effect, remove one layer at a time to return the patient to health. Often this happens in the reverse order in which the condition developed. But making an impact IS possible and you’ve seen many people personally attest to that on these blogs.
I think you’re incorrect when you say
Many of us have answered that. Nothing is likely to convince any of us that what we’ve witnessed and experienced didn’t happen. It happened. You can’t unhappen it. And as lynne said, if by some strange happenstance all homeopaths suddenly experienced it as no longer working, then we might have good reason to doubt it. Also, if there is a better explanation for it all than the rationale homeopathy provides, then most of us would probably accept it. To date, no rationale offered by the sceptics has come anywhere close to explaining consistently what goes on time and again in the nitty gritty detail of individual cases. And you’re wrong if you think that homeopaths aren’t constantly questioning what they observe and experience. This is an essential part of reflective practice. The dangers of self-delusion are well recognised, and when you’re practicing such an apparently implausible therapy then you want to be doubly, trebly sure.
December 22, 2007 at 7:43 pm
laughingmysocksoff
Homeopathy’s claims to produce no side-effects are based on the principle that when the focus of treatment is the whole individual rather than the disease, then there’s nothing which, by definition, can be a “side-effect” to that. However you could well argue that there’s an element of semantics here and that unfamiliar and unwanted symptoms could be seen to fit that designation.
It is possible to induce proving symptoms, particularly if a remedy is repeated too often inadvisedly. Many homeopaths will have had at least one case of a child exhibiting the mental pattern of Chamomilla (not a pretty sight) from being given too many OTC teething granules. It’s not always easy to convince people that they need to give the remedy only when symptoms show that it’s needed. The habit of pharmaceutical dosing regimes is deeply ingrained and many OTC remedies perpetuate that notion in their guidelines for use — inadvisable IMO. The critical point here though is that the symptoms are transient, and, if they appear at all, will generally last no more than 24 hours. In the instance of a Chamomilla proving, discontinuing the administration of the remedy will stop the symptoms and no permanent damage ensues.
This is in rather stark contrast to the side-effects produced by pharmaceutical interventions.
Many homeopaths will counsel patients in what they might experience following the administration of a remedy. It’s also the case that a good healing reaction can be preceded by a brief aggravation in symptoms. Again, this generally lasts no more than 24 hours, and since it frequently indicates the remedy is a good match, most patients will accept the temporary discomfort. They’ve usually been through much worse under biomedical treatment and knowing what to expect makes a big difference to how the experience is dealt with.
The same goes for volunteers for homeopathic provings. Volunteering to step into the unknown and get sick with wholly unpredictable (in a blinded proving) complaints for the benefit of others is not something everyone will countenance, but the knowledge that the symptoms are transient and produce no permanent changes helps enormously.
December 22, 2007 at 9:53 pm
John R
Laughing thanks for your reply.
I’ve just used an internet remedy finder (ABChomeopathy.com) to find some remedies for a few conditions. First I searched for a remedy to help with drowsiness while driving home from work in the evening. The remedy suggested was phosphorus. If this remedy is not correct for me (which you said happens about 40-50% of the time for first remedy selection) and I used the remedy, I would begin to prove the remedy, causing further drowsiness. Even if this only lasted for ~24hrs this would still be very dangerous when I drove home that evening.
I also found a remedy for suicidal feelings. Pulsatilla Nigricans was selected. If a suicidal patient took this remedy, but it was the wrong remedy for them, the proving process would be even more dangerous. It wouldn’t matter that the symptoms produced by the remedy only lasted 24hrs if they killed themselves after 2hrs due to an agravation of their symptons.
These are obviously extreme cases but, given that there isn’t even any effective regulation of homeopaths in the UK, what safeguards are there to prevent them happening? It is because homeopathy claims to be side effect free that homeopathic remedies avoid the nasty business of safety and efficacy testing. To prevent cases such as those I’ve mentioned above should all homeopathic remedies be licenced and only released following suitable testing?
December 22, 2007 at 10:33 pm
laughingmysocksoff
Interesting points John. And hard to answer because extremes like this are always within the realms of possibility. However, it seems to be the case that for people exhibiting pathology (as opposed to provers setting out with the intention to test remedies) if a remedy isn’t right then it just seems to sail right on past them without producing any proving symptoms of note. Unless you’re repeatedly dosing which, as I’ve already said, is inappropriate and not recommended.
Of course a proper homeopathic case-taking would never prescribe a remedy on a single symptom. Every symptom of your state would need to find its match in a single remedy for a confident prescription. For chronic complaints, self-prescribing is really not to be recommended.
I’d also have to say that although Pulsatilla nigricans can have suicidal ideation, it’s usually a cry for help. The Pulsatilla state lacks the resolve to follow through, so even if you were proving Pulsatilla, you’d probably end up being more of a pain to your nearest and dearest than in any real danger of topping yourself.
Also Phosphorus is extraordinarily sensitive to external impressions, so were you to doze off at the wheel, chances are you’d be equally likely to start into wakefulness at the slightest hint of danger.
What can I say? Life is full of risks. Homeopathy may lack “effective regulation” but the safeguards in place for conventional medicine don’t impress me muchly. Personally I’d rather take my chances with homeopathy and risk being among the 0.001% theoretically harmable than end up being one of the 4.5% of the population definitely harmed or killed by pharmaceutical interventions. And the lack of regulation of homeopathic remedies has far more to do with the prevailing assumption that there’s nothing in them than any claim about lack of side-effects!
What’s more, stimulants like alcohol have proven ability to turn reasonable human beings into homicidal maniacs, yet there’s no really effective regulation of alcohol availability that stops that happening every Friday night.
Specks of sawdust and planks of wood come to mind. And you can’t have it both ways. How can you agitate for more regulation at the same time as professing the whole therapy to be impossible?!
December 22, 2007 at 11:55 pm
John R
Laughing thanks for the reply again.
You’ve correctly inferred from my posts that I am skeptical about homeopathy (although it was probably fairly obvious from the nature of my questions).
When writing about the dangers of incorrectly prescibed remedies I was merely playing devil’s advocate. While I may be of the opinion that homeopathic remedies will have no effect, good or bad, members of the homeopathic community clearly think they do.
You mention harm caused to patients by conventional medicine. While this is obviously true you cannot say that steps have not been taken to minimise patient risk within the medical community. I am sure more could be done, but also know that the regulatory system in conventional medicine is constantly working to prevent future errors. Besides which, any problems in medicine do are not really relevant to this discussion.
As you say the lack of licencing regulations for homeopathic remedies does come from the assumption that they are nothing more than sugar pills or water. From the position of a homeopath, or a body representing homeopaths, this is not an belief that is held. Surely the homeopathic community should be taking steps to avoid the possibility of cases like those I mentioned above. If this is not the case it would appear it is homeopaths who are trying to have it both ways.
December 23, 2007 at 1:03 am
M Simpson
“However, it seems to be the case that for people exhibiting pathology (as opposed to provers setting out with the intention to test remedies) if a remedy isn’t right then it just seems to sail right on past them without producing any proving symptoms of note.”
Now I’m laughing my socks off!
You’re saying that a remedy given to somebody who doesn’t need it will produce an effect in that person if it’s part of a proving but not if it’s just a misdiagnosis.
How does it know?
December 23, 2007 at 8:58 am
laughingmysocksoff
Of course the homeopathic community take such steps! Just because it’s not formalised into legislation doesn’t mean it doesn’t exist. Have you ever heard of such cases? Instances where homeopaths have been implicated in unfortunate outcomes are incredibly rare, and even then can be open to question in that they can fail to take account of patient choice. Patient education is something most of us take very seriously. Forewarned is forearmed, and knowing there’s a possibility of these things happening means that most people are able to step back and witness the feelings rather than saddling up and riding them into the sunset.
On the contrary. I think they’re highly relevant because they emphasise the considerable gap between the ideal and the achievable reality. Is it realistic of biomedicine’s proponents to expect standards from homeopathy that biomedicine is itself unable to achieve? Medicine is an inexact science and there are no guarantees, whether legislation to that effect exists or not. Even such legislation as exists has proven toothless for people that have really been in need of its support. There is evidence enough to suspect that corporate and government interests may weigh in more heavily at the end of the day. Like I said, specks of sawdust and planks of wood …
I find it interesting that so many of the discussions on this subject seem filled with fear on behalf of a mythical Jo(e) Public who’s presumed to be a powerless, helpless bear of little brain, even less common sense and no ability to make up his/her own mind. I’ve yet to meet a person that fits this description outside of an institution where there are people devoted to their full-time care.
December 23, 2007 at 9:27 am
laughingmysocksoff
Good one, M!! You certainly got my socks going there too. How can the remedy possibly “know”?!!! That’s the daftest notion I’ve heard yet. It’s the state of the recipient of the remedy that determines their reaction to it!!
It’s an observation from practice. It’s often the case that active pathology displaces symptoms of a pre-existing state. Anyone can make this observation: it’s not a uniquely homeopathic perspective: eg. succumb to a good dose of the flu and your habitual heartburn and indigestion go into remission for the duration. The active pathology is the stronger dis-ease — so the rationale for this observation in relation to proving symptoms is that the strength of an active state is much less prone to perturbation by a remedy that doesn’t accurately mirror it than the state of a prover who is generally in reasonable health. People vary enormously in their sensitivity, of course, so some will experience nothing at all and others will notice more.
It’s also the case that someone engaged in a proving is observing themselves very closely so will tend to have a heightened awareness of subtle and transient changes which someone who’s mind is elsewhere might completely miss.
December 23, 2007 at 11:59 am
John R
Laughing you ask if I’ve heard of any cases like the ones I mentioned. No I haven’t but I’d say that is more due to lack of any effect, rather than the diligence of homeopaths. My point is that homeopaths who believe that these effects are possible should be the ones pressing for legislation. Apart from a moral duty to prevent occurances such as these, bodies representing homeopaths should be aware that cases such as these would reflect badly on their proffesion and, as such should be concerned.
Also your observations don’t really match your hypothesis. Do you have any evidence that the flu puts heartburn and indegestion into remission. Isn’t it more likely that a patient suffering flu feels so crap and tired that they are likely to take less notice of their heartburn. They’re also likely to be eating far less, which would account for any reduction in indigestion.
You also say that someone engaged in proving has a heightened state of awareness to any changes. Surely this is just due to the fact that they are looking for changes and are more likely to erroneously attribute these to the effects of the remedy. Both of these effects are best explained as psychological responces, rather than real physiological effects.
December 23, 2007 at 12:02 pm
Rich Scopie
“Anyone can make this observation: it’s not a uniquely homeopathic perspective: eg. succumb to a good dose of the flu and your habitual heartburn and indigestion go into remission for the duration.”
You’re telling me that you can only have one ailment at once? That ‘flu somehow “drives out” indigestion and heartburn??
More likely, I’d suggest, because if you have ‘flu, the last thing you feel like doing is over-stuffing your face with rich foods – the main causes of indigestion and heartburn.
December 23, 2007 at 4:56 pm
laughingmysocksoff
I’m saying that, according to the homeopathic perspective, you can only be in one state at a time. A lot of people experience remission of chronic symptoms when an acute supervenes. You can rationalise it whatever way you like, but it remains the case.
This homeopathic perspective on disease states largely hinges on viewing people’s complaints in terms of characteristic single remedy patterns. It’s a way of categorising symptom expressions that’s essentially no different in process — though different in outcome — to biomedicine’s categorisation of symptoms into groupings of discrete disease entities. It doesn’t necessarily mean it has any objective ‘reality’, any more than discrete disease entities do (at the end of the day you have one individual and a whole mixed bag of symptoms which may, or may not, involve the presence of pathognomonic micro-organisms: you can define and categorise that in many ways) but as a model it works pretty well. Employing that perspective in treatment regimes appears to be consistently valid and effective, which is why it’s become part of the homeopathic process, and it makes sense in terms of the rest of the model.
That process, in 6544 patients through a period of 6 years, produced results (both subjective and objective) which showed it to have been beneficial in over 70% of cases. Sure there’s no control group, but if 70% of 6544 people all suffering chronic complaints got better all of their own accord, including 301 cancer patients who were assessed as being much better (26%), better (27%) and slightly better (20%), while only 1% were much worse, 1% worse, and 8% slightly worse, why on earth are we bothering with all those expensive pharmaceutical interventions? The conclusion has to be that either homeopathy is doing something useful here, or people are far better off left to their own devices. Either way, it doesn’t look particularly good for biomedicine. (Homeopathic Treatment for Chronic Disease: A 6-Year, University-Hospital Outpatient Observational Study. Spence, David S and Thompson, Elizabeth A. Journal of Alternative and Complementary Medicine Volume 11, Number 5, 2005, pp. 793-798.)
December 24, 2007 at 3:58 am
Humber
laughingmysocksoff,
You wrote;
“Sure there’s no control group….”
Despite that peccadillo, the evidence is rock solid.
If Homeopathic remedies are so linked with the ‘state’ of the recipient, and can be used to treat disorders such as anxiety, panic and suicidal tendencies, surely chronic skepticism should respond to Homeopathic treatment.
If not, why not ?
December 24, 2007 at 9:19 am
laughingmysocksoff
The evidence is that the health of 70%+ of 6544 people, all suffering chronic complaints, including non-self-limiting conditions, which had failed to respond to biomedical intervention, improved over the 6 year study period. That doesn’t say it was homeopathic treatment that was responsible because of the lack of control group, but it does have rather serious implications for biomedical interventions and their massive expense to the NHS.
It does 🙂 Chronic scepticism has been ‘treated’ by homeopathy many times. A large number of the successful cases became homeopaths themselves. You volunteering?
December 24, 2007 at 10:11 am
laughingmysocksoff
John — sorry, your very good questions got lost amongst the rest for a moment there.
Of course the profession is concerned, which is why so much effort in recent years has gone into codifying ethics, putting continuing professional development and professional conduct procedures in place, and working towards a single register. Regrettably, the single register initiative is a mess right now and many of us are angry about that and the fact that some strong personalities evidently came to dominate the negotiations. The profession has some growing up to do yet, and a better balance to achieve in the hierarchies of its membership organisations, but to be fair, it’s working to put in place in just a few years what took decades to evolve in conventional medicine, and with very limited resources.
I covered this in my response to Rich.
Ahhh no … real physiological effects occur. Having taken part in several provings I can personally vouch for that. They arise within the proving timescales, peak, and resolve as the remainder of the proving effects reduce in intensity. Yes, you’re looking for changes, but a lot of them are pretty unmistakeable. And often they’ll be symptoms you’ve never experienced in your life before. If they’re similar symptoms to your habitual complaints, then their characteristics will be different to your normal experience of them. And when your symptoms are compared to those of other provers, then the same symptoms and the same characteristics are found to have occurred in several people. Provers’ characters and demeanours can change as well, which will often be something that their supervisors and families will pick up on before they do, and again the patterns here will be consistently reported throughout the proving group.
Individual responses to the proving will vary — some will have an intense experience and produce dozens of symptoms, others may seem to be hardly affected and only produce a handful of the most marked common symptoms. But it’s the fact that these symptoms are evident throughout the proving group that makes it unlikely they’re just psychological oddities. And that proving ‘group’ may be individuals who have no physical proximity to each other or even knowledge of each other.
It’s then the job of the proving coordinator to assemble all the data and exhaustively compare the different provers’ experiences looking for the common threads. A lot of reported symptoms will be rejected at this stage as insufficiently robust to attribute to the remedy. What is retained is what is distinctive and characteristic. This will be completely different from one proving to the next, and reprovings of the same substance by different people in a different location at a later date will produce the same distinctive and characteristic themes, symptoms and psychological patterning evident in the first proving.
Homeopathic literature contains 200 years’ worth of this data. It’s replicable, and a reliable indicator of any remedy’s potential efficacy in people who’s overall state matches its distinctive and characteristic themes, symptoms and psychological patterning.
December 26, 2007 at 6:04 am
Humber
As you admit, the results could be attributed to Homeopathy, or to doing nothing at all. The results could also be due to some other uncontrolled or unrecorded effect. Without the control, it is simply not evidence at all.
For the above reasons, failure of ‘biomedical intervention’ cannot be inferred.
The correct Homeopathic remedy for skepticism is a credible result from trails that meet the demands of the scientific method.
Homeopaths should co-operate with skeptics in these trails if only to prove to themselves that it works.
December 27, 2007 at 11:25 am
laughingmysocksoff
Of course it’s evidence! These observations were made, recorded and verified. Without the control all you can say is you don’t know WHY over 70% of these 6544 improved over the study period. You can’t say there’s no evidence for their improvement, OR deny that their case histories record that they had experienced no such improvement under “conventional” treatment.
That’s not a homeopathic remedy. That’s a conventional remedy.
I think you need to do some reading of the trial literature. Homeopaths have been cooperating in, designing and performing clinical trials for decades.
January 3, 2008 at 1:40 am
Humber
Laughingmysocksoff,
If I understand you correctly you accept that technically, the reported improvements could be due to Homeopathy, or to doing nothing at all. However, you consider the results to be so startling that there must be something at work, and that something is Homeopathy. If not, then the results must be due to the cessation of allopathic treatment. Without getting all Bertrand Russell on yo’ass, that’s not logical.
I contend that without a control it is not possible to parse the two possibilities. I could agree with you concerning the venomous nature of allopathy or not, and still not find a role for Homeopathic remedies in these trials. I could also attribute the result to any number of uncontrolled mechanisms, and that’s without questioning the validity of the data itself.
Homeopaths acknowledge they cannot provide a plausible mechanism and ask that skeptics accept Homeopathy largely on the basis of anecdote alone. We get the idea, but it’s a lot to ask.
I have looked at the trails, and find them unconvincing. What positive results there are, do not appear to be commensurate with Homeopathy’s strident claims.
Plausibility aside, the problem for skeptics is the quality and reliability of the data. Homeopaths answer this criticism by claiming bias in the mind of the skeptic, and the scientific method itself.
There is no doubt that bias exists on both sides, but not all biases are equal.
Perhaps you know of the basketball experiment where an audience is asked to count the number of passes made between players wearing either black or white shirts. Thirty seconds into the game, someone wearing a gorilla suit runs around the court in full view before departing. Typically, more than half the audience fails to see the gorilla. Of those that do not, many steadfastly refuse to believe that gorilla was there, and confabulate or claim conspiracy. The general lack of observation is due to inattentional blindness, but refusal to accept that fact is hubris.
Would you expect those in that last group to be objective observers of anything ?
The so-called ‘placebo effect’ is present not only in medicine, but almost all human matters. Subjects can be convinced that a drink is orange juice by its colour, or the way it is presented. The list is endless. Where the placebo effect is not due to measurement noise, it is effectively the result of persuasion, and human beings are easily persuaded.
Anecdotal evidence is generally unacceptable to skeptics – not out of slavish, uncritical adherence to a scientific hegemony, but because human beings are appalling observers !
It is quite contrary for Homeopathy to maintain that the observer is part of the system and then ask exemption for Homeopaths and their patients – especially in the light of your astonishing remark that nothing would change your mind.
The scientific method, where hypothesis must fit the observed data works in physics, geology, engineering and so forth. Science attempts to remove human bias as much as is possible. It is not perfect, but it is certainly closer than uncontrolled anecdotal reporting.
The frequently invoked ‘quantum uncertainties’ do not impact upon the countless practical applications of science that surround you, and to exclude medicine from scientific purview just because it concerns health, something close to our being, is special pleading.
To ask that science be perfect and ‘know everything’ before it can be applied to Homeopathy is simply reductionism. Creationists argue in the same manner; unless science can exposit each and every step of evolution, then it hasn’t made its case.
I have read your objections to double-blind trails. I could comment upon about them, and no doubt you would post a spirited rebuttal. Posts could oscillate in this manner until one of us becomes bored.
Lmso, I appreciate that you have to field a lot of comments from skeptics, and maintaining this blog must take considerable effort, but much of what you write is misdirected and repetitive.
How about injecting some new information into the debate?
On another site, Le Canard Noir has posted a challenge to Homeopaths.
httpwww.quackometer.net/blog/2007/12/simple-challenge-to-homeopaths
.html
You will know of this, so I need not repeat the details here.
As far as I can see, this test is within Homeopathic lore, and should show a result free of any of the purported biases.
Posting references to existing trials may be all well and googled, but they are third-hand, mostly inconclusive, open to interpretation or of dubious provenance.
This trail is different because it is simple, cheap and the Internet makes the process transparent. All involved will be accountable for what they write before and after the trials.
These trails would not be for the benefit of skeptics alone. The lack of consistent, plausible explanation means that Homeopathy has much to learn. This is an opportunity to learn something.
For the skeptics it addresses the claim of potentised water which we find so hard to swallow. No Quantum Mechanics, Post-Modernism or institutionalised bias.
I cannot speak for all skeptics, but I would want the tests to be fair and honest for both sides. I simply want to know the answer. If the tests provide a creditable result for Homeopathy, I will be amazed, but then again, I like to be amazed.
I think that you should take this test, and ideally recruit some of your colleagues.
What do you say?
January 3, 2008 at 12:10 pm
Rich Scopie
Apologies for the delay in replying, I’ve been busy enduring Christmas…
>>You’re telling me that you can only have one ailment at once? That ‘flu somehow “drives out” indigestion and heartburn??
>I’m saying that, according to the homeopathic perspective, you can only be in one state at a time. A lot of people experience remission of chronic symptoms when an acute supervenes. You can rationalise it whatever way you like, but it remains the case.
I’m sorry, but this just *isn’t* the case. An example: I’ve had a very painful shoulder for some months now. It hasn’t responsed to painkillers/anti-inflammatories, so I’ll be going back to the doctor shortly. I’m sure that given time, and rest (unfortunately more rest than I can give it at the moment) it’ll get better by itself. For the last three weeks I’ve also had a stinking cold. This hasn’t improved the shoulder one jot.
I appreciate that this is anecdote, not evidence, but then, as a homeopath you will no doubt be prepared to accept it as such. The “homeopathic perspective” is obviously flawed.
(Additionally, I banged my shin sharply on the corner of a low coffee table the other day. This improved neither my cold, nor my shoulder.)
January 3, 2008 at 4:16 pm
Andy Lewis
I too would like to add to Humber’s wise words and formally ask laughingmysocksoff to participate in the quackometer simple challenge.
I hope I have made it is easy and as cheap as possible for homeopaths to demonstrate what they say has merit. If you have suggestions as to how to make it easier to show a positive result for homeopathy then I am happy for you to use them as long as they maintain the statistical significance of the original test (so that we have an unambiguous result), is blinded carefully and is public.
All the debate on these boards could be silenced in a second if just one homeopath in the world was prepared to take up such a test of their claims. All of us sceptics would be humbled if you passed.
January 3, 2008 at 5:45 pm
georgepeele
A G A I N S T D R B E N G O L D A C R E
Cultural Dwarfs and Junk Journalism is Martin Walker’s fourth book charting the development of the corporate science lobby that has grown rapidly since New Labour came to power in 1997. One of the most recent exponents of the Lobby is Dr Ben Goldacre who has regurgitated a bad ‘Science’ column in the Guardian newspaper since 2003.
Like other quackbusters Goldacre claims to write factually based and scientifically accurate articles about health, medicine and science either supporting scientists and doctors or criticising individuals involved in alternative or nutritional health care. Goldacre’s writing, however, actually reflects the ideology of powerful industrial, technological and political vested interests.
Goldacre who it is claimed is a Junior doctor working in a London NHS hospital is actually a clinical researcher working at the centre of New Labour’s Orwellian spin operation that puts a sympathetic gloss on anything shown to create adverse reactions from MMR to Wi-Fi, while at the same time undermining cost-effective and long tried alternative therapies such as acupuncture and homoeopathy. Goldacre is involved with public health researchers well known for trying to prove that those who claim to be adversely affected by pollutants in our modern high-technology society, suffer from ‘false illness beliefs’.
Cultural Dwarfs and Junk Journalism, investigates Goldacre’s role in industry lobby groups and puts another point of view in defense of some of the people whom he has attacked, belittled, satirized, castigated, vilified, maligned and opined against in his junk journalism.
Cultural Dwarfs and Junk Journalism: Ben Goldacre, quackbusters and corporate science, is available from the Slingshot Publications web site as a free download, from mid-day on Wednesday January 2nd.
http://slingshotpublications.com/index.html
January 3, 2008 at 8:44 pm
ross
cool, perhaps if I keep on being mean about homeopathy on teh internets I can get a job in this New Labour Orwellian spin operation. I’m all yours big farmer.
January 3, 2008 at 9:59 pm
laughingmysocksoff
Humber, thanks for your well argued and considered reply. It’s nice to see someone finally willing to get down to the essentials. The majority of your general comments on the nature of human beings and their observational abilities I completely agree with. The thing is though, exactly the same comments are applicable to those who call themselves scientists and sceptics as those who call themselves homeopaths, and I could pick just as many holes on the same basis in any number of conventional trials as you can in homeopathic ones. We’re all in the same boat.
Ultimately all scientific theory — no matter how well “proven”, how apparently coherent or how useful in making predictions — is no more than metaphor, analogy, models, maps. We cannot know what the ultimate reality is since we can only experience reality in a subjective way and measure it either directly through our senses or indirectly through devices we’ve designed to extend the range of our senses. So scientific “fact” in fact amounts to no more than models and maps of common and consensus experience. The trouble starts when people mistake the map for the territory, imagine that the particular metaphor they’re employing is reality, and start fighting about who’s version of reality is “right” and who’s is “wrong”. There is no right and wrong. There’s just different ways of modeling it and different degrees of coherence in those models. Some are highly coherent and some are highly incoherent, and the fact that humanity employs many widely different and sometimes contradictory metaphors for different areas of human experience is indicative of the limitations of any one model to map the totality of human experience, of the conceptually fragmented nature of human intelligence, and of how far we still remain from any comprehensive model for our state. Don’t forget that what we take for “truth” and validity is entirely conditioned by whatever highly subjective cultural metaphor we’re immersed in, and where different models clash, they merely demonstrate the limitations of their applicability, not the “truth” or otherwise of any analogy over any other. As Einstein said “Few people are capable of expressing with equanimity opinions which differ from the prejudices of their social environment. Most people are even incapable of forming such opinions.”
Amongst our maps of common experience, the ‘scientific’ cultural metaphor gives more weight to objectified observations that are made with greater frequency by more people, and that can be made in a replicable and predictable way as an apparent result of performing certain prior actions or observations or by following a methodology dictated by a theoretical framework derived from the apparent temporal and functional relationships mapped between any series of observations and actions. However, to assume that reliability and replicability equate to some greater degree of “truth” is illogical, as is to assume that ‘truth by committee’ is the only valid way to relate to reality with a high degree of coherence. All we can say is that the observations are more common, more objectified, more reliable and more readily replicable, not that they are any more “true”, since we have no way of knowing whether uncommon experience is any less coherent with ultimate reality than common experience, or to what extent the strength of individual and collective belief in a metaphor creates its own replicability and reliability, ie. how much is self-referential feedback. This isn’t to say there’s no ultimate reality, but that we’re incapable of distinguishing it from our subjective involvement with it. Mostly we’re just mapping the bell curve of collective human perceptual abilities and intelligence.
Scientific thought has created a distinction between this “objective” category of observation and what we have observed to be a lesser degree of reliability, replicability and predictability in “subjective” perception. This line of thinking has resulted in an extraordinary perceptual dichotomy whereby only the “objective” has authority (consensual, controlled, consistent, reproducible, predictable, “real”) while the “subjective” is vilified (individual, inaccurate, unreliable, uncontrolled, biased, imaginary, delusional). The validity of this distinction is not only unproven, but unprovable. Since personal subjective reality is not only the only reality we are capable of experiencing, but also the only reality with any ultimate personal value to each of us, any arbitrary separation between “subjective” and “objective” can consequently only ever be a perceptual trick we play on ourselves. We seem to have arrived at an interesting paradox whereby the collective definition of “validity” is a complete inversion of the validity we individually espouse.
This is not to say it has no validity or that its validity is inferior to any other metaphor. It’s a matter of horses for courses. An objectified metaphor is supremely useful in relating to reality in an objectified way that’s predicated on averages, means and common factors. Consequently it’s served us extremely well in creating objects for an infinite variety of common purposes, modeling linear and spatial relationships between objects, etc, all of our industrial and technological achievements, and relating to other areas of human experience in a common, objectified, object-oriented manner. However, it’s far less successful as a metaphor in areas of experience with a high degree of individuality and subjectivity, or where process dominates. Health and disease is as much a subjective experience as it is objective, and an objectified metaphor is of little use when it comes to modeling the idiosyncratic subjective aspects of illness. CAM therapies such as homeopathy work in the subjective arena and employ different metaphors to model what goes on there. BUT YOU CANNOT DEVISE A SATISFACTORY PROOF SYSTEM WITHIN THE TERMS OF A METAPHOR PREDICATED EXCLUSIVELY ON WHAT IS COMMON AND OBJECTIVE FOR A METAPHOR THAT OPERATES IN THE REALMS OF THE INDIVIDUALISED AND SUBJECTIVE. Results of trials based on the common and objectified will therefore always produce equivocal results because this is not the principal realm in which homeopathy operates. This rationale would predict that all the strong evidence for the therapy’s efficacy (consistency, replicability, predictability) would be found within the realms of “subjective” rather than “objective” data, and this is exactly the case. It would also suggest that anecdotal evidence in support of the objectified therapy would be generally more equivocal than objectified trials suggest. A cursory perusal of the data might suggest some support for this hypothesis, as would the increasing popularity of CAM therapies. So in other words, subjective data supports the therapy predicated on a subjectified metaphor while objective data supports the therapy predicated on an objectified metaphor. Kind of obvious when you think about it that way.
Consequently I would confidently predict that this issue will never be satisfactorily resolved until we arrive at a metatheory which incorporates subjective experience and evidence with equal validity to the objective, arriving perhaps at the “evidence mosaic” which Riley has spoken of.
As to Andy’s experiment, yes, I’ve said before I think it’s a reasonable test in outline though it still assumes a localist hypothesis and I’m not convinced that’s how homeopathy operates so there might need to be some negotiation over the experimental protocol to everyone’s satisfaction. I’ve also said before I’d be willing to give it a go, BUT (and it’s a very large BUT), Andy’s behaviour in this debate has been such as to make any homeopaths highly sceptical that it would be conducted fairly or in a trustworthy manner. And so far, he’s omitted to fill in any of those oh-so-critical details such as who might be considered a trustworthy intermediary and adjudicator and exactly how the experiment would be conducted. The devil’s in the detail as ever. Over to you Andy …
January 9, 2008 at 5:50 pm
Humber
Laughingmysocksoff,
I would like to reply to all of the points in your reply, but it covers so much ground. However, I do not think that we are going to make much headway by arguing about arguing or the knowing of knowing. The result is always tautological or indeterminate.
Even if I accept your idea that all perceptions are a metaphor, this does not mean that I must accept that all metaphors are equal, for that is certainly false.
Science’s explanation of the creation of this planet and its subsequent life, is a much more accurate metaphor than the Australian aborigines’ idea that it was all put together by a giant lizard. Or don’t you agree?
It common to find alternative thinkers soaring to some epistemological plane, or drilling down to the limits of what is knowable, whilst holding contempt for knockabout questions about how their ideas might actually work.
OK, enough of the polemic. Let me try to take your point of view.
You maintain that exact science and Homeopathy are different interpretations of the world, and science may not simply declare itself to be the arbiter of reality.
These two worlds may indeed be different, but by how much? That’s a fair question, I think. Take a look at how both sides conduct and observe their respective medical trials.
(a) Both monitor patient external effects and accept patients’ natural language reports as being an accurate description of their internal state.
(b) Both use mathematics to quantify their results, and so subscribe to its rules and axioms.
(c) Both directly or indirectly attribute their results to the action of an agent.
(d) Both use the same rules of formal argument and its logical framework.
We also share many environmental and social conditions.
The list is not exhaustive, and a student of PM may write a ten page diatribe pointing to my intellectual Fascism, but already one is given good cause to ask what COULD REMAIN to account for any SIGNIFIGANT difference in the two ‘views’ of the world?
As far as I can see, the major differences are that Paradigm-H has introduced a new, non-local force at (c) and wants to violate much of (d). What is so ‘other worldly’ about that?
Because the two worlds are so similar, I need only accept the existence of the non-local force to make the two worlds generally concordant, and then use the common attributes to ask questions from the ‘inside’.
Can I directly measure the non-local force? Is there a secondary means of measurement that could be used to monitor the primary information channel? The force finds no consilience with any of the other sciences, so no useful analogs can be constructed. There is also nothing in the theoretical framework that I may use to make an estimate. It’s a bit dark in here!
Even if I accept the existence of the non-local force and that I cannot directly measure it, I can still take issue with any claims that Homeopathy may make as to the LEVEL OF EFFECT that scientific trails may have upon it. I can find nothing within Homeopathy that would allow me to determine it. Even the ratio of local to non-local effect is unknown. It’s all up for grabs.
The item introduced at (c) has no definite characteristics, is isolated and apparently beyond mensuration. More like a figment than a metaphor, I think.
The second string to the bow is that homeopathy relies on subjective, anecdotal reporting, and therefore cannot be put through the scientific mill because that is simply inappropriate. OK, but why not?
Homeopathy is subjective and anecdotal to the bone. Diagnosis depends largely on anecdotal patient reports and the perception of the practitioner to interpret them. The remedies themselves are subjectively assessed. The results are gathered by anecdotal reports.
There are no other significant means of measurement or control, meaning that anecdotal reporting is not a FREE choice, but a FORCED one, and such inconveniences have the tendency to be buried within a hypothesis so as to become integral to it.
Is that the real font of the objections to controlled trials?
For the above reasons, it is not possible to simply posit the existence of the non-local force, and ask science to accept it.
If you argue that scientific trails expose only the local biochemical effects then you have no option but to conduct full patient placebo trails to demonstrate the existence of the non-local effect, that are in accordance with the agreed rules of logic.
I don’t think that rational skeptics are denying you the use of anecdotal evidence, but doubt its quality. Homeopathy’s reliance upon anecdote and indeterminate force are weaknesses of the hypothesis that must be accepted, and not wished away.
Because everything is so subjective, tight control is mandatory. I know that you DO understand the need for a control if for no other reason than you raised is as an objection to the proving trails.
What if placebo trials were to show a creditable result for Homeopathy, but science held to the idea of the placebo effect, explaining that we had decided to accept your stance and introduced a new, quasi-local force that acted preferentially upon placebos. Does that idea ‘work’? Never mind, I’ll think of another.
What if I were to agree with you, would my previous view still be correct, or both correct?
It’s a stalemate at best. I can always defeat you, or at least provide enough obfuscation to deny you a decisive victory, by simply adopting your own ideas.
What of the placebo effect? It’s a bit mysterious, yet skeptics accept it. Well, yes, There is a veritable mountain of controlled evidence, and it can be seen at work in so many other ways. The mind relies so heavily on inference that such effects are to be expected.
The standard ‘psychological’ explanation of the effect, is that the patient takes the placebo BELIEVING that it is a medicine and is therefore CONVINCED that he is being cured. Well, maybe, but it could be simpler than that.
Let me illustrate the point with a personal anecdote. Ahem…..
Whilst in a remote part of the world I developed an acute and powerful pain in one of my molars, which I now know to have been an abscess on the root. All I knew was that I had the mother-of-all-toothache, and was days away from any hope of finding a dentist
I had some Ibuprofen with me and decided to ration it to cover the estimated time.
At night I would lie down and stare at the apex of my tent until I could no longer stand the pain, and take another pill. When I found myself once again reaching for the pills, I realized that on the previous occasion I had not taken the pill, yet the pain subsided as expected. Things that make you go mmm….
I remembered that whilst in the process of taking that pill, I was distracted by a sound from outside. In the circumstances, this higher level ‘danger’ signal took over. When the OK arrived, I went back to lying down, but without the pill.
The explanation might be something like ‘I THOUGHT I took the pill, and so fooled MYSELF into BELIEVING I was better’. It’s a bit crowded and convoluted in there, don’t you think?
I had also run out of water so swallowing the pills was difficult. What happened to the expected experiential ‘qualia’ of the pill on the tongue, and of the consequent swallowing? How could I have missed them? At what point did my socially derived expectations kick in? I didn’t actually take the pill, so not then. When I reached for them, or bought them? Not so simple. A topic for another time, perhaps.
Lmso, I do not see science as a paradigm or anything so grand. I see it as being much simpler than that. Human perception is littered with the relics of our evolutionary past, and science is simply a tool, a prosthetic, that keeps our monkey-brains on the straight and narrow. Almost by definition, this tool is going to produce results that challenge our innate ideas and perceptions. Some don’t like that at all, and become gorilla deniers.
Despite what you opine, Lmso, you are buying into an idea and tacitly claiming its superiority. To then use many other metaphors to explain that my metaphor is just a metaphor, well…
It is circular and internally inconsistent, which is why science dallied with the idea and gave it up.
I did not know that you were willing to take part in the proving trials, so I must have missed something. What is it about Andy Lewis’ ‘behavior’ that bothers you?
I think that you have all the freedom you need. If you have any further objections, please state them. It is rather difficult for we skeptics to anticipate all of them. Over to you then….
January 10, 2008 at 1:13 pm
laughingmysocksoff
Thanks for the well-considered reply, Humber. I think it’s only by getting beyond superficial appearances and exposing the very nuts and bolts of what constitutes our respective viewpoints that we’re going to get anywhere close to a resolution … and hopefully a far better understanding of the mechanisms involved in all therapeutic interventions in the process.
Precisely. Which is a very necessary point to make in the context of claims to objective validity on the part of current consensus scientific theory. Much of that ‘objectivity’ derives from circular self-referential logic, and is not as objective as it appears.
Certainly. And I wasn’t suggesting that was the case. Metaphorical quality is distinguishable by the extent of coherence and congruence exhibited in relation to the context it’s being employed in, but that doesn’t prevent several metaphors being simultaneously valid (within limits) if they model different aspects of any one context. Biomedical metaphor tends to model only what is material, common and objectified amongst us. It consequently leaves a massive amount of relevant data out of the equation.
Depends how you look at it 🙂 I can see the responses to this already, but what the hell …
If you take the perspective that all views of the world are just different metaphors for all our attempts, through all cultures and all times, to grasp the fundamental nature of existence, then you start to see them in a different light Emphasising the idea that they’re all essentially valid analogies describing the same process, you start to see what they have in common.
‘Science’ presents a highly fragmented view of the world. It restricts QM pretty much to particle physics, since that’s the area it’s proved itself most precise. For the rest, we have a largely Newtonian construct that fails to integrate the profoundly different perspective on existence that QM brought about, or to acknowledge or involve the role of consciousness and the subjectivity of the observer in any of it. Science is split off from psychology which is split off from philosophy … doesn’t look like a particularly comprehensive, coherent or satisfactory explanation to me. The apparent present scientific consensus on the creation of this planet also masks the number of different competing theories there are, how frequently they’re revised, and anomalies in the data which might suggest a different interpretation.
On the other hand, the giant lizard (dragon/snake) as world creator is, as metaphor, found in a large number of ancient creation myths the world over. Its role in these myths, regardless of the specific details of each, is as a metaphorical ‘bridge’ between the material (the world) and immaterial potentiality (the gods). Put this metaphor alongside QM (since both are describing the same process in different ways) and essentially the dragon/lizard represents wave function collapse; it’s what brings a fundamental particle of matter out of potentiality into existence. In fact, according to the ancient myths, it’s what brings the whole world into being, so they’re actually a bit ahead of us in saying that QM operates at a macroscopic level. The dragon/lizard also represents the psychological and philosophical process of how consciousness translates into matter, so it models an ongoing process, and as such acknowledges a greater role for consciousness in the creation of our reality. In that, it’s also ahead of science — the latest work in consciousness theory, which has still to make it into the body of the kirk, is only just beginning to work with these ideas.
Science is very linear. It sees things in straight lines and evolution as a long straight line of continual development and ‘advancement’. Ancient cosmologies work more with the idea of cycles — circles and spirals: what goes around comes around, but at a slightly different level each time — which is equally valid since we’re continually revisiting the same questions, just formulating our answers in different ways. Whether we progress or not, in terms of being somehow superior in our understanding to less technologically developed cultures, is more open to (very serious) question. Scientific metaphor provides very many more creative opportunities for interacting with the material dimensions, creating stuff, but it’s also pretty deficient at modeling process, systems with enormous numbers of variables, and — perhaps most importantly — the role of consciousness and self-referential thought systems in all of this. Our current global crisis has evolved as a result of human behaviour, largely since WWII, and largely predicated on our inability to think outside of an extraordinarily narrow, limited, linear and exclusively expansionist model of development. Ancient cultures have a far better and more holistic understanding of natural process. They’ve lived in harmony with the planet for thousands of years, whereas the modern world view, informed to a large extent by the ‘scientific’ perspective, has brought us to the brink of destroying our means of survival in less than 100 years, so as an accurate metaphor for the natural processes which we’re all subject to by virtue of being part of, and dependent on, the planetary ecosystem, it totally sucks.
This is because when you’re dealing with bits of reality that don’t currently fit all nice and pat into existing metaphor(s), it’s necessary to do this. You have to continually undermine the very foundations of the construction of knowledge to be able to ask the right questions to get the right answers. This is the very nuts and bolts of the scientific method, after all. The theory is just the theory, and no matter how good it’s proved itself within the limitations of our present world view, if observations of reality demand it evolves and expands, then they demand it evolves and expands. It doesn’t do to get complacent. As Hawking said, “The universe continues to surprise us”.
The contempt, I think, is partly a mirroring of the contempt in which alternative thinkers tend to be held by conventional thinkers, and partly the feeling arising from contemplating the sheer arrogance and hubris of a way of thinking that’s brought the entire planet to its knees.
It’s common to find sceptics and pseudosceptics resorting to dismissing alternative thinkers as deluded idiots while failing to take into account that many of these people have already trodden the path they’re walking, argued the same arguments, conducted the same thought experiments, seen it, done it, bought the T-shirt. Read John’s bio on his blog. There’s hundreds of us like him in ‘alternative’ areas of thought and practice. The reason that a lot of us ended up here is that a) the present ‘scientific’ world view ignored or discounted far too much of the picture for our satisfaction, and b) subjecting homeopathy to our own testing ended up making converts of us.
Stretching your world view isn’t an easy process. We know. We all went through it to get where we are. It’s a bit like foreign travel — gives you a rather different perspective on the country you were brought up in. Things you take for granted as ‘just the way it is’ don’t get taken for granted any more.
Very fair. And in trying to make my point, I’ve had to drive more of a wedge between them than is probably justified in some respects. Not, though, in others. While we’re dealing with the same underlying reality, the way we view that reality is quite different. What I’ve been trying to emphasise in the differentiation I’ve been making is that the assumptions which underly way we look at the world have a huge impact on resultant perspective, interpretation and action. Like I said, foreign travel … Holistic therapies take into account a whole mass of data that is completely ignored by the biomedical view as subjective and irrelevant. As a result we can discern patterns that aren’t otherwise apparent.
And I would take issue with some of your points …
To an increasing degree, biomedicine does not accept patients’ natural language reports as being an accurate description of their internal state. If that state isn’t shown by material investigations to have any organic foundation, then ‘truth’ defaults to the test results, not the patient. All too frequently though, it’s the patient who’s right and not the tests. The tragedy is that many are vindicated too late.
In some respects this is correct. But back to the analogy of foreign travel. You could say that all ways of living aren’t so very different, but you’re never going to discover the half of it by conceding only one aspect of a foreign culture into your world view and interpreting everything else in that culture by your own cultural standards.
I didn’t say homeopathy couldn’t be put through the scientific mill. Only that its efficacy couldn’t be satisfactorily demonstrated within the assumptions of the DBRCT. Like I’ve said before, first you have to ask the right questions.
No. There are no objections to the controlled trials per se, but to the premature and unsupported conclusions drawn from them that homeopathic remedies’ failure to show sufficient statistically significant effect means the whole therapy is bogus. Trial data is equivocal. It doesn’t support the null hypothesis. And it particularly doesn’t support the null hypothesis in view of the weight of case history and the number of satisfied patients. However, much of the sceptic — or should I say pseudosceptic — community regards that data as ‘invalid’. Rational sceptics may not deny it, but a quick trawl through the comments on this blog and others devoted to the subject will show you just how many do. My point has consistently been that a) despite its subjective nature, case history has a lot more than zero validity, and b) DBRCTs are as plagued with subjectivity as case history; it’s just less obvious where it’s hanging out.
All thought systems being self-referential, it’s inevitable they generate their own proof systems, which are then seen as questionable from outside of that system. This applies as much to biomedicine as it does to homeopathy. Ultimately what really matters is that sick people get better and that they’re happy with the process they went through to get there. If that’s the case, then the therapy is demonstrably effective, no matter how that was achieved.
If placebo trials were to show consistently creditable results for homeopathy, then perhaps I’d have to revise my global estimate of the effect attributable to the physical remedy itself, but it wouldn’t change my stance. I’ve seen far too much of the ‘quasi-local force’ as you call it to discount it, and I’m far more interested in getting to the bottom of what makes homeopathy effective than “proving” it to a bunch of sceptics in terms which they’ll accept. And as I said elsewhere, this effect will be operating in all healing interventions, not just homeopathic ones. Individuallised CAM therapies just appear to utilise it to a far greater and more precise extent than biomedicine does. If this mechanism provides an effective, safe means of healing, free of side-effects and at no astronomical cost to the NHS purse, then it’s got to be worth exploring.
And yes. It’s stalemate at best, and has been for 200 years already. You can always pick holes in my arguments and I can always pick holes in yours. That’s because no thought system (per Gödels Incompleteness Theorems) tends to be able to demonstrate its consistency and its completeness simultaneously. The solution to this impasse in formal logic is to defer to a higher order system that’s capable of encompassing the both, which is why I’ve repeatedly suggested we need a meta-theory capable of encompassing both biomedicine and the far more subtle and non-specific effects of CAM therapies. But we’re not going to get that for as long as the biomedical community keeps insisting on its supremacy and that homeopathy is ‘impossible’.
Your story about your toothache is a good illustration of just how hard it is to unravel all the subjective effects of any kind of non-specific intervention. Belief is hugely powerful, but there are other effects evident too, particularly in CAM therapies, which don’t fit into the patient-convincing-themselves box. There’s the role of the therapist and the impact of correlating the patient to a specific individualised intervention, not to mention other subtleties evident in the methods of other CAM interventions.
That’s all any of us do, Humber. And it’s no less true of science. That’s the point I’ve been trying to make in getting all epistemological on you. This is the nature of all thought systems so it’s pointless to try and claim any advantage on that score. Self-reference, circularity and inconsistency is inevitable. It’s how we go about constructing our ‘knowledge’. The trouble with the scientific perspective though is that it’s convinced itself (through circular logic of course) that the scientific perspective doesn’t do that. Unfortunately it does.
I’m well aware of the paradox and circularity inherent in saying that all metaphors have validity and then claiming that this particular view of things is more valid than views that think that only one view can be valid!! What can I say? To me it’s more plausible that we all have a window on the truth, and that by putting all those views together we’re going to get a lot nearer to the essence of it than by trying to find one approach to it alone. Truth is so multi-faceted, after all, and we’re all alive, so we’re all qualified to have a valid viewpoint on the nature of life.
There are many people on these blogs who clearly would rather find any alternative rationale than accept that homeopathy has efficacy, and the virulence of Andy’s attacks on homeopaths don’t exactly recommend him as a trustworthy open-minded participant in a fair trial. I’ve asked twice now that he define with a little more clarity exactly how the trials would be run, particularly who would take the role of intermediary/adjudicator. The devil’s in the detail with these things, as ever. There’s no point in putting in the time and energy on this if the results are going to be thrown out on some technicality, intimation of collusion, rigging or whatever, particularly if I’m going to ask that the methodology is adjusted to allow for the non-specific element of the remedy to come into play to give me a better chance of pinning it down.
The simplest protocol would be for me to supply Andy with 6 remedies which he would then send back to me one at a time with the labels removed, knowing what he’s sent on each occasion. But this requires an awful lot of trust on each side to play by the rules. I’m not hugely confident I can trust him. He’s probably not hugely confident he can trust me. To take potential remedy tampering out of the picture, I could suggest that I pick 6 remedies, then have Andy instruct a homeopathic pharmacy so send each to me in turn, again unlabelled, but with Andy knowing what he’s asked to be sent each time, but then it would be easy for sceptics to suggest the pharmacy had an interest in telling me what was being sent. It needs more thrashing out, this protocol.
January 11, 2008 at 4:06 pm
John R
“‘Science’ presents a highly fragmented view of the world. It restricts QM pretty much to particle physics, since that’s the area it’s proved itself most precise. For the rest, we have a largely Newtonian construct that fails to integrate the profoundly different perspective on existence that QM brought about, or to acknowledge or involve the role of consciousness and the subjectivity of the observer in any of it.”
I am sorry but this is just plain wrong. Newtonian mechanics is not separate from quantum mechanics in any way. Newtonian mechanics is a subset of quantum mechanics, just taken to its macroscopic limit. You can use quantum mechanics to describe things in the macroscopic world but the answers you get will just agree with Newtonian mechanics.
As has been stated elsewhere the application of ideas from quantum mechanics to every day problems is meaning less without a theoretical basis. The quantum explanations for homeopathy just don’t make sense. They are the same as a pupil telling his teacher that he hasn’t brought his homework to class because quantum tunneling effects caused it to fall out of his bag in his way to school.
You constantly say that all theories are just metaphors. Using the example of quantum tunneling again would you be willing to drive your car into a brick wall at 80 mph. If you believed in this metaphor would it make it valid and allow your car to pass through the wall. I’m guessing you’d rightly suggest anybody doing this would be insane as, while quantum tunneling is a real and predictable phenomenon, there is no reason to believe that this is possible. Why? Because suggesting a theory can support your belief in unreasonable unless the theory can predict your belief.
January 12, 2008 at 9:30 pm
laughingmysocksoff
That’s not what I was saying John. I said “we have a largely Newtonian construct that fails to integrate the profoundly different perspective on existence that QM brought about, or to acknowledge or involve the role of consciousness and the subjectivity of the observer in any of it.” This doesn’t mean that Newtonian mechanics is separate from QM, but that some of the fundamental tenets of QM, such as the limitations it placed on deterministic predictability and the emphasis it gave to the role of the observer as an essential determining factor in the outcome, have not been taken on board in mass consciousness. It’s just business as usual. Much of scientific investigation is pursued with the tacit assumption that the observer has very little to do with the outcome of the experiment and that therefore the results are “objective” and “valid”.
I’m not talking about effects that are taking place in the realm of the massive and material, John! (Though there are apparently Tibetan Buddhist masters who can put their hands through solid objects like walls.) I’m talking about subtle effects that are operating in the realm of consciousness which then produce effects which become evident in the lifeform which is the vehicle and expression of that consciousness. As I said to Andy elsewhere, how can he prove that his defining of the time evolving quantum mechanical wave functions to do his calculations isn’t the mechanism which establishes a conscious correlation with the entities he’s studying which then behave exactly according to predictions? The QM wave function doesn’t exist ‘out there’. It’s a mental construct, a metaphor we’ve devised to hang the theory on. And it works. Beautifully. But just because it works doesn’t mean it works independently of the consciousness that’s employing it, particularly if the whole process originates in our minds to begin with.
This is the principal reason why I stopped working in ‘conventional’ science. It just doesn’t explain enough of what goes on. We leave ourselves out of the equation all the time, largely because we just don’t see our role in what we do — not just in terms of an illusory level of objectivity, or how our entire rationale is predicated on questionable assumptions we take for granted as ‘fact’, but in how large a role we have in creating the very things we’re observing. Our metaphors aren’t just self-referential, they’re self-fulfilling.
You can observe this at work in homeopathy quite easily because there isn’t much in the physical dimension going on at the point of primary intervention. This doesn’t mean that these effects don’t underly interventions where there is far more material manipulation happening, but that they’re going to be less obvious because we’ll tend to presume the effect is all down to the biochemical changes.
We’re already aware that the ‘placebo effect’ is a significant factor in medicine, but it’s high time we stopped heaping derision on it, relabelled it, elevated it to a role of equal importance to the pharmaceutical effect, studied it in much more detail than it has been to date, and learned how to use it for maximum effect. Not least because it’s way cheaper to utilise than pharmaceutical interventions and doesn’t tend to kill people or destroy their quality of life through nasty side effects. I believe therapies like homeopathy are pointing the way here, showing the precision necessary for effective intervention and the power it has to induce changes that can sometimes appear almost miraculous.
January 18, 2008 at 5:50 pm
Humber
Lmso,
Thanks for the detailed reply, but I think that we are never going to agree on this matter of different worlds. I do have some remarks on this topic, but for the moment, I would like to stick to the matter of trails, and Dr Walach’s papers in particular.
I have read some other papers and those of his colleagues, but I can’t say that he supports your version of the non-local effect.
He writes;
“ Thus, at present it is not possible to claim clinical superiority for homeopathy—individualized or otherwise—over placebo. Basic research has neither isolated a possible information carrier, nor has it generated a theory or mechanism that is plausible and/or universally accepted, nor has it given rise to enough stable, replicable results to attract the interest ofmainstream research (Vickers, 1999), with the exception of the histamine model (Belon et al.,1999), which awaits further support. Space prohibits lengthy discussion of this in this paper)
but some arguments and conflicting evidence have been presented in more detail elsewhere”(Walach and Jonas, 2002).”
It seems that Dr Walach quite emphatically agrees with the skeptic’s view of the state of play. (Yes, Stable, replicable results WILL interest mainstream research).
The paper then argues against the localist hypothesis, by observing that despite having a plausible mechanism and some clinical effectiveness, Prozac does not show an overwhelming result in trials. This failure is attributed to a breakdown of the chain of cause and effect.
“This hypothesis is a “localist” one because it silently adheres to the accepted notions of causation. This modern notion of causation is only one element of the old Aristotelian notion of cause. Four kinds of cause were known to Aristotle, one of which he called “efficient cause,” that cause which is the dynamic reason for an observed change. Modern science has adopted efficient causation as the only “real” one.”
In the case of Prozac, “efficient cause” may apply to the drug and its modulation of the serotonin level, but it does not extend to patients’ reports. Medicine does don’t know enough to be able to say ‘serotonin level X will cause happiness Y’. The trials are conducted to see IF modulating the serotonin level produces the desired effect in the patient. There is nothing in this idea to justify the introduction of a non-local effect.
One may as well introduce a new law of physics on the basis of a magician’s trick.
“Suppose that the “active” principle of homeopathy resides in a complex mix of the homeopathic situation between patient, practitioner, remedy, history of medicinal substances and their use as codified in the homoeopathic material medica, with some mental interaction between
the doctor and patient—such as a flash of security, a spark of trust and hope. In other words, suppose homeopathy is a kind of field effect with no single element that can be isolated and attributed to the remedy alone. If that were the true picture, then testing the remedyalone would be like taking one transistor out of a radio set and testing it for its capacity to
play music.”
Medicine knows these effects. The ‘codified history of medicinal substance’ is called imprinting. The ‘mental interaction’ is called persuasion. I doubt by ‘mental interaction’ he means telepathic interaction, as you suggest. If he does, then there would be no need to argue the toss. There are no known bounds to telepathy, so it can be introduced at any point to explain any event. The paper would then not be scientific, but spiritual.
As you know, I am willing to concede the non-local effect and take it from there. John R outlined a blinded trial that I think meets your requirements. I have read the subsequent posts, but I still don’t see any show-stopping objections.
There is perhaps sticking point concerning the placebo.
It is claimed that the Homeopathic healing begins with the selection of the remedy, with the effect being enhanced by consumption. This I understand fits the data.
Another possibility is that the effect is at a maximum at the beginning of the consultation, weakened by the remedy’s selection and again when consumed. This too will fit the same data.
How do you know which version is correct?
In any event, and as I have mentioned earlier, the magnitude of any putative effects are not known, so it is not possible to claim that any step is quantifiably more significant than another. All said and done, I would still expect to see an improvement over and above that of the control group.
Skeptics assume that the remedy will have no effect, and would expect the same result for each group. If we allow you your assumptions, you should allow us ours.
I don’t think there is much hope of arranging a large placebo trial. I say it again, LCN’s proposal is cheap and effective. It obeys all the rules. I don’t think that Andy Lewis would be interested in gaining a victory by cheating or other malfeasance. Of course some remarks will be scathing or sarcastic, it would be boring if it were no so. You are right that some skeptical blogs are nothing more than self-congratulatory clubs, but if I were to apologise for them, I would say that they have probably become bored with asking for the evidence we see as being so crucial.
It is interesting that the proposal has come from the skeptical side, but it must be possible for you and your colleagues to make proposals to overcome any technical or practical difficulties. If I can assist, I will. Waiting for the Homeopathy’s academic branch to give the evidence to you, or at least provide the stimulus for more effort from elsewhere, is likely to be forlorn.
It is all well and good to propose a hypothesis, but in science, you have to work to prove it. If Homeopathy wants to gain any credibility it must meet us some of the way, and risk being wrong.
January 18, 2008 at 6:22 pm
openmind
I’ll go out on a limb here and say ‘no they can’t’. In fact, I’d be willing to bet all I have that they can’t. In fact, and I mean this sincerely, I’d bet my life that they can’t. Not because it is impossible, but because it is supremely unlikely.
LMSO, I think we are now getting to the crux of where we skeptics and you differ. We understand probability. How probable do you think it is that this could happen? Serious question.
January 19, 2008 at 8:27 pm
laughingmysocksoff
No he probably doesn’t. I’ve taken it a lot further in an attempt to get to the bottom of things and postulate some kind of plausible mechanism of action that’s capable of accounting for the anomalies and paradoxes as we witness in trying to “prove” the efficacy of the therapy.
Walach begins his paper with the following paragraph:
This is the crux of the matter really. It’s that second sentence. Any of us who practice homeopathy could say exactly the same thing. These experiences are not deniable, neither are they amenable to any combination of the alternative explanations offered by the sceptic camp. Patients say the same thing from their successful experience of the therapy. There’s no way around this. The alternative explanations do not fit and that’s got nothing to do with wishful thinking or bias.
To say homeopathy doesn’t work means denying these experiences in thousands of homeopaths and their patients while having no congruent alternative explanation for the phenomena. To say it does is to undermine the whole basis on which scientific testing is predicated. Clearly neither option is acceptable, not just from the point of view of people in either camp, but from a rational objective standpoint as well. Both have proved themselves on their own terms.
So how do we deal with this impasse? The only way out that seems plausible to me is to find a theoretical framework (a metaphor) capable of accounting for all of this. At present, there isn’t one, so logically we need to look outside our present models and suggest mechanisms which have so far not been subject to extensive investigation (because if they had we would have a better explanation already). This is not going to provide instant answers because an enormous amount of work remains to be done to test any theory put forward.
I don’t see how the second scenario fits the data at all. If it were so, then the patient would show signs of improvement coinciding with the start of the consultation. This doesn’t happen, not least because a large percentage of patients arrive at the consultation full of scepticism — they’ve tried everything else and are trying homeopathy as a last resort.
Patients frequently report a marked improvement in their condition before they receive the remedy from the practitioner. It can be so quick and strong they can pinpoint a date and time. This allows any correlation with the remedy decision to be established. Frequently there is. I’ve had this happen over a distance of 3,500 miles. Instant and dramatic improvement. Not only that, but the patient also reported two observations which together showed that subconsciously they’d even precisely identified the remedy, though they weren’t aware of this themselves. It’s these sort of instantaneous action-at-a-distance events that induces homeopaths to speculate that some quantum mechanical-related explanation might be appropriate.
The extent to which any step is quantifiably more significant than another varies from patient to patient. My own experience has been that there’s an inverse relationship between the two– ie. the more a patient reacts to the initial remedy decision, the less they react to the subsequent administration of the remedy and vice versa. Provided the remedy decision is correct, the improvement experienced is broadly the same in aggregate.
I’ve indicated my willingness to take part in Andy Lewis’s experiment. However, I know from my own proving experiences that I’m just as susceptible to the non-local as the local effect, so I’d like both to be operating, which means double blinding is out. I’m perfectly happy to do this blind — that’s the object of the experiment after all — but we need a protocol that both sides are happy with and some means of ensuring the experiment is conducted honestly and openly. From the sense I have of him, I don’t think Andy is the sort of person to cheat, but perhaps you can understand the reservations I have here given the virulence of his attacks on homeopaths to date.
So if discussions aren’t scathing and sarcastic they’re boring? Have you any idea how desperately sad that sounds? What that boils down to is a community of people that can only feel good about themselves if they’re putting others down. I know it’s a national disease we catch at an early age, but we have a choice when we get old enough to know better. And you wonder why so many people in this country are chronically sick and why so many are turning their backs on ‘science’?
What makes sceptics feel they have this inalienable right to demand homeopaths provide them with this “evidence” they want? Especially as they’ve obviously no intention of ever using homeopathy. Do your own research! That’s what everyone else does if they want to find out about something. The evidence is all there in the public domain with more being published all the time. Yes you might have to pay for some of it, but that’s no different to what homeopaths have to do if they want access to biomedical information. If you choose not to believe it, that’s your choice, but it doesn’t give you the right to make that choice on behalf of others and demand an end to homeopathy on the NHS when many people value and benefit from that service.
We all pay our taxes and NI contributions. If I can opt to support renewal resources by buying my electricity from an eco-friendly supplier, despite the fact that all the electricity goes into the same grid, why shouldn’t I have the right to make the same choices with my healthcare? A large number of patients plainly don’t require the same evidence standards as you do and they’re perfectly happy with their decisions, and with the treatment they get following those decisions. Who are you to say they’re “wrong” because they make their own choices according to different criteria than the ones you choose to use? It’s their lives. Their health. Their choice.
The belief system that is ‘science’ is in the process of being challenged on a number of fronts by phenomena that are resistant to “proof” within its narrow definitions, while its various proof systems are being shown to be increasingly fallible, so I think the onus is equally on the more fundamentalist factions in science to look to their foundational assumptions and properly employ the scientific method, rather than arrogantly assuming they arbitrate the only road to the truth from the perspective of the theory as it stands. Circular logic really isn’t very useful here.
January 19, 2008 at 9:25 pm
laughingmysocksoff
You think you understand probability, but if you don’t understand the role that consciousness plays in the creation of reality or what it’s capable of when you move beyond a set of limiting beliefs, then you don’t understand probability at all. If a large degree of what you take to be randomness is predicated on a level of causality you and the majority of humanity are not yet able to perceive or utilise then that level will behave in a more or less random fashion until such time as you discover how to manipulate it. For those that already know how to manipulate it, there is no randomness and probability calculations don’t apply.
Don’t make the mistake of thinking that your view of the world is the only one that’s valid or that western science constitutes the greatest advancement in the human intellect. Western science is great at technology. It barely even acknowledges the role of consciousness, which is one of the principle reasons why biomedicine is failing so badly because human beings are not machines. Eastern thought, on the other hand, is pretty weak on the technological side of things, but has explored the nature and capabilities of our consciousness even beyond the present capabilities of western technology.
Take this editorial (Jobst, Kim A. So What if There’s No Explanation? Journal of Alternative and Complementary Medicine, Volume 4, Number 4, 1998, pp. 355-357) for instance:
There are more things in heaven and earth, Horatio, Than are dreamt of in your philosophy.
January 20, 2008 at 9:30 pm
M Simpson
“Patients frequently report a marked improvement in their condition before they receive the remedy from the practitioner. It can be so quick and strong they can pinpoint a date and time.”
Oh come on! You’ve gone from post hoc ergo proctor hoc to ‘pre hoc ergo proctor hoc’! If there’s an improvement BEFORE a remedy is taken then you’ve got to be insane (or the possessor of a time machine, which effectively means the same thing) to think the remedy caused the improvement.
“Eastern thought, on the other hand, is pretty weak on the technological side of things” – damn right, what technology have the Japanese ever developed?
As for that anecdote about the Tibetan monk, good grief! Even assuming it’s a true account of what happened, I see nothing mysterious in a doctor diagnosing a patient and then a monk who doesn’t speak English diagnosing the same patient through an interpreter. Which is more likely: that the monk has supernatural powers or that the ‘interpreter’ simply repeated what the first doctor had said.
Note also the way that the gullible person recounting the story expresses amazement that the monk had found something which the doctor missed – without mentioning whether or not subsequent investigations showed this to be true.
Laughing, you’re making yourself look more and more credulous with every post and thereby doing your initial arguments no good at all.
January 21, 2008 at 5:24 am
Humber
Lmso,
You wrote;
“So how do we deal with this impasse? The only way out that seems plausible to me is to find a theoretical framework (a metaphor) capable of accounting for all of this. At present, there isn’t one, so logically we need to look outside our present models and suggest mechanisms which have so far not been subject to extensive investigation (because if they had we would have a better explanation already). This is not going to provide instant answers because an enormous amount of work remains to be done to test any theory put forward.”
Name one. Please name one possible idea that is not already on the table. Which parts of Dr Walach’ papers do you accept? It is disingenuous to only post the bits that support your ideas, and none from its critics.
No metaphor is needed, or asked for. The explanation can come later.
During the Cholera outbreak of 1854, science attributed the disease to a miasma in the London air. Snow put science’s miasma to the test by removing the handle from the water pump. We ask that Homeopathy does the same. If it cannot do this, then its claims of correctly administering the effect that it sells (and it does sell it) are questionable. It could be there all the time, for free. Waiting on the platform for a paradigm shift is likely to be a long one. The explanation is not required, just evidence.
The second scenario still fits the recorded data.
The patient may not necessarily show immediate improvement – coincidence is not implied. As you say ‘Patients frequently report a marked improvement in their condition before they receive the remedy from the practitioner’- for all you know, it may continue to be even better if you did not give the patient the remedy. The example given does nothing to contradict my hypothesis. The remainder confirms my claim that the level of the non-local effect cannot be determined. Homeopathic allopaths may be right.
“So if discussions aren’t scathing and sarcastic they’re boring? Have you any idea how desperately sad that sounds? What that boils down to is a community of people that can only feel good about themselves if they’re putting others down. I know it’s a national disease we catch at an early age, but we have a choice when we get old enough to know better. And you wonder why so many people in this country are chronically sick and why so many are turning their backs on ’science’?”
You protest too much. I said ‘some’ remarks. You are not above doing the same.
As I have said, Lmso, if you want us first to believe, then that is not an appropriate idea to put forward, and you know it.
I am not putting you down. I appreciate your point of view. You see your patients getting better, and your colleagues agree. There is 200 years of data. How could it be so wrong, for so long ?
You are not quite right when you say that skeptics deny you this evidence. As you know, we think that it is likely to be the placebo effect. We are indeed questioning Homeopath’s ability to distinguish this from the claimed effects of the remedies, but you seem unwilling to even consider the possibility. That is a fair statement, I think.
What are you trying to defend then? If you are that hurt by the process, declare yourself a religion and be done with it. Alternative science wants science’s approval and is not shy when they think they have it. Make up your mind, do you want to prove your point or not?
You are QUITE WRONG in thinking that I want to determine Homeopathy’s role, let alone destroy it. That is a social matter. Given the amount of money and resources that is wasted by our inept leaders, not only on the NHS but elsewhere, the matter is trivial. I do not expect that the majority are ever going to become rational materialists. I have told you – I am interested in the answer.
I have a friend who has lower back pain. His wife, a nurse, tells him to lose weight and exercise as the GP recommended. He chooses to go to the Chiropractor, returning with glowing reports. Should I deny him this, by demanding the closure of all Chiropractic ?
Not my choice, but neither is it his if he is misinformed.
(By the way, I have paid for some materials to the tune of $32. I asked Dr Walach for the mentioned papers, and he kindly sent them to me. I have papers authored by his colleagues trenchantly disagreeing with him. I read those too).
You may need to check your assumptions.
My opinion is that you put far too much stock in what you see, or hear from your patients. Do not underestimate the power of persuasion. Actually, you have little to fear from a negative result of any tests. With some window dressing and little talk, ‘probably moonshine’ can be converted in the patient’s mind to ‘there’s a chance it may work’
People rarely turn their backs on such thoughts once instigated.
A question for you, Lmso. If it were to be proven that Homeopathy was nothing more than the placebo effect, would you still practice?
I think the question of the local effect can be addressed by dose concentration. The patient is in effect a low dose prover. This restriction can be removed for trails where the subject is not actually suffering from the remedies’ target diseases.
It is up to you to use your knowledge and imagination to work around problems and not cry foul at every stumbling block. If you don’t care to prove your case, then that is up to you. Alternative science is always maintains that skeptics don’t listen and are close-minded. There are not many on this blog that accurately fit that description.
I understand why there needs to be an independent third party. That can be arranged. As a general remark, I see from what you have written on this subject, that you do not understand the scientific mind.
M Simpson:
Hello. For Homeopathy this is not an outrageous and idea.
Hahnemann’s Aphorism 32
“But it is quite otherwise with the artificial morbific agents which we term medicines. Every real medicine, namely, acts at ALL times, under ALL circumstances, on every living human being and produces in him its peculiar symptoms (distinctly perceptible, if the dose be large enough, so that evidently every living human organism is liable to be affected, and, as it were, innoculated with the medicinal disease at all times, and absolutely (unconditionally)…….”.
(my capitals)
I am contesting Homeopath’s objections that their test conditions are not met, when they do not know themselves how it works. I think that this limited understanding should not be used to force expensive and unnecessary conditions, if they can be avoided.
January 21, 2008 at 1:32 pm
openmind
LMSO, you haven’t answered my question. How likely do you think it is that a Tibetan Buddhist master (or anyone for that matter) could put their hands through solid objects?
If they can create reality by the manipulation of their consciousness then they can demonstrate putting their hands through a solid object. Probability does apply and I’d be quite happy to wager everything that I own against everything that you own that a demonstration would fail. Would you take this hypothetical bet?
I don’t. I don’t tend to think in such narrow minded terms, why ‘western science’ and ‘eastern thought’? This is pretty insulting to eastern scientists and western thinkers.
I think that the development of the scientific method is the greatest advancement in human history.
How has eastern thought explored the nature and capabilities of our consciousness? What are the findings of these explorations? What are the ramifications for science?
January 24, 2008 at 10:55 am
laughingmysocksoff
Rubbish M! To your narrow way of looking at things I guess that seems so, but you seem to be still assuming that the effect of the therapy resides only in the remedy when the bulk of the available evidence says it’s only part of the equation. When you’ve studied the effects of creating individual and group correlations in consciousness and the impact that it’s possible to produce and test, then such things are not in the least implausible. Neither do they require a time machine, just a non-local treatment effect.
Sigh … Oriental thought systems and philosophies have not produced great technological achievements. Japanese technology results from the application of Western technological and scientific method.
As I said elsewhere, implying fraud is the easy way out. It allows anyone to preserve their metaphor at the expense of the evidence … which is exactly what’s been going on in respect of the evidence base for homeopathy.
A Tibetan doctor does not require supernatural powers to do what he does. His abilities are entirely natural and the result of thorough training and practice in a system of medicine that’s markedly different from the Western model. You really do show the most extraordinary hubris with respect to your way of thinking M.
Or could it be that you’re showing yourself to be more and more narrow minded and literal and thereby doing your arguments no good at all?
January 24, 2008 at 11:47 am
laughingmysocksoff
The ideas are already on the table, though not necessarily with specific application to homeopathy. As I’ve said elsewhere I believe the answers will be found in the work being done under the umbrella of ‘quantum consciousness’.
Good example. From an earlier post:
From a quick trawl through various literature on the subject, it would appear untreated cholera has a mortality rate of anywhere between 30-80%. Typically it seems to be around 50-60% and can kill within a matter of hours.
16.4% mortality against 50-60% mortality for untreated cholera would not appear to be consistent with the idea that homeopathic treatment was inert. 16.4% mortality against even 30% mortality for untreated cholera would not appear to be consistent with the idea that homeopathic treatment was inert. At the time, the London Homeopathic Hospital was at Golden Street, close to the epicentre of the outbreak.
The figures for homeopathic treatment were so striking to the medical establishment of the time, that they suppressed them.
I think that removes the handle from the water pump somewhat. As for waiting on the platform for a paradigm shift, haven’t you noticed that one’s already underway?
Some practitioners may recommend the patient hold off on taking the remedy when they report a strong reaction coincident with the remedy decision. Although every case is unique so it’s impossible to say what might have happened if you’d done anything different, in such cases it’s often been observed that the effect doesn’t hold very long and that it’s then necessary to take the remedy itself which then results in a more robust and sustained improvement.
True. But I think you’ll find I usually use it in response to remarks of the same quality, and I certainly don’t do it because not to do so would be boring.
I’m not asking or wanting you to believe Humber. I’m not some kind of a missionary. Like I’ve said before, we all make our own choices about our belief systems in life. All I’ve been trying to do here is show that the scientific data doesn’t support the null hypothesis as the only logical and ‘scientific’ conclusion and that your circular logic is as open to question as mine is. Whether you take that on board or not is really neither here nor there. My purpose in starting this blog was to make sure that other points of view are “out there” and available to anyone asking questions about homeopathy’s evidence base. The mantra “there is no evidence” is factually unsupportable.
You may not personally deny the validity of case history and clinical studies Humber, or be one of those active in trying to cut off NHS funding to homeopathic services, but there are many here who have done and are doing exactly that, so I’ll accept I was wrong to generalise the comment to all sceptics, but not that what I describe isn’t happening.
Ha! No I don’t. Not at all. And as for checking my assumptions, that’s something I do all the time, hence my argument that thought systems create their own proof. But it remains the case that the power of persuasion and all the other alternative rationales that the sceptic camp has come up with are not a precise enough fit for the detailed observations made in homeopathic case histories. If it were, then the argument would have been settled long ago.
First define placebo effect. My contention is that this is a very poorly understood area of medical science which has become a rubbish bin (and looked on accordingly) for all the various non-specific effects of treatment that biomedicine can neither quantify nor adequately define. I suspect that further studies will show that it’s possible to harness these non-specific effects with a high degree of precision and strength to bring about healing in an effective, non-invasive way free from side-effects. I also suspect that it will be shown that CAM therapies like homeopathy do exactly that. So bearing that in mind, my answer would be yes. The bottom line is that if it works, it works. If we can instantaneously, dramatically, completely and permanently halt the symptoms and progress of serious conditions with ‘placebo effect’ then we should be doing exactly that, without poisoning and killing people, and without bankrupting our national health services.
Homeopathy has objected that test conditions aren’t being met because of the nature of the therapy. In order to conform to the quality requirements in DBRCTs, it’s necessary to use the therapy in a way that doesn’t reflect clinical practice. If the trial doesn’t reflect clinical practice then it’s not trialing the therapy. This has been as much a learning curve for homeopaths as it has for anyone. Through history, the tendency has generally been to assume that the major part of the effect resided in the remedy, hence the initial line of testing, but we’ve discovered that plainly it doesn’t. An effect is there, but it’s too weak to account for the impact of what’s observed in practice. Yet what’s observed in practice in respect of babies and animals precludes present definitions of ‘placebo effect’ as a valid explanation for the remainder.
January 24, 2008 at 12:09 pm
laughingmysocksoff
Yes, provided that the person doing the demonstration knew what they were doing. There are very few people who can get past the illusion of solidity to do this (despite the fact that science has demonstrated that solid objects are mostly empty space).
“Western science’ and ‘Eastern thought’ are broad generalisations referring more to traditions that the present distribution of each in the world. ‘Western science’ has crossed over to the east and ‘Eastern thought’ has crossed over to the west. No insult is implied to anyone involved in either.
I think those questions are a bit beyond the scope of this blog. I suggest you read the works of any of a number of physicists and other scientists and engineers who’ve explored the both and are presently attempting a synthesis of the two. The ramifications for science are immense. You could try Fritjoff Capra, Arthur M Young, Amit Goswami, or Fred Alan Wolf for starters.
January 24, 2008 at 1:50 pm
le canard noir
Sorry, Am I really understanding you correctly? You are saying that a homeopathic improvement in health can happen before the pill is taken?
So, not only is homeopathy in denial of physcis, chemistry and biologu, but also in basic cause and effect? That events (such as taking a pill) can influence past events (getting better)?
I think we now clearly more than ever see that homeopaths are magical thinkers.
January 27, 2008 at 9:37 pm
laughingmysocksoff
Have you actually read any of the discussions here Andy? There’s nothing remotely ‘magical’ about someone responding to a correlation established through consciousness. How many times have you been thinking of someone you haven’t heard from for a while and 5 minutes later the phone rings and it’s them? These correlations exist, whether you choose to dismiss them or not.
There’s nothing in homeopathy that’s a denial of physics, chemistry and biology either. It only appears that way because your model of each of these excludes the role of consciousness. Which is ludicrous anyhow, because without consciousness there would be no observer, no theory, no proof, no event. Failing to adequately account for our own role in what we observe, theorise about and act on is, IMO, science’s single greatest omission and it’s this that’s presently up for re-examination, homeopathy being just one of many systems that’s challenging the status quo.
It’s not homeopathy that’s in denial, it’s the very literally lifeless scientific world view.
January 27, 2008 at 11:47 pm
M Simpson
“How many times have you been thinking of someone you haven’t heard from for a while and 5 minutes later the phone rings and it’s them? These correlations exist, whether you choose to dismiss them or not.”
I don’t expect this will convince you at all, Laughing, because you fervently believe in unicorns and fairies, but for any interested bystanders…
This is called a coincidence and the only way this could be spooky is if it never happened. You know lots of people, you have a telephone. You think about people all the time, people ring you up all the time. But you never remember (why should you?) the many, many times when you think of somebody and they don’t ring you or the many, many times when someone rings whom you haven’t just thought of.
Laughing old chum, what’s a bit sad here is not that you’ll believe in absolutely anything but that you’ll believe in absolutely anything except reality.
January 28, 2008 at 3:40 am
Humber
Perhaps I did not explain well enough my use of the Cholera epidemic. Using some logic and epidemiology, Snow was able to demonstrate that the source of the infection was the water, and not science’s ineffable miasma. Without knowing anything about the way the water was affecting the victims, and despite fierce opposition, he demonstrated that the pump was indeed the cause (or more specifically, the vector). Only later was the pathogen identified. That is the parallel I was drawing. It is not always necessary to know all of the steps in the process to observe the final effect or to control it.
OK it’s your blog, Lmso, but purely point-of-view soapboxes are a dime a dozen.
What if tomorrow, a six-pack of unsupported assumptions were to be found in science’s basement. It is then realized that all of the other schools of thought, from The Church to Quantum.alt, have already told science everything they know, yet not refuted any scientific ideas!
Skeptics are already aware of the panoply of alternative ideas (most of them are bastardized versions of existing or former scientific ideas), what is missing is support.
(Other than waiting on the platform for a paradigm-train that goes ‘woo-woo’?)
Whatever the case, Lmso, I think the multiple-worlds idea is irrelevant to this topic. I could agree that neither side can claim objectivity, but then argue that your thoughts and ideas concerning Homeopathy are certainly objective facts about you, as mine are of me.
It would be reasonable to object that an individual’s ideas may influence the way he observes the world, but the significance of this claim must be substantiated at each instance and not applied as a blanket ‘thought stopper’, when it takes on all the charm and erudition of the teenage refrain “You can’t tell me what to think”.
This is a down to earth matter. There is no need to argue if humans ‘really’ have two ‘hands’. I don’t need to consider monks and walls at the moment.
February 3, 2008 at 3:02 pm
laughingmysocksoff
M old chap, what’s so sad here is that you can’t see the extent to which your reality is self-referential, contingent on the circular logic you employ to maintain its precepts and boundaries, or the extent to which apparent ‘consensus reality’ relies on selective perception. When you look around you for confirmation of where the boundaries of reality lie, you see only the reflection of your own boundaries. I do the same. We could carry on this argument for ever and never succeed in ‘proving’ anything to each other because we could always expose each other’s argument as self-referential and circular, and we could always do that because they are.
The fact that homeopathy and various other phenomena exist outside your boundaries and those of a lot of other people (though by no means the majority) means to you it can’t possibly exist. Yet thousands of other human beings are perfectly comfortable with it, gain a lot of benefit from using it, and demonstrate its replicability time and again. So in order to adhere to your version of reality, you have to rely on a combination of denying the evidence for different realities and judging all people who subscribe to them as either delusional idiots, liars or frauds. That’s not science. That’s prejudice.
Which is more real? Your ‘reality’ or mine? The answer is neither. Both are as real as each other. Both are predicated on self-referential thought systems which construct their own proof systems and both have their own narratives. Both are inhabited as if they are true and experienced as truth by those who inhabit them. The only difference between us appears to be that you mistake your personal reality for some objectively existing thing-in-itself which operates completely independently of your participation in it — which lends itself to the illusion that it can somehow trump my ‘reality’ — and I don’t.
Don’t mistake your personal vision of reality for anything more than the subjective, contingent and self-referential construct that it is. And don’t take my word for it either. Go study some philosophy. I’d recommend Kant.
February 3, 2008 at 4:20 pm
laughingmysocksoff
Humber I’m not trying to use this argument as a blanket thought-stopper, but rather to show a potential way out of the present impasse regarding the ‘proof’ or otherwise of homeopathy. As I see it, we’re only going to resolve the nuts and bolts of this 200 year-old argument by getting down to the basics of how we construct proof and knowledge. It’s a case of horses for courses. We’re not talking about something as simple as whether or not most human beings have two hands. We’re talking about a complex interaction between two human beings for which effects are claimed that lie outwith present consensus understanding of what impacts the progress of disease.
But let’s take a far more pragmatic approach instead.
One thing that’s become fairly apparent from talking to the people who’ve come to this blog is that many sceptics seem to have a highly idealised vision of scientific proof that just doesn’t translate to a clinical setting. For starters, a consultation with a patient begins and ends with anecdote. The whole basis of initiating any kind of investigation and treatment is anecdote. The ultimate assessment of success (or otherwise) is anecdote. It doesn’t matter a damn if all the patient’s objective physiological measures fall within ‘normal’ ranges. If they’re still experiencing symptoms, they’re still experiencing symptoms.
Further, a physician’s job, regardless of whether they’re a homeopath or a conventional doctor, is to make a diagnosis and treatment recommendation based on the individual in front of them. Clinical trial data might have some relevance in the final decision, but it’s a long long way from being the only piece in the jigsaw puzzle. And in the light of GSK’s Allen Roses stating a few years back that 90% of drugs only work in 30-50% of people who take them, then you could well argue that trial data should be substantially demoted in the evidence hierarchy in favour of case history and anecdote, since it’s case history and anecdote that’s providing that ultimate measure of efficacy.
Bear in mind too that the handful of clinical studies of homeopathy show a consistent 70% of individuals registering benefit from treatment. Let’s say regression to mean accounts for a whopping 50% of the homeopathic results and just 20% of the conventional results. That still makes the two therapies comparable in terms of efficacy. At a fraction of the cost of pharmaceutical drugs and with none of the side-effects, which option would you choose? Or would you still insist that homeopathy’s lack of explanatory rationale means it’s ‘impossible’?
February 29, 2008 at 5:32 pm
David Wright
“laughingmysocksoff” has really got it badly wrong. Hey, “laughing”, have your socks come off yet?
You are so busy laughing at nothing much that you don’t know if you are coming or going.
“anecdotal evidence” is just a loose term for unverified stories.
“laughingsocks” has not twigged it that all observational scientific data is what he calls “anecdotal”. The “scientist” observes something and writes it down. But that human observation is just an “anecdote” according to “laughing boy”. Wot a plonker.
The moment you verify the evidence, it cain’t be anecdote you bozo.
June 10, 2008 at 4:57 am
Dr. Nancy Malik
Homeopathy cures where Conventional Allopathic Medicine (CAM) fails
November 7, 2008 at 9:39 pm
paul
M. Simpsom
Someone with an open mind has been doing his research. So maybe it is more than just coincidence?
http://www.sheldrake.org/D&C/controversies/Dawkins.html