The preposterous nonsense known as homoeopathy has long exasperated doctors: but at whom, exactly, is their exasperation directed? At the homoeopaths themselves, or at the credulous and foolish public that persists in its patronage of such quackery on quite a large scale? According to a recent commentary in the New England Journal of Medicine, about 2 percent of Americans patronized homoeopaths last year.
The absurdity of homoeopathic theory – that diseases are cured by substances that produce similar symptoms to themselves, that those substances are more powerful the more dilute they became and so forth — was recognized by doctors very early on. Oliver Wendell Holmes wrote a famous polemic against it, as did Sir James Young Simpson, the discoverer of the anaesthetic properties of chloroform. But homoeopathy had one great advantage over its orthodox rival at the time of its development, the beginning of the nineteenth century, namely that at least it did no harm. This was an immense advantage, for the remedies used by orthodox medicine of the time were often worse than the diseases for whose cure they were employed.
The article in the Journal draws attention to the anomaly, as it sees it, of the lack of regulatory oversight of homoeopathic remedies sold over the counter. But one may ask why there should be such oversight of products that are sometimes so dilute that the chances are they do not contain a single molecule of the allegedly therapeutic substance. What harm can be done by such substances?
There are two possible answers to this. The first is that it is in principle wrong to deceive the public about the properties of what it buys. Therapeutic claims for homoeopathic remedies are inherently bogus and therefore ought to be prohibited, for falsehood is harmful in itself. And the second reason is that people who use such supposed remedies might continue to suffer from curable diseases for which, because of their resort to homoeopathy, they do not seek proper curative treatment.
Let us take the second argument first. As far as I am aware, no study has ever shown that people who resort to homoeopathy actually do suffer unnecessarily from curable diseases as a consequence, and research by a friend of mine showed why: he found that alternative medicine is usually not so much alternative as additional. When people who believe in homoeopathy have serious conditions, they therefore do not deprive themselves of orthodox medicine. In other words, the potential of homoeopathy to harm the public health on these grounds is very slight.
The first argument, that deception, whether it be conscious or not, should be prohibited, is to treat the public as minors incapable of distinguishing between truth and falsehood and therefore in need of state protection. In fact the promotion and sale of many goods relies both on the suggestion of falsehood and the suppression of truth, at least to some degree; and since homoeopathic remedies are harmless rather than poisonous, there is very little to protect the public from if it chooses to accept falsehood.
There is another great advantage of homoeopathic remedies not mentioned in the article in the Journal. Doctors are nowadays not permitted deliberately to prescribe placebos, and so, if they wish to take advantage on behalf of their patients of the placebo effect, have to prescribe pharmacologically active drugs with real side-effects. If they prescribed homoeopathic remedies instead, this problem would be avoided. The impressive flim-flam of homoeopathic labeling would impress the credulous and eliminate the risk of serious side-effects.
The advantage would be bought at the cost of a little deception, of course. Whether the end would justify the means I leave to philosophers to decide.