Homeopathy should be banned
Debate Rounds (3)
Invented in 1796 by the German physician Hahnemann, homeopathy is based on the on the idea the "like cures like" (law of similars) and furthermore, that high dilutions intensify the effect of the cure. In the "classical" approach, the homeopath conducts a lengthy interview with the patient, where an inventory of all the unpleasant / undesirable symptoms is taken, together with certain somatic characteristics such as "laterality" or on which side of the body are adverse effects preponderantly observed. Each symptoms has a number of "remedies" associated with it, all listed in "repertories". The homepath then choses one or several remedies which are often common to most of these symptoms, then establishes a concentration based on the severity of the symptoms, with the lower dilutions being prescribed for the less acute symptoms. The dilutions could however be extremely high, such as 10^-23. Such high dilutions have caused opponents to claim that the active substance is no longer present in the remedy (see Avogadro's Number) and that the only successes recorded by homeopathy are due to the placebo effect. However, to the best of my knowledge, there is no study that proves that homeopathy is harmful.
Before listing my constructives, I will patiently wait for my opponent to structure his :)
As I am uncertain which parts of my argument my opponent will focus on, I will spend this round briefly laying out the structure of my argument alongside brief specifics of my argument. As it becomes clear how my opponent is approaching this debate, I will end up bolstering the argument accordingly, and reserve the right to present new arguments to re-inforce the principle of any part of my argument if necessary.
As such, my argument is essentially as follows:
1) Homeopathy does not have a sound view of how medicine works. Any benefit that does result from using such treatments must therefore be down to the placebo effect alone.
- As my opponent pointed out in his opening round, a key tenet of homeopathy is that high dilutions of the active ingredient within water intensifies the effect of the cure. This does not seem to make medical sense, given perhaps the closest medical example of innoculations, which clearly do not infect the patient - an innoculation precisely being a diluted version of the disease. Another key tenet is that water is able to hold a "memory" of the active ingredient, and so somehow provide the benefits of the active ingredient by proxy. Even leaving aside the question of how this "memory" works, exactly why this is better than directly giving someone the active ingredient itself - especially when giving the ingredient directly is proven to work in traditional medicine - is uncertain.
2) Whilst the placebo effect is very useful on a small scale - for headaches, colds, etc. - and occasionally has its moments on a larger scale, it cannot be relied upon to treat people in their hour of need in the same way that other medicine can.
- The placebo effect is very much dependent upon the psychology of the person involved, in addition to the precise nature of the illness/disease being suffered. For example, if I am bleeding profusely from a primary artery, any amount of psychological assurance that I will be fine will inevitably fail and I would die within minutes. In addition, the uncertainty behind the level of psychological assurance required will always be an imprecise art - how sure need I be that my doctor knows what she's talking about, or that the medicine will work? - and so the placebo outcome cannot be ensured with any reliability.
3) People taken in by homeopathy are less likely to use conventional medicine in general. This causes huge harms when it comes to life-threatening diseases - malaria, cancer, etc. It is in this harmful consequence that the main harm of homeopathy can be seen, which is why it should be banned.
- The kind of people who turn to alternative medicines are those who are disaffected with traditional medicine, and are considering other forms of treatment. When homeopathy appears to work for them - perhaps due to the placebo effect on the small scale, or because of other treatments (deliberately or otherwise) given alongside the homeopathic remedy - they are therefore more likely to use homeopathy to the exclusion of other treatments. This becomes a problem when the patient suffers more serious illnesses, where a placebo alone cannot help.
- This is how a seemingly harmless remedy (which, given the level of dilution, essentially removes any active ingredient in many remedies - as my opponent pointed out - and becomes nothing but water) can lead to incredibly harmful consequences, meaning that it should be banned.
As I said earlier, as it is not clear what parts of this argument my opponent will focus on (for instance, it would be a reasonable approach for him to concede entirely that homeopathic remedies are not medically viable, whilst maintaining that it nonetheless shouldn't be banned), I will for now leave my argument at this level. I await my opponent's response.
I will present the following by way of constructive argumentation:
1. Unwanted interactions in classical medicine - Michael Jackson
2. Medicine is not a science, but rather a business model based on a professional monopoly (Rockefeller & Medicine Men, AMA wars 1920-1930, Milton Friedman's essay on regulating naturist medicine)
I shall now consider my opponent's arguments.
1. Pseudoscience / placebo -> not a reason to ban
Even on the assumption that there is something fundamentally wrong or unworkable with homeopathy - and not something that we just do not fully understand yet - that is still not a reason for banning a practice that does not hurt anybody. Before trying to understand how it works, we need to establish IF it works, and that seems to have already been established. The consensus before 2000 used to be that homeopathy is effective. Though that consensus has been seriously eroded in the past decade, the few trials of "individualized / interview-based / classical" homeopathy seem to indicate that it has an effect over placebo, unless the h-friendly studies are excluded for "poor methodology" (wikipedia):
--"A 1998 review found 32 trials that met their inclusion criteria, 19 of which were placebo-controlled and provided enough data for meta-analysis. These 19 studies showed a pooled odds ratio of 1.17 to 2.23 in favor of individualized homeopathy over the placebo, but no difference was seen when the analysis was restricted to the methodologically best trials. The authors concluded "that the results of the available randomized trials suggest that individualized homeopathy has an effect over placebo. The evidence, however, is not convincing because of methodological shortcomings and inconsistencies."--
If the current consensus - which seems to be against homeopathy effectiveness - is a basis to ban homeopathy, then back in the 70s, 80s and 90s, when homeopathy was considered effective, we should have banned classical medicine, which was far more expensive, less effective and used more resources. This is a severe incongruence / inconsistency in the "banning" argument. It also seems to suggest that the current consensus is the result of research tainted by significant more resources invested in research - i.e., big pharma vs small-time homeopaths.
2) Placebo - unworkable -> still not a reason to ban
My opponent seems to accept that h works solely on placebo, which I do not, for reasons previously explained. The use of homeopathy for treating "bleeding profusely from a primary artery" is an extreme example and it is not representative for how homeopathy is used. Similarly, I would not argue for banning classical medicine simply because mistakes are somehow made or because doctors sometimes kill or sexually abuse people. I will leave it to Logician to identify the logical fallacy present here.
3) Protecting people from themselves
I have significant difficulties attacking this argument in the 1 minute I have left precisely because it causes an intense emotional rxn in me. My opponent is suggesting that we restrict choice because people cannot decide for themselves..
This is perhaps the main reason why we do not have death sentences in civilized countries: new evidence may surface, opinions change and previously strong decisions / judgments can prove to be wrong. Banning large chunks of the cognitive continuum based on how does the scientific opinion wind blows at specific times is a terribly expensive way of running science and it is pure, unsweetened scienticism .
In conclusion, I believe that to ban a practice such as homeopathy it is necessary to conclusively prove that this practice is more detrimental than classical medicine, which is impossible, since homeopathy is at worst placebo / neutral. In contrast, a significant number of people, including celebrities such as Michael Jackson, die in the hands of their doctors of either unforeseen interactions in their medications.
1. 128 Linde K, Melchart D (1998), "Randomized controlled trials of individualized homeopathy: a state-of-the-art review", J Altern Complement Med 4 (4): 371–88, doi:10.1089/acm.1998.4.371, PMID 9884175.
My intention when I started this debate was to write a lengthy article to be summarized in this debate. I have yet to do so and am now running out of time. When done, I will publish it on http://www.edutarian.com...
Homeopathy shouldn't be conflated with alternative medicine as a whole. This debate is specifically about banning homeopathy. I concede that other alternative medicines have a lot going for them, and perhaps in some cases should be used in classical medicine. Any argument of my opponent's, therefore, that seeks to rebut my case by rubbishing classical medicine does not show why my case should fall.
=== Re-inforcement of my previous arguments ===
First of all, I accept that the first two of my arguments do not in and of themselves show that we should ban homeopathy: my argument was written more as a whole, in which the first two points acted as premises moving towards the conclusion, reached in the third point, that we should ban homeopathy. Written more formally, therefore, the argument I put forward was:
Premise 1: Homeopathy is a medically unsound practice, and thus instances where it seems to work (where it is the only treatment used) is explainable entirely by the placebo effect.
Premise 2: The placebo effect, whilst it has an amazing track record on a small scale, is unreliable and distinctly unamazing on the large scale.
Premise 3: People who use homeopathy and initially find it successful are far more likely to continue to use homeopathy in the future.
Intermediate Conclusion: This increased usage becomes a significant problem, and causes massive harms, when patients face large-scale - and often life-threatening - illnesses (e.g. cancer, malaria, etc.) which cannot be reliably treated in any way by homeopathy.
Main Conclusion: We should ban homeopathy.
1) ON THE EFFECTIVENESS OF HOMEOPATHY
I find my opponent's candour regarding the evidence on homeopathy refreshing: he implicitly accepted, for instance, that homepathy does not - when tested in methodologically fair conditions - show itself to be any better than the placebo effect, given that he didn't argue against his own sources which argued the contrary.
He did, in this point, however, argue that there is an "inconsistency" in the argument for banning homeopathy, claiming that this approach would've led someone in earlier decades to ban 'classical medicine'. This conclusion, though, does not follow, for my argument is that homeopathy does not work at all, not merely that it is 'less effective', as classical medicine may have been perceived. My argument for banning homeopathy is based on the fact that when the placebo effect breaks down in such treatments, there is nothing left, causing massive harms for people dependent on the treatment in the face of serious (and, in various cases, life-threatening) illnesses. This base means that it does not transfer to classical medicine, which will always have the bio-chemical effect regardless.
2) ON THE PLACEBO EFFECT BEING UNWORKABLE ON SERIOUS ILLNESSES
I used the "bleeding from primary artery" analogy only in relation to the specific point of how physical realities can overwhelm psychological 'placebo effects' that may also be in effect. To use a more homeopathic example, we can look to instances where homeopathic remedies have actually been used - and actively recommended by homeopaths - to protect against malaria when travelling in West Africa (where risk of malaria is high). This led to one specifically reported situation where:
"a woman had relied on homeopathy during a trip to Togo in West Africa, which resulted in a serious bout of malaria. This meant she had to endure two months of intensive care for multiple organ system failure. In this case, the placebo effect offered no protection. That's the harm." (http://www.1023.org.uk...)
I therefore extend my arguments about the ineffectiveness of the placebo effect on a large scale.
Moving onto another point made by my opponent in this section, I do not understand what my opponent was getting at with his "doctors sometimes kill or sexually abuse people" point. The bad practice of a very small minority of doctors doesn't somehow give itself to the conclusion that the medicine itself should be banned, and I'm baffled as to why my opponent seemed to think that the logical fallacy in that argument would undermine my argument in any way.
3) ON WHEN PEOPLE START TO RELY ON HOMEOPATHIC REMEDIES TO THE EXCLUSION OF CLASSICAL MEDICINE
I refer back to my earlier arguments about why it is acceptable to ban homeopathy. It is not a matter of 'wind blowing in specific ways at specific times', or 'classical medicine being unjustifiably "preferred" to homeopathy'; it is a matter of homeopathy being medically illiterate and unsound, and of fundamentally going against tried-and-tested and proven principles of science. I extend my examples in point 1 of my round 1.
I also quickly add four extra rebuttals:
1) It would be actually more expensive to allow all 'medicines' and sundry to be used, contrary to what my opponent assumed: introducing unproven and medically uncertain treatments into the mix ramps up the cost of the profession - whether it be because, like in the NHS, Government subsidies have to pay extra for the treatment; or because the patients themselves have to pay for the treatment.
2) Unlike death by capital punishment, a ban on homeopathy could be reversed if necessary (for example, if God changed the laws of science such that homeopathy actually made scientific sense).
3) If people are risking their health based on an incomplete medical understanding, then yes - they haven't truly decided for themselves. This is why we have trained doctors to make medical diagnoses in the first place.
4) Even if supporting the scientific facts in opposition to medically unsound hypotheses is "scientism" (which it isn't, see http://en.wikipedia.org...), then so be it. The burden then would be on my opponent to prove why this approach is bad, which thusfar he hasn't done.
=== Rebuttal of my opponent's arguments ===
It is unfortunate that my opponent did not have time to fully expand on his constructive material - hopefully he will be able to do so in the next round :) To deal quickly, therefore, with his two main points:
1) Unwanted interactions in classical medicine
The bad/reckless practice of some medical practitioners does not prove that classical medicine itself is harmful. Just because Michael Jackson's personal physician may have given him a recklessly high and eventually lethal concoction of drugs, that doesn't mean that all classial medicine is doomed. The unwanted interactions in such circumstances are down to the recklessness (or occasionally malice aforethought) of the doctors themselves.
I also extend my opening observation that homeopathy is not to be conflated with alternative medicine as a whole - therefore, even if my opponent were to prove conclusively that classical medical treatments is flawed, that would not in any way lead to the conclusion that homeopathy is OK and should not be banned.
2) On what medicine is.
As my opponent hasn't yet analysed this argument, and as I've not heard the argument before to know how it will progress, it is difficult for me to rebut this point at this stage. I will, however, point out that whilst the use of medicine can be politicised - either through price wars between drug companies, or through the decision about which drugs should be allowed (such as with NICE in the UK, see http://www.nice.org.uk...) - this doesn't bear upon whether the medical treatment itself is scientifically sound, or causes any benefits or harms. In this respect, medicine is certainly a science, even when the politicisation of medicine is not.
As I'm running out of characters, I shall leave my argument here for now. Homeopathy is harmful when it is relied upon in situations where it cannot help. It should therefore be banned.
InBonobo forfeited this round.
So, without further ado, onto my summary of the debate:
=== 1. Does homeopathy work? ===
This can be split into two sub-points, as follows:
a) Homeopathy doesn't make scientific sense
I shall extend what I said in my first round:
"[A] key tenet of homeopathy is that high dilutions of the active ingredient within water intensifies the effect of the cure. This does not seem to make medical sense, given perhaps the closest medical example of innoculations, which clearly do not infect the patient - an innoculation precisely being a diluted version of the disease. Another key tenet is that water is able to hold a "memory" of the active ingredient, and so somehow provide the benefits of the active ingredient by proxy. Even leaving aside the question of how this "memory" works, exactly why this is better than directly giving someone the active ingredient itself - especially when giving the ingredient directly is proven to work in traditional medicine - is uncertain."
In the edutarian article, my opponent argues that there is a precedent for biological entities responding to low dilutions, pointing to how sharks can smell blood from a long distance. This is not analogous, for two reasons:
i. Whilst the shark can smell the blood, it could not influence the shark in any way. Homeopathy claims that ingredients in low dosage can influence a patient better than (or, at least, just as much as) the original active ingredient. Even if, hypothetically, a person could see or smell the ingredient in the remedy, that would not make the remedy any more likely to work.
ii. My opponent himself mentioned Avogadro's Number in his first round, which leads to the conclusion that in very high doses, there is NO active ingredient in the remedy at all. (Note that my opponent has not tried to argue in this debate that Avogadro's Number is wrong.) This, in the case of many homeopathic remedies, completely destroys the shark analogy, simply because whilst there is some blood in the sea for the shark to smell, there is no active ingredient in such remedies to even theoretically affect the patient.
b) Reputable studies do not show homeopathy to have any effect better than the placebo
My opponent dismissed this fact in the edutarian article, saying that studies with poor methodology were "conveniently" discarded, as if somehow this is a political decision rather than a scientific one. This doesn't make sense: the very point of having a strong methodology is to prove that effect x (e.g. patient becomes healthy) was a result of cause y (e.g. the homeopathic remedy) at a rate better than chance/placebo. If this has not been proved, there is room to doubt that the homeopathic remedy was really what caused the patient to become healthy, or on the flipside that the remedy shown to be no better than a placebo was indeed a "true homeopathic remedy".
Given, then, that my opponent has already conceded that studies with good methodology show homeopathy to be no better than placebo, this shows - at best, and most charitable - that sufficient study has not yet been done, and so homeopathy cannot be said to be effective. At least charitable, it shows an unwillingness of homeopaths to subject themselves to proper scrutiny, perhaps because they realise that such studies would show homeopathy to be scientifically bankrupt.
My opponent further seems to imply through assertion that it is somehow impossible for homeopaths to ever do a scientific study with proper methodology, because somehow "Big Pharma" will just continue to do "better studies". I will point out that Richard Dawkins, certainly not a supporter of homeopathy, has provided a set-up (designed strictly to be as accommodating to homeopathic concerns about previous studies as possible) that would be a perfect proof of homeopathy's effectiveness beyond placebo - it can be found here: http://richarddawkins.net.... Performing a study under such conditions would be the "best study" that homeopathy could ever do... if there is any credibility to it. There isn't even a potential question of financial problems with performing such a study because, as Dawkins points out, one study would not break the bank as far as medical research goes - and at a push, the incredibly wealthy Prince Charles (a strong supporter of homeopathy) could fund it easily. So why don't they? If there is something to homeopathy, then homeopaths have nothing to worry about.
=== 2. Effectiveness of placebos ===
My opponent conceded in his edutarian article that: "There is no question that placebo alone cannot work for serious illnesses." His defense then boils boils down to the argument that I have not properly shown the positive effects of homeopathy to be merely down to a placebo. I believe that, as summarised already in this round, I actually have done this: as there is no scientific evidence for, or valid principles behind, homeopathy, the only cause for occasional success in such treatment must be down to the placebo effect alone.
=== 3. Banning homeopathy vs. banning classical medicine ===
My opponent continues to talk about Michael Jackson as an alleged example of when classical medicine failed. I extend what I said in the last round about conflating the actions of specific doctors with the medicine itself. The response to certain physicians acting recklessly/maliciously is to ban those physicians from practising medicine, not to ban the medicine itself, for in correct doses the medicine works fine. This principle even holds firm when we look to instances where medicinal side-effects cause illness/death through classical medicine, for the death is due not to the medicine itself - which worked perfectly as expected - but down to the prescribing doctor who didn't check the already-known side-effects against the patient's symptoms/pre-existing conditions.
Homeopathy, on the other hand, is different: the remedy ITSELF, for reasons I have already outlined, does not work in serious situations - homeopaths mean well, I'm sure, but it is the remedy that lets patients down, not the doctor unlike with classical medicine. This means that the two situations are not analogous, and my opponent's argument falls here.
(As a side-note, my opponent conceded in the edutarian article that the core benefit of homeopathy was "the interview and its holistic treatment of all the ills affecting the patient." On the one hand, this illustrates perfectly what I've said throughout this debate about how the placebo effect works - the patient becoming convinced, through their handling by the doctor, that the remedy will work.
On the other hand, this helps illustrate my most recent point, about how classical medicine going bad is down to the pastoral care by the doctor - the doctor not taking a fully holistic approach - and not in fact due to the medicine itself. Note that despite the holistic pastoral approach in homeopathy, it still causes massive harms when relied upon for serious illnesses. This lays the blame for the failure squarely on the remedy itself, not on the actions of the doctor.)
Because I'm running out of characters, I hope you'll all excuse my lack of extensive rhetoric in conclusion. My argument is clear: homeopathy does not work beyond placebo; placebos do not work for serious illnesses (as my opponent conceded); this causes massive harms which, being disanalagous with classical medicine, justifies a ban of homeopathy.
1 votes has been placed for this debate.
Vote Placed by RoyLatham 6 years ago
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