As a professor of complementary medicine insists homeopathy is just a placebo, Lisa Salmon weighs up the arguments for and against the treatment

HOMEOPATHY has been described by doctors as witchcraft, and explanations as to how it might work defy logic. Now an expert in complementary medicine has accused some homeopaths of lying, and is insisting that any benefits from homeopathy can be explained by the “placebo effect”.

Professor Edzard Ernst, Britain’s foremost professor of complementary medicine at Exeter University, warns that although most homeopaths believe in what they’re doing, they may also be unethical.

“The current knowledge clearly shows that homeopathy is not more than a placebo. Lying to patients is unethical, which is what those in the cynical side of homeopathy do,” he says.

“The evangelical believer is also unethical because he’s ill-informed.”

Homeopathy involves treatment with highly- diluted substances, with the aim of triggering the body’s natural system of healing. It’s based on the ‘like cures like’ principle – in other words, a substance which causes symptoms when taken in large doses is used in small amounts to treat those same symptoms.

Even its staunchest critics, including Professor Ernst, admit homeopathy does, in some cases, seem to work. Many patients insist the treatment has improved or cured their condition when conventional medicine has failed to do so.

However, when it does work, it’s not really known why. Nevertheless, the NHS spends about £4m a year on homeopathy, despite a Commons committee saying two years ago that there was no evidence that it worked.

The NHS points out that patients should be able to make informed choices about their treatment, and clinicians should prescribe the most appropriate treatment, which may include homeopathy. But it may be hard for patients to make choices when there’s such concern about the benefits of homeopathy.

Professor Ernst sparked the latest round of the homeopathy debate by writing an article in The Biologist which declared that homeopathy was “biologically implausible and potentially dangerous”. He has researched homeopathy for 20 years and insists he began by wanting to give it the benefit of the doubt.

However, he says: “I knew homeopathy was very implausible, but what I saw was impressive – people do get better when they see a homeopath. It has become clear to me that the placebo effect is the only explanation that fits all the data.”

He says the placebo effect is more complex than just expecting to get better, and includes the possibility of a condition improving on its own, or people having other treatments which might be responsible for an improvement.

In addition, the fact that the therapeutic relationship with the homeopath is quite intense, very empathetic and compassionate, may help people’s recovery, he says.

“In other words, homeopaths are good clinicians, except that they dish out placebos, which isn’t good.”

Professor Ernst also highlights the dangers of homeopathy, saying it’s often used as an alternative to effective interventions. For example, the advice from homeopaths not to immunise has become a major cause of low vaccination rates, he says.

HOWEVER, Dr Sara Eames, president of the Faculty of Homeopathy, which trains statutorily regulated healthcare professionals such as doctors and dentists in homeopathy, is bemused as to why Professor Ernst and other “opponents” should want to discredit homeopathy when she says it clearly helps so many people.

“It’s not really correct to say there’s no evidence for homeopathy. Most placebo-controlled trials, which filter out the placebo effect, are positive for homeopathy.”

Dr Eames, a former GP now working at the Royal London Hospital for Integrated Medicine, says patients usually turn to homeopathy because conventional medicine hasn’t helped them or because it has caused side-effects.

“A lot of people who have homeopathy are using it as a last resort after suffering with something for a long time. They don’t always come with great expectations. But every time I do a clinic, I see how it’s helped people.”

She admits that it’s not really known how homeopathy works, but that homeopaths understand it doesn’t work in a molecular way.

“We all know that homeopathic remedies are very dilute, so their mode of action is not possibly through molecules like a conventional drug. It’s a completely different model.”

Dr Eames stresses that homeopaths like herself, who are also doctors, will always advise patients to get their complaint fully medically investigated first.

Patients visit homeopaths for a wide range of complaints including arthritis, musculoskeletal problems, infections, migraine, gynaecological problems and allergies.

“It’s a really good use of NHS resources, because these patients who have chronic conditions are expensive to the NHS and if you can help them in a different way with homeopathy and lifestyle advice, you’re encouraging them to take control of their lives again, reduce their drug bills, and not consult their doctors so much.”

Patients with serious conditions such as cancer are encouraged to use conventional treatment if possible, but may need homeopathic help for the side-effects.

“If you’re not being helped by your conventional treatment, homeopathy’s worth a try, because it’s safe, inexpensive, and it does seem to help a large number of people.”

• To find a registered homeopath, visit findahomeopath.org.uk