Today I am in a very serious mood and on this occasion will choose to ignore Oscar Wilde’s aphorism: ‘Life is far too important ever to talk seriously about it’
In my last article I challenged Professor Edzard Ernst to a duel (okay - with only words as weapons) for accusing homeopaths of lying to their patients. For centuries in this country the slur of being accused of lying was considered one of the main reasons for challenging someone to a duel. It was actually considered the gallant thing to do in the circumstances - otherwise the accusation of lying would leave a stain on your character. Of course I have not been accused personally of lying – but as a doctor who does use homeopathy – I certainly object to being generically accused of lying. This was an insulting, wrong and vicious thing to say. The slur can be ameliorated if Ernst admits that it is simply a matter of his English not being up to scratch on that occasion and that what he meant to say was that homeopaths were saying things to their patients that he, Ernst, considered to be untrue. Lying is a different matter and as I’ve said I have never met a homeopathic doctor whom I thought was lying to his patients and I’ve met hundreds of them.
I regret to inform you that no answer to my challenge of a duel has been received. Perhaps Ernst prefers to confer with journalists than doctors. He has received far too much publicity already in my opinion. I don’t know what his qualifications or motives are other than the smearing of homeopathy and complementary medicine in this country. The paradox of this is that he claims to have been a homeopath and is apparently still a professor of complementary medicine! I don’t want to give the ghastly negative book he wrote with Simon Singh any more publicity than it has received – but feel the need to reiterate what I consider the hypocrisy and duplicity that is at its core.
The basic claim is that most of CAM and especially homeopathy are not ‘evidence based’ (This morning on Radio 4’s Today programme, I heard someone say that we live in an ‘evidentially-based’ society. Holy Jupiter! Must we have our language as well as our society totally deconstructed and then destroyed?) My answer to this was simple: Ernst knows that much of conventional medicine (eg spinal fusion, use of drugs for ADHD in children, angioplasty and stents and many many more examples) is not evidence based. How can he then selectively use ‘evidence based medicine’ as a club to bash homeopathy? Surely he should use it as a weapon to attack any form of medical intervention that lacks the requisite trials and results? Nobody addresses this point and people like Simon Singh and Edzard Ernst outrageously get away with an approach that reeks of double standards. In fact Dr Damien Downing has written an excellent piece on Ernst and his approach in the journal of the Alliance for Natural Health which articulately points out how much of what Ernst says applies far more to himself than to those he attacks.
So in bullet form:
1. Much of CAM is not evidence based. (fact)
2. Much of conventional medicine is not evidence based. (fact)
3. Therefore it is two-faced and hypocritical to use evidence based medicine as a weapon to attack CAM and homeopathy.
It could be used to attack any medical intervention that is not evidence based. That would be consistent but I would still be against attacking interventions that are not evidence based. We should allow doctors to practise the art of medicine as well as the science. This means they are allowed to use interventions that have worked for them or their colleagues and mentors and that suit their style of medicine and personality. Of course in critical situations if they ignore the evidence-based recommended approach to the detriment of their patients they will be called to account.
It’s all quite simple really. What is amazing is the amount of publicity this duplicitous, hypocritical and negative campaign has achieved with the result that quangos such as PCTs (Patient Care Trusts comprising mainly non-medical people) are able to threaten NHS homeopathic hospitals with closure by preventing doctors in their areas from choosing to refer patients to homeopathic hospitals! Yes you heard me correctly. Unelected committees consisting mainly of non-medically qualified people have exercised their power under the present system of financing healthcare on the NHS, to prevent GP’s from choosing to send selected patients to other doctors (homeopathic consultants) at homeopathic hospitals! And this has occurred because people like Ernst, Baum and others have misled the media and public by giving them the impression that orthodox medicine is all evidence based (it certainly is not) and that homeopathy and CAM are not (studies of multiple trials do not clearly demonstrate that homeopathy is no better than placebo - as Dr Downing clearly points out in his excellent article).
I plead ignorance of their true motives but the fact that so far they have been allowed to get away with this heist and get huge exposure on all the media for their propaganda with the result that many GPs have been prevented from referring patients to specialist homeopathic doctors is not merely tragic for decency and honesty in medicine; it is no less than an embarrassment for liberal democracy in this country.