Sunday, November 09, 2008

That Letter of the Disciples of Scientism

Dr. David Colquhoun writes about me and that UCL debate in his rather sneering blog in which he accuses anyone using alternative medicine of lying to their patients. This is a blatant and untrue insult which he arrives at via an illogical and irrational cascade of argument. Suffice to say that I've yet to meet a doctor using homeopathy who does not believe his or her homeopathic prescriptions have an effect independent of the placebo effect. Prof. Colquhoun might not think that homeopathic remedies have a physiological effect but homeopathic doctors using them certainly do. Anyway this is what he has to say about the UCL debate and myself:

Dr Brian Kaplan was there. He had given the meeting some publicity, in a web posting that also kindly gave publicity to our 2006 letter to the Times. He didn’t like the letter, which is unsurprising given that it turned out to be more effective than we could ever have hoped.

For once I agree with everything Prof. Colquhoun says here.

I was at the meeting and was happy to give it advance publicity.

I was also more than happy to give publicity to the letter that Colquhoun et al, a group of doctors and scientists, I have called Physicians of the Utmost Fame (apologies to Hilaire Belloc) wrote to NHS Directors of Commissioning. More than anything else, this letter was a slap in the face for Britain’s 40 000 GPs as it sought to go above their heads and thwart any of them that would like to send a patient for NHS homeopathic treatment.

Colquhoun is also right in saying that I did not like the letter. Here are my reasons:

It was inappropriately and highly misleadingly written on paper that had an NHS letterhead. This is what the Department of Health thinks of that:

A document entitled “Homoeopathic Services” which was distributed to Directors of Commissioning earlier this year has caused some confusion because it carried the NHS logo.
We would like to clarify that this document was not issued with the knowledge or approval of the Department of Health and that the use of the National Health Service logo was inappropriate in this instance.
The document does not represent any central policy on the commissioning of homoeopathy and PCTs continue to be responsible for making the decisions on what services or treatments to commission to meet their community’s health needs.

But of course this ‘correction’ was almost invisible after chief executives of 476 NHS Trusts had read this highly personal and opinionated viewpoint of the The Disciples of Scientism – on NHS paper! So yes I do agree it was effective. Expedient, opportunistic, misleadingly written on NHS paper, patronising and condescending to GPs – but effective, yes. And thus I must conclude that Prof. Colquhoun thinks that the end justifies the means. There are two possible reasons for this:

1. The people of the UK are too stupid or too uneducated to choose the sort of doctors they want and must be forced to have only medicine approved of by the Disciples of Scientism.

2. The General Practitioners of Britain cannot be trusted not to refer patients for ‘implausible’ forms of medicine such as homeopathy. This is my main point and has been for some time. Homeopathy is not and never was available on demand to the British public. You had to get your GP to refer you to an NHS clinic to get homeopathic medicine. Thus an honourable course of action by the Physicians of the Utmost Fame would have been to write their letter to a journal widely read by GPs such as the British Medical Journal. But GPs might have not appreciated the condescending and patronising tone of the letter and reserved the right to choose to refer to whatever NHS clinics they liked. Knowing this, the professors chose to go over the heads of GPs and write a letter (totally inappropriately on NHS paper) to chief executives of 476 NHS Trusts with the power to thwart GPs who wanted to send patients for NHS homeopathy!

Do I like that? No, Prof. Coquohoun I don’t. Bullying Britain’s GPs, leaving the utterly spurious impression that conventional medicine is based on solid evidence while homeopathy isn’t, writing to non-medical bureaucrats utterly inappropriately on NHS paper thus giving the false impression that your pompous letter was somehow an NHS document (a ‘technicality’ that would have your entire case for a reform in NHS policy unceremoniously thrown out in a British court of law), is definitely not to my taste. Perhaps I should wake up, abandon conscience, read The Prince, and fully understand that the end always justifies the means.

Professor David Coquhoun, I’m happy to debate this with you. Feel free to be assisted by the jeering journalist, Simon Singh or preferably the medically trained journalist, Ben Goldacre. Bring along the man who also nastily accused homeopaths of ‘lying’ to their patients, Prof. Edzard Ernst. I tried to defend honour in traditional British manner by challenging him to a duel – but alas no reply. Whatever happened to chivalry? In fact bring any of your fellow Physicians of the Utmost Fame or any of the other 13 Disciples of Scientism who co-signed that letter. Your case is so weak it has been transferred to the Intensive Care Unit.

Anywhere, any time, on any media, in front of any audience. I’m ready…

4 comments:

KenH said...

Intruiging! I hope this Dr Colquhoun takes you up on your challenge. It will be good to see the "man of science" exposed by you Dr Kaplan.

Becky said...

You say you've never met a Doctor prescribing homeopathy who doesn't believe in it - well, (and I'm well aware that this is just anecdote, so should be perfectly acceptable as gospel truth to other homeopaths) - I have one old school friend who's now a doctor, and two GPs I've had in my travels round the country, who, when I've asked about this, have admitted to prescribing homeopathy for "worried well" patients when they've specifically asked for it, mainly because, despite being told that it's utter rubbish, they demanded it in the manner of a four year old child demanding chocolate buttons. Finally, because they were well aware that there was nothing wrong with the patient, and they had better things to spend their time doing - like seeing genuinely ill people - they gave in and let them go off and see a homeopath.

Anonymous said...

You are a funny man. If you believe truly that there is a physiological mechanism to homeopathy then demonstrate the mechanism, otherwise your assertions are without validity.

Neuroskeptic said...

As a good disciple of scientism I must beg to differ when you say that:

"Dr. David Colquhoun ... accuses anyone using alternative medicine of lying to their patients."

This is a blatant and untrue blah blah. - If you read what he wrote again you'll see that what David is saying is that if someone who did not believe in the physiological action of homeopathy were to want to use it as a placebo anyway, this would involve lying, and indeed the better they lied, the better the placebo effect.

As he says, "If the placebo effect is real, it would be wrong to deprive patients of [placebos], if there is nothing more effective available." but he then notes that in fact this argument would lead doctors becoming professional liars.

Nowhere does he say that everyone who uses homeopathy is lying - that would be ridiculous. He's making a rather more subtle point about the ethics of placebos.

We scientismists might have our faults but at least we can read!