Homeopathy: what does the “best” evidence tell us?

In reply: Wardle’s letter raises several points that deserve comment. Wardle calls me dogmatic, misinformed and antihomeopathic. Such ad hominem attacks hardly promote a rational debate. When I started my job of scrutinising homeopathy 17 years ago, I was pro-homeopathy1 — I once worked in a German homeopathic hospital — and became more sceptical as the evidence base for homeopathy became more clearly negative.2 This, it seems to me, is the opposite of dogmatic.

Wardle cites the report by the House of Commons3 in the United Kingdom and claims that it “identified 24 condition-based systematic reviews and meta-analyses on homeopathy, of which nine were positive . . .”. In truth, it was a submission from homeopaths to the House of Commons that made this statement. The report itself found no positive evidence for homeopathy and even criticised how the homeopaths tried to mislead the inquiry.3

Wardle also thinks that clinical trials are “ill suited” to evaluate homeopathy because homeopathy is “complex and individuated” and clinical trials “rarely . . . reflect the real world”. The notion here is that, if the scientific method does not support our belief, it must be the former rather than the latter which is at fault. Adopting this attitude would take us right back into the Dark Ages. After discussing these issues for 17 years, I have the impression that most homeopaths are in favour of rigorous, reductionist science — insofar as it generates the results they want. Whenever this is not the case, they point to observational studies that are wide open to bias and confounding, and therefore show us precious little.

Finally, Wardle seems to imply that homeopathy works because patients like it and that this is what truly helps patients. The truth is that medicine has made huge advances only since we buried this attitude. It is time now that proponents of homeopathy do the same — not to conform with a dogma, but because patients would live longer and healthier lives.