Homeophobia? I am not a scientist but…

Article slightly amended from first version – woke up this morning to realised I’d forgotten to make a point.

Rustum Roy writes a belated rebuttal of Ben Goldacre’s diatribe about homeopathy in the Guardian last month. We are to understand that anyone who is sceptical about homoeopathy is to be regarded as a “homeophobe”. This is starting to sound even less like science and even more like identity politics.

A few lines in this article wrestled for my attention. First:

As it happens, there is agreement among all those who have studied liquid water that it is, in fact, the critics, who are totally wrong. Proof? Diamond is the planet’s hardest material; graphite one of the softest. They are absolutely identical in composition, and they can be interconverted in a millisecond with zero change of composition.

I hasten to preface this with the disclaimer that I am not a scientist, but hang on a minute. The Queen is not constantly in fear that, at any given millisecond, her priceless Koh-i-noor diamond might turn into a pencil. I’m sure there are processes that can convert carbon to diamonds and vice versa, but they aren’t exactly easy to come by.

The reason why carbon can exist in multiple forms is fairly well understood – if I remember my GCSE chemistry it is all to do with “spare” electrons – and it is hard to see what relevance it has here. We know, for instance, that water can interchange from liquid to solid to gas, but that doesn’t prove it has a “memory”.

In any case, I’m also not convinced that Goldacre was basing his argument on scepticism about the idea that might have a memory. He only mentioned the word once in his article. The science behind memory metals is now well understood, and there are other applications of the same principle.

But it is one thing to say that water might have a “memory” and quite another to claim that snake venom diluted in water to an extraordinary degree can be used as a cure for feverish symptoms. The argument is not with the science; it is taking that science and contorting it to an absurd degree. I might just as well claim that the alpha waves emitted by my brain can be used to program water.

Roy also writes:

But the main thrust of Goldacre’s argument is the role of the “placebo effect”. Yes, this works. And, yes, it is without doubt present in every homeopathic intervention; but it is far more powerfully present in orthodox medical pills because they are advertised so widely in billion-dollar campaigns.

Goldacre is accurate in pointing out the high rates of positive v negative outcomes in many of the homeopathy studies. But there are enormous discrepancies in any set of randomised controlled trials on the same orthodox pills.

Does Goldacre seriously suggest that a homeopathy paper with a positive outcome would be treated fairly in any mainstream journal?

This is a very circular argument. “My paper won’t get treated fairly, therefore I won’t submit it” is a pretty piss-poor excuse. And once again, Goldacre is not – as far as I’m aware – claiming that “orthodox” pills are the answer to everything. He’s has written plenty of critical articles about “Big Pharma”. When he writes about the placebo effect, he’s talking about its effect in traditional medicine as much as the alternative:

You both think you know about the placebo effect already, but you are both wrong. The mysteries of the interaction between body and mind are far more complex than can ever be permitted in the crude, mechanistic and reductionist world of the alternative therapist, where pills do all the work.

The placebo response is about far more than the pills – it is about the cultural meaning of a treatment, our expectation, and more. So we know that four sugar pills a day will clear up ulcers quicker than two sugar pills, we know that a saltwater injection is a more effective treatment for pain than a sugar pill, we know that green sugar pills are more effective for anxiety than red, and we know that brand packaging on painkillers increases pain relief.

A baby will respond to its parents’ expectations and behaviour, and the placebo effect is still perfectly valid for children and pets. Placebo pills with no active ingredient can even elicit measurable biochemical responses in humans, and in animals (when they have come to associate the pill with an active ingredient). This is undoubtedly one of the most interesting areas of medical science ever.

If the limit of Professor Roy’s ambition is to claim that homeopaths are no worse than big pharmaceutical companies interested more in making lots of money than they are in actually making people well, then whoop-de-doo. I thought you were claiming to be the good guys?

It reminds me of Great Cthulhu’s eternal presidential election slogan “why vote for the lesser evil?“.