Michael Eriksson's Blog

A Swede in Germany

Posts Tagged ‘medicine

Physicians who believe in Homeopathy (and how this resembles the Left)

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My last text dealt with human stupidity, and left me pondering, for the umpteenth time, the fact that even many highly educated (and often allegedly intelligent) people believe the oddest things. (See e.g. Minding the Campus for examples of how the U.S. college world is descending into an insane asylum run by the inmates, or how the same thing has happened in Sweden.)

One particularly odd special case is Homeopathy: If someone takes pseudo-scientific “gender studies” classes, sees no counter-weight, is fed a similar message by media*, and ends up being convinced of e.g. “Patriarchy”, this is not that remarkable. This especially as the average level of the “gender studies” students is not very high. But: how can it be that many physicians, with years of medical studies, internships, and own practice still often** believe in Homeopathy? This especially as the average level of medicine students tends to be quite high. Moreover, as very many laymen have learned that Homeopathy is quackery with less than half-an-hour of research?*** This is as would someone with a degree in astronomy believe in astrology.

*I was indoctrinated into a lot of odd ideas in my own, Swedish, youth, even just through media and school. (Cf. excursion.)

**For instance, according to Germany Wikipedia, Germany had 6712 physicians with a specialist (“Facharzt”) education in Homeopathy as of 2009. Not all of them are necessarily believers, but the number is still depressingly large.

***Which is not to say that this is a reliable amount of time in general. Often, so short a research would amount to too little, but Homeopathy has so glaringly obvious problems that it forms a special case. Indeed, half-a-minute (!) of research might often be enough.

I tried to look into the issue in Germany, e.g. to find an explanation from an apostate how belief survived and eventually disappeared. I found an excellent example in Natalie Grams, who became a physician, gained an additional doctorate*, and practiced Homeopathy until she tried to write a book in its defense—and found out that it was all humbug, around ten years after receiving her license to practice medicine (“Approbation”). She ended up writing a book attacking Homeopathy …

*Note that a Germany physician, unlike a U.S. one, is not awarded a pseudo-doctorate for having completed med school. The German medical doctorates are earned separately, as an additional qualification, and they are, at least nominally, real research doctorates. (There is some concern that they fall well short of the “Ph.D. level” in practice, but it is still a step up from the U.S. M.D.) Also see a comparison of a J.D. with my own education.

Below, I will quote, translate, and comment portions of a very long German article, which discusses her experiences in detail. Those familiar with e.g. the situation at U.S. colleges, in the Feminist and PC movements, etc., will recognize quite a few issues:*

*Note that some formatting might have been lost or changed due to copy-and-paste or technical issues. Further note that I have not necessarily tried to translate “idiomatically correct” or straighten out the often very poor “journalist German”, and that there might some inaccuracies in terminology on my behalf.

[Impfgegner und Anthroposophen] würden sich bisweilen nicht mit verbalen Anfeindungen begnügen, sondern auch vor körperlicher Bedrohung nicht zurückschrecken. Zu manchen ihrer Vorträge oder Buchpräsentationen kommt Grams daher lieber mit Begleitschutz. […] Beschimpfungen, Beleidigungen und Hassbotschaften ist sie längst ebenso gewöhnt wie plumpe Interventionsversuche. Kurz vor Beginn der Corona-Krise legten sich Widersacher ins Zeug, um einen Vortrag in einer Apothekerkammer zu verhindern.

Translation:
[Anti-vaxxers and Anthroposophen] would occasionally not be satisfied with verbal hostility, but resort to threats of violence. To some of her lectures and book presentations, Grams prefers to bring body-guards. […] She is as used to verbal abuse, insults, and hate messages as to attempts to intervene [against her, presumably]. Shortly before the beginning of the Corona crisis, her opponents tried to prevent a lecture in an Apothekerkammer*.

*Literately, roughly “pharmacists chamber”, which might match some uses of “chamber” (e.g. “chamber of commerce”) reasonably. Note that pharmacies are a major part of the Homeopathy problem in Germany, often selling these quackery products in preference of real medicine and without a word mentioning their uselessness. Cf. portions of an older text.

Comment:
Similar behavior appears to be quite common in Leftist circles, especially in the PC and Feminist factions, and at U.S. colleges.

Die größte Sünde, die sie in den Augen ihrer Gegner begangen hat, ist aber gewiss der Verrat: Natalie Grams hat die Seiten gewechselt. […] Hier exponiert sich nicht jemand aus der fernen Welt der notorischen Skeptiker, unverbesserlichen Zweifler und stur Wissenschaftshörigen, sondern eine Person aus der eigenen Mitte mit langjähriger profunder Innensicht, die mangelnde Plausibilität, Kollision mit Naturgesetzen, innere Widersprüche und unzulässige Heilsversprechen des Glaubenssystems Homöopathie aufzeigt.

Translation:
The greatest sin, that she committed in they eyes of the opponents, was surely the treason: Natalie Grams changed sides. […] Here someone exposes herself, who does not belong to the distant world of the notorious skeptics, incorrigible doubters, and stubbornly scientific, but is a person from the own circles with a long and profound internal view, who shows the lack of plausibility, the collision with natural laws, internal contradictions, and unallowed promises of cures* of the belief system Homeopathy.

*The German word (“Heilsversprechen”) might point to a hyperbolic (religious) “salvation” instead of “cure”. I am uncertain of the nuances. (Again, poor “journalist German” …)

Comment:
As with the PC (etc.) movement, no-one is worse than the traitor, someone who once had the “correct” opinion and then left for the other camp. In many cases, just being someone who “should” support the one camp is enough to cause immense ire, when failing to do so. (As with women who speak up against Feminism and are label “gender traitors” or, indeed, the “class traitors” of old.)

Freunde wandten sich ab, Weggefährten wurden zu Kontrahenten. Es sei vergleichbar mit dem Ausstieg aus einer Sekte.

Translation: Friends turned away from her, fellow travelers became opponents. It was like leaving a sect.

Comment:
Again, the same. I have heard repeated tellings of former good Leftists who literally lost friends over a change of heart. Indeed, when the Swedish Party SD first gained traction, there were campaigns to dump all Facebook “friends” who had had the audacity to vote for them. (This was more than ten years ago, so I am low on details and references, but a much older text might be of interest.

[Homöopathie schien sie von mysteriösen Nachfolgen eines Autounfalls zu retten.] Grams reagierte wie viele Menschen, die derartige Erfahrungen machen: Auf Ereignis A (eine homöopathische Behandlung) folgt Ereignis B (die Beschwerdefreiheit), also muss A die Ursache für B sein. Sie hinterfragte das keine Sekunde. […] “Es war meine homöopathische Erweckung.”

Translation:
[Homeopathy appeared to safe her from mysterious consequences of a car accident.] Grams reacted like many other humans, who have made such experiences: Event A (a Homeopathic treatment) followed event B (disappearing symptoms); ergo, A must be the cause of B. She did not question this for even a second. […] “It was my Homeopathic awakening.”

Comment:
This is mostly unrelated to PC issues and more of interest for her personal development. However, the mentioned “post hoc; ergo, propter hoc” thinking is a common problem, including in Leftists and PC contexts, as is the more general failure to separate causality and correlation, as with e.g. the observation that (on average) working-class parents have less academically successful children and the conclusion that this must be due to the lesser amount of money or lesser SES of the parents.

Sie begann eine Zusatzausbildung in Homöopathie und Traditioneller Chinesischer Medizin. […] Da wie dort war es erforderlich, große Stoffmengen auswendig zu lernen, viel Zeit für eine differenzierte Betrachtung blieb nicht. Genau wie ihre Kommilitonen kam sie auch gar nicht auf die Idee, eine solche für angebracht zu halten: Man war unter Gleichgesinnten, […] Es war ein Leben in einer Blase.

Translation:
She began additional* studies in Homeopathy and Traditional Chinese Medicine. […] Here as well as there,** it was necessary to learn large amounts of material by heart, not much time was left for a differentiated view[ing?]. Just like her fellow students, she did not even contemplate, that this was necessary: They were among fellow believers, […] It was a life in a bubble.***

*In addition to her regular medicine studies.

**Presumably, referring to her regular studies and the additional studies. The formulation is idiotic in German too.

***Note the English expression “echo chamber”.

Comment:
My main take-away is that medical* education might be flawed through focusing too much on knowledge and too little on understanding and thinking. However, both the lack of willingness to question (for whatever reason) and the “bubble” appear to match large portions of the social sciences, including “gender studies”, well.

*This, obviously, is a criticism that I have made against large portions of the education field in general, and is likely not specific to medicine. However, medical education does have a reputation of being based more on very hard work than on very high IQ.

Grams las [ein Anti-Homöopathie-Buch] und war wütend. Hier verhöhnten offenkundig Ahnungslose eine bewährte Therapie, auf die viele Menschen schworen, wie jeder Anwender und Scharen von begeisterten Patienten bestätigen konnten, zürnte Grams. [She wanted to write her own book in defense of Homeopathy.]

Translation:
Gram read [an anti-Homeopathy book] and was furious. Here an obvious ignorant spotted a proven therapy, that many humans swore on, that ever user and hordes of enthusiastic patients could confirm,* vexed** Grams. [She wanted to write her own book in defense of Homeopathy.]

*Equally bad in German, The intent is likely that they could confirm how well it worked.

**The German original uses a “zürnen” (“to grow angry” or “to grow angry at”) in a similar non-standard manner. The intent is likely that she expressed the opinion preceding the “vexed” while being vexed.

Comment:
This is broadly just an illustration of the prior quote, but it catches the mood in Leftist circles well: we have the truth and those who disagree are unenlightened buffoons, who should shut the fuck up until they have taken “gender studies 101”. (Also see excursion below.)

Dafür allerdings musste sie recherchieren. Sie war gezwungen, nach Belegen für die Wirksamkeit von Homöopathie zu suchen, […] Das Ergebnis war niederschmetternd. Grams stellte fest: Verdammt, die Kritiker haben recht. […] “In dem Moment ist meine Welt implodiert.”

Translation:
But to do this, she needed to research [the topic]. She needed to search for proof of the effectiveness of Homeopathy, […] The result was devastating. Grams found: Damn, the critics have it right. […] “In that moment, my world imploded.”

Comment:
And so it is with e.g. Feminism: actually look at the facts with an open and critical mind and the Feminist world-view proves a fantasy or nightmare. (Cf. e.g. 77 cents on the dollar, rape statistics, or any number of Woozles.) But: all too few are willing to do that …

[…] dass es einer seltsamen Beweislastumkehr gleichkommt, wenn gefordert wird, die etablierte Medizin müsse eben so lange forschen, bis sie auf Belege stoße, die den Homöopathen recht gäben; dass es ein seltsamer Sonderstatus der Homöopathie ist, wenn sie ihre Methode trotz seit 200 Jahren ausständiger Belege am Patienten anwendet, während alle anderen Sparten der Medizin zuerst Wirksamkeitsbeweise brauchen und dann erst therapieren dürfen; […]

Translation:
[…] that it is an odd reversal of the burden of proof, when established medicine is required to research, until it finds proof that the Homeopaths are right; that it brings an odd special status to Homeopathy, wenn it uses it methods on patients, despite 200 years of undelivered proofs, while all other branches of medicine have to give proof of effectivity first and treat later.

Comment:
The same problem is very common with “gender studies”, Feminism, Leftist propaganda. The rules are different for the Left, the non-Left must prove* its points while the Left is to be believed, and the Left has tolkningsföreträde on any issue.

*And any proof given is likely to be discounted for/in an unscientific or intellectually dishonest reason/manner, e.g. an unfounded accusation of sexism/racism, ridicule, or outright censorship.

Sie schrieb ihr Buch, […] Wie sie selbst, dachte Grams, müssten doch auch all ihre Kollegen daran interessiert sein, Argumente auszutauschen und das wissenschaftliche Fundament ihres therapeutischen Konzepts zu erörtern. Sie waren es nicht. Sie erntete Bestürzung, Ablehnung und offene Feindseligkeit. Sie hatte sich der Ketzerei schuldig gemacht.

Translation:
She wrote her book, […] Just like she, thought Grams, her colleagues must be interested in an exchange of arguments and a discussion of the scientific foundations of the therapeutic concept. They were not. She reaped chock, rejection, and open hostility. She had spoken heresy.

Comment:
Her expectation is a little surprising, as she had shown a similar reluctance herself, before her research, but the observations are well in line with the PC crowd: Their “truth” is the truth, the whole truth, and nothing but the truth–and must not be questioned.

Excursion on who is the unenlightened:
A very annoying problem, mentioned repeatedly, with the Left (and, apparently, Homeopaths) is that dissent is usually viewed as “You are an unenlightened buffoon. Once you have seen the light, you will also see that I am right.”, while the truth is usually the opposite. I, e.g., grow up with many Feminist prejudices that I only later learned were unfounded—and the more that I have seen of statistics, reasoning, Feminist debate methods, male and female behavior, etc., the more I have realized how flawed their world-view usually is. (The same applies to e.g. the “Old Left”, but I saw through it a lot earlier.)

For instance, the first major doubt came at some point in my teens: I read about a behavioral study in a news-paper, where male and female pedestrians had been placed at zebra crossings and the number of male and female drivers who did and did not halt had been counted. This seemed like a no-brainer: The kind and considerate women would tend to halt, the egoistic men would tend to drive, and when a “mere woman” waited at the crossing, men would be less likely to halt than for other men. The results were the exact opposite: Men halted more often than women, the constellation with the highest proportion of haltings was male driver/female pedestrian, and the one with the lowest proportion was female driver/female pedestrian. When I read this, I had a big “what the fuck” moment, and wondered if there had been some error somewhere. Today, based on another thirty (give or take) years of experiences with men and women, I would not have been the least surprised.

Written by michaeleriksson

June 23, 2020 at 12:59 am

No—Homeopathy does not work

with one comment

For the future, I plan to not be drawn into discussions of whether homeopathy works or various aspects of the argumentation and evidence in the issue—be it with Robert Hahn or someone else. (Separate posts on specific sub-issues may still occur, however.) Instead, I will simply link here—with the request that the supporter of homeopathy read the below links and refute the discussions present there first. In the exceedingly unlikely event that he manages to do so, I will be willing to reopen the issue.

The following lines of counter-arguments are faulty and/or dishonest and will not be accepted:

  1. The claim that experimental evidence shows that homeopathy works; in particular, in combination with the claim that attempts to e.g. point to a lack of a known mechanism are merely a cover-up intended to discredit this “fact”.

    As pointed out repeatedly in the links, experimental evidence speaks against homeopathy. The accepted (weak) effects are all explained by non-medicinal factors. (Cf. the item on anekdotal evidence.)

    Exception: If, theoretically, the supporter can show a subsequent change in scientific consensus on experimental evidence, this is obviously allowed. I stress that merely pointing to the existence of a few hundred published-in-CAM-journals papers are not enough—consider the number of studies showing the opposite, the significantly lower credibility of these journals compared to the leading mainstream journals, the often lower scientific value (worse methodology, smaller samples), and publication bias. Also note the discussions of meta-studies, including Linde’s, in the linked-to articles.

  2. Ad hominem towards the authors or their sources (including accusations of self-interest or being bought by the pharma industry): If their ideas, reasoning, or facts are faulty—attack these instead. If not, well, then there is no justification whatsoever in attacking the man. Also bear in mind that it is the homeopaths who have the greater self-interest in the issue (i.e. any attack based on self-interest will strike even harder in the other direction) and that it is exceedingly unlikely that the totality of the opposition would be faulty in this regard.

    Exception: If a convincing case can be made against an individual debater, study, whatnot, with regard to e.g. methodology (not merely an alleged motive) then this may obviously legitimately be used to question an individual statement or result.

  3. As a special case: Denying non-homeopaths the right to speak on the issue. These may be less knowledgeable in the subject field, but may also bring superior knowledge or ability in other areas, including scientific methods or critical thinking. The denial is particularly weak when the outsiders are medical researchers from other areas. Further, good and correct science can be explained to outsiders in a way that is convincing—if some field as-good-as-consistently fails to do so, then this speaks strongly against it. Science bears up to scientific scrutiny and critical investigation by outsiders—quackery does not. Indeed, unwillingness to allow outsiders the opportunity to poke holes and unwillingness to constructively engage critics are themselves strong (but not conclusive) indications of quackery.

    Further note that the critics are not limited to outsiders. The possibly most notable examples are Edzard Ernstw and Willem Betz, who were both once homeopaths and now are vocal critics.

  4. Anekdotal evidence: “I know that homeopathy works! I have tried it succesfully myself.”

    There are a number of reasons why individual experiences can seem to indicate that something works when it, in fact, does not. Cf. some of the below links.

    Among explanations we have e.g. the placebo effect, coincidence and natural healing (if a thousand sick people take a particular preparation, at least some of them are likely to, by themselves, become healthy at the “right” time by sheer coincidence), an increased tendency to take medicine when a problem is at its peak, confirmation bias, and “extra-medicinal” factors like a better patient–physician relation. Further note that it is not inconceivable that some less-than-religious homeopaths would prescribe conventional medicine every now and then…

Primary sources should be used with caution in any attempt at refutation (but are certainly allowed): There is much value in primary sources, but they are also dangerous and, if possible, secondary and (to a lesser degree) tertiary sources are to be preferred (just as with e.g. Wikipedia’s take on sources). Note e.g. the greater risks of partiallity, statistical noise, methodological errors, and mis- or over-interpretation when using primary sources. This is particularly important for laymen, who often draw too fargoing conclusions from research (as proved by any number of journalists over the years). Note also that if a primary source claims X, then there may be two others that claim non-X.

A common counter-argument against clinical studies, that homeopathy would demand an individual treatment and that merely giving every patient the same cure is misleading, does have some merit. However, I am well aware of it, it is not (taken by itself) enough to convince, and there is no need to repeat it. Consider that better results in individual treatment are also what a non-medicinal explanation predicts (in particular, when several remedies are tried until something “works”), that clinical trials are still valid investigative tools (if a particular remedy is good for only one in ten, then this should still make a noticeable difference in a large enough sample or a meta-analysis), and that the alleged extreme inconsistency in results is contrary to what would be expected a priori if a medicinal effect was present (the mechanims in the human body are very similar from person to person and so complete deviations in result are very rare, allergies and over-sensitivities excepted). Further, the obvious main line of homeopathic research would then be to find better classifications and groupings to systematically pin-point the right remedies, with uses including better treatment, integration of similar methods into school medicine, and … building better samples for clinical trials. Such attempts have not been successful, which speaks strongly for a non-medicinal explanation of any success stories. Indeed, by Occam’s Razor, it is more likely that the different effects on individuals are either just an excuse or a misinterpretation of events—not an actual difference.

On with the links:

http://en.wikipedia.org/wiki/Homeopathye Note the extensive discussions pro and contra on the talk pages.

http://www.homeowatch.org/e Many further links, including an own research over-viewe.

http://www.sciencebasedmedicine.org/?p=11e Note: First of five parts. The other parts are linked from there.

http://www.publications.parliament.uk/pa/cm200910/cmselect/cmsctech/45/45.pdfe A thorough parliamentary report (UK) which includes both a high level conclusion and (in the appendix) more detailed statements and research overviews. A brief non-PDF summary from a different sourcee.

http://apgaylard.wordpress.com/2009/09/06/a-homeopathic-refutation-part-one/e (The second part deals with the dangers of homeopathy and is of little relevance to this particular discussion.)

http://www.badscience.net/2007/11/the-lancet-benefits-and-risks-of-homoeopathy/e
http://www.badscience.net/2007/11/a-kind-of-magic/e

http://www.quackwatch.org/01QuackeryRelatedTopics/homeo.htmle

http://www.skepdic.com/homeo.htmle

http://www.ncahf.org/pp/homeop.htmle

http://www.spiked-online.com/index.php?/site/article/5100/e

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1874503/table/tbl1/e Overview of meta-analyses and re-analyses based on a much-touted-by-homeopaths work by Linde. (Similar, more extensive tables are present in the PDF report above.)

Also of interest:

http://www.quackwatch.com/01QuackeryRelatedTopics/holmes.htmle A long, very well-argued, and well-known refutation of homeopathy by Oliver Wendell Holmes; however, also a very old text, which could be unfair to the homeopathy of today in at least some regards. On the plus-side, it shines some light on why there really was no reason to expect homeopathy to work in the first place.

http://www.ukskeptics.com/article.php?dir=articles&article=it_works_in_animals.phpe A brief view on homeopathy and animals—a topic otherwise given little space in the linked-to articles.

http://www.sciencebasedmedicine.org/?p=4e A broader discussion of alternative medicines and pitfalls. Generally, this site (also present with an article series above) appears to have a large number of articles of direct or indirect relevance.

Written by michaeleriksson

January 26, 2011 at 5:57 am