The Person Behind the Science: The Moral Debate about Homeopathy and the NHS

by Dr. Nileema Conlon Vaswani in

Regardless of the scientific merits of Homeopathy, if we are to restrict patient choice we ought to have very good reasons for doing so. This week doctors and scientists have urged Primary Care Trusts (PCTs) to withdraw funding for NHS Homeopathic services. Their claims range from calling it "crack-pot" medicine to accusing it of "unproven remedies." If their recommendations are followed, this branch of medicine will not be available on the NHS and patients who want Homeopathic treatment will either have to pay for it privately or not have it at all.

To talk of "unproven remedies" is somewhat dangerous because science is always a work in progress. Although there are a lot of remedies that we consider established, they are in fact just what we know to be true or proven at a particular point in time. If conventional medicine has remedies that work on plenty of people then so does Homeopathy. To discredit it merely because the nature of its science is different seems both unfair and unscientific. Science is meant to be open-ended and open-minded, as there is always the possibility that something that appears to be established today may be discredited tomorrow. Even within conventional medicine, treatments that are used at one point in time may be frowned upon at another either because they do not serve the purpose for which they are intended or because they have undesirable side effects. The thalidomide tragedy is a case in point. The nature of science, including medical science, is that it is evolving; to claim otherwise would be less than honest.

One could make this a debate about numbers and claim that conventional medicine has stronger evidence to suggest that it works but, for the patient, evidence is a debate that goes beyond numbers. For some people, Homeopathy works; for others, it does not. For some people, conventional medicine works; for others, it does not. Even among conventional medicine, there are remedies that work for some and not for others. It is not necessary for Homeopathy and conventional medicine to stand in opposing camps; both are choices as indeed are the choices available within each of these types of medicine.

The point is perhaps well illustrated in the context of Psychology. Someone suffering from depression, for example, may benefit from counselling whereas someone else suffering from depression may benefit from medication. Neither method is right or wrong except for the individual affected. Similarly, one patient may prefer paracetamol as a painkiller, another may prefer aspirin and a third may prefer ibuprofen. Which of these is the right one to take depends on the individual taking the drug and what works for him just as the choice to take a Homeopathic painkiller, for example, would be the right choice for the patient for whom Homeopathy works.

Even if Homeopathic medicine is based on placebo effect, this is not necessarily problematic. The point is that the patient has been treated, either by the medicine itself or by the placebo effect, an effect that would not have occurred had he not taken the medicine. In the case of counselling, a client shares his problems with a counsellor, has the opportunity to talk and often finds his own solutions. Counsellors rarely tell people what to do; they encourage them to find a solution that is right for them. To that extent, a counsellor is only a catalyst because the client has found his own solution. Similarly, even if Homeopathy relies largely on the placebo effect for its success, this does not seem to be especially problematic. Just as the client might not have found his own solution to his problems without seeing a counsellor, a patient might not recover without taking his Homeopathic pills.

So far I have discussed the issue of patient choice and explained that different remedies, regardless of whether they are conventional or Homeopathic, work for different people. However, there is another dimension to this debate that is also worth exploring and this is the issue of whether a treatment like Homeopathy that is being met with scepticism ought to be funded by taxpayer’s money.

Sceptics of the science would say that as Homeopathy does not work, it ought not to be funded. Yet, it is not clear how maintaining funding for Homeopathy is any different from maintaining funding for IVF, counselling, high risk operations, and so on. In the case of Homeopathy, it is the success of the science that the sceptics question; in the case of these other examples, it is other factors that affect success.

Consider the example of IVF. One could argue that every unsuccessful attempt at IVF is a waste of taxpayer’s money and yet, this is a treatment that is offered on the NHS. It is difficult to see, in moral terms, how an IVF cycle that, for whatever reason, had a low chance of success is any more justifiable than Homeopathic treatment that may have a similar rate of success. Both run the risk of failure but why would it be morally wrong to stop people from IVF treatment based on the success rate but not wrong to prevent people from taking Homeopathic medicines when both are paid for by the state?

A moral comparison with counselling is also appropriate. Without undermining the benefits of counselling, it is possible that a client who undergoes counselling on the NHS does not benefit at all. Yet, to suggest that he not undergo counselling because he may not benefit would be harsh.

Finally, consider the case of someone who has to undergo a complicated and expensive heart surgery where the chances of success are very low and yet where if the surgery is successful, it would be benefit the patient immensely. Here, again, we have a case where we would consider it morally justifiable to try to help the patient and consider it morally wrong to deny him the surgery. Therefore, how would it be justifiable to support this type of scenario with NHS funds but not a scenario where a patient wants to be given Homeopathic treatment to help his condition?

Although the types of success are different as explained above, in terms of the best use of taxpayer’s money, the examples are identical. All these cases are important for the individuals concerned even though they all put a financial burden on the NHS without guaranteeing results.

This article is not about supporting or discrediting the science of Homeopathy but about offering patients a choice that works for them. The discussion also responds to possible concerns about the use of taxpayer’s money and explains that treatments that are considered worthy by some will be considered unworthy by others, a problem that will not disappear anytime soon as we all have our opinions and we all pay our taxes.