Homeopathy and Consumer Protection

Editor’s Note: It’s World Homeopathy Awareness Week.

Today’s guest post is from Dr. Chris MacDonald, PhD. Dr. MacDonald is Associate Professor, Department of Philosophy, Saint Mary’s University, and a Nonresident Senior Fellow at Duke University’s Kenan Institute for Ethics. Dr. MacDonald blogs at the Business Ethics Blog.

What should we think about homeopathy, from the point of view of Business Ethics? We can begin by asking the same questions about homeopathy as we would ask about any other product. Those questions fall under two main headings:

  1. Is it generally ethically OK to sell this product? Is it a product that should be on the market at all?
  2. If it’s generally ok to sell this product, what are the obligations of companies selling them? Are there any ethical limits on how or to whom they are marketed?

In a free society, there’s a general presumption in favour of free commerce. If Party A has a product and says to Party B, “Hey, you might like this,” and if Party B says, “Hey, I think I’d like some of that, here’s some money!” then they should generally be free to make the transaction. But there are limits. Some things cannot ethically be bought or sold (children or votes, for example). Other things can be sold, but only under special circumstances (cigarettes and alcohol, for example). And more generally, there is a very broad requirement that all transactions must be carried out without force, fraud, or deception.

Now, discussions over alternative therapies like homeopathy tend to be combative, rather than constructive, particularly on the Internet. That’s unfortunate, because a lot is at stake. Finding ways to have a constructive discussion is essential, but few make that effort. But there is common ground in the debate, and we should make good use of it. Both sides of the debate agree, for example — indeed they ethically have to agree — on the importance of consumer protection, though they may disagree on the right way of achieving it. Health is complex, and important, and the average consumer typically needs to be able to turn to experts to get good advice. There are plenty of unscrupulous individuals and companies out there willing to try to make a fast buck by preying on the gullible or the uninformed. Anyone who truly cares about health has to recognize that that’s a serious problem.

So, let’s look at homeopathy through the lens of consumer protection. Most generally, consumer protection means, first, making sure that products are safe (or “safe enough”, since almost all products carry at least some risk), and, secondly, making sure that products do what the manufacturer or seller says they’ll do.

Although I happen believe that homeopathy (like most other alternative therapies) does not in fact work, I want to have a constructive discussion about consumer protection with those who think it does. So I’m going to assume, for the sake of argument, two things that many skeptics are likely to deny.

  1. First, I’m going to assume that homeopaths (and supporters) genuinely believe in the power of homeopathy. That is, I’m going to assume that most homeopaths are not outright frauds. (Actually, that’s not just for the sake of argument. I strongly believe that to be a justified assumption. I strongly suspect that the vast majority of homeopaths and homeopathic pharmacies are 100% well-intentioned, and seek only to promote the health of their patients and customers.)
  2. Secondly, I’m even going to assume — again for the sake of constructive argument — that homeopathy works. I’ll assume that the anecdotes of homeopaths and their patients confirms the positive effects that Randomized Controlled Trials have thus far been unable to detect.

Next, given these assumptions, I’m going to pose two questions for homeopaths to answer, questions that I would likewise pose to any other kind of reputable business, especially any other reputable business in the field of health.

  1. How do we detect phoney homeopathic preparations? In order to protect consumers, we need to be able to detect fake remedies — fake versions (sold by counterfeiters) that are really just inert look-alike copies of genuine remedies. In an age of international trade and Internet-based pharmacies, phoney pills are a big problem. So, is there any way to test a homeopathic preparation to verify that it is genuine? If I buy homeopathic tablets, is there any test that can be done to see if they’re real or counterfeit? If authorities suspect a criminal organization of selling fake homeopathic tablets, how can they tell the difference between the criminal organization’s tablets and those manufactured by an honest homeopathic pharmacy?
  2. What advice would you give a potential patient/customer who is trying to choose among various alternative therapies? How should a potential customer/patient choose between homeopathy, Therapeutic Touch, acupuncture, Angel Therapy, and so on? In other words, how can consumers know that they’re about to buy something good, rather than something bogus? “Trust me” won’t do as an answer. Trust, in itself, is neither a good nor a bad thing; what we value is justified trust. What is it that justifies consumers in trusting you, rather than someone else? “Try it” also isn’t a good answer. When health is on the line, we shouldn’t have to experiment on ourselves. We should have some assurance ahead of time. Consumers deserve that. One alternative, of course, is to deny that this is an important question at all, by claiming that literally all alternative therapies work. But that would make little sense. There surely are fraudsters out there, offering stuff they know can’t work. And even ignoring outright fraud, the homeopathic philosophy claims to have identified the true nature of disease; other philosophies, it seems then, must have it wrong. Which ones? Consumers deserve your input on this important issue.

These are questions I expect any reputable business to be able to answer. They are also questions to which I have not yet heard homeopaths give good answers. (In fact, I asked a version of the 2nd question on my blog, with depressing results.) I’m honestly interested to hear any an answer.

In the end, what I’m really looking for here are reasonably generalizable standards of consumer protection across various categories of health products. What standard of evidence and safety should be applied to products offered for sale, quite generally? If homeopathic preparations are not expected to stand up to the rigours of Randomized Controlled Trials, why, in all fairness, should the products of the major pharmaceutical companies be forced to meet that standard? Surely Merck and GlaxoSmithKline would love to avoid having to jump through those hoops. Surely Big Pharma would love to be able to give vague answers to my questions above. But we don’t let them. And we’re right not to let them. The question is, can the Homeopathic industry demonstrate its commitment to ethics by giving clear answers, too?

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11 thoughts on “Homeopathy and Consumer Protection

  1. As for question #2, if you ask someone selling homeopathic “medicine,” you’ll most likely get a vague answer along the lines of “Well, just ask my clients if it works for them.”

  2. “Most generally, consumer protection means, first, making sure that products are safe (or “safe enough”, since almost all products carry at least some risk), and, secondly, making sure that products do what the manufacturer or seller says they’ll do.”

    And if not completely safe, then at least clearly/objectively labeled re: safety and/or efficacy so the consumer is making an *informed* choice.

  3. My best guess is that someone with a vested interest in homeopathy would answer thusly:

    1)

    -Make sure your homeopathic medicine is manufactured, packaged, and labeled in a facility with a site license signifying they are operating under GMP standards.

    -(In Canada) Make sure your product has a DIN-HM (Drug Identification number – Homeopathic Medicine), and is registered in the Health Canada product database.

    Example of a product license application form: http://www.hc-sc.gc.ca/dhp-mps/prodnatur/legislation/docs/ehmg-nprh_table2-eng.php

    Literature Health Canada offers on the licensing of Homeopathic Products:

    http://www.hc-sc.gc.ca/dhp-mps/prodnatur/legislation/docs/ehmg-nprh-eng.php

    I realize none of this involves actual chemical or physical analysis of the product-in-hand, but it’s because I can’t think of one, but I assume this is what someone peddling it would offer as an explanation.

    2)

    -Something along the lines of:
    “My cousin’s uncle tried it and it works.”
    “3 out of 5 of my clients feel better.”
    “My brother took it for 2 months and his blood pressure is much improved.”

    If you are trying to choose between two alternative therapies, I assume one would compare success rates, incidence and severity of adverse effects, and cost. Personally I would include comparison to a placebo, but that’s just my biting skepticism talking.

    I know it wasn’t exactly what you requested, but it’s as close as I could come up with.

  4. I think if you’re giving medical advice with conflicts with the advice of the patient’s GP or of general mainstream medical knowledge, then you should be equally as qualified in mainstream medicine as a GP in order to offer not just a second opinion, but to overrule mainstream knowledge. Patient choice should ideally be informed choice, but medical advice, whether ‘alternative’ or not, must absolutely be informed. Homeopaths should not offer medical advise against the mainstream without first being trained in the mainstream to an acceptable standard. This might help prevent patients using homeopathy for conditions where real medicine is required.

    • Nancy, do you have an argument to back up that suggestion? It’s pretty implausible, as it stands. Governments are supposed to show leadership, and try to do what’s best for the people.

      By the way, do you have answers to either of my questions in the blog posting? Or was this just a drive-by comment on your part?

      Chris.

  5. I think that pharmacists should seriously question whether they should be selling conventional drugs (or not). When you consider that most drugs eventually are found to be more harm than good, pharmacists must sincerely ask themselves if they are acting ethically by selling them.

    Further, pharmacists should always question when a patient is taking more than one drug at a time. Little or often no research has been conducted to verify the safety or efficacy of such practices, and pharmacists should warn patients that such practices are unscientific and potentially dangerous.

    Because most drugs are not tested on infants or the elderly, we should be particularly careful to warn these people that the safe dose of a drug has not been adequately tested.

  6. CK:

    No, I think it’s clearly false that “most drugs eventually are found to be more harm than good.” Some are eventually found to do more harm than good. But if you have data to back the “most” claim, I’d like to see it.

    But there’s a big difference between conventional drugs and homeopathy in this regard: makers of conventional drugs are actually held to standards of safety (including monitoring) and effectiveness. We see problems with conventional drugs because we bother to look.

    Chris.

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