Like many Canadians who saw last week’s news article “Health Canada licensing of natural remedies ‘a joke,’ doctor says” in the lead-up to Friday’s Marketplace episode on CBC, I was very interested in learning the story behind it. Unlike many Canadians, I wasn’t at all shocked or surprised by the outcome. This blog (and others) have been critical for years about the lack of oversight where the Natural Health Products Directorate (NHPD) is concerned. (The NHPD recently changed its name to the Natural and Non-prescription Health Products Directorate. (NNHPD)) See “Do the Natural Health Products Regulations Benefit Canadians?”, “Health Canada Gets Out a Big Rubber Stamp” & “Safe and Effective? A Consumer’s Guide to Natural Health Products” for some background. For those who haven’t had a chance to view the episode, it can be viewed here: Continue reading
Is it ethical to market complementary and alternative medicines? Complementary and alternative medicines (CAM) are medical products and services outside the mainstream of medical practice. But they are not just medicines (or supposed medicines) offered and provided for the prevention and treatment of illness. They are also products and services – things offered for sale in the marketplace. Most discussion of the ethics of CAM has focused on bioethical issues – issues having to do with therapeutic value, and the relationship between patients and those purveyors of CAM. This presentation — by a philosopher and a pharmacist — aims instead to consider CAM from the perspective of commercial ethics. That is, we consider the ethics not of prescribing or administering CAM (activities most closely associated with health professionals) but the ethics of selling CAM.
You can watch it here here.
It was great to see so many public members attend and participate. There was an extended Q&A afterwards, with some very thoughtful audience questions. Watch for more on this topic from us in the future.
Alternative medicine is ascendant in Canada. From the dubious remedies that are now stocked by nearly every pharmacy, to the questionable “integrative” medicine at universities, there’s a serious move to embrace treatments and practices that are not backed by credible evidence. Canada’s support for alternative medicine, and for its “integration” into conventional health care is arguably is worse than many other countries. Canada’s drugs regulator, Health Canada, has approved hundreds of varieties of sugar pills and declared them to be “safe and effective” homeopathic remedies. Some provinces are even moving to regulate homeopaths as health professionals, just like physicians, nurses and pharmacists. Given the regulatory and legislative “veneer of legitimacy” that homeopathy is being granted, you can see how consumers might be led to believe that homeopathic remedies are effective, or that homeopaths are capable of providing a form of health care. The reality is far uglier, and the consequences may be tragic. Canadian homeopaths are putting the most vulnerable in society at risk by selling sugar pills to consumers, while telling them that they’re getting protection from communicable diseases. Continue reading
As pseudoscience goes, homeopathy takes the cake for absurdity. It is an elaborate placebo system, based on nonsensical ideas about biology, biochemistry and medicine. A decision to use homeopathy is a decision to do nothing at all, because homeopathic “remedies” have no medicinal ingredients in them at all. They are inert. Homeopathy is based on the idea that “like cures like” (which is simply a form of magical thinking) involving successive dilutions of products in water. The dilutions are believed to increase, not decrease, the potency of the final product. And these are serious dilutions. Think of putting one drop of a substance into a container of water. Only that container is 131 light-years in diameter. That’s the “30C” dilution used by homeopaths. Homeopaths believe that the water molecules retains a “memory” of the original substance (while conveniently forgetting all the other products it has come in contact with.) The final remedy is diluted so so completely that most “remedies” don’t contain a single molecule of the the original substance you started with.
A homeopathic nosode is a homepathic “remedy” made from infectious material. Unbelievably, Health Canada approves homeopathic “nosodes” for sale in Canada, despite a lack of any evidence they can do anything. Due to lobbying by groups like Bad Science Watch, Health Canada eventually agreed to force products to label nosodes with the caution “This product is not intended to be an alternative to vaccination”. While this was better that the status quo, there was the fear that homeopaths and other alternative health providers (like naturopaths) would continue to promote homeopathy to prevent or treat communicable disease. And the skeptics were right. Continue reading
Kudos to the New Zealand-based Society for Science Base Healthcare for taking a pharmacy sale of a homeopathic remedy to the Advertising Standards Authority: Continue reading
This is another post in the naturopathy versus science series, where a naturopath’s advice is assessed against the scientific literature.
It’s Naturopathic Medicine Week in the United States, so it’s time for another look at the alternative medicine practice that blogger Orac likes to call the One Quackery to Rule them All. Naturopathy is an oddity among alternative medicine, because it’s a hodgepodge of other practices linked by an underlying belief in vitalism: the pre-scientific notion that living things have a “life force”. Vitalism disappeared from medicine when Wöhler synthesized urea in 1828, yet the belief in vitalism is a central tenet of naturopathic philosophy. Naturopaths liken themselves to be primary care providers akin to family physicians (general practitioners) but their practices are quite different: rather than make decisions based on scientific evidence, naturopaths pick and choose based on what they feel is congruent with their vitalistic philosophy, sometimes despite good scientific evidence that shows they are wrong. For example, homeopathy is an alternative medicine practice that is very popular with naturopaths. It is an elaborate placebo system where “remedies” contain no medicinal ingredients: they are literally sugar pills. There is no demonstrable medical effect from homeopathy, and so it isn’t part of science-based medicine. Yet homeopathy is a “core clinical science” for naturopaths, and the practice of homeopathy is part of their licensing exam.
Amazingly, the store retains the memory of being a homeopathy shop and continues to heal. (h/t @bexielady)
I’ve written more times that I want to about homeopathy, the elaborate placebo system of “remedies”. It looks like medicine, and pharmacies stock it on shelves alongside products that contain medicine. But with homeopathy the common “strengths” or “potencies” of products are usually so dilute there’s no possibility of a single molecule of the original substance remaining in the remedy. What’s further, the original substance isn’t medicine, either. They can be derived from from substances like Stonehenge (yes, that Stonehenge), shipwrecks, ascending colons, light bulbs, and even vacuum cleaner dirt. While homeopathic products are deemed “safe and effective” by Health Canada’s Natural Health Products Directorate, the awareness that homeopathic products contain no active ingredients and have no medicinal effects has become increasingly well known. In 2011, I noted that manufacturer Boiron had been served by two class action lawsuit, and that this might be the beginning of a trend.
The legal action route seems to be having an effect – which is good, given pharmacies and even regulators have refused to act. Homeopathy manufacturer Heel has decided to exit the North American market completely: Continue reading
Tuesday’s post on Target’s decision to sell homeopathy for the treatment of asthma stirred a lot of questions towards Target, given their decision to market the a product that has no proven medical benefit. There were also supporters of homeopathy in the comments, from a pharmacy student who said homeopathy works because of radiation, and another that suggested that if I don’t believe in homeopathy, I can’t believe in the warmth of the sun. To be absolutely clear, homeopathy is not only unproven, it’s disproven. There is no serious scientific debate about this fact. The best evidence demonstrates that homeopathy is exactly what we expect – an inert placebo with no therapeutic effects. Homeopathy is not “alternative medicine”, it is an alternative TO medicine, and to consumers who may not understand what “homeopathic” means, it’s highly misleading to package and sell this on pharmacy shelves alongside products that actually contain medicine. Continue reading