Ineffective treatment may not be harmless - Veterinary Practice
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Ineffective treatment may not be harmless

JOHN BONNER hears a professor of complementary medicine declare that one type ‘doesn’t work’

“SCOURGE of alternative medicine” is one of the many titles that Edzard Ernst has been granted during a distinguished academic career.

Since his retirement as the world’s first professor of complementary medicine at the Peninsula Medical School in Exeter in 2011, he has received many more honours but there is one which is always likely to elude him: to be called “Sir”.

That is because he has spent much of the past decade in a prolonged public spat with the heir to the throne of Great Britain and Northern Ireland. German-born but a British citizen since 1999, Professor Ernst has earned the lasting admiration of mainstream scientists and republicans alike for his actions in denying himself any prospect of a knighthood.

Perhaps his most memorable act of lèse-majesté was the occasion when he called Prince Charles a “snakeoil salesman” for his constant promotion of homoeopathy.

Given his reputation, those members of the staff and student body at the RVC who went to hear Professor Ernst speak at a special lecture at the Hawkshead campus earlier this year may have been surprised. Instead of the confrontational figure they might have been expecting, he revealed himself to be a genial chap with a rather impish sense of humour.

But there is no denying the passion that he brings to the task of debunking the opinions of his opponents in the field of complementary medicine. He believes that they are abusing the scientific method and misleading patients by peddling useless and potentially dangerous treatments.

Part of armamentarium

Yet, as Professor Ernst explained, he did not set out as crusader against non-conventional medicine. As with many German medics, he actually trained in homoeopathy and used it as part of his therapeutic armamentarium in the early part of his career.

He then worked in academic medicine in Germany and Austria before being asked to set up the group studying complementary medicine at Exeter in 1993. The post was funded by Maurice Laing, a wealthy businessman and supporter of homoeopathy. At that stage, he insists that he had an entirely open mind about the value of homoeopathy but his systematic examination of the evidence from hundreds of studies convinced him that it offers no genuine medical benefits.

Professor Ernst told his RVC audience that many of his fellow sceptics are wrong in claiming that there is little or no evidence on whether homoeopathy works: there have been hundreds of studies including 226 randomised controlled trials. The first of these involving a homoeopathic treatment was in 1835, long before such investigations became commonplace in conventional medicine.

Benefit of empathy

His conclusion after reviewing all those studies was that: “Even the best evidence does not warrant a positive recommendation for homoeopathy to be used in clinical practice – that is science-speak for ‘It doesn’t work’.”

He argued that it is the empathy shown by the homoeopath that is the cause of the benefits reported by patients, noting that an initial consultation at a homoeopathic clinic will typically last more than an hour. Any evidence of positive effects is generally a result of cherry-picking the findings or taking them from poor quality trials.

Meanwhile, the type of observational study often favoured by homoeopaths was next to useless. “The plural of anecdote is anecdotes – it isn’t evidence,” he warned.

If homoeopathic treatments are ineffective but harmless, is there any reason to deny them to those who want them? “But they will cause harm when they are used to replace an effective treatment,” he said.

‘Death warrant’

He criticised those individual homoeopaths who encourage parents to opt out of conventional vaccine treatment for their children.

Moreover, those doctors who have allowed cancer patients to have homoeopathic treatment rather than standard chemotherapy were “signing their patient’s death warrant”, he said.

But he insisted that in a democracy it would be wrong to ban these unconventional methods. Patients should be allowed to choose whatever treatment they want, even for conditions where it clearly won’t work.

“If my neighbour wants homoeopathic treatment for cancer, let him have it. But it should not be available on the NHS and homoeopaths should not be able to make false claims that their treatment works.”

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