Homeopathy and Double Blind Tests

The Globe and Mail reports that homeopathic remedies are shown by double blind tests to be no more effective than placebos.

I have watched my wife go through 6 years of training in homeopathy and now 4 years of practice. I was very sceptical in the beginning, but am not now. Some of the most convincing successes I have witnessed were when our children were pre-verbal, which would suggest that their improvement could not have been by placebo effect.

My observation as an informed outsider, strongly supports some of the comments in your article. Whereas for normal doctors, treatments are designed to work across masses of patients (bacterial infections need antibiotics, depressed people need anti-depressants, rhematics need anti-inflammatories, etc.), homeopathic symptom pictures are highly individualistic. There are literally thousands of possible remedies that might be indicated.

I have given long thought to how one could run a double blind test that would be valid, but I cannot see that it is possible. Double blind tests are of course critical to so much of what is good about modern scientific practices. As stated by the philosopher of science, Karl Popper, a claim that is not in principle falsifiable is not scientific. By this measure homeopathy is not science.

Should we throw it out then? From my observations, albeit not scientific, that would be a mistake. But that is not going to convince many. So let me at least raise a question in the minds of the scientific community.

The immune response is actually part of a highly complex ecosystem that is, in turn, a sub-system of the larger biosphere. As the recent War of the Worlds movie illustrated, we humans have evolved an immune system that is in a highly complex relationship with our environment.

Modern chaos theory and complexity theory have woken us to the fact that there are only a narrow range of empirical phenomena that can be explained scientifically -- that is according to the rules set down by Popper. There are a very large number of practical problems, from how long it will take concrete to set, to whether a tornado will touch down in Elora or Milton, to use a recent example, that are beyond scientific provability, or falsifiability.

This is unfortunately most evident in the area of the biosphere where debates rage over almost every theory, from global warming, to the theory of evolution itself -- neither of which are capable of meeting Popper's criteria (as he himself pointed out in relation to Darwin's theory). This is because the sheer complexity of the variables involved in the actual processes cannot be experimentally reproduced and subject to the principle of falsifiability. We could only do a double blind test of the theory of global warming, if we had thousands of world's identical to our own where we could test whether the increase and decrease of carbon dioxide actually affected global mean temperatures.

Nonetheless, practitioners of meteorological forecasting, for instance, do not throw up their arms in defeat and give up. Everyone in south-western Ontario was warned of tornado danger the day Elora was hit, for instance. Years of observation of trends told them there was danger. The general principles are understood, even if the precise causes and conditions are not capable of being isolated to the point that they could have restricted their warnings to the people who actually were affected.

I would suggest these observations pertain to medecine as well. Modern medicine has been fantastically successful at using science, including double blind testing, to deal with some aspects of our immune system. But like the biosphere, there are many aspects of the immune system whose complexity evades their efforts. Many illnesses are at best managed, but the true causes are unknown, cancer and arthritis being two of the most well-known. The complexity of the immune system in general and of individual's systems, in particular, make it as difficult to diagnose the scientifically precise causes as it is to predict where tornadoes will touch down (and what to do to prevent them).

Every doctor, normal or homeopathic, knows the truth of this. The longer they practise medicine, the more history they have with an individual patient, the more times they wrestle with certain conditions the better they get at managing illness. But it is not a precise science, double blind tests aside. It is an art, just as meteorology is an art.

The methods used to manage complex systems like the immune system are sometimes scientifically based, sometimes not. Sometimes conditions are sufficiently repeatable to allow for double blind testing, sometimes they are too individualistic and random to be repeatable in this way. Every doctor has his tricks that he has learned from experience, but were never taught in medical school. Much of normal effective medicine would never pass the test of falsifiability or double blind trials.

Homeopathy has been practised for over 150 years. In many countries outside of North America it is considered completely normal. I live in France, for instance, where it is considered just another specialty of a normal medical degree. In other words, doctors find it useful in treating patients. Patients are helped by it. But it is not a precise science and diagnosis and treatment are an art. Homeopaths get better the longer they practice. Their intuitions and insights become more finely honed.

Within science itself, the debates around chaos theory and complexity have shown us the limits of what we can expect to deal with scientifically. Let us not be to swift to then use the filter of "science" to rule out the practices of meteorologists, environmentalists, or doctors, of whatever stripe. If we are to throw out homeopathy on these narrow grounds, then we should also ignore the issue of global warming and give in to President Bush's suggestion that Intelligent Design should be taught alongside Darwin's theory of evolution.