Editorial: Doctors should shun quackery

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Devotees of homeopathy will have been reaching for the rescue remedy this week after hearing about the letter in the latest issue of the New Zealand Medical Journal, calling on GPs to keep away from unproven treatments.

Five researchers, from New Zealand and the UK, called on doctors to stop prescribing homeopathic remedies or referring their patients to homeopathic practitioners, on the grounds that such behaviour is "not consistent with the ethical or regulatory requirements of practising medicine".

It's the kind of thing that gets homeopathy's believers seriously hot under their collective collars. They see it as proof of the malign conspiracy between the medical profession and the pharmaceutical industry to keep patients away from guaranteed cures for all sorts of ailments.

The inconvenient problem is that the lead letter-writer, Tauranga-based medical researcher Professor Shaun Holt, has published two books about complementary or alternative medicines - called CAM in doctor shorthand.

The first, Complementary Therapies for Cancer, contains a couple of dozen suggestions of therapies that may improve the quality of life for cancer patients. They include fish oil, ginger (whose anti-nausea properties are well-established), yoga and massage.

The title of the second book, Natural Remedies That Really Work, rather implies that he's saying not all of them do, no matter what their proponents claim. An upcoming book discusses depression, in which he argues that natural therapies have a better record than conventional drugs.

Holt reckons homeopathy is the "nuttiest" of therapies in the CAM canon.

As its name suggests, it is based on the idea that like cures like, so a substance that might be expected to cause certain symptoms will, in dilute form, relieve them.

The difficulty is that dilution, which homeopaths variously call "dynamisation" or "potentisation". The more you dilute it, the stronger it gets, they say. In the strongest (which is to say, weakest) form, its potency is off the scale.

In late January, sceptics worldwide shot a hole in this by simultaneously and deliberately overdosing on the high-strength remedies with no ill effects and the letter by Holt and his colleagues follows a rather guarded Medical Council statement in March that reminded doctors of the obligation to inform patients when CAM is not consistent with conventional medicine and/or not supported by the majority of doctors.

Holt goes further. He wants New Zealand doctors to stop using homeopathy or even referring patients to homeopaths because, he says, referral "confers a credibility on homeopathy that it does not deserve".

It's easy to understand his hostility to quackery that numbers among recently concocted remedies milk sugars that have been bathed by the light from Saturn refracted through a telescope, crushed concrete from the Berlin Wall and ground dogs' testicles.

Doctors work within an evidence-based framework and patients expect their pronouncements and prescriptions to be based in science. There is not a single scientifically conducted trial that shows homeopathy to be effective and it should not be given the blessing - implicit or explicit - of medical practitioners.

People are perfectly free to seek whatever therapies they wish. But conventional doctors should stick to the traditions they have been trained in.