Offit (2013) questions the efficacy and validity of many alternative medical treatments including homeopathic medicine. Homeopathic medicine was developed about two centuries ago in Germany by Samuel Hahnemann based on the idea that the dilution of substances that create illness in healthy individuals will cure those symptoms in someone that is ill (Wertheimer & Brentson, 2014). Observational experiments resulted in a reference table of symptoms and substances which were used throughout the 19th century by homeopathic practitioners (Wertheimer & Brentson, 2014). While homeopathy grew in popularity in Western Europe, the United States and India, in America it remains unregulated (Wertheimer & Brentson, 2014). Homeopathic medicines are manufactured without reference points or consistency because of this lack of regulation or oversight (Wertheimer & Brentson, 2014). This, and allegations of lack of efficacy, are typically core points of those who are against homeopathy, while advocates for the practice dismiss these arguments as medicine wanting to retain control over health, to the exclusion of other practices.
Hahn (2013) makes the claim that efficacy analysis of homeopathy has indicated consistently that the practice has a beneficial effect. Hahn’s study provided a meta-analysis of pooled data of clinical trials which tested the efficacy of homeopathy against a placebo control group for comparison. According to Hahn, the academic challenge against homeopathy has been based on studies which exclude 90% of findings in the existing literature in order to prove a biased result that shows a lack of effect. Other flawed results are due to the mixing of homeopathic remedies and conditions in the pooled data, which fails to provide specific information regarding the efficacy of specific remedies for specific ailments. Hahn therefore disagrees with conclusions that homeopathic medicine lacks clinical efficacy, and recommends that further research be conducted with regard to the impacts of a single remedy on the effects that it has on a single condition, rather than the pooling of data regarding multiple health problems using a variety of homeopathic remedies. Levy (2014) agrees with Hahn, but provides an alternative interpretation of evidence which concludes that there is no reliable evidence showing that homeopathy is effective. Levy disagrees that clinical trials, such as those that are used to test the efficacy of drugs, are an inappropriate method of evaluating the performance of homeopathic medicine because homeopathic medicines are not drugs, and the delivery of homeopathic treatment is delivered in a context which clinical environments cannot provide.
Wertheimer and Brentson (2014) present a business case for embracing what Offit refers to as the nonsense of alternative medicine. They propose that despite a lack of standardization and evidence of efficacy, there has been enough study of placebo effects to ascertain that this can be a cost effective means of achieving patient satisfaction when they are expecting a prescription while also accessing improvement in their health complaint through the placebo effect. The placebo effect is a proven phenomenon which uses a neurobiological basis to initiate self-healing (Haresnape, 2013). The mechanisms by which this works includes the therapeutic attention and attribution of meaning which generates optimism and reduces anxiety (Haresnape, 2013). There is therefore a need to truly differentiate between a homeopathic medicine’s effects and the placebo effect by adding a control group which is not participating.
There was an emotional and tense debate in the academic literature regarding the use of homeopathic medicine in veterinary care. De Beukelaer, Renoux, Nicolai, and Tournier (2017) wrote a public article chiding their colleagues who had presented evidence against the use of homeopathic medicine in veterinary practice. Whitehead, Chambers, Lees, Pelligand, Toutain, and Whiting (2017) responded emphatically that they felt that the use of homeopathic medicine on non-humans was unethical, and that the underlying assumptions in the justification that homeopathic medicine has more than a biochemical aspect was scorned as falling into supernatural healing powers, ghosts and other unscientific concepts. Whitehead and colleagues maintain that the efficacy of homeopathy is implausible, and its use is unethical.
Gray (2017) proposes that in any discussion of the ethics of prescribing homeopathic medicines, the question should not be whether it is ethical to recommend unproven therapies but rather proposes that the ethics of concern are the domination of the medical paradigm over other cultural truths regarding healing. Cultural competence is therefore just as important as evidence based practice, and a care provider should consider the potential positive aspects of alternative therapies such as homeopathy from this perspective.
Complementary medicines do not fit well into the framework for medicine, however they may hold an appropriate position in the provision of health care treatments and interventions. Homeopathic treatments have as their strength their association with meaning attribution and a patient’s wish for individualized attention during consultation. This, rather than the medicine itself, is hypothesized to be an important aspect of successful treatment. There are strong psychosocial aspects to the idea of and implementation of homeopathic medicines, along with little guidance for the medical care provider regarding its use and efficacy. To that end, unless a practice such as homeopathy is shown by evidence to be harmful, nurse practitioners should not stand in the way of patients seeking complementary therapies such as homeopathy. Belief is a subjective and personal part of an individual’s worldview. I would not recommend homeopathy, I would want patients who are using homeopathy to feel that they could have an open communication about their use of homeopathy and the impacts they feel that it has on their symptoms and their health.
- De Beukelaer, E., Renoux, H., Nicolai, T., & Tournier, A. (2017). Veterinary homeopathy: a defence. Veterinary Record, 181(17), 456-457.
- Gray, B. (2017). How should we respond to non-dominant healing practices, the example of homeopathy. Journal of bioethical inquiry, 14(1), 87-96.
- Hahn, R. G. (2013). Homeopathy: meta-analyses of pooled clinical data. Complementary Medicine Research, 20(5), 376-381.
- Haresnape, C. (2013). An exploration of the relationship between placebo and homeopathy and the implications for clinical trial design. JRSM short reports, 4(9), 2042533313490927.
- Levy, D. C. (2014). Does the weight of evidence signal the end of homeopathy?.
- Offit, P. A. (2013). Do you believe in magic?: the sense and nonsense of alternative medicine. Harper Collins.
- Wertheimer, A. I., & Brentson, F. A. (2014). Homeopathic medicine should have a role in managed care. Managed care (Langhorne, Pa.), 23(11), 38-42.
- Whitehead, M., Chambers, D., Lees, P., Pelligand, L., Toutain, P. L., & Whiting, M. (2017). The authors of ‘Comparison of veterinary drugs and veterinary homeopathy: part 1 and 2’, respond. Veterinary Record, 181(17), 457-458.
