Wednesday, February 8, 2017

Russian Academy of Sciences Calls Homeopathy Pseudoscience

Despite our many political differences, here is one topic about which the United States and Russia should be able to completely agree – homeopathy is pure pseudoscience. In fact Russia may have just taken the lead on this topic.

The Commission Against Pseudoscience and Falsification of Scientific Research of the Presidium of the Russian Academy of Sciences just published a memorandum (“№2”, so I assume it is only their second) called: “About pseudoscientific homeopathy.” (It’s in Russian but just hit the Google Translate button.) Like the UK and Australia before them, members of the commission reviewed all the evidence regarding homeopathy and concluded:

The Commission argues that the treatment of ultra-low doses of various substances used in homeopathy has no scientific basis. This conclusion is based on a thorough analysis of publications in scientific journals, clinical study reports, compilation and systematic reviews. The Commission confirms that the principles of homeopathy and theoretical explanation of the mechanisms of its alleged actions contradict the known chemical, physical and biological laws and convincing experimental confirmation of its effectiveness are not available. Homeopathic diagnosis and treatment should be qualified as pseudoscientific.

In other words, homeopathy cannot possibly work, and when studied it does not work. How many scientific organizations around the world have to come to this conclusion before governments wake up and do their job?

That homeopathy is pure pseudoscience is not news. Its basic principles are essentially magic, and the preparation of homeopathic products is indistinguishable from brewing a magic potion. Its two core principles, as the commission states, are a priori dogma – that like cures like, and that diluting substances out of existence leaves behind their magical essence. Science has progressed over two centuries since these ideas were invented, and they remain just as much pseudoscience as they every were – more, in fact, because the more we learn about chemistry, biology, and physics the less plausible homeopathy becomes.

Before I get into the details of the commission’s specific recommendations, let’s take a moment to notice that there is a Commission Against Pseudoscience and Falsification of Scientific Research in the Russian Academy of Sciences. How wonderful is that? Mainstream scientific organizations need to realize that promoting science and countering pseudoscience go hand-in-hand. You can’t really have one without the other. Understanding and combating pseudoscience as a systemic cultural issue, however, never seems to be on the radar of such organizations.

The American Academy for the Advancement of Science (AAAS) and the National Academy of Sciences (NAS) do not have such commissions, but they should. They put together panels on scientific integrity and may tackle issues one at a time, but there is no central coordinated effort to combat pseudoscience as a phenomenon. The Russian Commission’s memorandum on homeopathy is an excellent example of why there should be.

Specific Recommendations

Each nation has its own regulation infrastructure, and so exactly how such recommendations are implemented (by which agency) will vary, but the details could apply anywhere. The commission’s recommendations are aimed at their Ministry of Health. They state that the adoption of homeopathy as part of the standard of care 20 years ago was undertaken without any systematic review of the scientific evidence. This error should be corrected by excluding homeopathy from any updates to the standard of care.

Their recommendations for labeling homeopathic products are interesting, and may even be a template for the FDA, which is currently reviewing its own regulation of homeopathy. First, they state that homeopathic products should be clearly labels as homeopathic. Any homeopathic preparation that is C12 or greater (“C” means a 1 to 100 dilution, so C12 is such a dilution 12 times) would likely leave behind no original ingredient. Therefore, they argue, such substances should not be included in the list of ingredients. That makes perfect sense. Therefore the ingredients list would include only things like water and sucrose which are actually in the final product.

For substances diluted out of existence, they suggest a separate list labeled “Used in preparation.” This can still cause some confusion, in my opinion, but at least they will not be listed as “ingredients.”

Further they recommend that products be monitored to make sure they do not contain actual active ingredients and are bypassing regulation by labeling them “homeopathic.” This is also a good idea, especially in light of recent events, such as the FDA warning about homeopathic teething products containing dangerous levels of belladonna.

They further recommend that products cannot advertise that they have medicinal properties that are not proven. This is similar to the recent FTC decision regarding homeopathic product labeling.

Finally, they specifically recommend that doctors be trained in popular medical pseudoscience and what the scientific evidence says about them. This way doctors will be better able to inform their patients who might inquire about such products.

All of these recommendations are spot on. I will note that while all of these measures will be positive, there is one measure that would be even more elegant and effective – simply ban the sale of homeopathic products. Homeopathy is fake medicine. Its sole reason for existing is to defraud the public by making or implying false medical claims for a completely worthless and inert product. (At best it’s inert, and sometimes may actually contain potentially harmful substances.)

Regulatory agencies are otherwise playing a game with the homeopathy industry. You can nibble away at homeopathic products by requiring accuracy in labeling, and evidence before making clinical claims. In the end, if product labeling was fully accurate and devoid of statements which mislead the public, what would you have? You would have a product without any active ingredients and without even the implication of any medicinal effect. Sellers will try to sneak by with statements and caveats, but the bottom line is that they will continue to do their best to deceive the public while regulatory agencies try to box them in.

As the FTC recently affirmed, the purpose of the agency is to protect the public from fraudulent health products. There is no such thing as a homeopathic product that is not a fraudulent health product, because there is no legitimate use of such products. Even if the package were thoroughly stripped of any misleading claims, the industry would still generate demand for their fraudulent products in other ways, such as through testimonials on websites.

I understand that the real issue here is consumer freedom – although it’s really about the freedom of an industry to sell a fraudulent product with misleading claims. The consumer is only free to waste money and potentially harm their health. The dance that regulatory agencies are doing is maintaining consumer freedom and choice while creating the illusion of proper regulation. Listing a substance as “prepared with” rather than an actual ingredient may be technically more accurate, but I doubt it will have a significant impact on the consumer.

As Daniel Patrick Moynihan is quoted as saying, “Everyone is entitled to his own opinion, but not his own facts.” That homeopathy cannot and does not work is a well-established scientific fact about which there is deep scientific consensus. Doctors don’t get to make up their own medical facts. They have to practice according to the evidence-based standard of care. Engineers don’t get to use “alternative theories” when designing a bridge. Public schools should not be able to teach whatever they think is science. Industries don’t get to make up their own facts about their products. That’s called fraud.

Where the science is uncertain, there is room for opinions. There is no uncertainty about homeopathy. Any other conclusion is science-denial, and not just denial of the clinical evidence that shows homeopathy doesn’t work, but of vast areas of basic science across several fields. To deny this conclusion is to deny the scientific enterprise itself.

As a society we should listen to the scientific community and act accordingly. All that is lacking here is the political will. This latest statement from the Russian Academy of Sciences adds to other similar reviews and statement, and hopefully we are inching closer to that political will.


Russian Academy of Sciences Calls Homeopathy Pseudoscience Steven Novella

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