Reinventing the wheel will not make it rounder: controlled trials of homeopathy reconsidered

Attitudes to evidence in acupuncture: an interview study

The use of complementary and alternative medicine is increasing in the Western world. However, there is no clear evidence of effect of alternative therapies. Moreover, there is no consensus between practitioners and researchers as to the right way of assessing the efficacy of alternative therapies. To investigate practitioners' perspective on evidence and ways of assessing efficacy twelve in-depth interviews were conducted in Denmark with acupuncturists, including physicians practising acupuncture, acupuncturists with a health-related background, and acupuncturists without a health-related background. Two themes predominated the study, first, the interviewees' general reflections on how it is possible to establish knowledge about an effect of acupuncture; and second the interviewees' reflections on the use of randomized controlled trials in acupuncture, including obstacles and alternatives to conducting randomized controlled trials. Further, two conceptions of what constitutes evidence were identified: a biomedical conception and an experience-based conception. Most interviewees were sceptical about the use of randomized controlled trials in acupuncture. Two reasons, especially, were given for this scepticism. First, practical and instrumental reasons concerning the specific elements of the randomized controlled trial or relating to limited resources; and second, value-based reasons are concerning the nature of acupuncture. However, the interviewees were really opposed only to a certain kind of randomized controlled trial, the so-called explanatory trial. They would actually welcome a pragmatic trial. The study gives valuable insight into an under explored field and provide a platform for further investigation, and a better informed discussion of the subject.

The biopsychosocial model and its potential for a new theory of homeopathy

Since the nineteenth century the theory of conventional medicine has been developed in close alignment with the mechanistic paradigm of natural sciences. Only in the twentieth century occasional attempts were made to (re)introduce the 'subject' into medical theory, as by Thure von Uexküll (1908-2004) who elaborated the so-called biopsychosocial model of the human being, trying to understand the patient as a unit of organic, mental, and social dimensions of life. Although widely neglected by conventional medicine, it is one of the most coherent, significant, and up-to-date models of medicine at present. Being torn between strict adherence to Hahnemann's original conceptualization and alienation caused by contemporary scientific criticism, homeopathy today still lacks a generally accepted, consistent, and definitive theory which would explain in scientific terms its strength, peculiarity, and principles without relapsing into biomedical reductionism. The biopsychosocial model of the human being implies great potential for a new theory of homeopathy, as may be demonstrated with some typical examples.

Evidence and simplicity: why we should reject homeopathy

Homeopathic medications are used by millions, and hundreds of millions of dollars are spent on these remedies in the USA alone. In the UK, the NHS covers homeopathic treatments. Nonetheless, homeopathy is held in considerable disrepute by much of the medical and scientific community. Many proponents of homeopathy are well aware of these criticisms but remain unimpressed. The differences of opinion run deep, and the debate seems deadlocked. We aim to shed some light on this situation. We briefly recap some of the major arguments on each side, but we try to go further by making explicit an underlying philosophical presupposition. In particular, we will claim that there is an important principle, which has ancient roots going back at least to Occam, some version of which constrains all empirical reasoning. We call this constraint the simplicity principle. We argue that this is not something specific to a scientific paradigm, but that, all of us, including proponents of homeopathy, are themselves deeply committed to the simplicity principle. However, once the simplicity principle is made explicit and applied to homeopathy, allegiance to homeopathy is clearly seen as irrational. The point is not merely the lack of clinical trials supporting homeopathy; rather, belief in the efficacy of homeopathy leaves a mountain of unexplained mysteries, and thereby flies in the face of the simplicity rule that guides the homeopaths' own reasoning and arguments. If nothing else, we hope that defenders of homeopathy will gain a greater understanding of why critics are so deeply reluctant to accept the efficacy of homeopathic interventions - and that this reluctance is not mere stubbornness or artificial allegiance to western medicine. Finally, we also hope thereby to illustrate the usefulness of philosophy in unearthing presuppositions in seemingly deadlocked debates.

Resonance, Placebo Effects, and Type II Errors: Some Implications from Healing Research for Experimental Methods

BACKGROUND

Classical experimental design presupposes that subjects, randomly separated into experimental and control groups, are independent and distinct. Treatments given to the experimental group ought to have no effect on the control group, which functions as a baseline to illustrate "what otherwise would have happened." Any change in the control group is often labeled an "anomaly." Examples of these types of anomalous phenomena can be found in placebo research, which often shows proportional unexpected and unexplained changes in control subjects. In four previously reported experiments on anomalous healing using "healing with intent" on mice injected with lethal doses of mammary adenocarcinoma (source, The Jackson Laboratories, Bar Harbor, ME; code, H2712; host strain, C3H/HeJ), a high percentage of both experimental and control mice exhibited an anomalous healing pattern, most often passing through stages of tumor ulceration to full life-span cure.

OBJECTIVE

In order to explain tumor regression of control animals, I posit the formation of "resonant bonds," which can link spatially separate groups. Healing given to the experimental animals can result in an unintended treatment to the control animals, producing anomalous healing akin to placebo effects.

MATERIALS AND METHODS

A recently completed experiment at the Terre Haute campus of the Indiana University School of Medicine has produced a successful test of resonance theory. One group of mice (n = 30) was injected with mammary adenocarcinoma cells and randomly divided into a treated group (n = 15) and untreated control group (n = 15). A second group of age-matched controls (n = 25) was left uninjected. Mice from each group were intermittently sacrificed to measure hematologic values and spleen weight.

RESULTS

As predicted by resonance theory, there were few differences between treated and untreated animals from the first group, but there were significant differences between these animals and the age-matched controls.

CONCLUSIONS

Some implications for placebo research and the way we normally conceptualize Type II errors will be discussed. Researchers are invited to reanalyze past data in light of resonance theory.

Generalized Entanglement: A New Theoretical Model for Understanding the Effects of Complementary and Alternative Medicine

BACKGROUND AND PROBLEM: A main problem for the acceptance of many methods belonging to the broad spectrum of complementary and alternative medicine (CAM) is that there is no conceivable theoretical bridge between the mainstream biomedical model and CAM theories and practice. Although empirical evidence is one important side of the coin of credibility, theoretical feasibility is the other. History of science teaches that no amount of empirical evidence will convince sceptics and followers of more conventional paradigms as long as there is no good theoretical model to make empirical findings plausible.

METHODS AND SOLUTION

I therefore propose to broaden the spectrum of theoretical concepts beyond the reigning local-causalist model toward a non-local model that encompasses effects as encountered in CAM. Such a model can be derived from a generalized and weaker version of quantum theory recently developed and published by my colleagues and I as weak quantum theory (WQT). This theoretical model predicts nonlocal correlations analogous to Einstein-Podolsky-Rosen (EPR)-like correlations in quantum mechanics proper. The discerning moment, though, is that these nonlocal correlations within WQT are not EPR correlations postulated to extend into the classical world, but a broader, generalized version of entanglement not dependent on the strict quantum nature of the system under question. WQT predicts entanglement between elements of a system if two variables or observables are complementary: one describing a global and one the local aspects of the system. Entanglement then ensues between those local elements of a system that are complementary to the global description or observable of that system.

DISCUSSION AND CONCLUSIONS

This paper explores this rather abstract and general notion and expands it into more concrete examples. It is at the moment a purely explanatory structure, which, however, lends itself to exact empirical testing due to rather precise predictions, which will be developed. Because this structure of generalized entanglement is ubiquitous and also operative in conventional medicine, and because it is derived from one of the strongest theories that science has developed so far, it would constitute a theoretical bridge between the different medical and scientific traditions.