The author of this article is Senior Lecturer for Health & Food Science at the University of Abertay Dundee, United Kingdom, teaching and researching in the related areas of genetics and bioethics. His research interest is encompassing GM food, gene therapy and genetic enhancement, and he is raising his voice for a change in legislation to give patients the option of ending their lives in dignity and freedom from suffering.

In his article Smith turns against homeopathy as follows:

1. 19th century formula:

a. He quoted the basic principles of homeopathy incorrectly by formulating 2 (law of similars [not similarities] and remedy proving or pathogenetic trial [not law of infinitesimals]) instead of 3 (Anamnesis) principles of homeopathy.

b. Smith misconceived the production of a homeopathic remedy by describing a D-potency, not marking it as an example. Moreover, the author seems “to expect” an increase in effectiveness although it is implausible for him. The wording is quite misleading and confusing.

2. Homeopathic Research:

a. Smith claimed that clinical trials were not carried out through randomized and double-blind studies by enrolling a large number of people in a group trial. In contrary, it was observational, individual and suggestible and therefore not meeting the actual gold standard.
In this context it is referred to the current test procedure in clinical trials: in phase 1 the new medication is tested on human beings (20 – 30 participants) for the first time after animal test series (no findings of toxicity and bio-kinetics on human beings is yet known!). No 2 is the dose finding phase with more than hundred participants. In phase 3 a placebo group is part of the testing, mostly (!) randomized. Phase 4 is the adverse reaction stage. The pharmacovigilance is not known and will be detected/corrected during its usage. To state it more precisely: dying after taking a simple cough medicine (Tussionex, in Germany Dicodid/ Polaronil or Wick® Formel 44 Husten-Stiller and in Ratiopharm® Hustenstiller-Kapseln), get an inflamed bowel or depression after using an acne remedy (Accutane), having birth defects in children (Accutane, Contergan) getting stomach pain as a side-effect after taking a drug against stomach pain (many of them), having a lethal heart problem after taking painkillers (Darvocet, Germany Darvon), obscenely expensive cancer remedies with no long-term effects on the patients (Avastin), or Mylotarg being associated with death while having no effect against leukemia.
Homeopathic remedies are tested on human beings since 200 years with no animal torture and no side-effects. Current test series in homeopathy are meeting the scientific gold standard and generate reproducible results, especially in the fields of asthma, sinusitis, influenza, and cancer. The author postulated rigorous trials for conventional medicine and considered it ethically unacceptable for homeopathy based on low likelihood of obtaining patient-benefiting results. This is contradictory to his former arguments.

b. Smith expresses his concern on the low-ranking journals, which is incorrect as homeopathic journals are peer-reviewed, and frequently flawed meta-analysis by quoting Edzard Ernst constantly. However, this author is interesting to read but certainly not the sole source for solid and justified arguments.

3. Placebo effects/Autonomy:
Smith tried to lay down that homeopathy is

a. equal to placebo (are most effective for short-term and less effective or ineffective “for conditions with a profound pathological basis”)

b. misleading patients (causing patients to believe an untruth)

c. ethically unacceptable

d. and to limit the patients “freedom to choose homeopathy . .. [as] conceptual possibility”.
At this point the article becomes pathological and requires a consequent scientific demonstration!.

Ad a: The placebo effect is one of the most widely used and familiar terms within science and medicine, yet it is not always clear just what is meant by a placebo effect. Though we might describe a placebo effect as being 'all in the mind', we now know that there is a genuine neurobiological basis to this phenomenon. In recent years the knowledge of the neural bases of the placebo effect has developed markedly resulting in a far better understanding of how it can influence both the course of a disease and the response to therapy.
Positive placebo responses have been reported in a number of PD trials, complicating the interpretation of efficacy results. These findings make interpretation of potential efficacy of an experimental treatment in an open-labeled study design extremely difficult and also raise the barriers for the design and interpretation of placebo-controlled trials in PD. Furthermore, as is the case with other diseases, the underlying basis for the placebo response in PD patients is poorly understood.

Ad b/c: It is a demonstration of disdainfulness of the author to believe that patients need restrictions and guidance. Stretching this to its extent means, the author’s hobby (windsurfing in the North Sea) should be considered as extreme unhealthy and therefore ethically unacceptable.

Ad d: If homeopathy is equal to nil (it is no placebo as laid down above), patient do not need any protection from authors like Smith and others.
Summarizing it can be stated that the author did not provide substantial new facts; in contrary he repeated old arguments and tried some “hoodwinking”.

Karin Thieves