Ethical dilemma: Is homeopathy ethical?

"Madam,

I am an evidence-based health professional. There is no evidence to suggest that homeopathy is effective at treating anything. As such, I am unable to recommend homeopathic products for the treatment of any condition. May I ask why you have a lack of trust in pharmacy products..."

We would then have a long chat in which I would try to assuage her fears about 'conventional' medicinal products and if that failed to convince her and she still wanted to purchase a homeopathic remedy I would direct her to a major multiple pharmacy chain who have a Professional Standards Director who is on-record as stating that his company stocks these products - without any evidence of their efficacy - because they sell (should such a thing exist *ahem*).
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Are there any proven homeopathic remedies for life threatening conditions?

It is not too difficult to work out which pharmacist the patient is more likely to take notice of. Unfortunately, we need to realise that it is not what we believe that matters, but in order that patients can have confidence in us, we need to listen to them rather than preach. There are occasions where it might be appropriate to pompously proclaim how clever we are and how important science is, but hayfever is unlikely to be one of them.

Even though they are not recommended, checking that the patient is not on any medication that can interact with the stocked homeopathic remedies. I would give all the information i could to the patient about the products so the patient can make a informed choice.

The idea of a 'conventional' medicine interacting with a homeopathic remedy is scientifically implausible.

I think I might have not been too clear earlier. Again, I agree with what your saying and in my conversations with customers in these situations is to present medication with clear cut evidence of efficacy first. If however, after informing and educating customers on these conventional remedies, they insist on alternatives for whatever reason, be it a placebo, then its clearly their own rightful decision. I think no matter how hard you try with evidence-based medicines with some, you will never be able to change their minds.

In such cases, i believe i won't be classed as exploiting customers or making a quick profit although you've steered the conversation towards it so i'll make a last comment:

Regarding desperate customers looking for hope in alternative medicine if for example their prognosis is not very good in terminal cancer patients or they've been diagnosed with ovarian failure..etc, i would never quash any hope they might have by blurting out "evidence-based weaknesses" of such treatments like acupunture, reflexology homeopathy..etc- thats my own personal view!

Good man rahul. Don't let the internet commenters drag you down!

Promised myself I was going to engage in this 'debate' any more but I can't resist replying to this one.

Right, if you're attempting to make a case for the efficacy of homeopathy it would probably be advisable to link to credible sources rather than linking to an organisation with the aim of promoting homeopathy. For example, the Cochrane Collaboration is the 'gold standard' organisation for the provision of information about the effectiveness of healthcare. They have published a raft of systematic reviews examining homeopathy none of which have suggested that it is more effective than placebo.

I do not dismiss homeopathy out of "personal disdain". That assertion is laughable. I dismiss it because it's implausible bunkum without a shred of evidence to support its use.

You go on to say "most of our little army of OTC products have less evidence than homeopathy in their use". That statement is demonstrably false. If you genuinely believe that there is 'more' and better evidence to support the use of homeopathy than the use of paracetamol, ibuprofen, aspirin, clotrimazole, hydrocortisone, aciclovir, lactulose, potassium citrate, loperamide, loratadine, cetirizine, omeprazole, ranitidine, mebeverine, hyoscine, malathion, diclofenac, fluconazole and promethazine then maybe you need to modify how you interpret evidence.

PS: You raised the issue of OTC preparations for cough. I agree. The evidence to support their use is absent. Ergo, I think pharmacists should refrain from supplying them also.

PPS: Again, I find the notion that articulating the fact that there is a lack of evidence to support the use of homeopathy means you are preaching or "holier than thou" disingenuous. In fact, seeing as a belief in the efficacy of homeopathy is based on blind faith I would argue that the proclamations of homeopathy supporters are much more akin to 'preaching' sermons.

This article obviously raises some issues as to where we stand as health professionals in regards to an evidence-based approach to treating hayfever.

I do agree that the evidence-base for homeopathic hayfever remedies is almost non-existent and therefore we should make the decision, using our knowledge and skills, to back credible sources of evidence i.e. randomised and placebo-controlled trials such as cochrane reviews which DO provide evidence for the use of OTC hayfever products. It may be an idea to find out why she "doesn't trust" pharmacy products. You might be able to change her mind.

But at the end of the day the decision to buy is with the customer. We can only give our best professional advice on the matter. Having failed to convince her, if she wants a homeopathic remedy to treat hayfever then she can have one.

the customer is always right, right?

Ahem:
http://www.telegraph.co.uk/health/alternativemedicine/8913820/Little-pill-big-trouble.html
quote: And yet the sceptics are wrong when they say there’s “no evidence” for homeopathy. There is evidence. But there’s much better evidence that says it doesn’t work.

Looks like you made the mistake here gavin.

As far as I am aware - if you have read the systematic reviews and do not believe in the concept of homeopathy, then you are a crook to sell such a product, knowing that it will not work, will prolong the patient's symptoms, and pocket you some profit as well.

Thanks Joe honestly no hard feelings at all. James