Death by Homoeopathy

It’s been too long, I know, but I promise that I’ll be picking things up and posting regularly from this point forward.

So let’s get down to business by starting with story that’s particularly dear to my heart, that of Simon Singh’s valient efforts to defend the principle of evidence-based medicine against not only a wholly misconceived libel action brought by the British Chiropractic Association but also a wholly perverse ruling on the meaning of the word ‘bogus’ by the Daily Mail’s least favourite judge, Mr Justice Eady.

Needless to say, I fully support both Simon and Sense About Science’s campaign to keep libel laws out of science and would heartily recommend that you add Jack of Kent to your RSS feed reader as by the far the most comprehesive source of information on this vitally important case.

Also definitely worth reading, if only a preface to what will shortly follow, is this article by the excellent Gimpy on a spectacularly snide attempt by the ‘Homoeopathy Worked For Me‘ website – which is operated by a registered charity called (laughably) ‘Homoeopathy: Medicine for the 21st Century’ (H:M21C)- to use the BCA’s action against Singh to discredit his (and Ezzard Ernst’s) evaluation of homoeopathy in ‘Trick or Treatment‘, which I’ve now (finally) got around to reading and can happily recommend.

Dismal as this site is, one of its sections, which purports to ‘debunk’ the  ‘myths’ surrounding homoeopathy caught my eye, not least because there’s at least one page in that section that is now desperately in need of amendment:

Myths about homeopathy 8:

“Homeopathy kills people”

This is a very new myth, and is literally impossible. Since the remedies stimulate the body’s own healing processes, their action is precisely opposed to that of fatal illness. What is actually meant – is that homeopaths prevent or delay the use of “real” medicine, leading to a patient dying sooner than they might have done. In other words it is simply the argument that homeopathy is ineffective, dressed up in a more dramatic and particularly aggressive form. Only hypothetical evidence is ever produced to support this myth, since the truth is that generally patients come to homeopaths AFTER conventional treatment has failed, rather than before conventional treatment.

The truth is that even in the teeth of death, when nothing can be done to stop what is happening or to extend life, homeopathy can still give relief and dignity to a person’s last moments.

Perhaps they’d like to explain that bit about ‘only hypothetical evidence’ ever being put forward in support of the argument that some people delay/shun conventional (i.e. evidence-based) treatment in favour of their little sugar pills to little Gloria Thomas of Sydney, Australia…

…or maybe because, because Gloria sadly died in May 2002, at the age of only 9 months, of sepsis arising out of an eye infection that would not have proved fatal had her parents not relied on homoeopathy to treat the child’s eczema.

Only last week, a court in Sydney found Gloria’s parents, Thomas and Manju Sam, guilty of the manslaughter of their child by gross criminal negligence.

This is, by any standards, an horrific case.

According to evidence given at trial, Gloria developed eczema at the age of four months, most likely as a result of having inherited the condition from her mother. In the five months that followed, until her untimely and wholly unnecessary death, was taken to a number of genuine healthcare professionals in Australia and in India but, on each occasion, was swiftly withdrawn from conventional medical treatment at the insistence of her father, who is himself a homoeopath, until she was eventually treated by Thomas Sam’s brother – also a homoeopath – who, according to the report in the Sydney Morning Herald, has recent completed a dissertation on the homoeopathic treatment of eczema.

(Unfortunately, in India, homoeopathy is given more or less equal status with conventional medicine).

On finally being admitted to hospital, in Sydney, with the eye infection that ultimately proved to be fatal, Gloria was found to severely malnourished with infections to the eye and skin of such severity that her cornea was found, on examination, to be ‘melting’ while a succession of doctors testified to the court that the condition of her skin was unlike anything they has seen before. At the time of her death, the court was told, Gloria was the weight of an average three month old baby, her skin was unnaturally pale and her hair had turned completely white (both her parents areof Indian descent). The forensic pathologist who examined Gloria’s body found that the child was so severely malnourished that her immune system was been compromised and her thymus gland has shrunken, having previously been perfectly normal.

Within the SMH report of the parent conviction there are two passages, in particular, that should give any rational human being serious pause for thought.

During the course of the trial, the Sam’s defence lawyer told the court that the Sams had been ‘devoted but misguided parents’ whose conduct fell short of gross criminal neglience before adding, without any trace of irony, that none of the healthcare professionals that the couple had consulted – conventional or homoeopathic – had warned them that the child’s condition could imperil its life. This should hardly come as any kind of surprise as, ordinarily, people do not die as a result of eczema – or, to be more precise, people do not die of secondary infections arising out of a skin condition, such as eczema, if that condition is properly treated and their immune system is not impaired by severe malnutrition.

Doctors, by and large, do not warn patients that a particular condition may be life-threatening if, in all but the most extreme situations, it isn’t and shouldn’t be, life threatening.

The SMH also reports, however, that after his daughter’s death, Thomas Sam told the polices that…

“Conventional medicine would have prolonged her life … with more misery. It’s not going to cure her and that’s what I strongly believe.”

…a statement that strongly echoes H:M21c’s assertion that…

“The truth is that even in the teeth of death, when nothing can be done to stop what is happening or to extend life, homeopathy can still give relief and dignity to a person’s last moments.”

Incurable does not, however, mean untreatable and the truth is that eczema is an eminently treatable condition.

While it cannot be cured, other than in the case of seborrhoeic dermatitis (which is known as ‘cradle cap’), it can be readily managed using anything from simple moisturisers through to anti-histamines, corticosteroids and immunomodulators, with antibiotics used to deal with relatively rare cases in which a bout of eczema results in a secondary infection. Eczema is, for most sufferers, a nuisance condition. It can be extremely uncomfortable and unpleasant when it flares up, even debilitating in the most severe cases, but it isn’t, in itself, life-threatening.

It resulted in a fatal infection in this case, only because Thomas Sam chose to deny his child the medical treatment she needed in order to treat her with woo.

Death by homoeopathy, or to be more precise, death by negligent disregard for an individual’s well-being and best interests arising from a misbegotten belief in the efficacy of sugar pills, is no myth and no hypothesis. It is, as the sad death of Gloria Thomas demonstrates, a very real and tragic phenomenon albeit one that we rarely see in the developed world where, thankfully, conventional, evidence-based medicine is very much the norm and almost always on hand to step in and save the day.

In the developing world, where homoeopaths and other woo merchants routinely – and without any effective safeguards or restraints – peddle their pills, potions and lotions as treatments, and even cures, for conditions such as malaria and AIDS, such deaths are a commonplace occurrence, albeit one almost entirely hidden from Western eyes, and one cannot help but agree with David Colquhoun‘s glossary definition of so-called ‘alternative therapists’ of this ilk:

Any alternative “therapist” who claims to cure Aids or malaria – Agent of culpable homicide.

If you have any doubts at all as to the merits of supporting Simon Singh and the singular importance of defending free speech and the free exchange of scientific ideas, evidence and opinion from the depredations of England’s reprehensible libel laws then consider carefully the sorry state of affairs that resulted in the tragic death of Gloria Thomas and understand that are people out there who don’t want you to hear the truth about so-called alternative ‘therapies’, people who will happily resort to the law to keep you in ignorance of the facts and, most importantly of, of the evidence.

  • Peter Traynor

    A good article with some good points. However, a couple of foolish and tragically misguided individuals do not a robust argument make. To give an example – Dr Crippen was a homeopath who murdered his wife…but that does not mean his wife was killed by homeopathy. Indeed, his wife was killed with scopolamine, used in coventional medicine…but this does not mean that conventional medicine killed her either. It was Dr Crippen’s murderous intent that did for her, just as it was the misguided efforts of several people who should have known better that did for ‘liitle’ Gloria Thomas.

  • http://www.surreptitiousevil.com Surreptitious Evil

    @Peter Traynor – But, Peter, you are entirely missing the point. Outside of the placebo effect, homeopathy does not do anything. If there is nothing wrong with you, therefore, I’d agree that homeopathy is no less dangerous than, say, tabloid astrology – it encourages a hideous anti-scientific mindset in the most gullible of society to the grievous damage of us all – but it isn’t actually going to kill you – it is just water.

    On the other hand, as Unity so pointedly demonstrates, if there is something wrong with you then not taking effective treatment because you are indulging in homeopathic remedies (i.e. water or sugar) can lead to the disease or condition getting much worse and even to death.

    None of the Thomas’s, as far as we know, set out to kill Gloria. They were using what they negligently thought was a “treatment”. It wasn’t and isn’t. It is woo. Completely and utterly ineffective.

    I am a Christian. I am a trained first aider. If you are unfortunate enough to crash your car and I come across you bleeding profusely, would I be negligently guilty if I prayed with or over you rather than tried to stop the bleeding? Not sure of the legalities of it but morally? Certainly. Even if you were also devout and the prayer made you feel much better as you slowly bled out.

  • Peter Traynor

    Sorry Surreptitious Evil, you are missing the point – at no point did I try and defend homeopathy, or refute the claims made against it, nor did i suggest that the Thomas’s family tried to kill her. I merely suggested that Unity’s argument and the example he used was as specious as he claims the arguments for homeopathy are.

  • http://www.ministryoftruth.me.uk Unity

    Peter:

    Perhaps I should clarify my position here.

    The argument against homoeopathy, generally, is one of science, i.e. the fact that there is no trace of active ingredients in any homoeopathic ‘remedies’ and no scientific basis to any of the claims made for its efficacy beyond those of a placebo.

    What I’m specifically rebutting here is H:M21C’s contention that the argument that some believers in homoeopathy delay or refuse conventional treatment to the clear detriment of their own best interests and well-being is merely hypothetical.

    In the circumstances, the sad case of Gloria Thomas most aptly satisfies William James’ classic ‘white crow’ test and, as such, I consider that my argument stands.

  • http://yorksranter.wordpress.com/ Alex

    If you are unfortunate enough to crash your car and I come across you bleeding profusely, would I be negligently guilty if I prayed with or over you rather than tried to stop the bleeding?

    In France, “non-assistance to a person in danger” is a criminal offence (the paps following Princess Diana’s car were charged with it for taking photos rather than calling an ambulance), and I think that would be just about a classic case of it. Similarly, the Thomases would certainly have risked prosecution under it.

    I’ve always found that a very strange piece of legislation; how far do you have to go to be certain of satisfying your implied duty to assist anyone in danger you encounter?

  • Pingback: Ass (as in donkey) « Brain Dump

  • http://www.surreptitiousevil.com Surreptitious Evil

    @Peter Traynor – Ah, so;

    “Dr Crippen was a homeopath who murdered his wife,” and “the misguided efforts of several people who should have known better that did for

  • the a&e charge nurse

    Authorities like Ben Goldacre (in Bad Science) characterises the Cochrane library as one of the most important developments in 20th centuary medicine.
    http://www.cochrane.org/reviews/

    While medics are increasingly trying to align practice with the evidence (where such evidence exists).
    http://ebm.bmj.com/

    I AM ASTOUNDED that anybody should regard this anything but the most effective approach and any individual (or agency) that seeks to undermine it threatens us all.

    Incidentally eczema can lead to significant complications as this paper illustrates.
    http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1292209&blobtype=pdf

    To my mind the case highlighted by Unity suggests that important child protection issues have been overlooked while obtaining health care from a largely unregulated market is also fraught with risk – especially when services are commissioned on behalf of vulnerable groups such as children.

  • Pingback: Virtual stars go kaboom on cue at claiborne

  • http://nourishingobscurity.blogspot.com/ jameshigham

    Glad you’re back.

  • http://blog.matthewcain.co.uk Matthew Cain

    Sorry it’s off topic but I thought this concept may help with your blog. The Bloggers’ Circle is a collaborative effort to increase the amount of debate your best posts attract. There’s more information here and it’s be great if you’d consider joining: http://blog.matthewcain.co.uk/blogging-circle-is-developing/

  • Keith
  • http://kochanski.org/blog G

    Since the UK is the best place in the world to sue people for libel, and this is an article that might get some homeopaths rather upset, you might want to protect yourself from their ire by making the article unavailable in the UK.

    How? Well, fortunately, the Computer Misuse Act 1990 specifies penalties – even prison time – for accessing a computer without authorization. Presumably, all you need to do is write that “Residents of the UK are not authorized to access these web pages. Violators may be subject to the Computer Misuse Act 1990.”