Tuesday, April 13, 2010

Witch doctors should be available on the NHS

One of my relations wrote to his MP opposing the MP's position on funding homeopathy through the NHS. Here's the interesting bit of the MP's reply:

Thanks for your e-mail. There are many people who consider that homeopathy is beneficial to them, and would thus disagree with both the Committee's conclusions and the view you express. In the grand scheme of the billions spent by the NHS, the cost of homeopathy is small - and if people sense that homeopathy is helping them get better, then that is sufficient reason why I think the present arrangements should continue.

It's instructive to reread this email with homeopathy replaced by witch doctors.

Thanks for your e-mail. There are many people who consider that witch doctors are beneficial to them, and would thus disagree with both the Committee's conclusions and the view you express. In the grand scheme of the billions spent by the NHS, the cost of witch doctors is small - and if people sense that witch doctors are helping them get better, then that is sufficient reason why I think the present arrangements should continue.

6 comments:

Confusion said...

I sympathise with the MP. One can consider 'witch doctors' and their ilk to be psychologists who operate under a false identity, to enable their clients to reap the full benefits of the placebo effect and a listening ear. As long as their services are not a replacement for regular medicine and the 'alternative' practitioner actively forwards his clients to regular medicine, then I see no harm in their services and indeed think they benefit the health of the general population.

JTresidder said...

@Confusion: You've never heard of a patient refusing *actual* medicine in favour of some voodoo or other?

No matter, you can catch up with specific examples of real harm at http://whatstheharm.net/

The first entry in the homoeopathy section - just to get you started - is a woman who was advised by a homoeopath to give up her asthma medication and subsequently died from an asthma attack.

Confusion said...

@JTresidder:

We should not throw away the baby with the bathwater. You can't generalize across witch doctors, just like you can't generalize across regular medicine. There is fodder to wipe the floor with parts of regular medicine and yet we still feel it is largely beneficial. Hell, half of the research on the 'regular' medication I take seems to show it shouldn't actually work.

I know several people that benefit from 'alternative' healthcare. I don't believe in any of the theories behind the treatments (and in many cases I know the explanations are wrong), but I do believe the treatments have an effect on these people. Now I don't really care about the mechanism at work and I don't care whether the practitioners understand what they are doing: it makes my friends happier and that is important to me.

I encourage these friends to only receive 'alternative' healthcare in addition to regular health care and never instead of it. Also, in any discussion on the subject, I emphasize that they should make sure that 'alternative' healthcare practitioners advise their clients to keep looking for solutions in regular health care.

My belief is that if practitioners violate that rule, they should be punished and prevented from causing harm. However, the other witch doctors seem to be doing a lot of good: more good than the bad a few of them cause.

tz said...

The government is the political realm, so if you want to have a NHS paid for by tax dollars, what it pays for by definition is politicized. Or to use the dirty word, "democratic".

It seems the worst possible thing you can think of is to attempt to present the data to everyone and let them choose for themselves what to believe and how to get treated. With their own money.

If you don't like the thought of your money being wasted on treatments you don't think work, then abolish the NHS.

You will never be able to have truth, democracy, and subsidy all at the same time. Pick two.

tz said...

Or put simply, JGC wishes to choose witch doctors should be able to treat you.

FleckerMan said...

I can't say I disagree with the MP's point. As much as I am against crack pots selling magic beans with fantastical made up mechanism, as long as they aren't telling people not to get vaccinations and not to take scientifically valid medicines, they are selling an effective placebo effect that is doing real good...

I think I am against the NHS funding Homeo-magic-opathy and similar crap, but can appreciate the argument for doing so.

There are real dangers that people avoid real, tested medicine for real diseases and effectively kill themselves through ignorance by relying on their magic pills, an ignorance we are in danger of encouraging by validating alternative therapies, but at the same time, real benefits through the placebo effect do come from these treatments, and for a subset of those diagnosed with Chronic fatigue, or who suffer from migraines, a magic pill from a trusted, friendly (quack)doctor really does make a genuine difference to their symptoms for the better.

It's hardly clear cut what is the optimum route, there is the short-term and the long-term effects of encouraging ignorance... I am against the NHS funding Magic on priniciple, but there are real, scientific arguments for supporting the placebo effect.

Ben Goldacre has more of interest on the topic of the Placebo effect and bad science at badscience.net