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Sunday, March 29, 2009

Cosmic Ordering, CAM and the NHS

A while back, I argued that it might not be a good idea to encourage the use of therapies, such as homeopathy, which work via the "placebo effect". (I've also previously said that what people call "the placebo effect" very often isn't one).

But there's more to say on this. Let us assume that homeopathy, say, is nothing more than a placebo (which it is). Let's further assume that homeopathy is actually quite a good placebo, meaning that when people go to see a homeopath they generally leave feeling better and end up experiencing better health outcomes - for whatever reason. This second assumption is exactly that, an assumption, because to my knowledge no-one has done a study of whether people who use homeopathy actually feel any healthier than they would if they had never heard of homeopathy and just got on with their lives. But let's assume it works.

Now, does this mean that homeopathy is a good thing? Well, sure, if it makes people feel better, it's a good thing. However - it doesn't follow that homeopathy, or any other form of complementary and alternative medicine which works as a placebo, should be available on the NHS. Many have argued that if CAM works, even if only by the placebo effect, it's still a useful thing which the NHS should support if patient's request it. I disagree.
A while back, South Bank University in London was widely mocked for getting a psychic to give a training session on "cosmic ordering". Cosmic ordering is the belief that you can get what you want in life by placing an order with the universe in the form of wishing really hard and then some quantum stuff happens and - I can't write any more of this. It's all crap. Anyway, the head of South Bank defended the session on the grounds that the staff requested it, liked it and found it useful.

Now if I applied for funding from my University to pay for a night down the pub for the whole of my Department I'd get the beaurocratic equivalent of a slap in the face. This despite the fact that people would enjoy it, it would help with team-building, and reduce stress levels. The point is that despite a Departmental night down the pub being, probably, a good thing in many ways, it's just not the kind of thing a University is responsible for. It would be incredibly unprofessional for University money to be spent on that kind of thing.

Likewise, it was unprofessional of South Bank to pay for a psychic to give a training course, even though the attendees liked it. Sorry to sound anal but Universities don't exist to give their staff what they want. They exist to pay their staff in exchange for their professional services & to help them carry out those services.

Likewise, the NHS, I think, doesn't exist to make people feel good, it exists to treat and prevent medical illnesses. So people like homeopathy and find it's helpful for relieving stress-related symptoms. Does that mean the NHS should be paying for it? Only if you believe that the NHS should also be paying for me to take a holiday to Thailand. I don't believe in homeopathy, but I do believe that a week on a Thai beach would do wonders for my stress levels. Or maybe I'd prefer a sweet guitar - I find playing guitar is great for relaxation, but it would be even better if I had a £700 model to play on. My well-being levels would just soar, if only until the novelty wore off. You get the point.

Most "complementary and alternative medicine" is medicine in appearance only. Just because homepaths hand out pills doesn't mean that what they do has anything to do with medicine. It's ritual. It's close to being entertainment, in a sense - which is not to belittle it, because entertainment is an important part of life. I'm sure there are many people for whom their sessions with their homeopath are really very useful. I just don't think the medical services should necessarily be paying for everything that people find helpful.


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