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fake médicine: Science-based medicine versus homeopathy in France

Homeopathy is The One Quackery To Rule Them All. The same is true all over the world. It’s also true that the preferred tactic of homeopaths and other quacks is to try to suppress criticism of their quackery, not to answer it with science. During Homeopathy Awareness Week, I present an example of this in France.

#fakemed, fake médecine, and Boiron Oscillococcinium
#fakemed and Boiron Oscillococcinium

Homeopathy Awareness Week started three days ago, on April 10, as it does every year because that’s the birthday of Samuel Hahnemann, the man who dreamt up homeopathy roughly 220 years ago. As I said at the time, I, like so many other skeptics, wanted to help celebrate this yearly occasion by reminding everyone that homeopathy is The One Quackery To Rule Them All. I figured that I couldn’t let the week go by without at least one more post about homeopathy, and, in fact, I couldn’t avoid the topic. While on Twitter, I saw something about “fake médicine”:

Yes, it’s from France. It reminded me of another story I discussed from France a while ago, in which Nobel Laureate turned antivaccine and pro-homeopathy crank Luc Montagnier made an appearance in which he tried to argue that vaccines could cause sudden infant death syndrome. This time around, it’s more about homeopathy. Unfortunately, like the story about Montagnier, there is very little in the way of English language reporting on this story. That always makes me leery of taking on a story, because I fear that I’ll miss something important and get the story wrong. On the other hand, I have a great antipathy towards quacks who try to silence critics with legal thuggery, as my posting history makes plain. Also, even after 30 years I can still read and speak French well enough to get the gist of most articles I read without using Google Translate. So I decided to dive in and see if I could figure out what’s going on.

It didn’t take me long to come across at least one interesting Tweet:

This is Agnès Buzyn, ministre des Solidarités et de la Santé (Minister of Solidarity and Health), stating support for homeopathy, specifically, “If it continues to be beneficial, without being harmful, it will continue to be reimbursed.” This is a pretty damned irresponsible thing for any minister of health in any country to say. Twitter was not pleased:

But what is this all about? It didn’t take me long to find a website called fake médicin, which contains a statement by 124 French doctors condemning alternative medicine and homeopathy in particular and calling on the French government to stop funding homeopathy and other alternative medicines. There’s an English version there too, but the statement is still worth citing fairly extensively. The doctors behind this statement begins by invoking the Hippocratic Oath as one of the oldest known ethical commitment that “requires a physician to provide the best possible care to his patients, in the most honest way,” noting that these two obligations “require a physician to continually seek to improve his or her (medical) knowledge and to inform his patients about what he can reasonably offer, as well as what treatments are unnecessary or contra-indicated.” It also cites French law:

…they forbid charlatanism and deception, impose the prescription and distribution of treatments for which the efficacy was established. They also proscribe the use of obscure remedies or remedies which do not clearly list the substances that they contain.

You can see where this is going with respect to homeopathy. The statement goes on to point out that the French General Medical Council is responsible for ensuring that its members “do not use their credentials to promote practices for which science was unable to demonstrate their usefulness or practices which can even be dangerous” and “do not become sales representatives of unscrupulous industries.” Here’s where the hammer falls, when the statement points out that the General Medical Council still tolerates practices that “are at odds with its own code of ethics” and that “public bodies organise or even contribute to the financing of some of these practices.”

Before I get to the meat of the statement, I was wondering just who was behind the fake médicine website. The site’s authors describe themselves as:

We are a group of health professionals with a wide variety of specialties and methods of practice. Our common viewpoint is that medicine must adapt its practices to the facts and seek to disseminate these facts by popularizing via Youtube videos, blogs, or through social networks.

We are not an association, we are perfectly apolitical and we are not driven by a conflict of interest, except perhaps the promotion of critical thinking.

In the era of “fake news”, fashionable term but serious issue, we have long noticed the activism of pseudo-medicines on the internet, trying to discredit our discipline to better sell theirs. We have also seen the damage that such speech can produce in the health field, such as anti-vaccine movements, or other conspiracy movements.

Yes, support for science-based medicine is important, and this group has it. The authors note:

The so-called “alternative” therapies are ineffective beyond any placebo effect and can even prove to be dangerous.

  • They can be dangerous because they treat irrelevant symptoms and over-medicalise populations, giving the illusion that any situation can be solved with a “treatment”.
  • They can be dangerous because they fuel and rely on a fundamental distrust of conventional medicine as shown by the unjustified polemics surrounding vaccines.
  • Finally, They can be dangerous because their use delays the diagnoses and necessary treatments, sometimes leading to dramatic consequences, especially in the treatment of serious diseases such as cancers.

I couldn’t have said it better. It’s also noted that support for pseudomedicines (i.e., quackery) is also a waste of money that taxpayer francs should not be spent on. Indeed, in France, homeopathic products can be reimbursed at a rate of 30% (but up to 90% in the Alsace-Moselle region) and benefit from a preferential status that exempts their manufacturers (like Boiron, a French multibillion dollar company) from having to demonstrate their efficacy.

So here’s what fake médicine calls for:

We urge the French General Medical Council and the French public authorities to make every effort to:

  • No longer allow physicians or healthcare professionals to continue to promote these practices using their professional credentials.
  • No longer recognise in any way homeopathy, mesotherapy or acupuncture diplomas as medical university degrees or qualifications.
  • Ensure that Medical Schools or institutes which deliver health trainings, may no longer issue diplomas covering medical practices for which the efficacy was not scientifically demonstrated.
  • No longer reimburse health care, medicines or treatments from disciplines which refuse to subject themselves to a rigorous scientific assessment.
  • Encourage initiatives aimed at delivering information on the nature of alternative therapies, their deleterious effects, and their real efficacy.
  • Require all caregivers to abide to the deontology of their profession, by refusing to deliver useless or ineffective treatments, by offering care in accordance with the recommendations of learned societies and the most recent scientific evidence and by demonstrating pedagogy and honesty towards their patients and offering an empathic listening.

Each and every one of these demands is something that I can get behind totally. Some of them are even applicable to the US.

So far, as of my writing this, there are 1,929 signatories:

of which 822 in medicine, 111 in care, 99 pharmacy, 75 in physiotherapy
229 in education education or research
253 in engineering or computer science
7 in dental, 5 in midwifery
and 329 in many other activities and who feel concerned.

The complete list of signatories is here.

It also didn’t take me long to find out that there’s a hashtag created by these same French physicians, #fakemed. The activity on this hashtag has not gone unnoticed:

More importantly:

And:

And:

And:

Just click on the Tweets and hit the “translate” button if you don’t know enough French to figure out what is being said.

And:

It turns out that the statement caused a major kerfuffle in France, as alluded to in the first Tweet I cited above. I looked for an English language story about the dustup, but basically failed to find a good one. I did, however, find a story in the French version of Slate, Fake médecines, vraies questions de société, or Fake medicines, real issues for society. Here’s what’s been happening.

On March 18, the fake médicine text was published in a column in Figaro. Addressed to the National Council of the College of Physician, the initiative and statement were spearheaded by doctors who are active on YouTube and other social media, François, author of the Youtube channel Primum non nocere and Jérémy Descoux, of Asclepios. The reaction was swift and nasty (translation a combination of Google Translate and myself changing the wording when I can to make it less clunky English):

The next day, reactions were not delayed. On March 19, Jérémy Descoux was invited on the set of LCI to defend the terms used in his statement . Its opponents unanimously condemned the approach: The benefits of popular medicines would be misunderstood; the practice of these by medical doctors would protect risks of abuse; and we should not risk undermining the flourishing French homeopathy industry. On March 20, it was the turn of science journalist Mathieu Vidard, host of the radio show La tête au carré, to express in an editorial his disagreement with the terms of the platform : according to him, this one would continue the chimeric ideal of a purely rational medicine. Those of you who pay attention to these things will recognize the sorts of logical fallacies, bad arguments, and misinformation used by Vidard. First, Vidard accused the doctors of “arrogance”:

Surfing on the theme of fake news, our doctors disguised as white geese drape themselves in the arrogance of their scientific respectability to knock – I quote – these false therapies with illusory efficacy.

Then there was the predictable appeal to popularity:

If this statement was not frankly insulting to practitioners as well as to the 40% of French people who resort to alternative medicine, we would have fun arguments of these fathers morality.

I like to respond to this by saying that the fact that one third of Americans believe in ghosts doesn’t mean that ghosts are real. The same is true of homeopathy. That 40% of the French public has used homeopathy doesn’t mean homeopathy works.

There was an invocation of the “magic” of placebos:

And they are right since no serious study has proven so far any effectiveness of this therapy [homeopathy]. The scientific content of alternative medicines is empty. Nothing but the placebo effect. So what?

Can all the allopaths boast of being able to treat each disease rationally? No, of course not.

So is not it possible to admit that there is sometimes a part of magic to cure?

At least he admits there’s no science behind homeopathy and alternative medicine.

Next up, the appeal to “holism” and the “human touch”:

In the conclusion of their statement, the 124 demand that all caregivers respect ethics and that they offer to their patients a benevolent listening. We had to dare! Because it is precisely because of dehumanized conventional medicine that patients who are tired of being considered as mere limbs turn to practitioners who can spend time with them and listen to them.

As I like to say, if the problem in modern medicine is insufficient empathy and not enough time to give the patients a “benevolent listening,” the solution is not to farm that function out to quacks. It is to train doctors to do better and change the financial incentives in the system to value face-to-face time with patient far more than our current reimbursement system does. Hilariously, right after this passage, Vidard claims that attacking the “humanistic function” of homeopaths and doctors using alternative medicine, the 124 risk driving patients into the arms of real quacks. Yes, I’ve lost track of how many fallacy-filled articles like Vidard’s I’ve deconstructed over they years, just in English.

Helpfully, Beatrice Kammerer, the author of the Slate.fr article, lists the fallacies used by defenders of homeopathy and gives several examples. Here are the fallacies:

  1. “Medicine is not only rational.” My response: True, but that does not mean medicine should embrace the irrational and pseudoscientific.
  2. “Scientific medicine is cold and dehumanized.” See my answer above.
  3. “The doctor’s role is not to tell me what to believe in.” My response: No one says that it is, but a doctor’s role is to recommend therapies and treatments with scientific evidence supporting their efficacy and safety. Homeopathy fails on that account.
  4. “If doctors are forbidden to prescribe homeopathy, people will rush to charlatans!” See my answer above.
  5. “Just because science does not understand how unconventional medicines work does not mean that they are ineffective.” My response: This is putting the cart before the horse. Show compelling evidence of efficacy. Then we’ll talk. Many of these medicines are claimed to work through impossible mechanisms. Homeopathy is an excellent example. For homeopathy to work, several well-established laws of physics and chemistry would have to be not just wrong, but spectacularly wrong.
  6. “Homeopathy may not cure, but it is good for many people.” My answer: The only people homeopathy is good for are homeopaths and the stockholders of Boiron and the owners of companies manufacturing homeopathic remedies.

Of course, homeopaths being homeopaths, the entirely predictable result of a serious threat to homeopathy has resulted in complaints to the College of Physicians about some of the doctors behind the fake médicine:

Here’s a story in Le Monde telling the tale:

The tension hasn’t decreased among doctors after the publication of a statement signed by more than 120 health professionals, March 19 in Le Figaro, against homeopathy and other alternative medicines . Following this text, the daily affirms, Thursday, April 12, that trade unions of homeopathic doctors, mesotherapists or accupuncturists have filed a complaint with the council of the order of the profession against 10 of 124 signatories – five doctors who expressed themselves in the media after the publication of the podium, and five others who signed it.

The statement castigated in particular “practices neither scientific nor ethical, but very irrational and dangerous” and spoke of “fake medicine ” (“false medicine”). The signatories asked the Council of the Order, “do not allow doctors or health professionals to use their title who continue to promote” these practices.

The unions criticize remarks as “offensive, defamatory and even insulting” and “contrary to the ethical principles of confraternity, consideration of professsion”, reports Le Figaro. They demand a “public apology.”

When a complaint is lodged with the Medical Association, the first step is an attempt at conciliation. If the mediation fails, “we will then draw lots of doctors from the list of [the signatories] every fortnight for new complaints,” warns Dr. Meyer Sabbah, the source of the complaint.

This is, of course, typical thuggery that homeopaths engage in. It reminds me of the time that Andy Lewis, a.k.a. Le Canard Noir, who ten years ago endured similar threats after he wrote a brilliant article, The Gentle Art of Homeopathic Killing, which showed that such claims actually violate homeopaths’ own code of ethics, resulted in a legal threat from the Society of Homeopaths. I’ve also documented similar types of legal thuggery from quacks directed at skeptics speaking out. Many have been victims, ranging from Paul Offit to Brian Deer to Ben Goldacre to Simon Singh to Rhys Morgan to Steve Novella, all of whom have had legal threats directed at them or been sued outright. The most recent example is a naturopath quack (but I repeat myself) who is suing ex-naturopath and current skeptic and scientist Britt Hermes. This is what homeopaths and other quacks do when criticized. Add to this the likelihood that the statement by the 124 French doctors threatened a huge French company (Boiron), business considerations and national pride probably amplified the usual thuggish reaction.

It is to the credit of the 124 French doctors who spoke out about The One Quackery To Rule Them All. Their statement needs to be publicized near and far during Homeopathy Awareness Week.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

32 replies on “fake médicine: Science-based medicine versus homeopathy in France”

Vive la vraie médecine!
Legal thuggery is despicable, not only because it is a time and money waster but the stress induced knowing that the right outcome may not happen in court. A naturopath in Quebec was responsible for the death of a patient, seemed clear that she was in the wrong all around but the judge acquitted her because the patient should have known she wasn’t a doctor. ?? Not the same as trying to suppress critics but illustrates the concept that having the facts on your side does not guarantee the outcome.

“When the facts are on your side, pound on the facts. When the law is on your side, pound on the law. When neither is on your side, pound on the table.”

The homeopaths do not have the facts on their side. They are selling water and/or sugar pills.

The unfortunate thing is that they may have the law on their side. In jurisdictions that derive from English common law (like the US and the UK), the definition of perjury includes making statements under oath that the witness knew, or should have known, were false. The “should have known” part is important, because anybody who has taken high school level chemistry (let alone anyone with a degree in a medical field) should know that homeopathy cannot work. But there is no guarantee that French law has any similar provision (IANA French L). And while the truth is an absolute defense against libel/defamation claims in the US, that is not true in most other jurisdictions. Furthermore, these plaintiffs have a deep-pocketed potential backer, Boiron.

So while I would like to think that the people making these complaints are pounding on the table, there is a risk that they actually do have something to work with legally.

When I visited France a few years ago I was alarmed by the blatant adverts of homeopathy prominently displayed in the windows of pharmacies. I spoke with a friend there who swears by homeopathy for her allergies and was unmoved by my explanation of what homeopathy really was. It is heavily promoted and ingrained in the culture.

Edzard Ernst also wrote about this – http://edzardernst.com/2018/04/finally-an-official-statement-about-homeopathy-from-a-french-health-minister/

The Nightingale Collaboration in this post http://www.nightingale-collaboration.org/news/190-nhs-homeopathy-20-years-of-decline.html about the decline of NHS homeopathy in the UK provide a helpful chart showing the usage of homeopathy across Europe.

French consumer awareness of the nature of homeopathy is unknown to me. Typically consumer awareness research only ever tackles the business of dilution, rarely the the Vitalistic beliefs behind homeopathy.

I’ve never looked in detail at French medicines regulation – but is underpinned by the same EU regulations as the UK. I imagine that much of the marketing of French homeopathic medicines is legally questionable if Boiron is representative of the industry in France. It’s worth pointing out that Boiron were part of the lobbying of the EU that resulting in current regulations – which effectively imposed recognition of homeopathic medicines as medicines in other EU member states with no tradition of homeopathy. It also imposed a regulatory regime that makes life extremely difficult for smaller manufacturers which has given the larger French and German manufacturers tremendous market power.

Both astrology and suppositories are popular in France.

Perhaps the scariest part about the Minister, Agnès Buzyn, is Bart B. Van Bockstaele’s comment about her in Ernst’s posting.

It’s worse. She is not only a doctor, but also a haematologist, cancer researcher and university professor.

As a french researcher I am always very upset by the love of french people for homeopathy and how widely it is accepted. The majority of people I know in France have at some point taken homeopathic “remedies”, and some still do. Some MDs will offer to prescribe sugar pills for random conditions (yeast infections, verrucas, nausea, …), and I stopped seeing some of them because of that.
From what I recall, some medical schools have homeopathy programs and in order to prescribe homeopathic remedies you need to have a medical degree. But most people just buy it at the pharmacy or get it from their family doctor.

First, Vidard accused the doctors of “arrogance”:

Of course. I got that one pretty recently. If the learned elite doesn’t say what they should, clearly they’re overestimating their own abilities and should just shut up. Cranks love experts who agree with them, but hate experts who don’t.

It’s always fun to read French, More so when It’s material like this!

Co-incidentally, the woo-meisters at prn.fm ( as I’ve been reporting on another thread) call SBM, RI and Dr DG “fake news/ fake medicine”.

AS my late father would often say : “Quelle load de merde”

AS my late father would often say : “Quelle load de merde”

Un ptit café avec ça?

Al

@ Alain:

Ha ha!

My father was quite an accomplished speaker/ writer of Franglais.

I notice that the bottle illustrated above is for etats grippaux HOWEVER it is medicine crappaux

Having never heard of “mesotherapy,” I was surprised when the second search suggestion that came up for me was “mesotherapy groupon.”

One good thing about prn.fm: they’re backing the idea that mass aluminum poisoning is due to chemtrails (as opposed to vaccines):

“I describe evidence of clandestine geoengineering activity that has occurred for at least 15 years, and which has escalated sharply in the last two years. The geoengineering activity via tanker-jet aircraft emplaces a non-natural, toxic substance in the Earth’s atmosphere which with rain water liberates highly mobile aluminum. Further, I present evidence that the toxic substance is coal combustion fly ash. Clandestine dispersal of coal fly ash and the resulting liberation of highly mobile aluminum, I posit, is an underlying cause of the widespread and pronounced increase in neurological diseases and as well as the currently widespread and increasing debilitation of Earth’s biota.”

http://prn.fm/brianna-blaschke-geochemist-says-we-are-being-poisoned-by-the-aluminum-found-in-chemtrails/

See, chemtrails cause autism. I knew it!

Cummulative load they say…but which one of these sources of alum bypass the “natural defense mechanism” of the spacial snowflake bodies…

Al :S

The geoengineering activity via tanker-jet aircraft emplaces a non-natural, toxic substance in the Earth’s atmosphere . . .

Those bastards! Why couldn’t they use a natural toxic substance for their nefarious scheme, something the earth provides in abundance?

Coal is not natural, eh? It’s amazing what you can learn on the Internet.

Coal is not only natural, it’s also organic and contains no artificial colors flavors or preservatives. And it is GMO and gluten free!

In the nausea-inducing fake medicine department, there was a 100% credulous article in my local paper this morning about Heather Askinosie, the “holistic medicine” and crystals “expert”, describing how you can feng shui your way to health and harmony with various crystals/gemstones (coincidentally, Heather has a jewelry business to help you accomplish these goals).

https://www.mindbodygreen.com/wc/heather-askinosie

mindbodygreen.com is a wonderful website by the way, if you want “both sides” on the vaccination “debate”.

One thing that will have to be considered is the “confraternité” argument (article 56 from the french code of medical etchics). I’m french but not a doctor so don’t know all the subtilities, and don’t if there is such a system in other countries.
Basically, as I understand it, it requires doctors to avoid showing dissent openly, and to rule disputes internally.
It might be used for legal thuggery.
Here is the article in english p.21 : https://www.conseil-national.medecin.fr/sites/default/files/code_de_deontologie_version_anglaise.pdf
Here it is explained in french : https://www.conseil-national.medecin.fr/article/article-56-confraternite-280
An exemple of ruling for “lack of contraternity” : http://www.psychomedia.qc.ca/sante/2014-03-19/confraternite-chez-les-medecins
And a blog criticizing it : https://farfadoc.wordpress.com/2013/06/04/confraternite/

What to do about homeoquackery at otherwise-legit pharmacies:

Make a half-page-sized “consumer information” notice, using the pharmacy’s logo & design details, so it looks “official.” Briefly explain how homeopathy “works” (law of similars etc., and dilution/succussion (sp?)). Then end up with the point that if water has memory, everything you drink has homeopathic pee, poo, and poison in it. Lastly, “If these ‘remedies’ don’t do anything, why do we sell them? Because you should be free to spend your money as you choose, and we should be free to earn ours as we choose.” Include the company’s website URL and consumer contact phone number.

Print in high-res color on high-quality paper, get it laminated, and post it in the Homeopathy section right next to the Oscillococcinum and similar dreck. I’ll bet it stays up for weeks because nobody who works there spots it as anything other than official company information. Have fun!

L’étude qui faisait le lien entre vaccin et autisme était une escroquerie.

There is no English word that has quite the same flavor as escroquerie.

@ Shay:

Whilst not using a single word,
I might translate the above as:

The study that linked vaccines and autism was a crock

That works for me.

Agnes Buzyn is no fool. She obviously knows that homeopathy is quackery. The point she is indirectly making is that on the whole, homeopathy seems to reduce usage of useless and dangerous medications on the whole. Which is indeed a problem… She is rationally fighting irrationality with irrationality, and managing public opinion. End point: she is picking up her fights one by one and homeopathy is not yet one of them. I do not believe she has hard data on this anyhow and she seemingly acknowledges that in that interview. Read between the lines. (And I HATE homeopathy).

How many people die each year from real, science based (taken as prescribed by an official licensed medical expert) pharmaceutical drugs? This is to check bias not a defence of Homeopathy. Can we have the figures please?

For a start, read this article.

https://sciencebasedmedicine.org/death-by-medicine/

Iatrogenic disease and death is a problem and most major hospitals have programs to reduce them. But, at least is extending the lives and even curing many patients. As a result, the death rate from cancer is going down.

The same cannot be said for homeopathic remedies.

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