A recent article in the Veterinary Practice News (VPN) revealed that the American Veterinary Medical Association (AVMA) is considering a resolution, proposed by the Connecticut Veterinary Medical Association (CVMA), relating to homeopathy, specifically, and to the role of science and scientific evidence in evaluating veterinary therapies more generally. The full text of Resolution 3 is available here, but the core of the measure consists is the following:
RESOLVED, that the American Veterinary Medical Association (AVMA) affirms that—
1. Safety and efficacy of veterinary therapies should be determined by scientific investigation.
2. When sound and widely accepted scientific evidence demonstrates a given practice as ineffective or that it poses risks greater than its possible benefits, such ineffective or unsafe philosophies and therapies should be discarded.
3. In keeping with AVMA policy on Complementary and Alternative Veterinary Medicine, AVMA discourages the use of therapies identified as unsafe or ineffective, and encourages the use of the therapies based upon sound, accepted principles of science and veterinary medicine.
4. Homeopathy has been conclusively demonstrated to be ineffective.
The resolution is supported by a detailed white paper, The Case Against Homeopathy.
The first three statements in the resolution are not likely to be controversial, and they are already included, usually implicitly, in a number of existing policy statements. The most directly relevant is the AVMA Policy on Complementary and Alternative Medicine, which states, “Claims for safety and effectiveness ultimately should be proven by the scientific method… Practices and philosophies that are ineffective or unsafe should be discarded.”
This has been the official policy of the AVMA for over a decade. However, no alternative therapy has ever been acknowledged to be ineffective or discarded, including homeopathy. There is, as the white paper makes clear, overwhelming evidence that homeopathy has no benefit beyond placebo, but because it is a belief system rather than a medical discipline, practitioners of homeopathy are unlikely to ever accept this. The final statement in the resolution is controversial only because this small group, passionate and ideologically committed to homeopathy, will undoubtedly challenge it vigorously.
And despite the fact that the vast majority of veterinarians do not practice homeopathy, any criticism of practices other veterinarians employ, regardless of the evidence against them, seems to have become virtually taboo within the profession. Collegiality and unity sometimes seem to take precedence over science and the interests of our patients and clients. However, there are a number of reasons why this resolution is important for the profession, as well as patients and their owners.
As has been discussed frequently before (1-8), offering homeopathic treatment without clearly identifying it as a placebo is unethical. It places patients at risk by substituting an ineffective therapy for real treatment, and it denies pet owners the right to make fully informed decisions about the care of their pets. Mainstream veterinary medicine has left behind bloodletting, purgatives, and many other 18th and 19th century therapies which failed the test of scientific validation, and it is not in the interests of our patients, our clients, or our profession to endorse a belief system like homeopathy which has similarly failed to generate meaningful evidence of real benefits beyond placebo effects in the last two hundred years.
Several organizations have endorsed the proposal. The Evidence-Based Veterinary Medicine Association has issued this statement urging passage of the resolution:
The AVMA has issued many policy statements acknowledging that veterinary medicine should be based on sound, legitimate science. The AVMA Policy on Complementary and Alternative Medicine, for example, states, “Claims for safety and effectiveness ultimately should be proven by the scientific method… Practices and philosophies that are ineffective or unsafe should be discarded.” However, despite overwhelming evidence and consensus among scientists that homeopathy is ineffective, a few veterinarians continue to promote it as an adjunct or alternative to conventional scientific medicine. This diminishes the credibility of the veterinary profession and does a disservice to our patients and our clients.
Other national veterinary groups, including the Australian Veterinary Association and the British Veterinary Association, have publically acknowledged that homeopathy is not an effective therapeutic approach. As the leading veterinary association in the world, it is important that the AVMA also demonstrate its commitment to modern, evidence-based medicine and the interests of our patients and the public. Resolution 3 protects the integrity of the AVMA and the veterinary profession as well as the trust of the public on which we depend.
The EBVMA Board of Directors unanimously endorses Resolution 3 and the supporting documents introduced to the AVMA House of Delegates by the Connecticut Veterinary Medical Association, and we encourage you to support passage of this important policy statement.
There have also been endorsements from the American College of Veterinary Clinical Pharmacology (ACVCP) and the American Academy of Veterinary Pharmacology and Therapeutics (AAVPT). Not surprisingly, the Academy of Veterinary Homeopathy (AVH) and the American Holistic Veterinary Medical Association (AHVMA) are fighting the measure. According to the VPN article,
Proponents of homeopathy welcome introduction of the resolution.
“This is a wonderful chance for us to educate other vets about the benefits of homeopathic veterinary medicine,” said Jeff Feinman, VMD, CVH. “The main argument [against] homeopathy is that it’s implausible, and we will show that that’s not true at all. The research is just now catching up with the basic science.”
It will be interesting to see how homeopaths attempt to make the argument that homeopathy is actually consistent with basic scientific knowledge, given the strong case to the contrary (for example, The Science of Homeopathy).
I suspect the attempt will involve some reference to quantum physics. By virtue of being strange, counterintuitive, and impossible to truly understand without fluency in advanced mathematics, quantum physics is a popular rope among proponents of pseudoscientific therapies like homeopathy. The argument seems to be something along the lines of, “Quantum physics is weird and true. Homeopathy is weird. Homeopathy must be true.”
There are a number of problems with this fallacious argument, including the fact that there is no demonstrated connection between the oddities seen at the subatomic level and the notion that water which once had some kind of substance in it magically remembers that substance and can thus cure patients afflicted with symptoms that might or might not be caused, in healthy patients, by that substance.
Another argument the AHVMA brings up in their comment about the resolution is that no homeopaths were consulted by the CVMA in developing the proposed resolution. The AHVMA says, “when anyone considers a modality, they should talk to people who are considered experts in the field.” This sounds quite reasonable, but it skips over the fact that homeopathy is not a recognized medical specialty in which one can legitimately be said to be an expert. Though homeopaths have gotten together and created certification standards for themselves, these are not recognized by the American Board of Veterinary Specialties, The European Board of Veterinary Specialties, the American Board of Medical Specialties, or any other organization responsible for identifying and accrediting medical experts. Astrologers and Psychics have organizations that accredit practitioners of these methods, but that’s not a mark of legitimacy to those practices.
Ordinary veterinarians are capable of evaluating the scientific evidence and drawing a reasonable conclusion on the merits of homeopathy. Homeopaths, on the other hand, will never acknowledge the lack of evidence supporting their claims since to do so would be to invalidate their own profession. So the suggestion that the AVMA should set up a “task force” to evaluate homeopathy and advise the House of Delegates is like arguing that creationists should advise school boards on how to teach evolution. We don’t need task forces with specialists in bloodletting, faith healing, or other belief systems claiming, against significant evidence, to be medical therapies, and there is no reason to have one for homeopathy.
The AVMA House of Delegates will debate Resolution 3 on January 5. The delegates consist of representatives of the state veterinary medical associations and a number of allied organizations. The list of delegates can be found here. I encourage all veterinarians to contact their delegates and urge them to support this resolution.
- Smith, K. Against homeopathy-A utilitarian perspective. Bioethics. 2012;26(8):398-409. which is reviewed at this link, for those who do not have access to the journal: http://www.sciencebasedmedicine.org/index.php/placebos-as-medicine-the-ethics-of-homeopathy/
- Freckelton I.Death by homeopathy: issues for civil, criminal and coronial law and for health service policy. J Law Med. 2012 Mar;19(3):454-78.
- Smith, K. Why homeopathy is unethical. Focus on Alternative and Complementary Therapies 2011;16(3):208–211.
- Shaw D. Homeopathy is where the harm is: Five unethical effects of funding unscientific “remedies.” J Med Ethics. 2010;36:130-131
- Shaw D. Unethical aspects of homeopathic dentistry. Br Dent J. 2010 Nov 27;209(10):493-6.
- Ernst, E. The ethics of complementary medicine. J Med Ethics 1996; 22: 197-198.
- Rollin, B. and Ramey, D. “Ethics, Evidence, and Medicine” in Ramey, D., Rollin, B. Complementary and Alternative Veterinary Medicine Considered. Iowa State Press, 2004.
- Rollin, B. An ethicist’s commentary of the case of a veterinarian utilizing homeopathic therapy. Can Vet J. 1995 May; 36(5): 268–270.