Editing Homeopathy (section)

== Ethics and safety ==
[[File:Rhustox.jpg|thumb|Homeopathic preparation ''Rhus toxicodendron'', derived from [[Toxicodendron radicans|poison ivy]]]]The provision of homeopathic preparations has been described as unethical.<ref name="unethical">{{cite journal |last1=Shaw |first1=DM |title=Homeopathy is where the harm is: Five unethical effects of funding unscientific 'remedies' |journal=Journal of Medical Ethics |volume=36 |issue=3 |pages=130–31 |year=2010 |pmid=20211989 |doi=10.1136/jme.2009.034959 |s2cid=206996446 |doi-access=free }}</ref><ref name="Shaw2010">{{cite journal |last=Shaw |first=David |title=Homeopathy and medical ethics |journal=Focus on Alternative and Complementary Therapies |publisher=Wiley |volume=16 |issue=1 |date=4 November 2010 |issn=1465-3753 |doi=10.1111/j.2042-7166.2010.01051.x |pages=17–21}}</ref> [[Michael Baum (surgeon)|Michael Baum]], professor emeritus of surgery and visiting professor of medical humanities at [[University College London]] (UCL), has described homeopathy as a "cruel deception".<ref name="Janes">{{cite news |author=Hilly Janes |url=http://www.timesonline.co.uk/tol/life_and_style/article4682309.ece |title=The Lifestyle 50: The top fifty people who influence the way we eat, exercise and think about ourselves |work=[[The Times]] |date=September 6, 2008 |archive-url=https://web.archive.org/web/20110727183929/http://www.timesonline.co.uk/tol/life_and_style/article4682309.ece |archive-date=July 27, 2011}}</ref> [[Edzard Ernst]], the first professor of [[alternative medicine|complementary medicine]] in the United Kingdom and a former homeopathic practitioner,<ref name="Ernst_memo">[https://publications.parliament.uk/pa/cm200910/cmselect/cmsctech/memo/homeopathy/ucm1602.htm Memorandum submitted by Edzard Ernst HO 16] to the [[House of Lords]]</ref><ref>
{{cite news
 |title=The alternative professor
 |url=https://www.theguardian.com/science/2003/sep/25/scienceinterviews.health
 |author=Boseley S
 |newspaper=[[The Guardian]]
 |date=July 21, 2008
 |location=London
}}</ref><ref name="Con?">{{cite news
 |url=https://www.independent.co.uk/life-style/health-and-wellbeing/features/complementary-therapies-the-big-con-813248.html
 |title=Complementary therapies: The big con?
 |work=The Independent
 |access-date=May 4, 2010
 |location=London
 |date=April 22, 2008
 |archive-url=https://web.archive.org/web/20090427070400/http://www.independent.co.uk/life-style/health-and-wellbeing/features/complementary-therapies-the-big-con-813248.html
 |archive-date=April 27, 2009 
}}</ref> has expressed his concerns about [[pharmacist]]s who violate their ethical code by failing to provide customers with "necessary and relevant information" about the true nature of the homeopathic products they advertise and sell.<ref>
{{cite news
 |title=Pharmacists urged to 'tell the truth' about homeopathic remedies
 |url=https://www.theguardian.com/science/2008/jul/21/pharmacists.homeophathy
 |author=Sample I
 |newspaper=[[The Guardian]]
 |date=July 21, 2008
 |location=London
}}</ref> In 2013 the [[Advertising Standards Authority (United Kingdom)|UK Advertising Standards Authority]] concluded that the [[Society of Homeopaths]] were targeting vulnerable ill people and discouraging the use of essential medical treatment while making misleading claims of efficacy for homeopathic products.<ref name="ASA">{{cite web|date=July 3, 2013|title=ASA adjudication on Society of Homeopaths|url=http://www.asa.org.uk/Rulings/Adjudications/2013/7/Society-of-Homeopaths/SHP_ADJ_157043.aspx|archive-url=https://web.archive.org/web/20130706020223/http://asa.org.uk/Rulings/Adjudications/2013/7/Society-of-Homeopaths/SHP_ADJ_157043.aspx|archive-date=July 6, 2013|access-date=July 4, 2013|publisher=ASA|df=mdy-all}}</ref> In 2015 the [[Federal Court of Australia]] imposed penalties on a homeopathic company for making false or misleading statements about the efficacy of the whooping cough vaccine and recommending homeopathic remedies as an alternative.<ref name="ACCC">{{cite web|title=Court imposes penalty for false or misleading claims by Homeopathy Plus and Ms Frances Sheffield |url=https://www.accc.gov.au/media-release/court-imposes-penalty-for-false-or-misleading-claims-by-homeopathy-plus-and-ms-frances-sheffield|publisher=ACCC|access-date=March 31, 2016|date=October 14, 2015}}</ref>[[File:1belladonna.jpg|thumb|Old homeopathic [[Deadly nightshade|belladonna]] preparation|alt=|left]]A 2000 review by homeopaths reported that homeopathic preparations are "unlikely to provoke severe adverse reactions".<ref>{{cite journal|last1=Dantas|first1=F|last2=Rampes|first2=H|year=2000|title=Do homeopathic medicines provoke adverse effects? A systematic review|journal=British Homoeopathic Journal|volume=89|pages=S35–S38|doi=10.1054/homp.1999.0378|pmid=10939781|s2cid=24738819}}</ref> In 2012, a systematic review evaluating evidence of homeopathy's possible [[adverse effect]]s concluded that "homeopathy has the potential to harm patients and consumers in both direct and indirect ways".<ref name="sr2012">{{cite journal|last1=Posadzki|first1=P|last2=Alotaibi|first2=A|last3=Ernst|first3=E|year=2012|title=Adverse effects of homeopathy: A systematic review of published case reports and case series|journal=International Journal of Clinical Practice|volume=66|issue=12|pages=1178–88|doi=10.1111/ijcp.12026|pmid=23163497|s2cid=2930768|doi-access=free}}</ref> A 2016 systematic review and meta-analysis found that, in homeopathic clinical trials, adverse effects were reported among the patients who received homeopathy about as often as they were reported among patients who received placebo or conventional medicine.<ref>{{cite journal|last1=Stub|first1=T|last2=Musial|first2=F|last3=Kristoffersen|first3=AA|last4=Alræk|first4=T|last5=Liu|first5=J|date=June 2016|title=Adverse effects of homeopathy, what do we know? A systematic review and meta-analysis of randomized controlled trials|url=https://munin.uit.no/bitstream/10037/10908/4/article.pdf|journal=Complementary Therapies in Medicine|volume=26|pages=146–63|doi=10.1016/j.ctim.2016.03.013|pmid=27261996|hdl=10037/10908}}</ref>

Some homeopathic preparations involve poisons such as [[Atropa belladonna|Belladonna]], [[arsenic]], and [[Toxicodendron radicans|poison ivy]]. In rare cases, the original ingredients are present at detectable levels. This may be due to improper preparation or intentional low dilution. Serious adverse effects such as seizures and death have been reported or associated with some homeopathic preparations.<ref name="sr2012" /> Instances of [[arsenic poisoning]] have occurred.<ref name="J Toxicology: Arsenic toxicity" />  In 2009, the FDA advised consumers to stop using three discontinued cold remedy [[Zicam]] products because it could cause permanent damage to users' sense of smell.<ref>Sources:

* {{cite news|author=Julianne Pepitone|date=June 16, 2009|title=Zicam may damage sense of smell – FDA|publisher=[[CNNMoney.com]]|url=https://money.cnn.com/2009/06/16/news/companies/zicam_sense_of_smell/index.htm?section=money_latest}}
* {{cite web|date=June 16, 2009|title=Information on Zicam Cold Remedy nasal gel, Zicam Cold Remedy nasal swabs, and Zicam Cold Remedy swabs, kids size|url=https://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm166834.htm|publisher=[[Food and Drug Administration (United States)|FDA]]}}</ref> In 2016 the FDA issued a safety alert to consumers<ref name="FDAconsumers">{{cite web |url=https://www.fda.gov/safety/medwatch/safetyinformation/safetyalertsforhumanmedicalproducts/ucm523435.htm |title=Homeopathic Teething Tablets and Gels: FDA Warning – Risk to Infants and Children |publisher=FDA |date=September 30, 2016 |access-date=October 17, 2016}}</ref> warning against the use of homeopathic teething gels and tablets following reports of adverse events after their use.<ref name="FDANewsRelease">{{cite web |url=https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm523468.htm |title=FDA warns against the use of homeopathic teething tablets and gels |publisher=FDA |date=September 30, 2016 |access-date=October 17, 2016}}</ref>  A previous FDA investigation had found that these products were improperly diluted and contained "unsafe levels of belladonna" and that the reports of serious adverse events in children using this product were "consistent with belladonna toxicity".<ref name="arstechnicaFDA">{{cite web |url=http://arstechnica.co.uk/science/2016/10/fda-homeopathic-teething-gels-may-have-killed-10-babies-sickened-400/ |title=FDA: Homeopathic teething gels may have killed 10 babies, sickened 400 |publisher=Ars Technica UK |date=October 13, 2016 |access-date=October 17, 2016 |author=Mole, Beth}}</ref>

Patients who choose to use homeopathy rather than [[evidence-based medicine]] risk missing timely diagnosis and effective treatment, thereby worsening the outcomes of serious conditions such as cancer.<ref name="Mayo Clinic Proceedings: trials" /><ref name="pmid12974558">{{cite journal |last1=Malik |first1=IA |last2=Gopalan |first2=S |title=Use of CAM results in delay in seeking medical advice for breast cancer |journal=European Journal of Epidemiology |volume=18 |issue=8 |pages=817–22 |year=2002 |pmid=12974558 |doi=10.1023/A:1025343720564 |s2cid=19059757 |quote=CAM use [in the developing countries this study solely considered] was associated with delay in seeking medical advice (OR: 5.6; 95% CI: 2.3, 13.3) and presentation at an advanced stage of disease}}</ref><ref name="pmid8554846" /><ref name="BBC malaria" /> The Russian [[Commission on Pseudoscience]] has said homeopathy is not safe because "patients spend significant amounts of money, buying medicines that do not work and disregard already known effective treatment."<ref>{{Cite web|date=2017-02-07|title=Memorandum #2. Homeopathy as pseudoscience|url=http://klnran.ru/en/2017/02/memorandum02-homeopathy/|access-date=March 19, 2021|website=[[Commission on Pseudoscience]]}}</ref> Critics have cited cases of patients failing to receive proper treatment for diseases that could have been easily managed with conventional medicine and who have died as a result.<ref name="Baby_Gloria">Case of Baby Gloria, who died in 2002:
*{{cite news
 |title = Homeopath Thomas Sam guilty of daughter Gloria's death
 |newspaper = [[The Daily Telegraph (Sydney)|The Daily Telegraph]]
 |location = Sydney
 |date = June 5, 2009
 |url = http://www.dailytelegraph.com.au/news/homeopath-thomas-sam-guilty-of-daughter-glorias-death/story-e6freuy9-1225723018271
 |access-date = March 17, 2010
 |archive-date = November 18, 2012
 |archive-url = https://web.archive.org/web/20121118064506/http://www.dailytelegraph.com.au/news/homeopath-thomas-sam-guilty-of-daughter-glorias-death/story-e6freuy9-1225723018271
 }}
*{{cite news
 |title        = Parents guilty of manslaughter over daughter's eczema death
 |newspaper    = [[The Canberra Times]]
 |date         = June 5, 2009
 |url          = http://www.canberratimes.com.au/news/national/national/general/parents-guilty-of-manslaughter-over-daughters-eczema-death/1533293.aspx
 |archive-url  = https://web.archive.org/web/20100625160931/http://www.canberratimes.com.au/news/national/national/general/parents-guilty-of-manslaughter-over-daughters-eczema-death/1533293.aspx
 |archive-date = June 25, 2010
 |df           = mdy-all
}}</ref><ref name="Dingle">{{cite web |author1=Alastair Neil Hope |author2=State Coroner |url=https://www.scribd.com/doc/68731728/Coroner-Dingle-Finding |title=Coroner's inquest into the death of Penelope Dingle. Ref No: 17/10 }}</ref> They have also condemned the "marketing practice" of criticizing and downplaying the effectiveness of medicine.<ref name="Goldacre20072" /><ref name="Dingle" /> Homeopaths claim that use of conventional medicines will "push the disease deeper" and cause more serious conditions, a process referred to as "suppression".<ref>
{{cite book
 |author=Schmukler AV
 |year=2006
 |url=https://books.google.com/books?id=E1fVzLCmk5gC&q=suppression+homeopathy&pg=PA16
 |title=Homeopathy: An A to Z Home Handbook
 |publisher=Llewellyn Worldwide
 |page=16
 |isbn=978-0-7387-0873-7
}}</ref> In 1978, [[Anthony Campbell (physician)|Anthony Campbell]], a consultant physician at the Royal London Homeopathic Hospital, criticized statements by [[George Vithoulkas]] claiming that [[syphilis]], when treated with antibiotics, would develop into secondary and tertiary syphilis with involvement of the [[central nervous system]].<ref>{{cite journal|author=Campbell A|date=October 1978|title=The science of homoeopathy, by G. Vithoulkas|journal=British Homoeopathic Journal|type=book review|volume=67|issue=4|pages=299–301|doi=10.1016/S0007-0785(78)80061-1|s2cid=69144584 }}</ref> Vithoulkas' claims echo the idea that treating a disease with external medication used to treat the symptoms would only drive it deeper into the body and conflict with scientific studies, which indicate that [[penicillin]] treatment produces a complete cure of syphilis in more than 90% of cases.<ref name="Birnbaum">{{cite journal|vauthors=Birnbaum NR, Goldschmidt RH, Buffett WO|year=1999|title=Resolving the common clinical dilemmas of syphilis|url=http://www.aafp.org/afp/990415ap/2233.html|journal=American Family Physician|volume=59|issue=8|pages=2233–40, 2245–46|pmid=10221308|access-date=September 3, 2007|archive-date=June 6, 2011|archive-url=https://web.archive.org/web/20110606033808/http://www.aafp.org/afp/990415ap/2233.html}}</ref>

The use of homeopathy as a preventive for serious infectious diseases, called [[homeoprophylaxis]], is especially controversial.<ref name="BBC-malaria">{{cite news|date=January 5, 2011|title=Is bad homeopathic advice putting travellers at risk?|work=Newsnight|agency=BBC|url=http://news.bbc.co.uk/1/hi/programmes/newsnight/9341713.stm|access-date=January 10, 2015}}</ref> Some homeopaths (particularly those who are non-physicians) advise their patients against [[vaccine|immunization]].<ref name="pmid8554846" /><ref name="pmid9243229">{{cite journal |last1=Ernst |first1=E. |title=The attitude against immunisation within some branches of complementary medicine |journal=European Journal of Pediatrics |volume=156 |issue=7 |pages=513–15 |year=1997 |pmid=9243229 |doi=10.1007/s004310050650|s2cid=25420567 |doi-access=free }}</ref><ref>{{cite journal |last1=Ernst |first1=E |title=Rise in popularity of complementary and alternative medicine: reasons and consequences for vaccination |journal=Vaccine |volume=20 |pages=S90–93; discussion S89 |year=2001 |doi=10.1016/S0264-410X(01)00290-0 |pmid=11587822}}</ref> Others have suggested that vaccines be replaced with homeopathic "nosodes".<ref>
{{cite journal
 |author =Pray WS
 |title =The challenge to professionalism presented by homeopathy
 |journal =American Journal of Pharmaceutical Education
 |volume =60
 |pages =198–204
 |year =1996
|issue =2
 |doi =10.1016/S0002-9459(24)04582-0
 }}</ref> While Hahnemann was opposed to such preparations, modern homeopaths often use them although there is no evidence to indicate they have any beneficial effects.<ref>
{{cite journal
 |title =A challenge to the credibility of homeopathy
 |journal =American Journal of Pain Management
 |year =1992
 |author =Pray WS
 |issue  =2
 |pages =63–71
}}</ref><ref>{{cite journal |last1=English |first1=J |title=The issue of immunization |journal=British Homoeopathic Journal |volume=81 |pages=161–63 |year=1992 |doi=10.1016/S0007-0785(05)80171-1 |issue=4|s2cid=71502677 }}</ref> Promotion of homeopathic alternatives to vaccines has been characterized as dangerous, inappropriate and irresponsible.<ref name="CBC-Irresponsible">{{cite web|date=November 28, 2014|title=Vaccine alternatives offered by homeopaths 'irresponsible'|url=http://www.cbc.ca/news/health/vaccine-alternatives-offered-by-homeopaths-irresponsible-1.2852408|access-date=January 10, 2015|work=Marketplace|publisher=CBC}}</ref><ref name="BBC-Poling">{{cite news|author=Poling, Samantha|date=September 13, 2010|title=Doctors warn over homeopathic 'vaccines'|agency=BBC|url=https://www.bbc.co.uk/news/uk-scotland-11277990|access-date=January 10, 2015}}</ref> In December 2014, the Australian homeopathy supplier [[Homeopathy Plus!]] was found to have acted deceptively in promoting homeopathic alternatives to vaccines.<ref name="ACCC-HPlus">{{cite web|date=December 23, 2014|title=Court finds Homeopathy Plus! vaccine claims misleading|url=https://www.accc.gov.au/media-release/court-finds-homeopathy-plus-vaccine-claims-misleading|access-date=January 10, 2015|publisher=Australian Competition and Consumer Commission}}</ref> In 2019, an investigative journalism piece by the [[The Daily Telegraph|''Telegraph'']] revealed that homeopathy practitioners were actively discouraging patients from vaccinating their children.<ref>{{Cite news|last1=Rushton|first1=Katherine|last2=Foggo|first2=Daniel|last3=Barnes|first3=Sophie|date=2019-11-01|title=Homeopaths warning mothers not to have children vaccinated, investigation reveals|language=en-GB|work=[[The Daily Telegraph]]|url=https://www.telegraph.co.uk/news/2019/11/01/homeopaths-warning-mothers-not-have-children-vaccinated-investigation/ |archive-url=https://ghostarchive.org/archive/20220111/https://www.telegraph.co.uk/news/2019/11/01/homeopaths-warning-mothers-not-have-children-vaccinated-investigation/ |archive-date=January 11, 2022 |url-access=subscription |url-status=live|access-date=2019-11-03|issn=0307-1235}}{{cbignore}}</ref> Cases of homeopaths advising against the use of anti-malarial drugs have also been identified,<ref name="BBC malaria" /><ref name="Guardian malaria" /><ref name="pmid11082104" /> putting visitors to the tropics in severe danger.<ref name="BBC malaria">
{{cite news
 |author =Jones M
 |title =Malaria advice 'risks lives'
 |date =July 14, 2006
 |periodical =[[Newsnight]]
 |publisher =[[BBC Television]]
 |url =http://news.bbc.co.uk/2/hi/programmes/newsnight/5178122.stm
 |access-date =March 24, 2009
}}</ref><ref name="Guardian malaria">
{{cite news
 |author =Jha A
 |title =Homeopaths 'endangering lives' by offering malaria remedies
 |date  =July 14, 2006
 |url =https://www.theguardian.com/science/story/0,,1820103,00.html
 |newspaper =[[The Guardian]]
 |location =London
}}</ref><ref name="pmid11082104">{{cite journal |last1=Starr |first1=M. |title=Malaria affects children and pregnant women most |journal=BMJ |volume=321 |page=1288 |year=2000 |doi=10.1136/bmj.321.7271.1288 |issue=7271|pmc=1119021 |pmid=11082103}}</ref><ref name="Coffman">{{cite web|author=Coffman, Becky |url=https://www.cdc.gov/malaria/stories/homeopathic_drugs.html |url-status=dead |archive-url=https://web.archive.org/web/20140324180407/https://www.cdc.gov/malaria/stories/homeopathic_drugs.html |archive-date=March 24, 2014 |title=A cautionary tale: the risks of unproven antimalarials |publisher=[[Centers for Disease Control]] |date=January 28, 2019 }}{{cbignore}}</ref>

A 2006 review recommends that pharmacy colleges include a required course where ethical dilemmas inherent in recommending products lacking proven safety and efficacy data be discussed and that students should be taught where unproven systems such as homeopathy depart from evidence-based medicine.<ref>
{{cite journal
 |author=Pray WS
 |title=Ethical, scientific, and educational concerns with unproven medications
 |journal=American Journal of Pharmaceutical Education
 |volume=70
 |issue=6
 |page=141
 |year=2006
 |pmid=17332867
 |pmc=1803699
 |doi=10.5688/aj7006141
}}</ref>