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BY DR BETTY CHAAR
Over the years there has been growing
concern over the role of homeopathy in
The fact that many pharmacies offer homeopathic
products amongst their many ranges of over-the-
counter products means these concerns are of
particular interest to the pharmacy profession. So
serious has this issue become to the profession
globally, that the International Pharmaceutical
Federation (FIP) is currently formalising its position
on behalf of the pharmacy profession worldwide --
and the message is crystal clear.
Therefore, regardless of whether you personally
believe in homeopathy or not, or carry the stock in
your pharmacy or not, it is incumbent on each and
every pharmacist to be aware of and well versed in
the arguments both for and against homeopathy,
and where we as pharmacists stand.
Homeopathy is a practice created by Samuel
Hahnemann (1755-1843) based on the belief that
minute quantities of substances dissolved in water
can have powerful healing effects on the human
This is based on two premises:
• that substances that may cause illness or symptoms
in a healthy person can, in very small doses, treat
those symptoms in a person who is unwell, and
• that highly diluted preparations retain a 'memory'
of the original substance. Homeopathic medicines
are prepared by taking a substance (e.g. plant,
animal material, or chemical), diluting it in water
or alcohol, then forcefully hitting the container
against a hand or a surface.
Of course there are no direct adverse events to
report as a direct result of consuming or applying
homeopathic substances of such minimal
concentrations. The concerns lie in the fact that some
people, in choosing such options lose crucial time
in which more effective, evidence-based treatments
could have been used. There are literally hundreds
of documented incidents of harm caused by lack
of efficacy that can be found on the internet, with
names, places and times of death for some. These
reports are increasing the gravity of existing concerns.
In 2015 the National Health and Medical Research
Council (NHMRC) released a major report on
homeopathy which has resonated around the world.
Its message is about lack of efficacy, the danger of
time lost, and lack of evidence to support claims of
any therapeutic value except that of a placebo.
In terms of pharmacists' ethical duties in
practice, and the bioethical principles that guide
contemporary healthcare practice, we often need
to consider the principle of respect for patient
autonomy as 'first amongst equals', and herein
lies the ethical dilemma. Do we respect patient
autonomy, when we suspect the patient is either
uninformed or lacks awareness of the crucial
importance of the parameters of time and efficacy
in the treatment of healthcare conditions? Do we
respect patient autonomy in the face of defiance
and strong beliefs?
These questions have often plagued healthcare
professionals, particularly before the introduction
of the NHMRC Report, when everything bandied
around was more or less hearsay. However, this
report now informs our standards of practice and
should be recognised as such. Therefore it is our
duty to ensure our own knowledge is up to date,
and that of our client/patient. Once we are assured
that the individual has made an informed decision,
either way -- we have thereby met our duties as a
healthcare professional. It is also strongly advisable
to document any discussion of this nature for any
follow up if needed.
u The PSA Position Statement on Complementary
Medicines includes homeopathy (www.psa.org.au/
NHMRC statement on homeopathy -- March 2015
Based on the assessment of the evidence of effectiveness of homeopathy, NHMRC
concludes that there are no health conditions for which there is reliable evidence
that homeopathy is effective. Homeopathy should not be used to treat health
conditions that are chronic, serious, or could become serious. People who choose
homeopathy may put their health at risk if they reject or delay treatments for which
there is good evidence for safety and effectiveness. People who are considering
whether to use homeopathy should first get advice from a registered health
practitioner. Those who use homeopathy should tell their health practitioner and
should keep taking any prescribed treatments. The National Health and Medical
Research Council expects that the Australian public will be offered treatments and
therapies based on the best available evidence.
People who use homeopathy need to understand the potential benefits and
risks to enable them to make an informed decision. Health practitioners also
need to know what homeopathy is, be aware of the current scientific evidence
from research on homeopathy, and understand any possible benefits and risks
to patients, particularly when people decide to use homeopathy instead of other
DR BETTY CHAAR MPS
is Senior Lecturer and
MPharm Co-ordinator at
the Faculty of Pharmacy,
the University of Sydney.
in this column are not
necessarily those of the
Pharmaceutical Society, its
Board or staff.
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