This is the beginning of a new series discussing science and how we need to think about and approach the science and research of homeopathy. Guest writer Dr. David Nortman ND provides excellent perspectives on the philosophy and sociology of science and how that affects and limits our understanding of homeopathy.
David Nortman, N.D.
Homeopathy is one of the most controversial subjects in contemporary culture. On the surface homeopathy is just another form of natural medicine, yet its notoriety among skeptics is unmatched by that of any other field. It is perplexing how it is at once the butt of endless ridicule and an object of fear, as though the entire modern world would collapse into a primitive state if there were something true about it. The debate rarely rises above patent falsehoods and simplistic accusations. When it does, it is thought to be resolvable through recourse to scientific evidence, which it is commonly alleged homeopathy has none to offer.
In their interactions with the public and scientists, homeopaths can do very little to influence the reception of scientific evidence. Even though the growing evidence base for homeopathy is a mouse click away, it is routinely ignored, or else rejected as non-scientific even when it fully complies with the criteria of evidence-based medicine. Research into homeopathy, already limited due to lack of funding, is further suppressed by frequently being blocked from publication in recognized journals. So even though evidence-based medicine is supposed to be an impartial arbiter of the truth, in practice the evidence is subjugated to a culture that is unfavourable or outright hostile to homeopathy.
All of this goes to show that the question of evidence for homeopathy is not purely a matter of science: the ‘evidence’ in evidence-based medicine is a complex amalgam of clinical judgement, statistics, scientific politics, human psychological quirks, and broader cultural influences such as economics and politics. Yet both sides of the debate tend to get swept into an analysis of the data without first considering these factors.
So what is the ‘evidence’ of evidence-based medicine? In the context of homeopathy, what sort of data would constitute adequate evidence in its favour? Scientists, though they peddle in evidence, are not necessarily the most qualified to answer it. The notion of evidence has evolved over history, and multiple interpretations coexist at any one time, so the tools of philosophy and sociology of science must be invoked in order to provide an adequate answer. I would like to suggest that this question is the decisive one in the debate about the scientific status of homeopathy, and that little progress will be made without addressing it up front, no matter how much further evidence is put on the table. So let us begin this discussion by way of a little introduction to these disciplines, after which we will consider their relevance to homeopathy.
The philosophical perspective
Philosophy of science is a field of study that contemplates the foundations, methods, and implications of science. Its main task is to describe how successful science has been practiced historically and deduce how science ought to be practiced in the present.
The scientific method was formulated early on to establish the proper criteria of doing science, and it is widely considered to be its foundation and the reason for its astounding success. The tools of the scientific method include systematic observation and experimentation, quantification of observations or measurements, and the formulation, testing, and modification of hypotheses. The most desirable outcome of applying the scientific method is the discovery of laws of nature that are valid across all time and space.
In the case of living organisms, the ultimate goal is to uncover the universal mechanisms that underlie life on earth. There are reductionist scientists who argue, based on the assumption that there is no fundamental difference (other than level of complexity) between living and non-living entities, that the life sciences should produce laws of nature like those of physics or chemistry. However, living organisms are not only far more complex than physical objects and molecules, but are also fundamentally different from inanimate matter in ways that we still don’t fully appreciate.
Other scientists argue that life is also creative and not merely governed by fixed laws and mechanisms. They note, for example, that living creatures are goal-directed through their striving to survive and reproduce rather than merely to be, and that this quality cannot be captured in the terms of physics or chemistry. Instead of insisting on reducing their observations to laws and mechanisms, such scientists are content with describing biological processes simply out of curiosity and fascination with the beauty of life or for the sake of advancing various human aims such as medicine and environmental protection.
The truth lies somewhere in between: there are mechanistic aspects to life, but these seem to be embedded in a world governed more by probabilistic patterns than by strict causal interactions. And as some physicists and biologists are beginning to recognize, our world may ultimately be governed by laws of consciousness and even free will. Philosophy of science continues to evolve along with the sciences that it studies, and the gulf between the natural and life sciences may one day shrink and even disappear altogether.
The sociological perspective
Until the early twentieth century science was described as a growing accumulation of knowledge through the application of logic and the scientific method. But an unbiased look at the history of science has since revealed that science is influenced by society and is not immune to scientists’ psychological quirks. While the philosophy of science studies how science ought to be practiced, sociology of science describes how science is actually practiced. By emphasizing the inescapable human factor, the sociological perspective complements the more idealistic perspective of the philosophy of science.
One of the first scientists to call attention to the social construction of scientific knowledge was Ludwik Fleck, in Genesis and Development of a Scientific Fact (1935). Fleck introduced the idea that knowledge doesn’t simply accumulate over time but rather gets continually reshaped within an ever-evolving cultural context. According to him, every culture is characterized by a thought style that has a decisive influence on the thought collective constituted by the scientists practicing within any given field.
Building on this insight, in The Structure of Scientific Revolutions (1962) Thomas Kuhn famously argued that scientific progress is a social phenomenon that moves forward in fits and starts. Kuhn argued that any field of science alternates between normal science (the phase when existing assumptions are reinforced and anomalous data is ignored or rejected) and revolutionary science (the phase when assumptions are broken down and replaced by new assumptions).
Normal science does not live up to the ideal of science as open-ended inquiry because it inevitably adheres to some dogma or paradigm. It this way it resembles institutional religion and other non-scientific activities. Even though it refers to an underlying truth, a paradigm is a human-centric description of the truth rather than a direct representation of reality. Crucially, each paradigm functions like a distinct language that is largely incomprehensible to the practitioners of another paradigm.
Normal science transitions to revolutionary science whenever the existing paradigm no longer depicts a convincing picture of reality or otherwise fails to serve the needs of the society in which it was formulated. Revolution within a scientific field leads either to its disintegration (for example, alchemy, which was abandoned in favour of chemistry) or to a transition to a new paradigm (for example, Newtonian physics, which was successfully incorporated within modern physics).
Homeopathic research: the road forward
Once both the philosophical and sociological perspectives are considered, the reason that homeopathic research is routinely rejected becomes clear: homeopathy exists within a different paradigm from conventional medicine, so there is disagreement and misunderstanding about the most basic concepts. For example, what constitutes disease in homeopathy (an imbalance leading to psychological and functional symptoms) is not even considered a disease in conventional medicine; meanwhile what constitutes a cure in conventional medicine is often interpreted as suppression in homeopathy. When it comes to study design, conventional studies usually test one medication for one diagnostic category, an approach which is problematic and limiting in homeopathy. Conventional clinical research also tends to focus on narrow outcome measures (a specific sign or symptom) rather than holistic outcome measures (overall state of being).
For the time being homeopathy is an island unto itself, inaccessible and unknown to the wider public, so there is much work to be done in bridging the terms and concepts of homeopathy with those of other scientific disciplines. For this reason, focusing on research into homeopathy without educating the public about the homeopathic paradigm is putting the cart before the horse.
As of yet there is no established paradigm that incorporates both conventional medicine and homeopathy under one umbrella, but an intriguing proposal is Rupert Sheldrake’s Morphic Field Theory, as described in his book The Presence of the Past. Exploring this and other similar theories could draw the public’s curiosity and make homeopathy more plausible and coherent.
More generally, homeopaths could make their life easier by adopting a more contemporary thought style and by becoming well-informed about the history, philosophy, and sociology of science. There are terms such as ‘allopathy’ that are incomprehensible to most and carry disparaging connotations, and others such as ‘life force’ that refer to something real but in the outdated lingo of vitalism. Similarly, referring to Hahnemann’s writings to bolster a homeopathic argument without also grounding it in present-day evidence is characteristic of pre-scientific thought styles and hurts the homeopathic cause. Finally, acknowledging the enormous achievements of modern medicine rather than denigrating it as thoroughly abominable would go a long way toward healing the rift between the disciplines.