A debate on homeopathy

Delegates refer resolution discouraging homeopathy for further review
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The debate continues on whether the AVMA should take a position on homeopathy.

The theory of homeopathy is that diseases can be cured by administering ultrahigh dilutions of substances that in a healthy individual would produce signs similar to those reported for the disease.

The AVMA House of Delegates deliberated during its Jan. 5 regular winter session on a resolution that would discourage homeopathy as ineffective.

Dr. Epstein
Dr. Shelley R. Epstein, a past president of the AVH, offered arguments in several forums to suggest that homeopathy can stand up to scrutiny. (Photos by R. Scott Nolen)

“Do we want to continue being part of this false premise?” asked Dr. Robert H. Belden, Connecticut alternate delegate.

The Connecticut VMA submitted the resolution and prepared a white paper on “The Case Against Homeopathy” as an addendum. Veterinary organizations as well as individual veterinarians wrote to the HOD arguing for and against the resolution, and the Academy of Veterinary Homeopathy submitted a white paper on “The Evidence Base for Homeopathy.”

Dr. Shelley R. Epstein, a past president of the AVH, offered arguments in several forums to suggest that homeopathy can stand up to scrutiny.

Hundreds of homeopathy advocates among the general public contacted the AVMA via email, telephone, Facebook, and Twitter to voice their opposition to the resolution.

Following deliberation, the HOD voted to refer the resolution to the AVMA Executive Board to consider referral to the AVMA Council on Veterinary Service. The House Advisory Committee had recommended that action. The council already is reviewing the existing AVMA Guidelines for Complementary and Alternative Veterinary Medicine, which do not describe the value of individual modalities.

Divisive measure

The board had recommended that the HOD disapprove the resolution discouraging homeopathy.

Dr. Douglas G. Aspros, AVMA president, said during a board meeting the resolution is divisive without benefit to the AVMA or AVMA members, and he hopes the AVMA will avoid considering such resolutions in the future.

Earlier, during a joint meeting of the board and House Advisory Committee, he said that passage of the resolution wouldn’t stop anyone from practicing homeopathy or change the opinions of those who hate homeopathy, and the resolution gives the appearance of the AVMA “putting its big foot” on top of homeopathy practitioners.

Dr. Kenneth E. Bartels, HAC vice chair, said during the joint meeting that the resolution could put the AVMA on a slippery slope toward examining many other modalities such as acupuncture, low-level laser therapy, and chiropractic care. He noted that products used in complementary practice are sold from booths in the AVMA Annual Convention’s exhibit hall.

Dr. Michael L. Whitehair, District IX representative on the board, said during the board meeting that the AVMA should still have room for conversation about homeopathy, but not at the policy level.

Opposing the resolution

Homeopathy advocates were very vocal in advance of the HOD session.

The 133-member Academy of Veterinary Homeopathy and the American Holistic VMA wrote to the HOD in defense of veterinary homeopathy. The AVH white paper cites studies supportive of the principles that highly diluted homeopathic remedies can have physiologic effects and that these remedies can be effective at treating disease.

“The risks are negligible in the hands of trained veterinary homeopaths, and the benefits in even some of the most severe cases can be strong,” according to the paper.

Others who wrote in opposition to the resolution to discourage homeopathy included staff veterinarians at the Organic Valley farmer cooperative in Wisconsin and Dr. Hubert J. Karreman, a dairy practitioner who served on the task force that developed the AVMA Guidelines for Complementary and Alternative Veterinary Medicine.

Dr. Epstein of the AVH spoke to a House reference committee that discussed the resolution ahead of the HOD session. She favored referring the resolution to the Council on Veterinary Service. She said AVH members were compiling about 200 papers on homeopathy, adding, “You’ll say, ‘Wow, how did I ever think it was implausible?’”

Dr. Timothy L. Montgomery, Georgia delegate, said during the committee meeting that practitioners of alternative veterinary medicine have contacted him to express concern that the AVMA could also discourage veterinarians from using other modalities.

During the HOD session, Dr. Kim A. Nicholas, Washington state delegate, said he has seen things work that he doesn’t understand—from acupuncture to drugs to a kitten’s purr.

“Just because I don’t necessarily understand something, doesn’t necessarily mean that it doesn’t work,” Dr. Nicholas said.

Supporting the resolution

Skeptics of homeopathy also made their case before and during the HOD session.

“There is a conspicuous absence of evidence of benefits despite centuries of use and investigation,” according to the white paper from the Connecticut VMA. “And there are real risks, not to mention ethical concerns, associated with substituting an ineffective therapy for truly beneficial medical care.”

Dr. Goldman (center)
Dr. Arnold L. Goldman, Connecticut delegate to the AVMA, speaks during a House reference committee meeting about a resolution from the Connecticut VMA to recognize homeopathy as ineffective.

The paper cites portions of the AVMA Guidelines for Complementary and Alternative Veterinary Medicine, including this: “The AVMA believes that all veterinary medicine, including CAVM, should be held to the same standards. Claims for safety and effectiveness ultimately should be proven by the scientific method.”

According to the paper, controlled scientific investigations have failed to demonstrate effectiveness of homeopathic remedies beyond placebo effects.

The Evidence-Based Veterinary Medicine Association, American College of Veterinary Clinical Pharmacology, and American Academy of Veterinary Pharmacology and Therapeutics wrote to the HOD to support the resolution to discourage homeopathy. So did Dr. Narda G. Robinson, an assistant professor who teaches complementary veterinary medicine at the Colorado State University College of Veterinary Medicine & Biomedical Sciences.

During discussion in the House reference committee, some committee members said they originally supported the measure but later concluded that the issue required further review. The committee recommended referring the resolution to the Council on Veterinary Service.

During the HOD session, the Connecticut delegate and alternate delegate spoke in favor of passing the resolution to discourage homeopathy.

“Here is an opportunity to distance ourselves from what most of us already know is an ineffective practice and to re-emphasize our foundations in science,” said Dr. Arnold L. Goldman, Connecticut delegate.

Referral and review

The Executive Board likely will make a decision at its April meeting whether to refer the resolution to the Council on Veterinary Service or to take another action.

Regardless, the council will review the AVMA Guidelines for Complementary and Alternative Veterinary Medicine this year. Members of the AVMA who wish to comment on the guidelines may do so by visiting the AVMA policies page.