It's all in the mind

A while ago I commented on the British Chiropractic Association (BCA) dropping their libel action against science writer Simon Singh where the BCA had sued Dr Singh over a newspaper article in which he alleged that the organisation promoted “bogus treatments”.

I fear that my comments on alternative treatments may have opened a whole can of worms and have given every lawyer in the country carte blanche to comment on the efficacy of such treatments.

Richard Barr, a consultant with Scott-Moncrieff Harbour and Sinclair, in Solicitors Journal, wrote:

“When your baby dies, don’t sue me” warned the angry obstetrician when my wife (as she then wasn’t) refused his advice to stay in hospital because her as yet unborn son was stubbornly in the breach position. The obstetrician said there was no hope of turning him and he insisted she should have a Caesarean. She on the other hand really wanted to have a home birth; the problem was solved when her midwife administered a homeopathic remedy. Within hours the baby turned and was born naturally. Last year the baby achieved first class honours at Oxford Brookes University.

Oxford Brookes University! That shows the dangers of dabbling in alternative remedies.

Mrs Barr subsequently decided to train as a homeopath on the basis that although: “on the face of it, it makes no sense at all but I have seen it work so many times that I am convinced that homeopathic remedies work” and expressed the view that there was something about homeopathy that was far more effective than placebo. Richard Barr agrees.

Now, the way that science discovers whether a particular form of treatment works, or works better than placebo, is by undertaking thorough blind trials. If the treatment is shown to outperform the placebo then this suggests that it is effective. When this has been attempted with homeopathy, it has failed to produce any such clear result (see The end of homeopathy?). So how has Mrs Barr been able to identify a set of statistically relevant outcomes that have eluded science?

On the subject of “how does it work”, Richard Barr explains: “It should be remembered that homeopathy is not just a matter of dishing out pills. The key seems to be in the time spent analysing the individual and coming to the indicated treatment for that person. Homeopaths … take a huge amount of time to find out about their patients as opposed to the seven minutes or so that are allocated to the average GP appointment”. Barr has almost certainly hit the nail on the head here but appears to have missed, or at least isn’t prepared to publically spell-out, what conclusion this leads to. To the extent to which homeopathy does, questionably, work, it is not because the extra time spent with the patient is more likely to lead to the “correct” pill being prescribed. There is nothing in homeopath pills that could work. It is the very act of spending time a significant amount of time with the patient, sympathetically discussing their problems, that produces the positive results that homeopathy and other alternative treatments sometimes seem to produce. This is the powerful, and much under-valued, placebo effect.

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Of course, I suppose one should not be surprised that lawyers are as susceptible as non-lawyers to alternative therapies and superstitious beliefs. I would confidently predict that a number of readers of the Legal Costs Blog believe, at least to a certain extent, in astrology. I would be equally confident that a high proportion of these readers are Capricorns. Capricorns are well known for their irrational belief in a connection between star signs and personality traits.

Having said all of this, I am seriously considering hiring Paul the “psychic” octopus to advise me on the level of success fees that costs judges are likely to allow in public liability tripping claims.

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For yet more on the power of the placebo effect, watch this:

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(If you receive the Legal Costs Blog via email you made need to adjust your security settings or visit the Blog online to view the video.)

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