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| - This article was originally published in Greek on 6 February 2024
Over the years, homeopathy has been advocated both by non-institutional groups and official bodies as an evidence-based scientific practice. Within this framework, homeopathy meetings and seminars have been organized, sometimes with the support of official scientific or governmental entities. In November 2023, the 19th Panhellenic Conference of Homeopathy was held, organized by the Hellenic Homeopathic Medical Society (HHMS), which was supported by the Athens Medical Association and the Ministry of Health. Similar events have taken place in the past, raising questions about the endorsement of healthcare professionals in a practice that is not recognized as a medical specialty, as we will delve into further in this article.
Upon reviewing the scientific literature, it becomes evident that there is no reliable evidence supporting the effectiveness of homeopathy in treating any disease. Furthermore, the mechanism of action of homeopathy itself is not consistent with established biochemical mechanisms. In this article, we aim to conduct a detailed examination of the principles and effectiveness of homeopathy, as well as its status in the Western world, including its recognition by official institutions in Greece.
- Recent background of actions and support of homeopathy in Greece
- Scientific evidence for the efficacy of homeopathy
- The broader history of homeopathy in Greece and statements by official institutions
- Conclusions
Recent background of actions and support of homeopathy in Greece
The Hellenic Homeopathic Medical Society (HHMS)
The conference that triggered criticism directed at the Athens Medical Association and the Ministry of Health for endorsing homeopathy was organized by the Hellenic Homeopathic Medical Society (HHMS). Established in 1971, the organization currently comprises doctors who also practice homeopathy. Despite efforts to promote homeopathy as a scientifically grounded practice, which contradicts the available scientific literature as we will discuss further in this article, the HHMS has already organized numerous seminars and conferences. Additionally, the organization has attempted to integrate homeopathy into university curricula.
On the organization’s official website, there is a section that includes articles containing severe scientific claims. Among these claims are assertions of susceptibility to AIDS due to vaccination, treatment of childhood infections such as otitis and laryngitis with homeopathic preparations, and purportedly more effective treatment of cancerous nephroblastoma after surgery with homeopathy instead of chemotherapy.
An article still published on the organization’s official website claims that the Gardasil vaccine against HPV contains aluminum, which is portrayed as a dangerous neurotoxin stored primarily in the brain, leading to various serious health issues. This assertion regarding the harmful effects of aluminum in HPV and other vaccines is one of the most widely recognized pseudoscientific claims. However, it’s important to note that the aluminum used in these vaccines is not in its metallic form; instead, it is present in compounds known as adjuvants. Adjuvants play a crucial role in enhancing the vaccine’s effectiveness by stimulating a robust immune response with a smaller vaccine dose. Extensive studies have been conducted to assess the safety and efficacy of these compounds, and current literature indicates no associated risks with their use in commercially available vaccines.
These findings are corroborated by official health agencies such as the US Centers for Disease Control and Prevention (CDC) and the European Medicines Agency (EMA). Both agencies provide separate reports on the efficacy and safety of Gardasil, essential prerequisites for vaccine approval and use in the general population. In a previous article, we extensively analyzed the scientific evidence concerning the safety and effectiveness of HPV vaccines, as well as debunked prevalent misconceptions on the topic.
Another instance is an article on the HHMS website presenting the case of a 50-year-old woman who opted out of surgery for breast cancer and agreed to a homeopathic treatment. According to homeopath Venetia Vergou-Bazaiou, the author of the article, the patient underwent a biopsy, after which surgery on the right breast was recommended. After consultation with Mrs. Vergou-Bazaiou, the patient decided against surgery. As claimed by the author, three years later, the tumor was no longer palpable, and until that examination, surgery was deemed unnecessary. However, the article fails to provide relevant information to ascertain whether the tumor was benign or malignant, whether the patient received concurrent treatments, and the rationale behind the initial surgery recommendation. Furthermore, no studies have demonstrated that homeopathic treatment can stop the progression of breast cancer. This claim poses a significant risk as it may prompt patients to reject evidence-based conventional treatments or life-saving interventions in favor of unproven practices.
These articles exemplify typical instances, with numerous similar articles available on the website of the Hellenic Homeopathic Medical Society. Furthermore, as we will examine, such claims are not isolated incidents. The conference program held in November 2023 included scheduled speeches promoting pseudoscientific claims, such as the unfounded assertion that vaccines cause autism.
It is noteworthy that the Hellenic Homeopathic Medical Society is not the only organization conducting such seminars or publishing articles with severe medical claims. Another example is the National Society of Homeopathic Medical Cooperation, which features an article by psychiatrist Vangelis Zafiriou claiming that:
Η ομοιοπαθητική είναι κατάλληλη για όλες τις ηλικίες και για τις πιο δυσκολοθεράπευτες παθήσεις όπως το άσθμα, οι αλλεργίες, τα συχνά κρυολογήματα στα παιδιά και τους ενήλικες, οι ημικρανίες, η κολίτιδα, το έλκος, οι φοβίες, η κατάθλιψη, η νευρογενής ανορεξία, το έκζεμα, η ψωρίαση, η δυσμηνόροια, άλλα γυναικολογικά προβλήματα.
Για την εικαζόμενη δράση της ομοιοπαθητικής σε σειρά ασθενειών μερικές από τις οποίες αναφέρονται και στην λίστα που παραθέτει ο κ. Ζαφειρίου στο άρθρο του, θα γίνει σχετική ανάλυση στην συνέχεια του άρθρου.
Claims made during the 19th Panhellenic Conference of Homeopathy
The conference, held at the Eugenides Foundation in Athens, featured a broad spectrum of topics. However, as we will discuss later in this article, many of these topics lack scientific evidence.
Some presentations raised more significant concerns, such as the speech by Constantinos Dardayannopoulos, who asserted having successfully treated himself for COVID-19 using homeopathic remedies. To date, no randomized, double-blind, placebo-controlled clinical trials have established the efficacy of any homeopathic treatment in preventing or treating COVID-19. Only one such study, published in the Journal of Integrative Medicine1Adler, Ubiratan Cardinalli, et al. “Homeopathy for COVID-19 in primary care: A randomized, double-blind, placebo-controlled trial (COVID-Simile study).” Journal of Integrative Medicine, vol. 20, no. 3, 1 May. 2022, pp. 221-9, doi:10.1016/j.joim.2022.03.003., examined 86 patients and found no statistically significant difference between the effects of the examined homeopathic preparation under and a placebo.
Constantinos Phytopoulos’ speech at the conference raises even more significant concerns, particularly regarding the homeopathic treatment of a boy on the autism spectrum. In addition to the scientifically unfounded approach of treating autism with homeopathy, Dr. Phytopoulos made a Facebook post claiming that the patient’s autism was likely the result of vaccination:
On Saturday, November 25, from 18:30 to 19:00 in the Satellite Room at the Eugenides Foundation, as part of the 19th PANHELLENIC CONFERENCE OF HOMEOPATHIC MEDICINE, I will present a case of a boy who RECOVERED after homeopathic treatment and experienced a skin healing reaction, moving him OUT OF the AUTISM SPECTRUM, which he probably entered following vaccination.
The claim that vaccines cause autism is a pseudoscientific belief perpetuated for decades by members of the anti-vaccination movement, lacking any scientific foundation. We will delve deeper into this issue later in the article.
Support for the conference by the Athens Medical Association, the Ministry of Health and the University of the Aegean
While the 19th Panhellenic Conference of Homeopathy garnered significant attention, it wasn’t the first event organized by the Hellenic Society of Homeopathy to receive support from official bodies. According to publicly available data from Diavgeia, both the 17thInformation about the conference here and 18thInformation about the conference here conferences were endorsed by the Ministry of Health and the Athens Medical Association (ΑΜΑ). Notably, the Athens Medical Association includes the organization in its list of official professional health organizations, alongside entities such as the Hellenic Society of Cardiology and the Hellenic Society of Rheumatology.
AMA’s decision to endorse the 19th homeopathy conference sparked reactions from various members of the scientific community. One such example is the letter of protest from pathologist and scientific collaborator of FactReview, Panagiotis Houpas, in which he stated the following:
To the Athens Medical Association
Athens 28/11/2023
Dear Colleagues.
The 19th Panhellenic Homeopathic Congress, titled “Developments in Homeopathic Education – Half a Century of Experience,” took place in Athens from November 24 to 26, 2023. According to its organizers, the conference was held under the auspices of the Athens Medical Association (AMA).
In the July-September 2023 edition of the journal “Homeopathic News” by the Hellenic Homeopathic Medical Society (page 53), the President of the Society, Dr. Demosthenes Papamethodiou (Neurologist, MSc), wrote an article on the occasion of the conference. Among other points, he stated: “The contribution of this highly effective medical method (i.e. homeopathy) in the treatment of viral infections and epidemics is enriched by recent works, including evidence from the recent pandemic. The International Academy of Classical Homeopathy recently published a retrospective analysis of the effectiveness of homeopathy in treating COVID-19. Vigilance and a competitive disposition are required from all of us against the imposition of the extremely profitable but also dangerous mRNA technology, as it is gradually proving to be. New plans are emerging to mandate vaccination for healthy and vulnerable groups against the coronavirus and to replace existing vaccines with this new technology.
According to the official program of the conference, among other notable presentations, there was a session by fellow psychiatrist Dr. Konnos Phytopoulos titled “Homeopathic Treatment of a Boy on the Autism Spectrum.” A few days prior (on Thursday, November 23, 2023, at 1:00 a.m.), on the colleague’s social media profile, the following statement was posted: “On Saturday, November 25, from 18:30 to 19:00 in the Satellite Room at the Eugenides Foundation, as part of the 19th PANHELLENIC CONFERENCE OF HOMEOPATHIC MEDICINE, I will present a case of a boy who RECOVERED after homeopathic treatment and experienced a skin healing reaction, moving him OUT OF the AUTISM SPECTRUM, which he probably entered following vaccination. The efficacy of Homeopathic practice… etc. It is unclear whether this colleague publicly supported these views during the conference. However, I would like to raise the following questions:
When did the AMA officially endorse this conference, and what was the rationale behind this decision? Was the AMA aware of the viewpoints of the organizers and presenters regarding significant public health issues such as vaccines? Does the AMA support these viewpoints? If not, does the AMA believe it should clarify its position, even retroactively, despite potential harm caused by the anti-vaccine implications made “under its auspices”?”
Sincerely,
Panagiotis D. Houpas
Doctor specializing in Internal Pathology
AM ISA: 039347
Regarding the Ministry of Health’s endorsement of the most recent conference, as indicated in the corresponding publication on Diavgeia and confirmed by a Ministry press representative, the decision was signed by a previous Minister, without necessarily reflecting the stance of the current administration. However, as previously mentioned, upon examining corresponding decisions on Diavgeia, this isn’t the first instance of such a conference being held under the auspices of the Ministry of Health, indicating longstanding and consistent support for the practice of homeopathy.
In addition to the aforementioned institutions, another organization that has consistently supported the homeopathy conferences organized by the Hellenic Society of Homeopathy for several years is the University of the Aegean. The University of the Aegean was also the first to establish a postgraduate homeopathy program, which was ultimately discontinued in 2017. A search in the archives of the Hellenic Society of Homeopathy reveals that the 14th, 15th, and 16th Panhellenic Conferences of Homeopathy were held under the auspices of the University of the Aegean.
Scientific evidence for the efficacy of homeopathy
Claims about the mechanism of action of homeopathy
The fundamental principle of homeopathy is encapsulated in the phrase “like cures like” (similia similibus curentur), coined by the founder of the practice, Samuel Hahnemann, in 1796. This concept posits that substances capable of causing specific symptoms in healthy individuals can also alleviate those same symptoms in patients when administered in highly diluted form. For example, Allium Cepa, or red onion, which induces tearing when cut, is used as a homeopathic remedy for treating runny nose and allergic rhinitis. It’s important to note that homeopathy emerged at a time when understanding of disease causation was limited. Concepts such as pathogenic microorganisms and basic mechanisms of action of medicines were unknown, leading to the development of theories about the efficacy of highly diluted preparations, which have since remained largely unchanged.
The process by which substances used in homeopathic preparations are treated involves successive dilutions coupled with vigorous shaking, known as “dynamization.” To prepare a homeopathic remedy, the original substance is diluted at each stage, with vigorous shaking applied to each dilution to “imprint the identity” of the substance onto the solution. Some homeopathic remedies boast dilutions as high as 30C, which means that the final solution contains 1 part of the active substance per 10 to the power of 60 solvent molecules. In layman’s terms, this means that the final solution contains no molecules of the original substance.Given the particularly small sizes at the atomic scale in chemistry, there is a number used to describe that we have a discrete “piece” of an element or compound in a solution, the Avogadro number. This number tells us that a “piece”, or mole, of an element or compound consists of approximately 6×1023 molecules. Therefore, in a homeopathic preparation with a reported concentration of 1 molecule (not mole) of substance in 1060 molecules of solvent, we practically have no molecules inside.
Various hypotheses have emerged over the years attempting to explain how a solution devoid of a single molecule of the original active ingredient could still be purportedly effective in treating ailments within the realm of homeopathy. One of the most renowned conjectures, still embraced by many homeopaths today, is the concept of “water memory.” This hypothesis was developed and tested by immunologist Jacques Benveniste in 1988. In his study published in the journal Nature2Davenas, E., et al. “Human basophil degranulation triggered by very dilute antiserum against IgE.” Nature, vol. 333, no. 6176, June 1988, pp. 816-8, doi:10.1038/333816a0. Archived here., Benveniste employed the homeopathic process of diluting a solution of human antibodies to the extent that none remained in the solution. He then asserted that when a specific type of white blood cell was introduced to the solution, it exhibited reactions consistent with the presence of antibodies.
According to the water memory hypothesis, the molecules of the solvent retain the structural arrangement they acquired while the active substance was present in the solution. This retained arrangement purportedly mimics the action of the active substance without the substance itself needing to be present in the solution. For a clearer visualization and understanding of the proposed mechanism, refer to the figure below.
In reality, the molecules of a solvent can temporarily retain the arrangement they form around a solute molecule after its removal, but this arrangement persists for an infinitesimally brief period. A subsequent study published in the journal Nature3Cowan, M. L., et al. “Ultrafast memory loss and energy redistribution in the hydrogen bond network of liquid H2O.” Nature, vol. 434, no. 7030, Mar. 2005, pp. 199-202, doi:10.1038/nature03383. Archived here., which investigated the interactions between water molecules and the bonds they form with each other, demonstrated that such arrangements may remain intact for only femtoseconds, or approximately four millionths of a second. Even if these arrangements were to persist for a longer duration, there is no known biochemical mechanism that would enable them to mimic the action of another chemical compound within the body. Benveniste’s study was subsequently subjected to a series of replication attempts4Hirst, S. J., et al. “Human basophil degranulation is not triggered by very dilute antiserum against human IgE.” Nature, vol. 366, no. 6455, Dec. 1993, pp. 525-7, doi:10.1038/366525a0. Archived here.5Ovelgönne, J. H., et al. “Mechanical agitation of very dilute antiserum against IgE has no effect on basophil staining properties.” Experientia, vol. 48, no. 5, 1 May. 1992, pp. 504-08, doi:10.1007/BF01928175. Archived here. aimed at verifying the validity of the proposed mechanism, none of which have succeeded in confirming its veracity to date.
Apart from the concept of water memory, other hypotheses about the mechanism of action of homeopathy have been proposed, including speculative biochemical mechanisms that remain unidentified to this day, as well as vague references to quantum mechanics. However, none of these hypotheses have been substantiated as real or even plausible mechanisms of action for homeopathy through reputable scientific studies.6Mukerji, Nikil and Edzard Ernst. “Why homoeopathy is pseudoscience.” Synthese, vol. 200, no. 5, 14 Sept. 2022, pp. 394-29, doi:10.1007/s11229-022-03882-w.
The overturn of homeopathy in the UK
In addition to scrutinizing the chemical and biological plausibility of homeopathy, numerous endeavors have been made to assess its efficacy in human subjects under real-world conditions. However, due to the wide array of methodologies and limitations inherent in such studies, their interpretation necessitates meticulous literature reviews.
Generally, the most robust studies are those featuring large participant cohorts randomly assigned to distinct groups, receiving either genuine homeopathic remedies or a placebo, without the knowledge of either the patients or the treating physicians regarding which intervention was administered. Nonetheless, since conducting such studies is highly demanding, the majority of relevant research fails to meet these demanding criteria.
The first modern and comprehensive institutional evaluation of homeopathy was conducted by an expert committee of the British Parliament in 2009-2010. This review determined that the theoretical basis of homeopathy is implausible, as previously mentioned, yet it chose to independently examine its clinical effectiveness7Turner, Andrew. “Evaluating the UK House of Commons Science and Technology Committee’s position on the implausible effectiveness of homeopathic treatments.” Theor. Med. Bioeth., vol. 38, no. 4, 1 Aug. 2017, pp. 335-52, doi:10.1007/s11017-017-9415-y.. The committee meticulously examined all available literature reviews on the subject and found that positive findings were only reported in superficial reviews that failed to assess the quality of each study.
The most comprehensive and high quality review conducted to date, published in 2005 in the scientific journal The Lancet8Shang, Aijing, et al. “Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy.” Lancet, vol. 366, no. 9487, 27 Aug. 2005, pp. 726-32, doi:10.1016/S0140-6736(05)67177-2. Archived here., concluded that only the smallest and lowest-quality studies tended to present clearly positive results for homeopathy. However, when exclusively considering the highest-quality studies, any indication of efficacy became statistically uncertain, whereas a high level of certainty remained for conventional treatments. The review asserted that the findings are consistent with the notion that homeopathic products demonstrate only placebo efficacy, attributable to the well-documented placebo effect. This effect refers to the patient’s subjective perception of improvement in their condition, even when administered a completely inactive product9Pardo-Cabello, Alfredo Jose, Victoria Manzano-Gamero, and Emilio Puche-Cañas. “Placebo: a brief updated review.” Naunyn-schmiedeberg’s Archives of Pharmacology 395.11 (2022): 1343-1356. DOI: 10.1007/s00210-022-02280-w.
Overall, the expert panel arrived at the following negative conclusion regarding homeopathy:
By providing homeopathy on the NHS and allowing MHRA licensing of products which subsequently appear on pharmacy shelves, the Government runs the risk of endorsing homeopathy as an efficacious system of medicine. To maintain patient trust, choice and safety, the Government should not endorse the use of placebo treatments, including homeopathy. Homeopathy should not be funded on the NHS and the MHRA should stop licensing homeopathic products.
By 2010, the British Medical Association had also voted to eliminate homeopathy from the NHS, leading to the gradual phasing out of its insurance coverage. In 2013, the british advertising authority concluded that sellers of homeopathic products were misleading the public with claims of efficacy, thus deterring them from seeking out truly effective and often necessary therapeutic practices.
Since 2007, there had been growing concern in the United Kingdom regarding the presence of undergraduate programs in homeopathy at some universities. However, by 2012, all such programs had been discontinued. Currently, UCAS, the main body for applications to British universities, does not list any undergraduate programs in homeopathy.
In 2016, it was revealed that the NHS in England was still spending millions towards homeopathy coverage. Consequently, in 2017, coverage was completely halted due to concerns of mismanagement of resources. The British Homeopathic Association contested this decision, leading to a legal battle with the NHS. However, in 2018, the UK High Court ruled in favor of the NHS. This decision predominantly affected England, but Wales and Northern Ireland have also ceased funding homeopathy entirely. In Scotland, only 5 out of 14 local councils still provide coverage for homeopathy, primarily through a single local center specializing in alternative medicine.
In 2021, the professional certification of another British organization, the “Society of Homeopaths (SoH),” was revoked following complaints of unscientific practices. The promotion of the “CEASE therapy” by the SoH, which claimed to “eliminate autism” supposedly caused by previous vaccination, played a central role in this decision. The CEASE practice has since been condemned by other institutions in the UK, the Netherlands, and Canada. It’s important to note that the alleged link between the autism spectrum and vaccinations has been debunked by the scientific community for many years10DeStefano, Frank and Tom T. Shimabukuro. “The MMR Vaccine and Autism.” Annu. Rev. Virol., vol. 6, no. 1, 29 Sept. 2019, pp. 585-600, doi:10.1146/annurev-virology-092818-015515.. Currently, there is no proven treatment for autism, only management practices11Kalra, Ruchika, et al. “Recent advancement in interventions for autism spectrum disorder: A review.” Journal of Neurorestoratology, vol. 11, no. 3, 1 Sept. 2023, p. 100068, doi:10.1016/j.jnrt.2023.100068.. Additionally, it’s worth mentioning that proposals to “cure autism” are controversial, as a significant portion of the autism spectrum could be considered natural neurodiversity, and the large majority of people on the spectrum seem to reject the notion of a “cure.”
Furthermore, the clinical utility of homeopathy is also challenged by other reputable British institutions, such as the Royal Pharmaceutical Society. Cancer Research UK, the world’s largest independent cancer research organization, emphasizes that homeopathy lacks reliable scientific evidence for cancer prevention or treatment. Patients with cancer may be at risk if they stop their standard treatment and turn to unproven alternatives. Indeed, two analyses that examined12Johnson, Skyler B., et al. “Use of Alternative Medicine for Cancer and Its Impact on Survival.” J. Natl. Cancer Inst., vol. 110, no. 1, 1 Jan. 2018, pp. 121-4, doi:10.1093/jnci/djx145. the 5-year outcomes of hundreds of cancer patients who used alternative versus conventional practices found that mortality rates were twice as high in the former group13Skyler B. Johnson, M. D. “Complementary Medicine, Refusal of Conventional Cancer Therapy, and Survival Among Patients With Curable.” JAMA Oncol., vol. 4, no. 10, 1 Oct. 2018, pp. 1375-81, doi:10.1001/jamaoncol.2018.2487..
The changing stance of the Western world on homeopathy
Outside of the UK, another comprehensive recent review of homeopathy was conducted by Australia’s National Health and Medical Research Council (NHMRC) in 2010-201514National Health and Medical Research Council. Effectiveness of Homeopathy for Clinical Conditions: Evaluations of the Evidence – Overall Report (2015). Archived here.. This review incorporated input from all previous systematic literature reviews, institutional opinions, and proponents of homeopathy, and similarly concluded that there was no reliable evidence of its effectiveness for any condition. In its conclusions, the NHMRC pointed out:
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.
However, advocates of homeopathy disputed the NHMRC’s conclusions. In 2017, a complaint about the conduct of the review was filed with the Australian Ombudsman, which eventually delivered an opinion on the matter in 2023. The Ombudsman did not reach any negative conclusions about the review or the NHMRC, but offered suggestions for improving NHMRC public communication.
Possibly due to this development, since 2020, the original page where the NHMRC report was posted has been taken down, and a revised version has been published, which includes a separate FAQ document. In this document, the NHMRC clarified that it only considered studies with at least 150 participants, as smaller studies are widely known in the literature to significantly overestimate the effectiveness of a given practice15Dechartres, Agnes, et al. “Influence of trial sample size on treatment effect estimates: meta-epidemiological study.” BMJ, vol. 346, 24 Apr. 2013, p. f2304, doi:10.1136/bmj.f2304..
In this document, the NHMRC also clarified misconceptions surrounding the so-called ‘Swiss report of homeopathy’. Between 1998 and 2005, the Swiss government conducted an evaluation of 5 complementary and alternative practices, including homeopathy. Regarding homeopathy, the Swiss government evaluated two reviews: the comprehensive review of 2005 mentioned earlier, and another review published in 2006, which reached positive conclusions16Bornhöft, Gudrun, et al. “Effectiveness, safety and cost-effectiveness of homeopathy in general practice – summarized health technology assessment.” Forsch. Komplementmed., vol. 13, no. Suppl, 2006, pp. 219-29, doi:10.1159/000093586. Archived here.. However, unlike the 2005 review, the 2006 review did not focus on higher quality studies. After examining the available data, the Swiss government decided in 2005 to cease insurance coverage of homeopathy.
This decision was reversed in 2011, despite the opposing view of yet another scientific committee, due to the popularity of homeopathy and a relevant referendum in 2009. It is worth noting that the contentious popularity observed in some countries is a socio-psychological phenomenon that has been thoroughly studied and does not correlate with the level of evidence17Cukaci, Cemre, et al. “Against all odds—the persistent popularity of homeopathy.” Wien. Klin. Wochenschr., vol. 132, no. 9, 2020, p. 232, doi:10.1007/s00508-020-01624-x.. For instance, astrology remains popular in many countries, despite being extensively debunked for decades.
In 2017, the European Academies’ Science Advisory Council (EASAC)18European Academies’ Science Advisory Council. Homeopathic products and practices: assessing the evidence and ensuring consistency in regulating medical claims in the EU (2017). Archived here. also published its position on the topic. The EASAC includes 25 national scientific academies, including the Academy of Athens. In the final conclusions of the EASAC, the following are stated, among other things:
Any claimed efficacy of homeopathic products in clinical use can be explained by the placebo effect or attributed to poor study design, random variation, regression towards the mean, or publication bias. […]
Homeopathy raises issues of concern for patient-informed consent if health practitioners recommend products that they know are biologically ineffective.
There are also potential safety concerns for homeopathic preparations because of poorly monitored production methods, and these require greater attention to quality control and assessment of adverse effects. […]
The promotion and use of homeopathic products risks significant harms. First, by incurring delay in the patient seeking appropriate, evidence-based, medical attention or, even worse, deterring the patient from ever doing so. Secondly, by generally undermining patient and public confidence in the nature and value of scientific evidence for decision making in health care and other societal priorities. […]
EASAC recommends the following:
There should be a consistent regulatory requirement for claims for the efficacy, safety and quality of all medicinal products to be based on verifiable and objective evidence, commensurate with the claims being made. The necessity for robust data applies to products for both human and veterinary medicine. In the absence of such robust and verifiable evidence, a product should not be approvable by national regulatory agencies for the designation medicinal product.
Public health-system budgets are under increasing pressure. Evidence-based public health systems should not offer reimbursement for homeopathic products and services unless they are demonstrated to be efficacious and safe by rigorous testing.
The composition of homeopathic products should be labelled in a similar way to other health products available in the pharmacy (OTC) or elsewhere. That is, the current exceptional labelling permitted for homeopathic products should be replaced by a simple description of the ingredients and their amounts present in the formulation.
Advertising and marketing of homeopathic products and services must be regulated to be accurate and clear: advertising claims made for efficacy and safety should not be allowed without demonstrable and reproducible evidence.
The above developments have led to a broader shift in attitudes towards homeopathy across several European countries. In 2018, Spain announced its intention to combat the dissemination of pseudoscience on multiple fronts, ranging from medical societies, to healthcare and advertising. Additionally, in 2020, homeopathy suffered its first legal defeat in Spain, as a group of homeopaths failed in their lawsuit against their critics. In 2019, France decided to phase out insurance coverage for homeopathy within two years, despite the practice’s significant popularity. Similarly, in early 2024, the German government declared its intention to discontinue its insurance coverage in the near future, despite Germany being historically considered the practice’s ‘birthplace’ with strong social and traditional legislative support.
Regarding safety, the EASAC noted that while it is often assumed that homeopathic preparations could not have side effects due to their level of dilution, this is not always the case. A recent review19Stub, Trine, et al. “Adverse effects in homeopathy. A systematic review and meta-analysis of observational studies.” Explore, vol. 18, no. 1, 1 Jan. 2022, pp. 114-28, doi:10.1016/j.explore.2020.11.008. Archived here. found that the reporting of time-related adverse events with homeopathic preparations was common, although these reports were generally not serious and occurred more frequently with respective conventional medicine. However, the literature is relatively limited, and it is not possible to systematically test whether serious side effects occur for the thousands of different homeopathic preparations, especially at a more unusual rate.
In recent years, concerns have also been raised by competent institutions in the USA20Abbasi, Jennifer. “Amid Reports of Infant Deaths, FTC Cracks Down on Homeopathy While FDA Investigates.” JAMA, vol. 317, no. 8, 28 Feb. 2017, pp. 793-5, doi:10.1001/jama.2016.19090. Archived here. regarding safety, especially with the finding of serious medical incidents and deaths in infants in connection with homeopathic toothache products. In several cases, the only plausible causal link could be made to the preparations in question. In 2017, the US Food and Drug Administration (FDA) announced that in some cases a much higher concentration of the potentially deadly belladonna poison had been found than was listed on the packages of the products.
In late 2023, the FDA highlighted the heightened risk posed by untested products to the eyes, as this route of administration bypasses key bodily defenses. Specifically concerning homeopathic products, the FDA announced that they should be removed from the market. This decision resulted from a series of serious incidents involving infections and blindness attributed to unapproved products, followed by product recalls and factory inspections.
The US National Center for Complementary and Integrative Health (NCCIH) also confirms the problematic evidence base of homeopathy, and for its safety it similarly notes that certain products may contain significant amounts of active ingredients that may cause side effects or interactions with conventional medicine.
Systematic biases in pro-homeopathic literature
One of the key publications cited by homeopathic advocates is a 2014 review specifically on personalized homeopathy21Mathie, Robert T., et al. “Randomised placebo-controlled trials of individualised homeopathic treatment: systematic review and meta-analysis.” Syst. Rev., vol. 3, no. 1, Dec. 2014, pp. 1-16, doi:10.1186/2046-4053-3-142., which seemingly found statistically significant effectiveness of the practice.
In the scientific community, one of the factors that explains any positive findings22Antonelli, Michele and Davide Donelli. “Reinterpreting homoeopathy in the light of placebo effects to manage patients who seek homoeopathic care: A systematic review.” Health Soc. Care Community, vol. 27, no. 4, 1 July 2019, pp. 824-47, doi:10.1111/hsc.12681. is the interpersonal doctor-patient relationship, which is the main characteristic of personalized homeopathy sessions, along with the broader lifestyle improvement advice that can be provided in this context. This finding aligns with a 2008 clinical study on rheumatoid arthritis, which randomized the provision of an interpersonal session, irrespective of whether a personalized or non-homeopathic formulation was administered23Brien, Sarah, et al. “Homeopathy has clinical benefits in rheumatoid arthritis patients that are attributable to the consultation process but not the homeopathic remedy: a randomized controlled clinical trial.” Rheumatology (Oxford, England), vol. 50, no. 6, June 2011, p. 1070, doi:10.1093/rheumatology/keq234..
Coinciding with this explanation, in 2017, the same research group from the 2014 review, published predominantly negative results for non-personalized homeopathy24Mathie, Robert T., et al. “Randomised, double-blind, placebo-controlled trials of non-individualised homeopathic treatment: systematic review and meta-analysis.” Syst. Rev., vol. 6, no. 1, Dec. 2017, pp. 1-28, doi:10.1186/s13643-017-0445-3.. This review revealed that even among the studies of relatively higher quality, most of them lacked significant reliability. While initial assessments indicated a modest efficacy across all studies, this observed efficacy was halved and became statistically uncertain when considering only the three studies that were deemed reliable. Notably, when attempting to account for the selective publication of primarily successful studies within the overall sample, the effectiveness was once again halved, leading to overall uncertainty.
As shown in an independent analysis in 202225Gartlehner, Gerald, et al. “Assessing the magnitude of reporting bias in trials of homeopathy: a cross-sectional study and meta-analysis.” BMJ EBM, vol. 27, no. 6, 1 Dec. 2022, pp. 345-51, doi:10.1136/bmjebm-2021-111846., the entire body of homeopathy literature presents systematic biases, with a large portion of studies not registering their examination criteria before publication or changing them afterwards for more positive findings, as well as a tendency for many studies to never be published, which likely had negative findings. Problems of this level cannot be reliably corrected in a statistical manner, as attempted by the 2014 and 2017 reviews.
Indeed, a subsequent analysis in 202326Sigurdson, Matthew K., et al. “Homeopathy can offer empirical insights on treatment effects in a null field.” J. Clin. Epidemiol., vol. 155, 1 Mar. 2023, pp. 64-72, doi:10.1016/j.jclinepi.2023.01.010. Archived here. examined 50 of the most recognized clinical studies of homeopathy and found that half included common statistical errors, and many described their findings in a positive way that was not justified by their data. Additionally, the most frequent examination criterion concerned subjective factors, based on patient self-reports. Overall, the analysis described the field of homeopathy clinical research as a suitable example for identifying illusory results in real scientific subjects.
An independent analysis from the same year27Perrier, Quentin, et al. “Relationship between the conflicts of interest and the results of meta-analyses of homoeopathy trials.” BMJ EBM, vol. 28, no. 6, 1 Dec. 2023, pp. 426-7, doi:10.1136/bmjebm-2022-112228. Archived here. found that the presence of conflicts of interest in reviews favored conclusions supporting homeopathy. Notably, the main authors of the 2014 and 2017 reviews had declared connections to and funding from homeopathy advocacy entities, such as the British Homeopathic Association.
Similarly, research from as early as 2005 had found that studies on homeopathy published in journals focusing on alternative medical practices reported twice as many positive outcomes as those published in conventional scientific journals28Caulfield, Timothy and Suzanne DeBow. “A systematic review of how homeopathy is represented in conventional and CAM peer reviewed journals.” BMC Complement. Altern. Med., vol. 5, no. 1, Dec. 2005, pp. 1-4, doi:10.1186/1472-6882-5-12..
These observations have been followed by several retractions of homeopathic studies by scientific journals in recent years. Noteworthy among these are the retractions of an unreliable clinical trial on depression, of a problematic review concerning the treatment of Attention-Deficit Hyperactivity Disorder (ADHD), and of an unsubstantiated article advocating for the treatment of COVID-19 using homeopathy. It is also worth mentioning that this article on COVID-19 treatment was co-authored by Dimitris Kalliantas, who had been featured in earlier publications and conferences of the Hellenic Homeopathic Medical Society and had served as the president of the Hellenic Classical Homeopathic Dental Association (deceased in 2023).
The broader history of homeopathy in Greece and statements by official institutions
Inquiries directed to HHMS, the Ministry of Health and the Athens Medical Association
We posed questions to the Hellenic Homeopathic Medical Society (HHMS) regarding its stance on vaccination and whether it advises the use of homeopathic remedies for treating serious diseases instead of conventional methods. The response was non-specific, with the organization stating that “the limited scope of a journalistic investigation does not facilitate a scientifically grounded discussion on Public Health issues”.
As previously mentioned, this is not the first time that an HHMS conference is held under the auspices of the Ministry of Health, with similar endorsements recorded in Diavgeia for 2016 and 2019. Additionally, we have noticed that the same has happened for acupuncture conferences, another pseudoscientific practice, which will be examined more thoroughly in a future article.
Examining the official endorsement document for the 2023 homeopathy conference, we discover that the Ministry of Health’s information office is listed as the organizer, with the former Health Minister, Thanos Pleuris, as the signatory. The decision for endorsement was made based on a related circular from 2016, which states that this action acknowledges the scientific work of the respective institution and encourages the development of similar events and initiatives. It is also stated that the endorsement is given after a thorough examination of a detailed application, which includes the institution’s statute and its conference program.
We posed inquiries to the Ministry of Health concerning the rationale behind endorsing a conference that promotes pseudoscientific and anti-vaccination claims. Additionally, we sought out the viewpoint of the current administration of the Ministry (Mr. Pleuris had left 9 months before the conference). These questions were directed to both the administrations of Michalis Chrysochoidis and Adonis Georgiadis. However, despite repeated attempts to communicate with ministry officials, we were ultimately informed that the Ministry opted not to provide a comprehensive and official response to our inquiries. Furthermore, they declined to critique or defend the prior decisions regarding the granting of endorsement to previous homeopathy conferences.
Simultaneously, we posed similar questions to the other organization that endorsed the conference, the Athens Medical Association (AMA). The president of the Association and current regional governor of Attica, Giorgos Patoulis, along with the vice-president, Fotios Patsourakos, responded to our inquiries. First of all, they directed us to the press release they had issued shortly after Dr. Houpas’s open letter:
The Athens Medical Association, regarding the comments concerning its endorsement granted – as early as March 2023 – to the conference titled “Developments in Homeopathic Education – Half a century of experience,” held recently in Athens, oughts to clarify the following:
● The granting of endorsement does not inherently signify the acceptance of every scientific claim presented during the conference, regardless of its source.
● The AMA maintains a steadfast position that scientific conferences serve as venues for constructive and productive scientific discourse. Consequently, it encourages such dialogue and extends its endorsement to conferences organized by scientific entities.
● The AMA has consistently emphasized that homeopathy, along with any alternative treatment, should only be administered by adequately trained medical professionals. This stance is rooted in the understanding that any therapeutic, diagnostic, or preventive procedure falls within the realm of medical practice, as defined by Article 1 of Law 3418/2005.
Homeopathy is considered a complementary therapeutic approach, and homeopathic preparations have been regulated as remedies since 1994 and as medicinal products since 2013.
During our telephone conversation, representatives of the AMA further stated that while the Association neither supports nor rejects homeopathy, it also does not dismiss it outright. Dr. Patsourakos’s statement, “we are not throwing any colleagues under the bus,” encapsulates this stance. For the AMA, providing patronage signifies support for scientific dialogue and the exchange of relevant viewpoints.
When specifically asked about the anti-scientific and anti-vaccine positions associated with the HHMS, the AMA representatives emphasized the Association’s support for vaccination campaigns. Additionally, they highlighted that the AMA opposes scientifically unfounded assertions, such as claims that homeopathy can cure cancer.
However, what came as unexpected was the announcement that the AMA Board of Directors unanimously decided to grant endorsement to the aforementioned conference, despite the absence of a submitted conference program and without conducting any review of the HHMS’s website or broader positions. For the AMA, the mere fact that the HHMS is “a scientific company approved by the state, has obtained a license from the Court of First Instance, and includes doctors on its board of directors” suffices. It’s worth noting that such a policy is uncommon in the international medical and academic community, and we have been unable to find a corresponding published policy from any medical entity.
Regarding the legal recognition of the HHMS, we reached out to a competent official from the Court of First Instance of Athens and she confirmed that the HHMS submitted its statute as a society in 1971, and in the beginning, it was identified as “scientific society.” Such a designation is common for medical organizations, such as the Hellenic Pulmonary Society. However, the relevant articles of the Civil Code do not contain a similar provision. Therefore, the inclusion of the term “scientific society” in the statute of each institution does not require any certification process but rather serves as a self-determination. The official from the Court of First Instance confirmed that this interpretation applies in the case of the HHMS as well.
In 2014, the Ministry of Health drafted legislation for the formalization of Scientific Medical Societies, which, among other provisions, outlined recognition only for internationally acknowledged medical specialties. However, due to unrelated reasons, this draft was criticized by domestic medical societies, including the Panhellenic Medical Association, and was subsequently withdrawn. In 2017, a new legislative proposal about the establishment of a supervisory body responsible for overseeing medical organizations, was also rejected, this time by the AMA.
Therefore, as a result, there is currently no official state certification for these organizations. Interestingly, while the AMA website lists various medical companies including homeopathic, both the websites of the Ministry of Health and the Athens Medical Association, do not include in their directories any alternative medicine companies, including those involved in homeopathy.
The problematic position of homeopathy in Greece
In 2006, the University of the Aegean approved, for the first time in Greece, a postgraduate study program regarding homeopathic products. This program was promoted, among others, by the HHMS. However, the decision was condemned by the AMA in 2007:
With the replacement of Ministerial Decision 11027/B7 (Government Gazette 575/t.B’ 12.5.2003) by the Ministry of Education and Religious Affairs, approving the Master’s Program of the Department of Product and Systems Design Engineering of the University of the Aegean, titled: ‘HOLISTIC ALTERNATIVE THERAPEUTIC SYSTEMS – CLASSICAL HOMEOPATHY’ (Government Gazette publication 1912/29.12.2006), the Board of Directors of the Athens Medical Association is pointing out the following:
These types of Ministerial Decisions ignore the fact that the practice of homeopathy has not been recognized as an official medical specialty in Greece, and the Ministry of Health and Community Solidarity has not engaged in the dialogue requested by medical organizations to address this unresolved issue.
These decisions create additional confusion and impose financial burdens on doctors pursuing postgraduate degrees that are not recognized by the official state or the medical community.
It is surprising that an educational institution is established without any association with the provision of health services or medical science.
Therefore, there is a need to review the specific Ministerial Decision and consider revoking it.
The institutionalization of such a curriculum has also faced criticism from members of the general public and certain media outlets. Nonetheless, the program persisted for several years until it was suspended by the Senate of the University of the Aegean in decisions made in 2012 and 2013. When looking into the specific reasons for the program’s cancellation, we reached out to the University of the Aegean. A representative informed us that the cancellation was attributed to insufficient interest from students.
It is noteworthy, however, that these decisions coincide with the discontinuation of corresponding university programs in the United Kingdom, as mentioned earlier. Additionally, we noticed that until 2012, the HHMS conferences received endorsement from the University of the Aegean, which was not continued in subsequent years.
Despite the AMA’s previous negative stance on post-graduate programs, approximately a decade later, it opted for the first time to provide patronage to an HHMS homeopathy conference. In 2016, 24 doctors, members of the AMA, composed an open letter of protest to its administration, denouncing the conference as promoting “medieval practices.” It was highlighted that as early as 1996, the then-president of the AMA had declined to participate in a television show featuring a homeopath. The letter stated, among other things:
Homeopathy is not recognized as a medical specialty, and none of its principles are grounded in scientific evidence or aligned with conventional medicine. It is concerning that modern medicine in the 21st century is reverting to medieval methodologies and embracing the beliefs of Samuel Hahnemann, the founder of homeopathy. Despite attempts to portray alternative therapies as scientifically supported, they remain rooted in medieval and pagan practices. Have you ever read the materia medica (homeopathic pharmacology) to understand what homeopathy treats and how? Are you aware that homeopathic remedies sometimes include substances derived from diseased tissues, such as extracts from cancerous tissues or secretions from gonococcal urethritis and tuberculous caverns? Did you know that homeopaths claim to be able to cure even emotional states like jealousy using homeopathic remedies? (Reference: George Vithoulkas, Classical Homeopathy for Anxiety & Jealousy. Groma Publishers Baar, Switzerland, 2004, p. 47-48).
The more one reads about this “renowned” homeopathy, the more surprising it becomes that it is embraced by scientists. As doctors, we were even more astonished to discover that the AMA organized a conference under its auspices.
The indifference and endorsement of pseudosciences only serve to maximize their influence, making it more difficult to challenge them.
The AMA has a duty to protect not only the general public from pseudosciences (alternative therapies) but also science and truth itself. Therefore, it should correctly inform the general public through its announcements. An attempt in this direction was made in 1997 when a committee was appointed to study and draw conclusions about these therapies. Following a related study, which we are referencing here, alternative therapies were characterized as UN.THE.M (Unorthodox Therapeutic Methods). We are including the publication of this study as well as the publication of the then President of the AMA, Kon. Oikonomou from 1996. In this publication, when invited to participate in a television show featuring a homeopath, he refused on the grounds that “…Homeopathy is not a science and therefore whoever represents it is not a scientist…”
We urge the AMA not to undermine its scientific credibility and not to disparage the scientific knowledge acquired through extensive systematic study and research, which has contributed to the remarkable advancements of modern medicine.
The next major development occurred in March 2018 when the newspaper ‘Ta Nea tis Kyriakis’ reported that the Central Board of Health (KESY) had categorically rejected the recognition of homeopathy as a scientific practice. It also recommended the temporary suspension of medical licenses for doctors who chose to practice homeopathy:29Κεντρικό Συμβούλιο Υγείας. «Σχετικώς με τη θεσμοθέτηση της ομοιοπαθητικής» (2018). Archived here.
Homeopathy does not constitute a medically or pharmaceutically recognized therapeutic scientific method or practice. It is not equivalent to complementary to Medical Science, and does not even qualify as “alternative medicine”.
Doctors, dentists, and non-physicians wishing to practice homeopathy can only obtain certification through the various Greek Homeopathy organizations of which they are registered members. State certification for the practice of homeopathy requires a professional practice permit from the Ministry of Commerce.
The professional title of Homeopathy should not incorporate defining terms such as “alternative medicine,” “therapeutic,” “medical practice,” or other related medical terminology. A suitable title could simply be “Homeopathic Practice.” It is essential that the title of the Homeopathy profession explicitly indicates that it is based on non-scientifically proven and non-equivalent medical practices.
In particular, doctors and dentists who wish to practice homeopathy should refrain from practicing their medical specialty concurrently or in combination with homeopathy. Doing so would contradict their scientifically-based medical education. Specifically, they should be officially suspended from practicing medicine for the duration of their practice in homeopathy. This suspension of their medical specialty should be noted on their homeopathy practice license, which is also granted by the Ministry of Commerce. Additionally, their patients should be informed of this suspension as a mandatory disclosure.
Although the KESY is the highest advisory body of the Ministry of Health, its aforementioned recommendation was not implemented legislatively.
It is also important to note that there is no provision for the official publication of KESY’s recommendations. Therefore, we have not been able to review all of its subsequent decisions. However, individuals familiar with the decision-making process informed FactReview that only one other decision of similar relevance exists, but it does not mention homeopathy. This decision was made a few months after the previous one and recommended the establishment of “Complementary Medicine,” which encompasses practices that can be used alongside Conventional Medicine. However, only “Therapeutic Exercise, Spa Medicine, and Acupuncture” were defined in this category. Despite this recommendation, we have not found any implementation of it in any legislation either.
To date, the only recognition of the homeopathic profession is through the BAC code 86.90.19.12 (Business Activity Code), listed under the name “homeopathic services.” The BAC file is the domestic version of the European NACE occupation system, which is intended solely to describe existing professional activities, regardless of their scientific validity. The practice of homeopathy is not categorized under established medical professional services codes but rather in a subcategory of non-conventional services, alongside “alternative therapy services,” “nail therapist services,” and “non-physician nutrition guidance services.” It is worth mentioning that there is even a BAC code for “astrological and spiritual services.”
With regard to the recognition of homeopathic preparations, this was first institutionalized in the European Union with a directive of 1992, which was then transferred to the more broadly updated pharmaceutical directive of 2001. As the European Commission clarified for the reason for institutionalization, it was not a position for or against the practice, but for the recognition that it was already being widely used, that there was a need to homogenize conflicting law between different member states, and that safety and quality certification for consumers was needed30“EPLR – European Pharmaceutical Law Review: The Coherency of Regulatory Requirements for Homeopathic Medicinal Products in the EU and the EAEU.” 25 Jan. 2024, doi: 10.21552/eplr/2019/2/4.. While these directives recognized homeopathics as a class of medicines with similar licensing arrangements, they simultaneously set out the fundamental exception of the need to demonstrate efficacy.
In Greece, as early as 1989, the then Minister of Health issued a circular recognizing homeopathic preparations as “galenic” products. These are products that pharmacists can prepare to meet the needs of individual patients. However, in 1998, a new circular was issued, abolishing insurance coverage for homeopathic preparations. The rationale provided was that their level of dilution rendered testing their effectiveness impossible, and that insurance coverage did not apply uniformly across European countries. Subsequently, insurance coverage from certain funds was only exceptionally recorded in publications in the following years.
In 2011, the National Organization for the Provision of Health Services (EOPYY in Greek) was established through the merger of several funds. Subsequently, in 2012, a ministerial decision clarified that while galenic preparations in general would be reimbursed by EOPYY, this policy would not extend specifically to homeopathic preparations. In 2013, the 2001 European directive was incorporated into domestic law, reaffirming the exception regarding the proof of effectiveness. As expected by the European law, it was also stipulated that homeopathic preparations must explicitly state that they “have no approved therapeutic indications.” This requirement was reiterated in the most recent ministerial decision of 2018, as confirmed by competent officials of the National Organization for Medicines (EOF in Greek) and EOPYY.
It is important to note that while the certification of homeopathic preparations required in Europe generally mitigates significant safety risks, this does not extend to uncertified preparations that may be sold online. For instance, in 2018, 2019, and 2022, the EOF withdrew such uncertified preparations from the Greek market and issued warnings to the general public.
Finally, we sought the position on the issue of homeopathy from the other major medical associations in Greece.
First, the president of the Panhellenic Medical Association (PMA), Athanasios Exadaktylos, informed FactReview that the PMA was approached to endorse the recent homeopathy conference of the HHMS, but he refused.
In terms of recognizing the practice, Dr. Exadaktylos stated that homeopathy is not considered a medical specialty. As evidenced by the aforementioned developments abroad, it is viewed as a complementary approach that cannot replace conventional medicine or be relied upon as the sole form of treatment. He also confirmed that there is no corresponding homeopathy university curriculum, anywhere in the Western world.
Dr. Exadaktylos said that at a physician’s discretion, specific drugs such as arnica pills could be used in addition to conventional drugs, but that these cases should be about targeted drug use, not a “self-indulgence game,” which some physicians may pursue even though they know that such a preparation acts simply as a placebo.
Dr. Exadaktylos also stated that the broader concept of holistic medicine, upon which homeopathy is based, was not groundbreaking at the time of its invention. Instead, it had been an already known concept since the time of Hippocrates, many centuries earlier. We note that similarly, modern medicine includes evidence-based holistic approaches such as interdisciplinary research31Fontana, Luigi, et al. “Transdisciplinary research and clinical priorities for better health.” PLoS Med., vol. 18, no. 7, 27 July 2021, p. e1003699, doi:10.1371/journal.pmed.1003699., the bio-psycho-social model32Cormack, Ben, et al. “The biopsychosocial model is lost in translation: from misrepresentation to an enactive modernization.” Physiotherapy Theory and Practice, 2 Nov. 2023, doi:10.1080/09593985.2022.2080130. Archived here., and personalized medicine33Beccia, F., et al. “An overview of Personalized Medicine landscape and policies in the European Union.” Eur. J. Public Health, vol. 32, no. 6, 1 Dec. 2022, pp. 844-51, doi:10.1093/eurpub/ckac103..
Lastly, Dr. Exadaktylos mentioned that there are philosophical ideas within homeopathy that may be useful, such as addressing the issue of overprescription of conventional medicines34Safer, Daniel J. “Overprescribed Medications for US Adults: Four Major Examples.” J. Clin. Med. Res., vol. 11, no. 9, Sept. 2019, p. 617, doi:10.14740/jocmr3906.. However, these are also issues considered and addressed within conventional medicine in an evidence-based manner35Ogden, Joy. “NHS overprescribing: the national review recommendations.” Prescriber, vol. 33, no. 2, 1 Feb. 2022, pp. 35-38, doi:10.1002/psb.1971..
After repeated attempts to contact the Medical Association of Thessaloniki, they opted to not comment on the matter.
Subsequently, we communicated with the Larissa Medical Association (LMA), and its president, Konstantinos Giannakopoulos, informed FactReview that the LMA does not hold a separate position on homeopathy but aligns with the stance of the PMA.
Regarding the Patras Medical Association, following the publication of the negative opinion by the KESY in 2018, they had also rejected homeopathy as a medical practice and had specifically highlighted publicly its concerning association with the anti-vaccination movement. In response, the HHMS had published a rebuttal, denying any connection with the anti-vaccination movement. However, as we showed, this claim contradicts the society’s subsequent stance.
The Board of Directors of the Patras Medical Association announces the decision number 2 (22/02/2018) of the 266th plenary session of the KESY, regarding the practice of homeopathy:
“Homeopathy does not constitute a medically or pharmaceutically recognized therapeutic scientific method or practice. It is neither equivalent to nor complementary to Medical Science, nor does it qualify as ‘alternative medicine’.”
Due to the lack of scientific evidence supporting the efficacy of homeopathy as a method of treatment, many countries in Europe have rejected its inclusion in medical science.
In recent times, a particularly concerning phenomenon has emerged in our country: doctors who identify as homeopaths are discovered to be either covert or overt supporters of the anti-vaccination movement. The unfounded assertion that homeopathy serves as a universal remedy and a replacement for vaccination is highly unscientific. It constitutes an attempt to deceive citizens and poses significant dangers to public health, carrying both criminal and disciplinary liabilities for those who promote it.
Given that this unfortunate trend has also surfaced in our municipality, the Patras Medical Association has already initiated the appropriate investigation procedures. As a competent scientific body, it strongly advises citizens to exercise utmost caution regarding practices that may endanger individual and public health.
Vaccines represent a significant advancement for humanity. The failure to adhere to vaccination programs has resulted in the recent outbreak of measles, with hundreds of cases reported nationwide and tragic fatalities among those who neglected or defied the scientifically-proven protection against infectious diseases.
So, lastly we reached out to the president of the Patras Medical Association, Anna Mastorakou. She stated that the primary issue the association has encountered with homeopathy is that some doctors are exceeding the reasonable scope of the practice. This includes discontinuing prescriptions of conventional medicines, thereby jeopardizing patients’ health.
This issue had particularly concerned the association in 2018, during an outbreak of measles when a pediatrician advocated treating the outbreak with homeopathic preparations instead of vaccination. It is worth noting that this outbreak resulted in dozens of deaths of children across Europe36European Centre for Disease Prevention and Control. Measles – Annual epidemiological report for 2018. Stockholm: ECDC; 2020. Archived here., deaths that could have been prevented with higher vaccination coverage37Cutts, F. T., et al. “Using models to shape measles control and elimination strategies in low- and middle-income countries: A review of recent applications.” Vaccine, vol. 38, no. 5, 1 Jan. 2020, p. 979, doi:10.1016/j.vaccine.2019.11.020.38Di Pietrantonj, Carlo, et al. “Vaccines for measles, mumps, rubella, and varicella in children.” Cochrane Database of Systematic Reviews, no. 4, 2020, doi:10.1002/14651858.CD004407.pub4.. In contrast, as confirmed by a recent review39Hawke, Kate, et al. “Homeopathic medicinal products for preventing and treating acute respiratory tract infections in children.” Cochrane Database of Systematic Reviews, no. 12, 2022, doi:10.1002/14651858.CD005974.pub6., there is no reliable evidence supporting the effectiveness of homeopathy for treating respiratory infections in children.
Regarding the broader use of homeopathy, Dr. Mastorakou stated that it can be cautiously employed by physicians who are mindful of its limitations. However, based on her clinical experience and the available scientific data, there is no clear evidence of any additional benefits beyond the placebo effect.
Conclusions
After examining all the available data, it becomes evident that homeopathy, despite its widespread popularity, remains a pseudoscientific practice. A comprehensive review of scientific literature indicates that it has not demonstrated efficacy beyond the placebo effect in treating any health condition. Moreover, the preparation method of homeopathic remedies renders them impossible to exert any biochemical effects. The successive dilution and dynamization processes lead to final products containing negligible amounts, if any, of the initial active substance. Claims regarding the mechanisms of action of homeopathic preparations, such as water memory, have been subjected to laboratory studies and have subsequently been debunked. To date, no credible mechanism of action for these preparations has been documented.
Complementary to the examination of the data on the efficacy of homeopathy, the analysis of the actions of homeopathy organizations in Greece reveals support from some significant institutional bodies for the practice. One of the most well-known associations, the Hellenic Homeopathic Medical Society, has organized a series of homeopathy conferences under the auspices of the University of Aegeus, the Athens Medical Association, and the Ministry of Health. However, this institutional support, along with the claims made by homeopathic associations and individual homeopaths regarding the efficacy of the practice, contradicts the broader and now established scientific consensus on the matter.
Αρχισυντάκτης στο FactReview και fact-checker με βασικό αντικείμενο την επιστημονική αρθρογραφία και ανάλυση επιστημονικής παραπληροφόρησης.
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