How to Handle Worsening of Condition during Treatment - Risk Assessment in Homeopathic Practice

Abstract

Even though homeopathy is regarded as a harmless intervention, homeopathic practice may not be entirely risk-free. Risk in homeopathy can be divided into direct and indirect risk. Direct risk refers to traditional adverse effects of an intervention; indirect risk is related to adverse effects in a treatment context, e.g. the practitioner. Available data suggest that the risk profile of homeopathic remedies in ultra-molecular potencies is minor, but there is a potential for indirect risk related to homeopathic practice. The concept of ‘homeopathic aggravation' which is unique for homeopathy may impose a particular risk as it allows the health status of the patients to deteriorate before there is a possible improvement. In that respect it is imperative to distinguish homeopathic aggravations from adverse effects. In a general risk evaluation of the homeopathic treatment it may be useful to assess the patient's symptoms in accordance with the natural course of disease and to evaluate any negative deviation from the normal curve as a possible adverse effect of the treatment. It is imperative that more emphasis is placed on patient safety during the education in homeopathy, and that students are trained to identify serious and red flag situations.

Mind the Gap! Lay and Medical Perceptions of Risks Associated with the Use of Alternative Treatment and Conventional Medicine

“…The doctors' perceptions are examples of 'objective', scientific risk knowledge concerning direct risks, i.e. risk caused by the treatment itself and related directly to the intervention [44]. The encounter between patients' and doctors' risk perceptions can be perceived as 'risk as politics', involving power structures and knowledge systems within modern risk societies [45].…”

“…Particularly in stressful situations, lay people seem to use their positive and negative feelings as a guide to their evaluation of risks and benefits [45][46][47]. Patients have a need to understand their risk on an individual and personal level, while doctors often approach risk very analytically and logically; medical reality is encoded in abstract symbols, words, and numbers [2][3][4][5][6][7][8][9][44][45][46][47]. In this study, patients' risk assessment was based on their own negative experiences with conventional health care and those perceived in their social environment.…”

Adverse effects of homeopathy, what do we know? A systematic review and meta-analysis of randomized controlled trials

“…Nonetheless, homeopathic treatment with ultra-molecular remedies has been proven to be clinically effective, but the mechanisms of effect remain unclear and under discussion. It has been speculated, that psychological mechanisms such as the placebo effect, potentially play a role (32) As a consequence of this complex situation, a rather broad definition of risk, including both direct and indirect risk, maybe most appropriate in order to map the potential harm to patients related to the homeopathic treatment situation (33). This definition should encompass all potentially unwanted effects, without making assumptions about their mechanisms.…”

“…(6), (33) Direct risk Risk related to the intervention, e.g., harm caused by pharmacological products, medical treatments and procedures (5), (6) Homeopathic aggravations (direct and indirect risk)…”

Die Zukunft der Homöopathie

“…Und nicht zu vergessen: Homöopathie ist pragmatisch hilfreich [24,25,26,27]. Zwar kommt es bei homöopathischer Behandlung gelegentlich zu einer Erstverschlimmerung [28,29], aber die Behauptung, Homöopathie sei gefährlich [30], ist eine fahrlässige Interpretation der Daten [31]. …”