Homeopathic cures fail; kid dies; parents murderers?

Great Debates
1

From James Randi’s weekly column we find a discussion of a New South Wales tragedy.

A nine month old girl died of sepsis. Her parents had sought to cure their daughter by using homeopathic remedies. The coroner says that, in her view, there is sufficient evidence to make the parents criminally liable for the death of their daughter: treating her with homeopathic remedies instead of the medically-prescribed pharmaceuticals caused the death, and this is criminal negligence.

No, says Randi. He points out that the practice of homeopathy is accepted by Australian health authorities, that homeopaths are permitted to practice in Australia as professionals, that homeopathic preparations are legally sold in stores in Australia, and that homeopathy is legally advertised via the media in Australia. Because of these factors, he says, the parents could conclude that homeopathy is effective and were within their legal rights to administer what they believed was appropriate medical care. He admits they were stupid, but believes that stupidity falls short of criminal negligence.

I’m not expert on Australian law, so I won’t offer an opinion on the accuracy of Randi’s views there. But as a general principle, do you agree with the proposition that because homeopaths are permitted to practice as professionals , advertise and sell their products, that a person gets a pass for killing their child by relying on homepathic remedies?

I don’t know that I do. I might feel differently if the parents had consulted a particular homepathic practioner, but their self-reliance strikes me as absolutely unreasonable.

2

I think homeopaths are crackpots of the highest order and the case is tragic. However, it is their child and they have the legal right to make decisions for her. The fact that homeopathic remedies are legal in Australia is an additional point to take into account but it isn’t the most important one. I hope Australia does take a closer look at this however. This situation isn’t uncommon. Jehovah’s Witnesses common make the same types of decisions in the U.S. as well as Christian Scientists. I have never heard the Amish view of cutting, edge hospitalized medicine but I would guess that it is restricted as well.

You can’t stop people from being crackpots but no one should be forced to have modern medical care. The logical extension of that would be that sick kids of parents with alternate beliefs would be taken from their parents and given whatever medical care some other entity deems appropriate. Those cases may not be as clear-cut as this one.

3

So, if the parents thought high doses of arsenic would cure a cold they have the legal right to administer it?

4

IMHO, that is key. Perhaps this can be judged the same as a case whereby the parents decided to treat the child themselves, but with the wrong or incorrectly executed non-homeopathic standard treatment. If the child showed no improvement, the parents should have taken the kid to a professional. This poor kid was possibly further doomed because she would have taken to a homeopathic practitioner (maybe), but since they never took her it seems to me that the fact that homeopathy was involved may not be pertinent.

5

Here’s a story about the case (which apparently involves questions of malnutrition as well as medical quackery). Discussion here.

I largely agree with this, with the provisos that 1) there should be no absolute legal right to provide quackery-based “care”, and more importantly 2) children by numerous legal precedents cannot decide to forego quality, evidence-based medicine.

It’s possible that prosecution of the parents will be made more difficult by Australia’s embrace of homeopathy. I doubt that will completely let them off the hook, though, as the parents reportedly chose to ignore informed medical opinion in favor of homeopathic treatment.

6

So what you’re saying is that the parents practiced medicine without a license.

7

I don’t think you could say that because they didn’t do anything that would be recognized as medicine. The opposite is true and that is why they may be in trouble. An analogy might be a faith healer that they brought in everyday. What if they are members of an indigenous tribe or devout in a religion that promotes alternatives to western medicine? Should that be treated differently?

8

For me, it would have to boil down to a question of malice aforethought. If you judge them to be merely stupid, then you must either forgive or set about the impossible task of determining who will be licensed to reproduce, just about as slippery a slope as I can imagine.

The law is a hammer, and this is not a nail.

9

Just a clarification: Murder, which the OP alludes to in his subject line, does require malice aforethought. But Criminally Negligent Homicide – the charge I am lead to believe is the one actually debated – requires only that persons took actions they should have known would result in death. A much lower standard.

By no measure are the parents murderers. Were they criminally negligent? I’d say it depends on the facts, specifically how quickly the child went downhill – would it have been apparent to the reasonable person that the measures they were taking were not working?

10

Tough call. The problem is that the law must be rather indiscriminate in order to cover all eventual permutations of applicable cases. I can’t think of any version that would not radically infringe on a patient’s right to seek the type of care of their choice.

Of course, an argument could be made that only certain types of treatment meet the standards for care according to the authorities in regard to minors only. That might allow the state to pursue a prosecution against parents who operate outside the acceptable range, while allowing adults their full freedom to practice as they choose. It wouldn’t be an easy one to pass though and would set a precedent that the freedom to practice religion is only applicable to those of majority age.

11

I think that crimininal neglignce would have to involve some level of knowledge that homeopathy is not real medicine. In a culture that allows pseudomedicine to practiced, sold and advertised without clear delineation from real medicine, I don’t think it can automatically assumed that patients or the parents of patients really know the difference. Parents such as the ones in this case might actually have no idea that they aren’t getting normal, valid care. They themselves would be victims of a fraudulent industry. It’s the industry itself which is culpable.

12

Yes, I agree with this. Adults have the right to avil themselves of whatever quackery or faith healing takes their fancy, but they should not have the right to deprive their children of access to legitimate medical care and if they don’t like it, that’s just too bad.

13

Might want to guess again. I’ve had to visit Children’s Hospital in Pittsburgh many times, and have often seen Amish families there.

They have an interesting view of medicine and how it fits in with their simple lifestyle, but they will use modern medicine as needed.

14

Culpable, maybe, but they’d be hard to go after. Homeopathy was specifically protected by U.S. law and isn’t easy to regulate. Per Cecil:

15

That doesn’t mean it is unregulated. From the FDA:

*However, homeopathic products are not exempt from all FDA regulations. If a homeopathic drug claims to treat a serious disease such as cancer it can be sold by prescription only. Only products sold for so-called self-limiting conditions–colds, headaches, and other minor health problems that eventually go away on their own–can be sold without a prescription (over-the-counter)…Over the past several years, the agency has issued about 12 warning letters to homeopathic marketers. The most common infraction was the sale of prescription homeopathic drugs over-the-counter. “It’s illegal, it’s in violation, and we’re going to focus on it,” says Miracco.
Other problems include:

products promoted as homeopathic that contain nonhomeopathic active ingredients, such as vitamins or plants not listed in homeopathic references
lack of tamper-resistant packaging
lack of proper labeling
vague indications for use that could encompass serious disease conditions. For example, a phrase like “treats gastrointestinal disorders” is too general, explains Miracco. “This phrase can encompass a wide variety of conditions, from stomachache or simple diarrhea to colon cancer,” he says. “Claims need to be specific so the consumer knows what the product is intended to treat and the indication does not encompass serious disease conditions that would require prescription dispensing and labeling.”

…the American Academy of Pediatrics has no specific policy on homeopathy. If an adult asked the academy’s Sanders about homeopathy, he would tell that person to “do your own investigation. I don’t personally prescribe homeopathic remedies, but I would be open-minded.”

That open-mindedness applies only to adults, however. "I would have problems with somebody imposing other than conventional medicine onto a child who’s incapable of making that decision," he says.*

The basic message of the linked FDA info page seems to be “Homeopathic drugs don’t really have potential to do good or harm, and we have other fish to fry so we won’t waste our time on them.”

The lack of a firm opinion on homeopathy’s lack of value may well be influenced by political realities (similar to those preventing the agency from effectively regulating other alternative remedies).

Incidentally, for every small-scale or poorly conducted study purporting to show homeopathy works, there are numerous examples of good research demonstrating that it’s quackery.

16

OK, I’m subscribing to this Thread–it promises to be of interest.

17

I think it’s ridiculous that any homeopathic products would require a prescription, as they are only water after all.

I think that by making some homeopathic preparations only available by prescription, it lends them a faux-legitimacy. If an uninformed and credulous consumer sees that homeopathy can be prescribed, then can really be blamed if they take homeopathy’s claims at face value and believe it works as well as conventional medicine?

I think that was Randi’s point in the OP - if the government regulates and allows homeopathy to be promoted in such a way that many members of the public believe it works to treat disease, can we really blame the parents for believing that it works?

18

This old GQ thread had some interesting perspectives on the Amish and technology. The consensus was that they don’t reject tech out of hand, they just drastically minimize it as they feel it interferes with their realtionship to God and to the community. They’re fine with medicine, and will use any available procedure to cure their children.

19

(snip)

Perhaps the government believes that some regulation of this stuff is better than none at all considering it is a 200 million dollar a year industry. Cite With that kind of money being tossed around it is probably better to have someone regulating what you can put in this stuff and to whom you sell it to.

20

I’m not saying there should be no regulation. But instead of allowing homeopathic products that claim to treat cancer being available by prescription only, they should be regulated to not be allowed to make that treatment claim.

Other “alternative medicine” products are regulated such that they can’t make health claims unless there’s evidence to back it up. Homeopathy just got lucky in that they’re grandfathered in.