The idea that a common Judaeo-Christian ethics or Judeo-Christian values underpins American politics, law and morals has been part of the "American civil religion" since the 1940s. In recent years, the phrase has been associated with American conservatism,
but the concept—though not always the exact phrase—has frequently
featured in the rhetoric of leaders across the political spectrum,
including that of Franklin D. Roosevelt and Lyndon B. Johnson.
The current American use of "Judeo-Christian" — to refer to a value
system common to Jews and Christians — first appeared in print on 11
July 1939 in a book review by the English writer George Orwell, with the phrase "… incapable of acting meanly, a thing that carries no weight the Judaeo-Christian scheme of morals."
Orwell repeated the term in his 1941 essay: "It was the idea of human
equality—the "Jewish" or "Judeo-Christian" idea of equality—that Hitler
came into the world to destroy."
Orwell's usage of the term followed at least a decade of efforts
by Jewish and Christian leaders, through such groups as the U.S. National Conference of Christians and Jews
(founded in 1927), to emphasize common ground. The term continued to
gain currency in the 1940s. In part, it was a way of countering antisemitism with the idea that the foundation of morals and law in the United States was a shared one between Jews and Christians.
Orwell was not the first to publicly speak about the moral commonality of Jewish and Christian traditions. On May 19, 1939, Albert Einstein,
in a speech at Princeton Theological Seminary, explaining the
importance of moral principles for modern science, emphasized: "The
highest principles for our aspirations and judgments are given to us in
the Jewish-Christian religious tradition."
And back in 1884, three years after a large-scale wave of anti-Jewish pogroms in Russia, Vladimir Solovyov (Soloviev), a prominent Russian philosopher and Christian writer, wrote in his essay "The Jews and the Christian Question":
"Our religion begins with a personal relationship between God and
man in the ancient covenant of Abraham and Moses, and is confirmed in
the closest personal unity of God and man in the New Testament of Jesus
Christ, in which both natures exist inseparably, but unmerged as well.
These two covenants are not two different religions, but only two stages
of one and the same Divine-human religion, or speaking in the language
of the German school, two moments of one and the same God-human process.
This single and true Divine-human Judeo-Christian religion proceeds by a
direct and magisterial path amid the two extreme errors of paganism, in
which first man is absorbed by Divinity (in India), and then Divinity
itself is transformed into a shadow of man (in Greece and Rome)."
Franklin D. Roosevelt
The first inaugural address of Franklin D. Roosevelt
(FDR), in 1933, the famous speech in which FDR declared that "the only
thing we have to fear is fear itself", had numerous religious
references, which was widely commented upon at the time. Although it
did not use the term "Judeo-Christian", it has come to be seen by
scholars as in tune with the emerging view of a Judeo-Christian
tradition. Historian Mary Stuckey emphasizes "Roosevelt's use of the
shared values grounded in the Judeo-Christian tradition" as a way to
unify the American nation, and justify his own role as its chief
policymaker.
In the speech, FDR attacked the bankers and promised a reform in
an echo of the gospels: "The money changers have fled from their high
seats in the temple of our civilization. We may now restore that temple
to the ancient truths. The measure of the restoration lies in the extent
to which we apply social values more noble than mere monetary profit." Houck and Nocasian, examining the flood of responses to the First Inaugural, and commenting on this passage, argue:
The nation's overwhelmingly Judeo-Christian response to
the address thus had both textual and extratextual warrants. For those
inclined to see the Divine Hand of Providence at work, Roosevelt's
miraculous escape [from assassination] in Miami was a sign—perhaps The
Sign—that God had sent another Washington or Lincoln at the appointed
hour. ... Many others could not resist the subject position that
Roosevelt ... had cultivated throughout the address—that of savior.
After all, it was Christ who had expelled the moneychangers from the
Temple. ... [Many listeners saw] a composite sign that their new
president had a godly mandate to lead.
Gary Scott Smith stresses that Roosevelt believed his welfare programs
were "wholly in accord with the social teachings of Christianity." He
saw the achievement of social justice through government action as
morally superior to the old laissez-faire
approach. He proclaimed, "The thing we are seeking is justice," as
guided by the precept of "Do unto your neighbor as you would be done
by."
Roosevelt saw the moral issue as religiosity versus anti-religion.
According to Smith, "He pleaded with Protestants, Catholics, and Jews to
transcend their sectarian creeds and 'unite in good works' whenever
they could 'find common cause.'"
Atalia Omer and Jason A. Springs point to Roosevelt's 1939 State of the Union Address,
which called upon Americans to "defend, not their homes alone, but the
tenets of faith and humanity on with which their churches, their
governments and their very civilization are founded." They state that,
"This familiar rhetoric invoked a conception of the sanctity of the
United States' Judeo-Christian values as a basis for war."
Timothy Wyatt notes that in the coming of World War II
Roosevelt's isolationist opponents said he was calling for a "holy war."
Wyatt says:
Often in his Fireside Chats or speeches to the houses of
Congress, FDR argued for the entrance of America into the war by using
both blatant and subtle religious rhetoric. Roosevelt portrayed the
conflict in the light of good versus evil,
the religious against the irreligious. In doing so, he pitted the
Christian ideals of democracy against the atheism of National Socialism.
Lyndon Johnson
Biographer Randall B. Woods has argued that President Lyndon B. Johnson
effectively used appeals to the Judeo-Christian ethical tradition to
garner support for the civil rights law of 1965. Woods writes that
Johnson undermined the Southern filibuster against the bill:
LBJ wrapped white America in a moral straight jacket. How
could individuals who fervently, continuously, and overwhelmingly
identified themselves with a merciful and just God continue to condone
racial discrimination, police brutality, and segregation? Where in the
Judeo-Christian ethic was there justification for killing young girls in
a church in Alabama, denying an equal education to black children,
barring fathers and mothers from competing for jobs that would feed and
clothe their families? Was Jim Crow to be America's response to "Godless
Communism"?
Woods went on to assess the role of Judeo-Christian ethics among the nation's political elite:
Johnson's decision to define civil rights as a moral
issue, and to wield the nation's self-professed Judeo-Christian ethic as
a sword in its behalf, constituted something of a watershed in
twentieth-century political history. All presidents were fond of
invoking the deity, and some conservatives like Dwight Eisenhower had
flirted with employing Judeo-Christian teachings to justify their
actions, but modern-day liberals, both politicians and the intellectuals
who challenged and nourished them, had shunned spiritual witness. Most
liberal intellectuals were secular humanists. Academics in particular
had historically been deeply distrustful of organized religion, which
they identified with small-mindedness, bigotry, and
anti-intellectualism. Like his role model, FDR, Johnson equated liberal
values with religious values, insisting freedom and social justice
served the ends of both god and man. And he was not loath to say so.
Woods notes that Johnson's religiosity ran deep: "At 15 he joined the
Disciples of Christ, or Christian, church and would forever believe
that it was the duty of the rich to care for the poor, the strong to
assist the weak, and the educated to speak for the inarticulate."
History
1930s and 1940s
Promoting
the concept of the United States as a Judeo-Christian nation first
became a political program in the 1940s, in response to the growth of
anti-Semitism in America. The rise of Nazi anti-semitism in the 1930s
led concerned Protestants, Catholics, and Jews to take steps to increase
understanding and tolerance.
In this effort, precursors of the National Conference of
Christians and Jews created teams consisting of a priest, a rabbi, and a
minister, to run programs across the country, and fashion a more
pluralistic America, no longer defined as a Christian land, but "one
nurtured by three ennobling traditions: Protestantism, Catholicism and
Judaism. ... The phrase 'Judeo-Christian' entered the contemporary
lexicon as the standard liberal term for the idea that Western values rest on a religious consensus that included Jews."
In the 1930s, "In the face of worldwide antisemitic efforts to
stigmatize and destroy Judaism, influential Christians and Jews in
America labored to uphold it, pushing Judaism from the margins of
American religious life towards its very center."
During World War II, Jewish chaplains worked with Catholic priests and
Protestant ministers to promote goodwill, addressing servicemen who, "in
many cases had never seen, much less heard a Rabbi speak before." At
funerals for the unknown soldier, rabbis stood alongside the other
chaplains and recited prayers in Hebrew. In a much publicized wartime
tragedy, the sinking of the Dorchester,
the ship's multi-faith chaplains gave up their lifebelts to evacuating
seamen and stood together "arm in arm in prayer" as the ship went down. A
1948 postage stamp commemorated their heroism with the words:
"interfaith in action."
1950s, 1960s, and 1970s
In December 1952, then-President-elect Dwight Eisenhower,
speaking extemporaneously a month before his inauguration, said, in
what may be the first direct public reference by a U.S. president to the
Judeo-Christian concept:
[The Founding Fathers said] 'we hold that all men are
endowed by their Creator ... ' In other words, our form of government
has no sense unless it is founded in a deeply felt religious faith, and I don't care what it is. With us of course it is the Judeo-Christian concept, but it must be a religion with all men created equal.
By the 1950s, many early modern conservatives emphasized the Judeo-Christian roots of their values.
In 1958, economist Elgin Groseclose claimed that it was ideas "drawn
from Judeo-Christian Scriptures that have made possible the economic
strength and industrial power of this country."
Senator Barry Goldwater
noted that conservatives "believed the communist projection of man as a
producing, consuming animal to be used and discarded was antithetical
to all the Judeo-Christian understandings which are the foundations
upon which the Republic stands."
Belief in the superiority of Western Judeo-Christian traditions led conservatives to downplay the aspirations of the Third World to free themselves from colonial rule.
The emergence of the "Christian right"
as a political force and part of the conservative coalition dates from
the 1970s. According to Cambridge University historian Andrew Preston,
the emergence of "conservative ecumenism." bringing together Catholics,
Mormons, and conservative Protestants into the religious right
coalition, was facilitated "by the rise of a Judeo-Christian ethic."
These groups "began to mobilize together on cultural-political issues
such as abortion and the proposed Equal Rights Amendment for women." As Wilcox and Robinson conclude:
The Christian Right is an attempt to restore
Judeo-Christian values to a country that is in deep moral decline. ...
[They] believe that society suffers from the lack of a firm basis of
Judeo-Christian values and they seek to write laws that embody those
values.
1980s and 1990s
By the 1980s and 1990s, favorable references to "Judeo-Christian values" were common, and the term was used by conservative Christians.
President Ronald Reagan
frequently emphasized Judeo-Christian values as necessary ingredients
in the fight against Communism. He argued that the Bible contains "all
the answers to the problems that face us." Reagan disapproved of the growth of secularism and emphasized the need to take the idea of sin seriously. Tom Freiling, a Christian publisher and head of a conservative PAC, stated in his 2003 book, Reagan's God and Country, that "Reagan's core religious beliefs were always steeped in traditional Judeo-Christian heritage." Religion—and the Judeo-Christian concept—was a major theme in Reagan's rhetoric by 1980.
President Bill Clinton
during his 1992 presidential campaign, likewise emphasized the role of
religion in society, and in his personal life, having made references to
the Judeo-Christian tradition.
The term became especially significant in American politics, and, promoting "Judeo-Christian values" in the culture wars, usage surged in the 1990s.
Since 9/11
According to Hartmann et al.,
usage shifted between 2001 and 2005, with the mainstream media using
the term less, in order to characterize America as multicultural. The
study finds the term is now most likely to be used by liberals in
connection with discussions of Muslim and Islamic inclusion in America, and renewed debate about the separation of church and state.
In the case of Marsh v. Chambers, 463 U.S. 783 (1983), the Supreme Court of the United States
held that a state legislature could constitutionally have a paid
chaplain to conduct legislative prayers "in the Judeo-Christian
tradition." In Simpson v. Chesterfield County Board of Supervisors, the Fourth Circuit Court of Appeals held that the Supreme Court's holding in the Marsh case meant that the "Chesterfield County could constitutionally exclude Cynthia Simpson, a Wiccan
priestess, from leading its legislative prayers, because her faith was
not 'in the Judeo-Christian tradition.'" Chesterfield County's board
included Jewish, Christian, and Muslim clergy in its invited list.
Responses
Some
theologians warn against the uncritical use of "Judeo-Christian"
entirely, arguing that it can license mischief, such as opposition to
secular humanism
with scant regard to modern Jewish, Catholic, or Christian traditions,
including the liberal strains of different faiths, such as Reform Judaism and liberal Protestant Christianity.
Two notable books addressed the relations between contemporary Judaism and Christianity. Abba Hillel Silver's Where Judaism Differs and Leo Baeck's Judaism and Christianity
were both motivated by an impulse to clarify Judaism's distinctiveness
"in a world where the term Judeo-Christian had obscured critical
differences between the two faiths."
Reacting against the blurring of theological distinctions, Rabbi Eliezer Berkovits wrote that "Judaism is Judaism because it rejects Christianity, and Christianity is Christianity because it rejects Judaism."
Theologian and author Arthur A. Cohen, in The Myth of the Judeo-Christian Tradition, questioned the theological validity of the Judeo-Christian concept and suggested that it was essentially an invention of American politics, while Jacob Neusner, in Jews and Christians: The Myth of a Common Tradition, writes, "The two faiths stand for different people talking about different things to different people."
Law professor Stephen M. Feldman, looking at the period before
1950, chiefly in Europe, sees the concept of a Judeo-Christian tradition
as supersessionism,
which he characterizes as "dangerous Christian dogma (at least from a
Jewish perspective)", and as a "myth" which "insidiously obscures the
real and significant differences between Judaism and Christianity."
Abrahamic religion
Advocates of the term "Abrahamic religion" since the second half of the 20th century have proposed an inclusivism that widens the "Judeo-Christian" concept to include Islam
as well. The rationale for the term "Abrahamic" is that Islam, like
Judaism and Christianity, traces its origins to the figure of Abraham,
whom Islam regards as a prophet. Advocates of this umbrella term
consider it the "exploration of something positive" in the sense of a
"spiritual bond" between Jews, Christians, and Muslims.
Australia
Australian
historian Tony Taylor points out that Australia has borrowed the
"Judeo-Christian" theme from American conservative discourse.
Jim Berryman, another Australian historian, argues that from the
1890s to the present, rhetoric upholding Australia's traditional
attachment to Western civilisation emphasizes three themes: the core
British heritage; Australia's Judeo-Christian belief system; and the
rational principles of the Enlightenment.
These themes have been expressed mostly on the Australian
center-right political spectrum, and most prominently among
conservative-leaning commentators.
Development theory is a collection of theories
about how desirable change in society is best achieved. Such theories
draw on a variety of social science disciplines and approaches. In this
article, multiple theories are discussed, as are recent developments
with regard to these theories. Depending on which theory that is being
looked at, there are different explanations to the process of
development and their inequalities.
Modernization theory is used to analyze the processes in which
modernization in societies take place. The theory looks at which aspects
of countries are beneficial and which constitute obstacles for economic development. The idea is that development assistance
targeted at those particular aspects can lead to modernization of
'traditional' or 'backward' societies. Scientists from various research
disciplines have contributed to modernization theory.
Sociological and anthropological modernization theory
The earliest principles of modernization theory can be derived from the idea of progress, which stated that people can develop and change their society themselves. Marquis de Condorcet
was involved in the origins of this theory. This theory also states
that technological advancements and economic changes can lead to changes
in moral and cultural values. The French sociologistÉmile Durkheim
stressed the interdependence of institutions in a society and the way
in which they interact with cultural and social unity. His work The Division of Labor in Society
was very influential. It described how social order is maintained in
society and ways in which primitive societies can make the transition to
more advanced societies.
Other scientists who have contributed to the development of modernization theory are: David Apter, who did research on the political system and history of democracy; Seymour Martin Lipset, who argued that economic development leads to social changes which tend to lead to democracy; David McClelland, who approached modernization from the psychological side with his motivations theory; and Talcott Parsons who used his pattern variables to compare backwardness to modernity.
Linear stages of growth model
The linear stages of growth model is an economic model which is heavily inspired by the Marshall Plan which was used to revitalize Europe's economy after World War II. It assumes that economic growth can only be achieved by industrialization. Growth can be restricted by local institutions and social attitudes, especially if these aspects influence the savings rate and investments. The constraints impeding economic growth are thus considered by this model to be internal to society.
According to the linear stages of growth model, a correctly designed massive injection of capital coupled with intervention by the public sector would ultimately lead to industrialization and economic development of a developing nation.
The Rostow's stages of growth model is the most well-known example of the linear stages of growth model. Walt W. Rostow
identified five stages through which developing countries had to pass
to reach an advanced economy status: (1) Traditional society, (2)
Preconditions for take-off, (3) Take-off, (4) Drive to maturity, (5) Age
of high mass consumption. He argued that economic development could be
led by certain strong sectors; this is in contrast to for instance Marxism
which states that sectors should develop equally. According to Rostow's
model, a country needed to follow some rules of development to reach
the take-off: (1) The investment rate of a country needs to be increased
to at least 10% of its GDP, (2) One or two manufacturing
sectors with a high rate of growth need to be established, (3) An
institutional, political and social framework has to exist or be created
in order to promote the expansion of those sectors.
The Rostow model has serious flaws, of which the most serious
are: (1) The model assumes that development can be achieved through a
basic sequence of stages which are the same for all countries, a
doubtful assumption; (2) The model measures development solely by means
of the increase of GDP per capita; (3) The model focuses on
characteristics of development, but does not identify the causal factors
which lead development to occur. As such, it neglects the social structures that have to be present to foster development. Economic modernization theories such as Rostow's stages model have been heavily inspired by the Harrod-Domar model which explains in a mathematical way the growth rate of a country in terms of the savings rate and the productivity of capital. Heavy state involvement has often been considered necessary for successful development in economic modernization theory; Paul Rosenstein-Rodan, Ragnar Nurkse and Kurt Mandelbaum argued that a big push model
in infrastructure investment and planning was necessary for the
stimulation of industrialization, and that the private sector would not
be able to provide the resources for this on its own.
Another influential theory of modernization is the dual-sector model by Arthur Lewis. In this model Lewis explained how the traditional stagnant rural sector is gradually replaced by a growing modern and dynamic manufacturing and service economy.
Because of the focus on the need for investments in capital, the
Linear Stages of Growth Models are sometimes referred to as suffering
from ‘capital fundamentalism’.
Critics of modernization theory
Modernization theory
observes traditions and pre-existing institutions of so-called
"primitive" societies as obstacles to modern economic growth.
Modernization which is forced from outside upon a society might induce
violent and radical change, but according to modernization theorists it
is generally worth this side effect. Critics point to traditional
societies as being destroyed and slipping away to a modern form of
poverty without ever gaining the promised advantages of modernization.
Structuralism is a development theory which focuses on structural
aspects which impede the economic growth of developing countries. The unit of analysis is the transformation of a country's economy from, mainly, a subsistence agriculture to a modern, urbanized manufacturing and service economy. Policy prescriptions resulting from structuralist thinking include major government intervention in the economy to fuel the industrial sector, known as import substitution industrialization
(ISI). This structural transformation of the developing country is
pursued in order to create an economy which in the end enjoys
self-sustaining growth. This can only be reached by ending the reliance
of the underdeveloped country on exports of primary goods
(agricultural and mining products), and pursuing inward-oriented
development by shielding the domestic economy from that of the developed
economies. Trade with advanced economies is minimized through the
erection of all kinds of trade barriers and an overvaluation of the
domestic exchange rate; in this way the production of domestic
substitutes of formerly imported industrial products is encouraged. The
logic of the strategy rests on the infant industry argument, which states that young industries initially do not have the economies of scale
and experience to be able to compete with foreign competitors and thus
need to be protected until they are able to compete in the free market. The Prebisch–Singer hypothesis states that over time the terms of trade for commodities deteriorate compared to those for manufactured goods, because the income elasticity of demand of manufactured goods is greater than that of primary products. If true, this would also support the ISI strategy.
Structuralists argue that the only way Third World
countries can develop is through action by the state. Third world
countries have to push industrialization and have to reduce their
dependency on trade with the First World, and trade among themselves.
Dependency theory is essentially a follow-up to structuralist
thinking, and shares many of its core ideas. Whereas structuralists did
not consider that development would be possible at all unless a strategy
of delinking and rigorous ISI
was pursued, dependency thinking could allow development with external
links with the developed parts of the globe. However, this kind of
development is considered to be "dependent development", i.e., it does
not have an internal domestic dynamic in the developing country and thus
remains highly vulnerable to the economic vagaries of the world market.
Dependency thinking starts from the notion that resources flow from the
‘periphery’ of poor and underdeveloped states to a ‘core’ of wealthy countries, which leads to accumulation of wealth in the rich states at the expense of the poor states. Contrary to modernization theory, dependency theory states that not all societies progress through similar stages of development.
Periphery states have unique features, structures and institutions of
their own and are considered weaker with regards to the world market economy,
while the developed nations have never been in this colonized position
in the past. Dependency theorists argue that underdeveloped countries
remain economically vulnerable unless they reduce their connections to
the world market.
Dependency theory states that poor nations provide natural resources and cheap labor for developed nations, without which the developed nations could not have the standard of living
which they enjoy. When underdeveloped countries try to remove the
Core's influence, the developed countries hinder their attempts to keep
control. This means that poverty of developing nations is not the result of the disintegration of these countries in the world system, but because of the way in which they are integrated into this system.
In addition to its structuralist roots, dependency theory has much overlap with Neo-Marxism and World Systems Theory, which is also reflected in the work of Immanuel Wallerstein,
a famous dependency theorist. Wallerstein rejects the notion of a Third
World, claiming that there is only one world which is connected by
economic relations (World Systems Theory). He argues that this system inherently leads to a division of the world in core, semi-periphery and periphery. One of the results of expansion of the world-system is the commodification of things, like natural resources, labor and human relationships.
The basic needs model was introduced by the International Labour Organization
in 1976, mainly in reaction to prevalent modernization- and
structuralism-inspired development approaches, which were not achieving
satisfactory results in terms of poverty alleviation and combating
inequality in developing countries. It tried to define an absolute
minimum of resources necessary for long-term physical well-being. The poverty line
which follows from this, is the amount of income needed to satisfy
those basic needs. The approach has been applied in the sphere of
development assistance, to determine what a society needs for
subsistence, and for poor population groups to rise above the poverty
line. Basic needs theory does not focus on investing in economically
productive activities. Basic needs can be used as an indicator of the
absolute minimum an individual needs to survive.
Proponents of basic needs have argued that elimination of absolute poverty is a good way to make people active in society so that they can provide labor more easily and act as consumers and savers.
There have been also many critics of the basic needs approach. It would
lack theoretical rigour, practical precision, be in conflict with growth promotion policies, and run the risk of leaving developing countries in permanent turmoil.
Neoclassical theory
Neoclassical development theory has it origins in its predecessor: classical economics.
Classical economics was developed in the 18th and 19th centuries and
dealt with the value of products and on which production factors it
depends. Early contributors to this theory are Adam Smith and David Ricardo. Classical economists argued – as do the neoclassical ones – in favor of the free market, and against government intervention in those markets. The 'invisible hand' of Adam Smith makes sure that free trade will ultimately benefit all of society. John Maynard Keynes was a very influential classical economist as well, having written his General Theory of Employment, Interest, and Money in 1936.
Neoclassical development theory became influential towards the end of the 1970s, fired by the election of Margaret Thatcher in the UK and Ronald Reagan in the USA. Also, the World Bank
shifted from its Basic Needs approach to a neoclassical approach in
1980. From the beginning of the 1980s, neoclassical development theory
really began to roll out.
Structural adjustment
One of the implications of the neoclassical development theory for developing countries were the Structural Adjustment Programmes (SAPs) which the World Bank and the International Monetary Fund wanted them to adopt. Important aspects of those SAPs include:
Postdevelopment theory is a school of thought which questions the idea of national economic development altogether. According to postdevelopment scholars, the goal of improving living standards
leans on arbitrary claims as to the desirability and possibility of
that goal. Postdevelopment theory arose in the 1980s and 1990s.
According to postdevelopment theorists, the idea of development is just a 'mental structure' (Wolfgang Sachs) which has resulted in a hierarchy of developed and underdeveloped nations, of which the underdeveloped nations desire to be like developed nations. Development thinking has been dominated by the West and is very ethnocentric,
according to Sachs. The Western lifestyle may neither be a realistic
nor a desirable goal for the world's population, postdevelopment
theorists argue. Development is being seen as a loss of a country's own
culture, people's perception of themselves and modes of life. According
to Majid Rahnema,
another leading postdevelopment scholar, things like notions of poverty
are very culturally embedded and can differ a lot among cultures. The
institutes which voice the concern over underdevelopment are very
Western-oriented, and postdevelopment calls for a broader cultural
involvement in development thinking.
Postdevelopment proposes a vision of society which removes itself from the ideas which currently dominate it. According to Arturo Escobar,
postdevelopment is interested instead in local culture and knowledge, a
critical view against established sciences and the promotion of local grassroots movements. Also, postdevelopment argues for structural change in order to reach solidarity, reciprocity, and a larger involvement of traditional knowledge.
Sustainable development is development that meets the needs of the
present without compromising the ability of future generations to meet
their own needs. (Brundtland Commission) There exist more definitions of sustainable development, but they all have to do with the carrying capacity of the earth and its natural systems and the challenges faced by humanity. Sustainable development can be broken up into environmental sustainability, economic sustainability and sociopolitical sustainability. The book Limits to Growth, commissioned by the Club of Rome, gave huge momentum to the thinking about sustainability. Global warming issues are also problems which are emphasized by the sustainable development movement. This led to the 1997 Kyoto Accord, with the plan to cap greenhouse-gas emissions.
Opponents of the implications of sustainable development often point to the environmental Kuznets curve. The idea behind this curve is that, as an economy grows, it shifts towards more capital and knowledge-intensive production.
This means that as an economy grows, its pollution output increases,
but only until it reaches a particular threshold where production
becomes less resource-intensive and more sustainable. This means that a
pro-growth, not an anti-growth policy is needed to solve the
environmental problem. But the evidence for the environmental Kuznets
curve is quite weak. Also, empirically spoken, people tend to consume
more products when their income increases. Maybe those products have
been produced in a more environmentally friendly way, but on the whole
the higher consumption negates this effect. There are people like Julian Simon however who argue that future technological developments will resolve future problems.
Amartya Sen and Mahbub ul Haq are the most well-known human development theorists. The work of Sen is focused on capabilities:
what people can do and be. It is these capabilities, rather than the
income or goods that they receive (as in the Basic Needs approach), that
determine their well-being. This core idea also underlies the
construction of the Human Development Index, a human-focused measure of development pioneered by the UNDP
in its Human Development Reports; this approach has become popular the
world over, with indexes and reports published by individual counties,
including the American Human Development Index and Report in the United States. The economic side of Sen's work can best be categorized under welfare economics, which evaluates the effects of economic policies on the well-being of peoples. Sen wrote the influential book Development as Freedom which added an important ethical side to development economics.
Homeopathy or homoeopathy is a pseudoscientific system of alternative medicine. It was conceived in 1796 by the German physician Samuel Hahnemann. Its practitioners, called homeopaths or homeopathic physicians,
believe that a substance that causes symptoms of a disease in healthy
people can cure similar symptoms in sick people; this doctrine is called
similia similibus curentur, or "like cures like". Homeopathic preparations are termed remedies and are made using homeopathic dilution.
In this process, the selected substance is repeatedly diluted until the
final product is chemically indistinguishable from the diluent. Often not even a single molecule of the original substance can be expected to remain in the product.
Between each dilution homeopaths may hit and/or shake the product,
claiming this makes the diluent "remember" the original substance after
its removal. Practitioners claim that such preparations, upon oral
intake, can treat or cure disease.
All relevant scientific knowledge about physics, chemistry, biochemistry and biology contradicts homeopathy. Homeopathic remedies are typically biochemically inert, and have no effect on any known disease. Its theory of disease, centered around principles Hahnemann termed miasms, is inconsistent with subsequent identification of viruses and bacteria as causes of disease. Clinical trials have been conducted and generally demonstrated no objective effect from homeopathic preparations. The fundamental implausibility of homeopathy as well as a lack of demonstrable effectiveness has led to it being characterized within the scientific and medical communities as quackery and fraud.
Homeopathy achieved its greatest popularity in the 19th century.
It was introduced to the United States in 1825, and the first American
homeopathic school opened in 1835. Throughout the 19th century, dozens
of homeopathic institutions appeared in Europe and the United States.
During this period, homeopathy was able to appear relatively successful,
as other forms of treatment could be harmful and ineffective. By the
end of the century the practice began to wane, with the last exclusively
homeopathic medical school in the United States closing in 1920. During
the 1970s, homeopathy made a significant comeback, with sales of some
homeopathic products increasing tenfold. The trend corresponded with the
rise of the New Age movement, and may be in part due to chemophobia, an irrational aversion to synthetic chemicals, and the longer consultation times homeopathic practitioners provided.
In the 21st century, a series of meta-analyses
have shown that the therapeutic claims of homeopathy lack scientific
justification. As a result, national and international bodies have
recommended the withdrawal of government funding for homeopathy in
healthcare. National bodies from Australia, the United Kingdom,
Switzerland and France, as well as the European Academies' Science Advisory Council and the Russian Academy of Sciences have all concluded that homeopathy is ineffective, and recommended against the practice receiving any further funding. The National Health Service in England no longer provides funding for homeopathic remedies and asked the Department of Health to add homeopathic remedies to the list of forbidden prescription items. France removed funding in 2021, while Spain has also announced moves to ban homeopathy and other pseudotherapies from health centers.
History
Homeopathy was created in 1796 by Samuel Hahnemann.
Hahnemann rejected the mainstream medicine of the late 18th century as
irrational and inadvisable, because it was largely ineffective and often
harmful. He advocated the use of single drugs at lower doses and promoted an immaterial, vitalistic view of how living organisms function. The term homeopathy was coined by Hahnemann and first appeared in print in 1807. He also coined the expression "allopathic medicine", which was used to pejoratively refer to traditional Western medicine.
Concept
Samuel Hahnemann Monument, Washington, D.C., with the inscription Similia Similibus Curentur – "Like cures Like"
Hahnemann conceived of homeopathy while translating a medical treatise by the Scottish physician and chemist William Cullen into German. Being sceptical of Cullen's theory that cinchona cured malaria
because it was bitter, Hahnemann ingested some bark specifically to
investigate what would happen. He experienced fever, shivering and joint pain:
symptoms similar to those of malaria itself. From this, Hahnemann came
to believe that all effective drugs produce symptoms in healthy
individuals similar to those of the diseases that they treat. This led to the name "homeopathy", which comes from the Greek: ὅμοιοςhómoios, "-like" and πάθοςpáthos, "suffering".
The doctrine that those drugs are effective which produce
symptoms similar to the symptoms caused by the diseases they treat,
called "the law of similars", was expressed by Hahnemann with the Latin
phrase similia similibus curentur, or "like cures like". Hahnemann's law of similars is unproven and does not derive from the scientific method. An account of the effects of eating cinchona bark noted by Oliver Wendell Holmes, published in 1861, failed to reproduce the symptoms Hahnemann reported. Subsequent scientific work showed that cinchona cures malaria because it contains quinine, which kills the Plasmodium falciparum parasite that causes the disease; the mechanism of action is unrelated to Hahnemann's ideas.
Provings
Hahnemann began to test what effects various substances may produce
in humans, a procedure later called "homeopathic proving". These tests
required subjects to test the effects of ingesting substances by
recording all their symptoms as well as the ancillary conditions under
which they appeared. He published a collection of provings in 1805, and a second collection of 65 preparations appeared in his book, Materia Medica Pura (1810).
As Hahnemann believed that large doses of drugs that caused
similar symptoms would only aggravate illness, he advocated for extreme
dilutions. A technique was devised for making dilutions that Hahnemann
claimed would preserve the substance's therapeutic properties while
removing its harmful effects. Hahnemann believed that this process enhanced "the spirit-like medicinal powers of the crude substances". He gathered and published an overview of his new medical system in his book, The Organon of the Healing Art (1810), with a sixth edition published in 1921 that homeopaths still use today.
Miasms and disease
In the Organon, Hahnemann introduced the concept of "miasms" as the "infectious principles" underlying chronic disease and as "peculiar morbid derangement[s] of vital force".
Hahnemann associated each miasm with specific diseases, and thought
that initial exposure to miasms causes local symptoms, such as skin or
venereal diseases. His assertion was that if these symptoms were
suppressed by medication, the cause went deeper and began to manifest
itself as diseases of the internal organs. Homeopathy maintains that treating diseases by directly alleviating their symptoms,
as is sometimes done in conventional medicine, is ineffective because
all "disease can generally be traced to some latent, deep-seated,
underlying chronic, or inherited tendency".
The underlying imputed miasm still remains, and deep-seated ailments
can be corrected only by removing the deeper disturbance of the vital
force.
Hahnemann's hypotheses for miasms originally presented only three local symptoms: psora (the itch), syphilis (venereal disease) or sycosis (fig-wart disease). Of these the most important was psora,
described as being related to any itching diseases of the skin and was
claimed to be the foundation of many further disease conditions.
Hahnemann believed it to be the cause of such diseases as epilepsy, cancer, jaundice, deafness, and cataracts.
Since Hahnemann's time, other miasms have been proposed, some replacing
illnesses previously attributed to the psora, including tuberculosis and cancer miasms.
Hahnemann's miasm theory remains disputed and controversial
within homeopathy even in modern times. The theory of miasms has been
criticized as an explanation developed to preserve the system of
homeopathy in the face of treatment failures, and for being inadequate
to cover the many hundreds of sorts of diseases, as well as for failing
to explain disease predispositions, as well as genetics, environmental factors, and the unique disease history of each patient.
19th century: rise to popularity and early criticism
Homeopathy
achieved its greatest popularity in the 19th century. It was introduced
to the United States in 1825 by Hans Birch Gram, a student of
Hahnemann. The first homeopathic school in the United States opened in 1835 and the American Institute of Homeopathy
was established in 1844. Throughout the 19th century, dozens of
homeopathic institutions appeared in Europe and the United States, and by 1900, there were 22 homeopathic colleges and 15,000 practitioners in the United States.
Because medical practice of the time relied on treatments which
were often ineffective and harmful, patients of homeopaths often had
better outcomes than those being treated by medical practitioners.
Though ineffective, homeopathic preparations are rarely detrimental,
thus users are less likely to be harmed by the treatment that is
supposed to be helping them.
The relative success of homeopathy in the 19th century may have led to
the abandonment of the ineffective and harmful treatments of bloodletting and purging and begun the move towards more effective, science-based medicine.
One reason for the growing popularity of homeopathy was its apparent
success in treating people suffering from infectious disease epidemics. During 19th-century epidemics of diseases such as cholera,
death rates in homeopathic hospitals were often lower than in
conventional hospitals, where the treatments used at the time were often
harmful and did little or nothing to combat the diseases.
Even during its rise in popularity, homeopathy was criticized by scientists and physicians. Sir John Forbes, physician to Queen Victoria,
said in 1843 that the extremely small doses of homeopathy were
regularly derided as useless and considered it "an outrage to human
reason". James Young Simpson
said in 1853 of the highly diluted drugs: "No poison, however strong or
powerful, the billionth or decillionth of which would in the least
degree affect a man or harm a fly." Nineteenth-century American physician and author Oliver Wendell Holmes was also a vocal critic of homeopathy and published an essay entitled Homœopathy and Its Kindred Delusions (1842).
The members of the French Homeopathic Society observed in 1867 that
some leading homeopaths of Europe not only were abandoning the practice
of administering infinitesimal doses but were also no longer defending
it. The last school in the United States exclusively teaching homeopathy closed in 1920.
Revival in the 20th century
According to academics Paul U. Unschuld [de] and Edzard Ernst, the Nazi
regime in Germany was fond of homeopathy, and spent large sums of money
on researching its mechanisms, but without gaining a positive result. Unschuld also states that homeopathy never subsequently took root in the United States, but remained more deeply established in European thinking. In the United States, the Food, Drug, and Cosmetic Act of 1938 (sponsored by Royal Copeland, a Senator from New York
and homeopathic physician) recognized homeopathic preparations as
drugs. In the 1950s, there were only 75 solely homeopathic practitioners
in the U.S. By the mid to late 1970s, homeopathy made a significant comeback and the sales of some homeopathic companies increased tenfold.
Some homeopaths credit the revival to Greek homeopath George Vithoulkas,
who conducted a "great deal of research to update the scenarios and
refine the theories and practice of homeopathy" in the 1970s,but Ernst and Simon Singh consider it to be linked to the rise of the New Age movement. Bruce Hood
has argued that the increased popularity of homeopathy in recent times
may be due to the comparatively long consultations practitioners are
willing to give their patients, and to a preference for "natural" products, which people think are the basis of homeopathic preparations.
Towards the end of the century opposition to homeopathy began to increase again; with William T. Jarvis, the President of the National Council Against Health Fraud,
saying that "Homeopathy is a fraud perpetrated on the public with the
government's blessing, thanks to the abuse of political power of Sen.
Royal S. Copeland."
21st century: renewed criticism
Since the beginning of the 21st century, a series of meta-analyses have further shown that the therapeutic claims of homeopathy lack scientific justification. This had led to a decrease or suspension of funding by many governments. In a 2010 report, the Science and Technology Committee of the United Kingdom House of Commons recommended that homeopathy should no longer receive National Health Service (NHS) funding due its lack of scientific credibility; NHS funding for homeopathy ceased in 2017. They also asked the Department of Health in the UK to add homeopathic remedies to the list of forbidden prescription items.
In 2015, the National Health and Medical Research Council of Australia found that "there are no health conditions for which there is reliable evidence that homeopathy is effective".
The federal government only ended up accepting three of the 45
recommendations made by the 2018 review of Pharmacy Remuneration and
Regulation. The same year the US Food and Drug Administration (FDA) held a hearing requesting public comment on the regulation of homeopathic drugs. In 2017 the FDA announced it would strengthen regulation of homeopathic products.
The American non-profit Center for Inquiry (CFI) filed a lawsuit in 2018 against the CVS pharmacy for consumer fraud over its sale of homeopathic medicines. It claimed that CVS was selling homeopathic products on an easier-to-obtain basis than standard medication. In 2019, CFI brought a similar lawsuit against Walmart
for "committing wide-scale consumer fraud and endangering the health of
its customers through its sale and marketing of homeopathic medicines".
They also conducted a survey in which they found consumers felt ripped
off when informed of the lack of evidence for the efficacy of
homeopathic remedies, such as those sold by Walmart and CVS.
In 2021, the French healthcare minister phased out social security reimbursements for homeopathic drugs.
France has long had a stronger belief in the virtues of homeopathic
drugs than many other countries and the world's biggest manufacturer of
alternative medicine drugs, Boiron, is located in that country. Spain has also announced moves to ban homeopathy and other pseudotherapies. In 2016, the University of Barcelona
cancelled its master's degree in Homeopathy citing "lack of scientific
basis", after advice from the Spanish Ministry of Health. Shortly afterwards the University of Valencia announced the elimination of its Masters in Homeopathy.
Homeopathic preparations are referred to as "homeopathic remedies". Practitioners rely on two types of reference when prescribing: Materia medica and repertories. A homeopathic materia medica is a collection of "drug pictures", organized alphabetically. A homeopathic repertory is a quick reference version of the materia medica
that indexes the symptoms and then the associated remedies for each. In
both cases different compilers may dispute particular inclusions in the
references. The first symptomatic homeopathic materia medica was arranged by Hahnemann. The first homeopathic repertory was Georg Jahr's Symptomenkodex, published in German in 1835, and translated into English as the Repertory to the more Characteristic Symptoms of Materia Medica in 1838. This version was less focused on disease categories and was the forerunner to later works by James Tyler Kent. There are over 118 repertories published in English, with Kent's being one of the most used.
Consultation
Homeopaths generally begin with a consultation, which can be a 10–15
minute appointment or last for over an hour, where the patient describes
their medical history. The patient describes the "modalities", or if their symptoms change depending on the weather and other external factors.
The practitioner also solicits information on mood, likes and dislikes,
physical, mental and emotional states, life circumstances, and any
physical or emotional illnesses. This information (also called the "symptom picture") is matched to the "drug picture" in the materia medica
or repertory and used to determine the appropriate homeopathic
remedies. In classical homeopathy, the practitioner attempts to match a
single preparation to the totality of symptoms (the simlilum), while "clinical homeopathy" involves combinations of preparations based on the illness's symptoms.
Homeopathy uses animal, plant, mineral, and synthetic substances in its preparations, generally referring to them using Latin names. Examples include arsenicum album (arsenic oxide), natrum muriaticum (sodium chloride or table salt), Lachesis muta (the venom of the bushmaster snake), opium, and thyroidinum (thyroid hormone). Homeopaths say this is to ensure accuracy. In the USA the common name must be displayed, although the Latin one can also be present.
Homeopathic pills are made from an inert substance (often sugars,
typically lactose), upon which a drop of liquid homeopathic preparation
is placed and allowed to evaporate.
Isopathy is a therapy derived from homeopathy in which the
preparations come from diseased or pathological products such as fecal,
urinary and respiratory discharges, blood, and tissue. They are called nosodes (from the Greek nosos,
disease) with preparations made from "healthy" specimens being termed
"sarcodes". Many so-called "homeopathic vaccines" are a form of
isopathy.
Tautopathy is a form of isopathy where the preparations are composed of
drugs or vaccines that a person has consumed in the past, in the belief
that this can reverse the supposed lingering damage caused by the
initial use. There is no convincing scientific evidence for isopathy as an effective method of treatment.
Some modern homeopaths use preparations they call "imponderables"
because they do not originate from a substance but some other
phenomenon presumed to have been "captured" by alcohol or lactose. Examples include X-rays and sunlight. Another derivative is electrohomeopathy,
where an electric bio-energy of therapeutic value is supposedly
extracted from plants. Popular in the late nineteenth century,
electrohomeopathy is extremely pseudo-scientific.
In 2012, the Allahabad High Court in Uttar Pradesh, India, handed down a
decree stating that electrohomeopathy was quackery and no longer
recognized it as a system of medicine .
Other minority practices include paper preparations, in which the
terms for substances and dilutions are written on pieces of paper and
either pinned to the patients' clothing, put in their pockets, or placed
under glasses of water that are then given to the patients. Radionics, the use of electromagnetic radiation such as radio waves,
can also be used to manufacture preparations. Such practices have been
strongly criticized by classical homeopaths as unfounded, speculative,
and verging upon magic and superstition. Flower preparations are produced by placing flowers in water and exposing them to sunlight. The most famous of these are the Bach flower remedies, which were developed by Edward Bach.
Hahnemann
claimed that undiluted doses caused reactions, sometimes dangerous
ones, and thus that preparations be given at the lowest possible dose.
A solution that is more dilute is described as having a higher
"potency", and thus are claimed to be stronger and deeper-acting. The general method of dilution is serial dilution,
where solvent is added to part of the previous mixture, but the
"Korsakovian" method may also be used. In the Korsakovian method, the
vessel in which the preparations are manufactured is emptied, refilled
with solvent, with the volume of fluid adhering to the walls of the
vessel deemed sufficient for the new batch. The Korsakovian method is sometimes referred to as K on the label of a homeopathic preparation. Another method is Fluxion, which dilutes the substance by continuously passing water through the vial. Insoluble solids, such as granite, diamond, and platinum, are diluted by grinding them with lactose ("trituration").
Three main logarithmic
dilution scales are in regular use in homeopathy. Hahnemann created the
"centesimal" or "C scale", diluting a substance by a factor of 100 at
each stage. There is also a decimal dilution scale (notated as "X" or
"D") in which the preparation is diluted by a factor of 10 at each
stage.
The centesimal scale was favoured by Hahnemann for most of his life,
although in his last ten years Hahnemann developed a quintamillesimal
(Q) scale which diluted the drug 1 part in 50,000.
A 2C dilution works out to one part of the original substance in 10,000
parts of the solution. In standard chemistry, this produces a substance
with a concentration of 0.01% (volume-volume percentage). A 6C dilution ends up with the original substance diluted by a factor of 100−6
(one part in one trillion). The end product is usually so diluted as to
be indistinguishable from the diluent (pure water, sugar or alcohol). The greatest dilution reasonably likely to contain at least one molecule of the original substance is approximately 12C.
Hahnemann advocated dilutions of 1 part to 1060 or 30C. Hahnemann regularly used dilutions of up to 30C but opined that "there must be a limit to the matter". To counter the reduced potency at high dilutions he formed the view
that vigorous shaking by striking on an elastic surface – a process
termed succussion – was necessary.
Homeopaths are unable to agree on the number and force of strikes
needed, and there is no way that the claimed results of succussion can
be tested.
Critics of homeopathy commonly emphasize the dilutions involved in homeopathy, using analogies.
One mathematically correct example is that a 12C solution is equivalent
to "a pinch of salt in both the North and South Atlantic Oceans. One-third of a drop of some original substance diluted into all the water on earth would produce a preparation with a concentration of about 13C. A 200C dilution of duck liver, marketed under the name Oscillococcinum, would require 10320 universes worth of molecules to contain just one original molecule in the final substance.
The high dilutions characteristically used are often considered to be
the most controversial and implausible aspect of homeopathy.
Provings
Homeopaths claim that they can determine the properties of their preparations by following a method which they call "proving".
As performed by Hahnemann, provings involved administering various
preparations to healthy volunteers. The volunteers were then observed,
often for months at a time. They were made to keep extensive journals
detailing all of their symptoms at specific times throughout the day.
They were forbidden from consuming coffee, tea, spices, or wine for the
duration of the experiment; playing chess was also prohibited because
Hahnemann considered it to be "too exciting", though they were allowed
to drink beer and encouraged to exercise in moderation. At first Hahnemann used undiluted doses for provings, but he later advocated provings with preparations at a 30C dilution, and most modern provings are carried out using ultra-dilute preparations.
Provings are claimed to have been important in the development of the clinical trial, due to their early use of simple control groups, systematic and quantitative procedures, and some of the first application of statistics in medicine. The lengthy records of self-experimentation by homeopaths have occasionally proven useful in the development of modern drugs: For example, evidence that nitroglycerin might be useful as a treatment for angina
was discovered by looking through homeopathic provings, though
homeopaths themselves never used it for that purpose at that time. The first recorded provings were published by Hahnemann in his 1796 Essay on a New Principle. His Fragmenta de Viribus (1805) contained the results of 27 provings, and his 1810 Materia Medica Pura contained 65. For James Tyler Kent's 1905 Lectures on Homoeopathic Materia Medica, 217 preparations underwent provings and newer substances are continually added to contemporary versions.
Though the proving process has superficial similarities with
clinical trials, it is fundamentally different in that the process is
subjective, not blinded, and modern provings are unlikely to use pharmacologically active levels of the substance under proving.
As early as 1842, Oliver Holmes had noted that provings were impossibly
vague, and the purported effect was not repeatable among different
subjects.
Outside of the alternative medicine community, scientists have long considered homeopathy a sham or a pseudoscience, and the medical community regards it as quackery. There is an overall absence of sound statistical evidence of therapeutic efficacy, which is consistent with the lack of any biologically plausible pharmacological agent or mechanism. Proponents argue that homeopathic medicines must work by some, as yet undefined, biophysical mechanism. No homeopathic preparation has been shown to be different from placebo.
Lack of scientific evidence
The lack of convincing scientific evidence supporting its efficacy
and its use of preparations without active ingredients have led to
characterizations of homeopathy as pseudoscience and quackery, or, in the words of a 1998 medical review, "placebo therapy at best and quackery at worst". The Russian Academy of Sciences
considers homeopathy a "dangerous 'pseudoscience' that does not work",
and "urges people to treat homeopathy 'on a par with magic'". The Chief Medical Officer for England, Dame Sally Davies, has stated that homeopathic preparations are "rubbish" and do not serve as anything more than placebos. In 2013, Mark Walport, the UK Government Chief Scientific Adviser and head of the Government Office for Science said "homeopathy is nonsense, it is non-science." His predecessor, John Beddington, also said that homeopathy "has no underpinning of scientific basis" and is being "fundamentally ignored" by the Government.
Jack Killen, acting deputy director of the National Center for Complementary and Alternative Medicine,
says homeopathy "goes beyond current understanding of chemistry and
physics". He adds: "There is, to my knowledge, no condition for which
homeopathy has been proven to be an effective treatment." Ben Goldacre says that homeopaths who misrepresent scientific evidence to a scientifically illiterate
public, have "... walled themselves off from academic medicine, and
critique has been all too often met with avoidance rather than
argument". Homeopaths often prefer to ignore meta-analyses in favour of cherry picked positive results, such as by promoting a particular observational study
(one which Goldacre describes as "little more than a
customer-satisfaction survey") as if it were more informative than a
series of randomized controlled trials.
In an article entitled "Should We Maintain an Open Mind about Homeopathy?" published in the American Journal of Medicine, Michael Baum and Edzard Ernst –
writing to other physicians – wrote that "Homeopathy is among the worst
examples of faith-based medicine... These axioms [of homeopathy] are
not only out of line with scientific facts but also directly opposed to
them. If homeopathy is correct, much of physics, chemistry, and
pharmacology must be incorrect...".
Plausibility of dilutions
A homeopathic preparation made from marsh tea: the "15C" dilution shown here means the original solution was diluted to 1/1030 of its original strength.
The exceedingly low concentration of homeopathic preparations, which often lack even a single molecule of the diluted substance, has been the basis of questions about the effects of the preparations since the 19th century. The laws of chemistry give this dilution limit, which is related to the Avogadro number, as being roughly equal to 12C homeopathic dilutions (1 part in 1024). James Randi and the 10:23 campaign groups have highlighted the lack of active ingredients by taking large 'overdoses'.
None of the hundreds of demonstrators in the UK, Australia, New
Zealand, Canada and the US were injured and "no one was cured of
anything, either".
Modern advocates of homeopathy have proposed a concept of "water memory",
according to which water "remembers" the substances mixed in it, and
transmits the effect of those substances when consumed. This concept is
inconsistent with the current understanding of matter, and water memory
has never been demonstrated to have any detectable effect, biological or
otherwise. Existence of a pharmacological effect in the absence of any true active ingredient is inconsistent with the law of mass action and the observed dose-response relationships characteristic of therapeutic drugs.
Homeopaths contend that their methods produce a therapeutically active
preparation, selectively including only the intended substance, though
in reality any water will have been in contact with millions of
different substances throughout its history, and homeopaths cannot
account for the selected homeopathic substance being isolated as a
special case in their process.
Practitioners also hold that higher dilutions produce stronger
medicinal effects. This idea is also inconsistent with observed
dose-response relationships, where effects are dependent on the
concentration of the active ingredient in the body. Some contend that the phenomenon of hormesis may support the idea of dilution increasing potency,
but the dose-response relationship outside the zone of hormesis
declines with dilution as normal, and nonlinear pharmacological effects
do not provide any credible support for homeopathy.
Efficacy
Explanations for efficacy of homeopathic preparations:
The intensive consultation process and expectations for the homeopathic preparations may cause the effect
Therapeutic effect of the consultation
The care, concern, and reassurance a patient experiences when
opening up to a compassionate caregiver can have a positive effect on
the patient's well-being.
Since many diseases or conditions are cyclical, symptoms vary over
time and patients tend to seek care when discomfort is greatest; they
may feel better anyway but because of the timing of the visit to the
homeopath they attribute improvement to the preparation taken.
Non-homeopathic treatment
Patients may also receive standard medical care at the same time as
homeopathic treatment, and the former is responsible for improvement.
Cessation of unpleasant treatment
Often homeopaths recommend patients stop getting medical treatment
such as surgery or drugs, which can cause unpleasant side-effects;
improvements are attributed to homeopathy when the actual cause is the
cessation of the treatment causing side-effects in the first place, but
the underlying disease remains untreated and still dangerous to the
patient.
No individual homeopathic preparation has been unambiguously shown by research to be different from placebo. The methodological quality of the early primary research was low, with problems such as weaknesses in study design and reporting, small sample size, and selection bias.
Since better quality trials have become available, the evidence for
efficacy of homeopathy preparations has diminished; the highest-quality
trials indicate that the preparations themselves exert no intrinsic
effect. A review conducted in 2010 of all the pertinent studies of "best evidence" produced by the Cochrane Collaboration
concluded that "the most reliable evidence – that produced by Cochrane
reviews – fails to demonstrate that homeopathic medicines have effects
beyond placebo."
In 2009, the United Kingdom's House of Commons Science and Technology Committee concluded that there was no compelling evidence of effect other than placebo. The Australian National Health and Medical Research Council
completed a comprehensive review of the effectiveness of homeopathic
preparations in 2015, in which it concluded that "there were no health
conditions for which there was reliable evidence that homeopathy was
effective."
The European Academies' Science Advisory Council (EASAC) published its
official analysis in 2017 finding a lack of evidence that homeopathic
products are effective, and raising concerns about quality control.
In contrast a 2011 book was published, purportedly financed by the
Swiss government, that concluded that homeopathy was effective and cost
efficient. Although hailed by proponents as proof that homeopathy works, it was found to be scientifically, logically and ethically flawed, with most authors having a conflict of interest. The Swiss Federal Office of Public Health later released a statement saying the book was published without the consent of the Swiss government.
Meta-analyses, essential tools to summarize evidence of therapeutic efficacy, and systematic reviews
have found that the methodological quality in the majority of
randomized trials in homeopathy have shortcomings and that such trials
were generally of lower quality than trials of conventional medicine.A major issue has been publication bias, where positive results are more likely to be published in journals.This has been particularly marked in alternative medicine journals,
where few of the published articles (just 5% during the year 2000) tend
to report null results.
A systematic review of the available systematic reviews confirmed in
2002 that higher-quality trials tended to have less positive results,
and found no convincing evidence that any homeopathic preparation exerts
clinical effects different from placebo. The same conclusion was also reached in 2005 in a meta-analysis published in The Lancet.
A 2017 systematic review and meta-analysis found that the most
reliable evidence did not support the effectiveness of
non-individualized homeopathy.
Health organizations, including the UK's National Health Service, the American Medical Association, the FASEB, and the National Health and Medical Research Council of Australia,
have issued statements saying that there is no good-quality evidence
that homeopathy is effective as a treatment for any health condition. In 2009, World Health Organization official Mario Raviglione criticized the use of homeopathy to treat tuberculosis; similarly, another WHO spokesperson argued there was no evidence homeopathy would be an effective treatment for diarrhoea. They warned against the use of homeopathy for serious conditions such as depression, HIV and malaria. The American College of Medical Toxicology and the American Academy of Clinical Toxicology recommend that no one use homeopathic treatment for disease or as a preventive health measure.
These organizations report that no evidence exists that homeopathic
treatment is effective, but that there is evidence that using these
treatments produces harm and can bring indirect health risks by delaying
conventional treatment.
Purported effects in other biological systems
While some articles have suggested that homeopathic solutions of high
dilution can have statistically significant effects on organic
processes including the growth of grain and enzyme reactions, such evidence is disputed since attempts to replicate them have failed. In 2001 and 2004, Madeleine Ennis published a number of studies that reported that homeopathic dilutions of histamine exerted an effect on the activity of basophils. In response to the first of these studies, Horizon aired a programme in which British scientists attempted to replicate Ennis' results; they were unable to do so.
A 2007 systematic review of high-dilution experiments found that none
of the experiments with positive results could be reproduced by all
investigators.
In 1988, French immunologist Jacques Benveniste published a paper in the journal Nature while working at INSERM.
The paper purported to have discovered that basophils released
histamine when exposed to a homeopathic dilution of anti-immunoglobulin E
antibody. Skeptical of the findings, Nature assembled an
independent investigative team to determine the accuracy of the
research. After investigation the team found that the experiments were
"statistically ill-controlled", "interpretation has been clouded by the
exclusion of measurements in conflict with the claim", and concluded,
"We believe that experimental data have been uncritically assessed and
their imperfections inadequately reported."
Ethics and safety
Homeopathic preparation Rhus toxicodendron, derived from poison ivy
The provision of homeopathic preparations has been described as unethical. Michael Baum, professor emeritus of surgery and visiting professor of medical humanities at University College London (UCL), has described homeopathy as a "cruel deception". Edzard Ernst, the first professor of complementary medicine in the United Kingdom and a former homeopathic practitioner, has expressed his concerns about pharmacists
who violate their ethical code by failing to provide customers with
"necessary and relevant information" about the true nature of the
homeopathic products they advertise and sell. In 2013 the UK Advertising Standards Authority concluded that the Society of Homeopaths
were targeting vulnerable ill people and discouraging the use of
essential medical treatment while making misleading claims of efficacy
for homeopathic products. In 2015 the Federal Court of Australia
imposed penalties on a homeopathic company for making false or
misleading statements about the efficacy of the whooping cough vaccine
and recommending homeopathic remedies as an alternative.
A 2000 review by homeopaths reported that homeopathic preparations are "unlikely to provoke severe adverse reactions". In 2012, a systematic review evaluating evidence of homeopathy's possible adverse effects concluded that "homeopathy has the potential to harm patients and consumers in both direct and indirect ways".
A 2016 systematic review and meta-analysis found that, in homeopathic
clinical trials, adverse effects were reported among the patients who
received homeopathy about as often as they were reported among patients
who received placebo or conventional medicine.
Some homeopathic preparations involve poisons such as Belladonna, arsenic, and poison ivy.
In rare cases, the original ingredients are present at detectable
levels. This may be due to improper preparation or intentional low
dilution. Serious adverse effects such as seizures and death have been
reported or associated with some homeopathic preparations. Instances of arsenic poisoning have occurred. In 2009, the FDA advised consumers to stop using three discontinued cold remedy Zicam products because it could cause permanent damage to users' sense of smell. In 2016 the FDA issued a safety alert to consumers warning against the use of homeopathic teething gels and tablets following reports of adverse events after their use.
A previous FDA investigation had found that these products were
improperly diluted and contained "unsafe levels of belladonna" and that
the reports of serious adverse events in children using this product
were "consistent with belladonna toxicity".
Patients who choose to use homeopathy rather than evidence-based medicine risk missing timely diagnosis and effective treatment, thereby worsening the outcomes of serious conditions such as cancer. The Russian Commission on Pseudoscience
has said homeopathy is not safe because "patients spend significant
amounts of money, buying medicines that do not work and disregard
already known effective treatment."
Critics have cited cases of patients failing to receive proper
treatment for diseases that could have been easily managed with
conventional medicine and who have died as a result. They have also condemned the "marketing practice" of criticizing and downplaying the effectiveness of medicine.Homeopaths claim that use of conventional medicines will "push the
disease deeper" and cause more serious conditions, a process referred to
as "suppression". In 1978, Anthony Campbell, a consultant physician at the Royal London Homeopathic Hospital, criticized statements by George Vithoulkas claiming that syphilis, when treated with antibiotics, would develop into secondary and tertiary syphilis with involvement of the central nervous system.
Vithoulkas' claims echo the idea that treating a disease with external
medication used to treat the symptoms would only drive it deeper into
the body and conflict with scientific studies, which indicate that penicillin treatment produces a complete cure of syphilis in more than 90% of cases.
The use of homeopathy as a preventive for serious infectious diseases, called homeoprophylaxis, is especially controversial. Some homeopaths (particularly those who are non-physicians) advise their patients against immunization. Others have suggested that vaccines be replaced with homeopathic "nosodes".
While Hahnemann was opposed to such preparations, modern homeopaths
often use them although there is no evidence to indicate they have any
beneficial effects. Promotion of homeopathic alternatives to vaccines has been characterized as dangerous, inappropriate and irresponsible. In December 2014, the Australian homeopathy supplier Homeopathy Plus! was found to have acted deceptively in promoting homeopathic alternatives to vaccines. In 2019, an investigative journalism piece by the Telegraph revealed that homeopathy practitioners were actively discouraging patients from vaccinating their children. Cases of homeopaths advising against the use of anti-malarial drugs have also been identified, putting visitors to the tropics in severe danger.
A 2006 review recommends that pharmacy colleges include a
required course where ethical dilemmas inherent in recommending products
lacking proven safety and efficacy data be discussed and that students
should be taught where unproven systems such as homeopathy depart from
evidence-based medicine.
Homeopathy is fairly common in some countries while being uncommon in
others; is highly regulated in some countries and mostly unregulated in
others. It is practiced worldwide and professional qualifications and
licences are needed in most countries.
A 2019 WHO report found that 100 out of 133 Member States surveyed in
2012 acknowledged that their population used homeopathy, with 22 saying
the practice was regulated and 13 providing health insurance coverage.
In some countries, there are no specific legal regulations concerning
the use of homeopathy, while in others, licences or degrees in
conventional medicine from accredited universities are required. In 2001
homeopathy had been integrated into the national health care systems of
many countries, including India, Mexico, Pakistan, Sri Lanka, and the
United Kingdom.
Regulation
Some homeopathic treatment is covered by the public health service of several European countries, including Scotland, and Luxembourg. It used to be covered in France until 2021.
In other countries, such as Belgium, homeopathy is not covered. In
Austria, the public health service requires scientific proof of
effectiveness in order to reimburse medical treatments and homeopathy is
listed as not reimbursable, but exceptions can be made; private health insurance policies sometimes include homeopathic treatments. In 2018, Austria's Medical University of Vienna stopped teaching homeopathy.
The Swiss government withdrew coverage of homeopathy and four other
complementary treatments in 2005, stating that they did not meet
efficacy and cost-effectiveness criteria, but following a referendum in 2009 the five therapies were reinstated for a further 6-year trial period.
In Germany, homeopathic treatments are covered by 70 percent of
government medical plans, and available in almost every pharmacy. In January 2024, German health ministerKarl Lauterbach
announced plans to withdraw all statutory health insurance coverage for
homeopathic and anthroposophic treatments, citing a lack of scientific
evidence for their efficacy.
The English NHS recommended against prescribing homeopathic preparations in 2017.
In 2018, prescriptions worth £55,000 were written in defiance of the
guidelines, representing less than 0.001% of the total NHS prescribing
budget. In 2016 the UK's Committee of Advertising Practice compliance team wrote to homeopaths in the UK to "remind them of the rules that govern what they can and can't say in their marketing materials".
The letter told homeopaths to "ensure that they do not make any direct
or implied claims that homeopathy can treat medical conditions" and asks
them to review their marketing communications "including websites and
social media pages" to ensure compliance. Homeopathic services offered at Bristol Homeopathic Hospital in the UK ceased in October 2015.
Member states of the European Union are required to ensure that homeopathic products are registered, although this process does not require any proof of efficacy. In Spain, the Association for the protection of patients from pseudo-scientific therapies is lobbying to get rid of the easy registration procedure for homeopathic remedies.
In Bulgaria, Hungary, Latvia, Romania and Slovenia homeopathy, by law,
can only be practiced by medical practitioners. However, in Slovenia if
doctors practice homeopathy their medical license will be revoked.
In Germany, to become a homeopathic physician, one must attend a
three-year training program, while France, Austria and Denmark mandate
licences to diagnose any illness or dispense of any product whose
purpose is to treat any illness.
Homeopaths in the UK are under no legal regulations, meaning anyone can
call themselves homeopaths and administer homeopathic remedies.
Homeopathics at a homeopathic pharmacy in Varanasi, IndiaHomeopathic medicines at a store in West Bengal, India
Some medical schools in Pakistan, India, and Bangladesh, offer an undergraduate degree programme in homeopathy. Upon completion the college may award a Bachelor of Homoeopathy Medicine and Surgery (B.H.M.S.).
In the United States each state is responsible for the laws and licensing requirements for homeopathy. In 2015, the FDA held a hearing on homeopathic product regulation. At the hearing, representatives from the Center for Inquiry and the Committee for Skeptical Inquiry summarized the harm that is done to the general public from homeopathics and proposed regulatory actions: In 2016 the United States Federal Trade Commission
(FTC) issued an "Enforcement Policy Statement Regarding Marketing
Claims for Over-the-Counter Homeopathic Drugs" which specified that the
FTC will apply the same standard to homeopathic drugs that it applies to
other products claiming similar benefits.
A related report concluded that claims of homeopathy effectiveness "are
not accepted by most modern medical experts and do not constitute
competent and reliable scientific evidence that these products have the
claimed treatment effects." In 2019, the FDA removed an enforcement policy that permitted unapproved homeopathics to be sold. Currently no homeopathic products are approved by the FDA.
Homeopathic remedies are regulated as natural health products in Canada. Ontario
became the first province in the country to regulate the practice of
homeopathy, a move that was widely criticized by scientists and doctors. Health Canada
requires all products to have a licence before being sold and
applicants have to submit evidence on "the safety, efficacy and quality
of a homeopathic medicine". In 2015 the Canadian Broadcasting Corporation tested the system by applying for and then receiving a government approved licence for a made-up drug aimed at kids.
In Australia, the sale of homeopathic products is regulated by the Therapeutic Goods Administration. In 2015, the National Health and Medical Research Council
of Australia concluded that there is "no reliable evidence that
homeopathy is effective and should not be used to treat health
conditions that are chronic, serious, or could become serious". They
recommended anyone considering using homeopathy should first get advice
from a registered health practitioner. A 2017 review into Pharmacy Remuneration and Regulation recommended that products be banned from pharmacies; while noting the concerns the government did not adopt the recommendation. In New Zealand there are no regulations specific to homeopathy and the New Zealand Medical Association does not oppose the use of homeopathy, a stance that has been called unethical by some doctors.
Prevalence
Homeopathy is one of the most commonly used forms of alternative medicines and it has a large worldwide market.
The exact size is uncertain, but information available on homeopathic
sales suggests it forms a large share of the medical market.
In 1999, about 1000 UK doctors practiced homeopathy, most being
general practitioners who prescribe a limited number of remedies. A
further 1500 homeopaths with no medical training are also thought to
practice. Over ten thousand German and French doctors use homeopathy.
In the United States a National Health Interview Survey estimated 5
million adults and 1 million children used homeopathy in 2011. An
analysis of this survey concluded that most cases were self-prescribed
for colds and musculoskeletal pain. Major retailers like Walmart, CVS, and Walgreens sell homeopathic products that are packaged to resemble conventional medicines.
The homeopathic drug market in Germany is worth about 650 million
euro with a 2014 survey finding that 60 percent of Germans reported
trying homeopathy. A 2009 survey found that only 17 percent of respondents knew how homeopathic medicine was made. France spent more than US$408 million on homeopathic products in 2008. In the United States the homeopathic market is worth about $3 billion-a-year; with 2.9 billion spent in 2007. Australia spent US$7.3 million on homeopathic medicines in 2008.
In India, a 2014 national health survey found that homeopathy was used by about 3% of the population.
Homeopathy is used in China, although it arrived a lot later than in
many other countries, partly due to the restriction on foreigners that
persisted until late in the nineteenth century.
Throughout Africa there is a high reliance on traditional medicines,
which can be attributed to the cost of modern medicines and the relative
prevalence of practitioners. Many African countries do not have any
official training facilities.
Veterinary use
Homeopathic cures for small animals on the Isle of Man
Using homeopathy as a treatment for animals is termed "veterinary
homeopathy" and dates back to the inception of homeopathy; Hahnemann
himself wrote and spoke of the use of homeopathy in animals other than
humans. The use of homeopathy in the organic farming industry is heavily promoted.
Given that homeopathy's effects in humans are due to the placebo
effect and the counseling aspects of the consultation, such treatments
are even less effective in animals.
Studies have also found that giving animals placebos can play active
roles in influencing pet owners to believe in the effectiveness of the
treatment when none exists. This means that animals given homeopathic remedies will continue to suffer, resulting in animal welfare concerns.
Little existing research on the subject is of a high enough scientific standard to provide reliable data on efficacy. A 2016 review of peer-reviewed articles from 1981 to 2014 by scientists from the University of Kassel,
Germany, concluded that there is not enough evidence to support
homeopathy as an effective treatment of infectious diseases in
livestock. The UK's Department for Environment, Food and Rural Affairs (Defra) has adopted a robust position against use of "alternative" pet preparations including homeopathy. The British Veterinary Association's position statement on alternative medicines says that it "cannot endorse" homeopathy, and the Australian Veterinary Association includes it on its list of "ineffective therapies".
