"Choice" in Medicine

A theme I’ve heard a lot about from alternative medicine types is “choice”. Homeopaths in particular are extremely keen that everyone be given a choice between ‘conventional’ and homeopathic medicine. Choice is, of course, a good thing. People should have a choice wherever possible. But the way alternative medicine practitioners use the word is disingenuous at best.

I’m going to skip over the argument for choice within the NHS, as I think that’s more to do with entitlement issues and the persecution complex fringe groups always adopt when their absurd privileges are taken away – hence every ‘attack on Christianity’ news report you’ve ever read or the endless ‘put the football on the BBC’ petitions on the 10 Downing Street website. The problem with ‘choice’ as an argument for providing alternative remedies is that their practitioners are intent on taking away any choice you may have.

A particularly gutsy Deal Or No Deal contestant may find themselves offered the swap with only the 1p and £250,000 boxes in play. Their dilemma, essentially, is between the prize in box 4 and the prize in box 17. One of them is life-changing money, the other won’t cover their bus fare if they live down the road. If they call it wrong, we wouldn’t incredulously ask them why anyone would want 1p instead of £250,000. They were never given a meaningful choice.

Both extremes of the ‘choice’ argument can agree on one thing: homeopathy and evidence-based medicine do not both work. One of them cures diseases, and the other is a waste of time and money. A patient given a choice between homeopathy and real medicine is in the same position as the Deal Or No Deal contestant above: they want the medicine that will cure their disease, but they don’t know which box it’s in. The patient has no meaningful choice until they’re told which medicine works (at which point they still have no meaningful choice since one option just seems silly).

An uninformed choice is no choice at all, so the people pushing for consumer choice are the skeptics who work to disseminate evidence of efficacy or lack thereof, to expose quacks and to debunk media scare stories. They are giving people the information which enables them to make a choice. Homeopaths are effectively arguing that we are ‘anti-choice’ because we want to give people information that will make the choice so easy it will cease to exist. I think they are anti-choice because they deprive people of information that makes the choice meaningful – and often give out misinformation that makes the answer to their dilemma both obvious and wrong. When they die of a treatable condition, will the homeopath stand up in court and say ‘this is what he chose’?

Nobody is arguing that consumers should have a choice between conventional business deals and Nigerian princes who e-mail them opportunities.