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Tuesday, October 13, 2009

In the interests of fairness...

Yesterday I blogged about the unfortunate resolution* to the case of Madeline Neumann, a little girl who died of untreated but treatable diabetes because her parents declined medical treatment in favor of faith healing. My overall point was less that faith healing is ineffective- although that's the case- and more that the light sentence her parents received indicates that we have a long way to go in the U.S. before all religious are treated equally under the law.

At the same time, however, I don't want to give the impression that I think only Christian extremists do this sort of thing- I don't think that at all. Instead, I think that all kinds of wacky non-evidence-based belief systems can lead to pretty horrific outcomes. Take homeopathy, for example. Homeopathy is based on the idea that you treat a symptom with a substance that produces reactions similar to the symptom itself. So, if you have a fever, you should give the feverish person a drug that will induce fever. Some of you on reading this are probably thinking, "that sounds crazy," and rightly so. Homeopathy has a gimmick, however, and the gimmick is a real beaut. The gimmick is that they dilute the "medicine" using water. Specifically, a small amount of the medicine- which I will henceforth call the "reactant"- is mixed in distilled water and shaken. Then a small amount of that water is removed, added to another volume of distilled water, and shaken. Then you do it again, and again, and again, in a potentially lengthy chain of serial dilutions until eventually the final "medicine" is effectively all water with no detectable traces of the reactant left. If you ever look on the packaging for homeopathic products they will often list an ingredient followed by a multiplication factor (e.g. 8x). This factor indicates the number of times the ingredient was diluted in the style described above and more dilutions are generally considered better. Homeopathy argues that this is because the dilution increases the potency by essentially causing the water to take on the properties of the chemical diluted in it. That, however, is obviously untrue as otherwise all water would pretty much taste powerfully like sewage by this point. I will agree, however, that if you must use a homoepathic product more dilutions really is better because at least that way there's less of a chance that you will actually be dosed with the reactant, which is itself often a toxic or lethal substance.

Now, given that homeopathic products are essentially inert and usually consist of little other than water, coloring, and perhaps a little gelatin, one wonders what the harm could be? Well, simply put, the same as the harm in faith healing: reliance on an ineffective treatment may produce a failure to avail oneself of effective treatments. Take, for example, the case of Thomas and Manju Sam, whose daughter is dead because of their reliance of homeopathy:

A husband and wife were jailed Monday for the manslaughter of their baby, who died after they chose to use homeopathic remedies rather than conventional medicine to treat her severe skin disorder.

Thomas Sam, a 42-year old college lecturer in homeopathy, and his wife Manju, 37, of Sydney, were convicted in June of the manslaughter of their nine-month-old daughter Gloria, who died of septicemia and malnutrition in May 2002.

The Indian-born, university-educated parents had faced a maximum penalty of 25 years each in prison if convicted. Instead, New South Wales state Supreme Court Justice Peter Johnson ordered Thomas Sam to serve at least six years in jail, with a maximum sentence of eight years, and Manju to serve at least four years in jail with a maximum of five years and four months. The couple wept as they were sentenced.


Prosecutors said the parents rarely consulted conventional doctors and never contacted a skin specialist after a nurse noticed that their previously healthy baby had developed severe eczema at four months old.

Instead, prosecutors said Thomas Sam continued to consult homeopaths and natural medicine practitioners as his daughter’s health continued to plummet and her black hair turned white.

Gloria became malnourished by battles against frequent infections that invaded her bloodstream through skin broken by her severe rashes. Her parents finally admitted her to a hospital, where doctors said she was severely ill. The doctors gave her morphine for the pain and began treating an eye infection that had started to melt her corneas.

Indeed, the Sams are a case effectively parallel to the Neumanns from yesterday. Both relied on ineffective treatment, both did so perhaps because of a rejection of "western culture", and both ended up with a daughter who died painfully and slowly. Both were even eligible for up to 25 years of jail time. The main difference appears to be that the Neumanns are getting off with six months of jail time while the Sams are getting at least four or six (for Manju and Thomas, respectively) years. The Sam case comes to us from Australia, and so is not entirely comparable, but the contrast is nevertheless disquieting.

Religious freedom and freedom of conscience are good things, but it's more than a little upsetting when dogmatic adherence to a belief system causes fatalities. Moreover, I am less than thrilled the degree of punishment varies so widely between nations with similar cultural backgrounds based perhaps on the religion and background of the defendants.

* Actually, given that the Neumanns are appealing even the slap on the wrist they received over this, calling it a "resolution" may be a smidge premature.

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