January 3, 2013
AVMA delegates to scrutinize veterinary homeopathy
Debarking, stem cell policies among several up for debate
By: Jennifer Fiala
For The VIN News Service
When a patient with canine lymphoma presented in Dr. Todd Cooney’s practice several weeks ago, the veterinarian did not recommend chemotherapy drugs to treat the dog's condition.
Instead, he prescribed for the patient two remedies: honeybee venom and table salt.
“It sounds bizarre, but it works,” said Cooney, who’s studied homeopathy for four years and practiced veterinary medicine for nearly 30. “There’s now no trace of the cancer.”
While no one is questioning this
particular case of Cooney's, his and every other veterinary homeopathic
practice in the country could be affected by scrutiny of homeopathy in
general by the American Veterinary Medical Association (AVMA).
This weekend, the AVMA House of Delegates will gather in Chicago for the group’s Winter Session. On the table is a prospective bylaws change and seven resolutions, one of which calls for the AVMA to publicly discourage and identify homeopathy as an “ineffective practice.”
Submitted by the Connecticut Veterinary Medical Association (CVMA), the resolution asks the AVMA to affirm that the safety and efficacy of veterinary therapies should be determined by scientific investigation, and when scientific studies deem therapies to be ineffective or unsafe, those therapies should be discarded.
“Although veterinarians may legally employ any therapy that complies with the applicable laws and regulations governing the practice of veterinary medicine, the AVMA believes that veterinarians have an ethical duty to society, and to patients and their owners, to base medical judgments and recommendations on the best available scientific evidence,” the resolution states.
What prompted the CVMA to tackle the topic of homeopathy is unclear. However, an accompanying white paper submitted by the group suggests that the CVMA’s decision to debunk homeopathy wasn’t made lightly. In some 30 pages, the group pokes holes in the methodology of studies that suggest homeopathic remedies are efficacious and challenges claims of positive clinical outcomes.
Supporters of homeopathy have fired back that many studies, including recent clinical trials, demonstrate the efficacy of homeopathic remedies.
Dr. Gary Block, board-certified in internal medicine and a House delegate representing Rhode Island, said that from an evidence-based standpoint, homeopathy is “hocus pocus.”
As an example, he points to water therapy — a traditional homeopathic remedy that’s prepared by diluting chosen substances in distilled water until none of the original substance remains. Water has memory, practitioners of homeopathy believe, allowing substances dissolved in water to leave an enduring impact even if the water is diluted beyond the point where no molecule of the original substance remains.
“To me, the resolution states the obvious,” Block said. “Homeopathy is not a scientific discipline. We do our clients a disservice when we promote it as one.”
Cooney believes that such criticisms might stem from a lack of knowledge about homeopathy. "I think there are a few people in AVMA who've just decided that they don't
like it," he said.
A majority vote is required for resolutions to pass the AVMA House of Delegates, which has representatives from nearly every state and a dozen or more allied groups. While AVMA policies carry no legal or regulatory teeth, how the nation’s largest membership group for veterinarians stands on issues can influence state licensing bodies governing the practice of veterinary medicine.
The idea that the AVMA might publicly discredit homeopathy has officials with the Academy of Veterinary Homeopathy — a group of 133 veterinarians not represented in the AVMA House of Delegates — on the defense.
In a white paper that counters the CVMA’s findings, Dr. Shelley Epstein, a veterinary homeopath in Wilmington, Del., and former Academy of Veterinary Homeopathy (AVH) president, wrote that “… all medicine involves balancing risks against benefits.”
“In the case of homeopathy, the risks are negligible in the hands of trained veterinary homeopaths, and the benefits in some of even the most severe cases can be strong,” she stated.
Dr. Jeff Feinman, a veterinary homeopath in Connecticut, agrees. He’s dismayed that he and other veterinary homeopaths in the state weren't consulted by the CVMA before the group drafted its resolution.
“My personal feeling is that anything that can be done to limit therapeutic options is not a good thing,” he said.
Feinman worries that if the AVMA rejects homeopathy, other complementary and alternative modalities might be next. “This could just be the first target,” he said.
AVH officials echoed that concern in a Dec. 19 letter to House delegates: "On
the surface, homeopathy would appear to represent an easy target for
extinction, or at least for expulsion from the ranks of veterinary
medicine. We have concerns that this would represent a slippery slope
for the AVMA."
Bernard Rollin, a professor of philosophy and animal sciences at Colorado State University, chuckles about homeopathic remedies such as water therapy. His tone turns serious, however, when talking about the ethics of treating patients with remedies discredited by basic science.
Veterinarians take an oath to do no harm, Rollin said, and prescribing remedies that have no basis can do the opposite. That said, “There are lots of therapies that work in ways we never expected, even in mainstream medicine,” he acknowledged.
“If a veterinarian were to give full disclosure, and I mean full disclosure — admitting that there’s no scientific evidence for a homeopathic remedy — but the owner is still hell-bent on doing (the treatment), a veterinarian could offer it, and monitor the animal to make sure it doesn’t cause anything negative.”
That doesn’t mean Rollin endorses homeopathy. In fact, he notes “a very strong objection to alternative medicine in general.”
“There’s no such thing as alternative medicine. There’s medicine that’s scientifically proven and unproven,” Rollin said, playing off an editorial published in 1998 in the New England Journal of Medicine. “If homeopathy is true, modern chemistry is false. I’m not ready to give up modern chemistry. Are you?”
Other AVMA business
- In addition to homeopathy, House delegates will debate and vote on a resolution designed to broaden leadership opportunities within the AVMA. Brought by veterinary medical associations in Maine, Pennsylvania, Puerto Rico and Vermont, the resolution abolishes a requirement the House Advisory Committee — a seven-member body elected to advise and make recommendations to the House of Delegates and Executive Board — be comprised of veterinarians from specific areas of practice such as food animal, equine or research.
- A resolution brought by the Wisconsin Veterinary Medical Association and American Association of Bovine Practitioners proposes adding "oversight" terminology to the AVMA's current definition of the veterinary-client-patient relationship. "In herd health medicine, whether food producing animals or shelter animals, strengthened oversight will support the veterinarian’s role in providing supervision and guidance as well as improving protocol and standard operating procedures compliance," the resolution states. The changed language reflects the U.S. Food and Drug Administration's call for veterinary oversight of producers' use of medicated feeds.
- Revisions to the AVMA's policy on canine devocalization are proposed by the AVMA Executive Board. If changed, the policy will emphasize that devocalization should be used as a last resort before euthanasia.
- A resolution submitted by the AVMA Executive Board proposes a policy on livestock handling tools that states, in part: "The AVMA believes that mechanical aids to direct livestock movement should be used sparingly and not to strike animals."
- The AVMA Executive Board proposes revising the association's current policy on stem cells by omitting the descriptor “pluripotent," which could be "interpreted as limiting the scope of this policy to a certain subset of stem cells," the resolution states.
- The AVMA Executive Board wants to add references to dogs, cats, small mammals, fish, reptiles and
amphibians to the group's policy on electric identification systems.
- A bylaws change is being proposed that would permit the association to post intended bylaws changes to the AVMA website. Right now, prospective changes to the AVMA bylaws are published in the Journal of the American Veterinary Medical Association at least 30 days prior to a House of Delegates session.
VIN News Service commentaries are opinion pieces presenting insights, personal experiences and/or perspectives on topical issues by members of the veterinary community. To submit a commentary for consideration, email firstname.lastname@example.org.
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