How do we decide the ethics of treatments that are not evidence based?

Ben Gray1,

1 Otago University Wellington 23a Mein Street Newtown Wellington 6021 New Zealand

Recent issues of the Journal of Bioethical Inquiry have had several papers discussing the ethics of homeopathy. In this presentation I will argue that asking whether a treatment modality is ethical or not is unhelpful. Any treatment is always provided by a practitioner; homeopathic treatments are dispensed by homeopaths. It is well described that the placebo response applies to virtually all such therapeutic relationships and that there is sound evidence establishing the neurophysiological basis of this response. Conversely the assertion that conventional medical practice is evidence based does not bear up to examination with only between 6-15% of many guidelines being based on high level evidence. In particular there are many surgical procedures for which there is no good evidence, and for some, good evidence that the only benefit  is from the placebo response.

This paper will present a framework for considering whether any particular health practice can be seen as ethical and how we should respond to practitioners who are not part of the conventional medical world.


Ben Gray has been a GP for more than 25yrs and a senior lecturer in Primary Health Care and General Practice for the last 8 years. He completed his Masters in Bioethics and Health Law in 2014 with a dissertation on how does the concept of cultural competence affect the practice of bioethics and health law. He convenes the teaching of professional skills attitudes and ethics to undergraduate medical students at Otago University Wellington