Background
Summary of Council decision:
Two issues were investigated, both of which were Upheld.
Ad description
A page on the website www.stevehomeopath.co.uk, for Steve Scrutton Homeopathy, was headed "Depression". Text stated "Homeopathy has been treating depression now for over 200 years. In the Homeopathy Materia Medica the term 'depression' is not used, it is a highly medicalised word. Instead, it is the word 'sadness' that is used. Large numbers of homeopathic remedies have large, and quite intricate symptom pictures dealing with all kinds of emotions - including sadness or depression. In his book, Homeopathic Psychology, Philip Bailey, MD., list [sic] 35 remedies as being the most useful, and provides detailed psychological descriptions of each remedy. Here are some of them, with brief descriptions:
Alumina - Powerful depression: despair, anger, anxiety. often [sic] contemplates suicide; alternates with contained state. Withdraws into self (Nat Mur, Aurum) Desire to kill self with knife. PMT; post natal depression. Confusion with sudden bouts of rage or violent impulses". Nine more remedies and descriptions followed.
Text further on compared randomised controlled tests (RCTs) involving homeopathy with conventional medical treatment for moderate to severe depression. Text stated "In other, simpler words, the authors found that individualised homeopathic prescribing using Q (LM) potencies is as effective as fluoxetine in the treatment of patients suffering acute moderate to severe depression". Text under the heading "Conventional Medical Treatment for Depression" stated "According to the NHS Direct website, your doctor might refer you for counselling (talking therapy), and if he does this there are no drugs involved, and therefore no adverse consequences. Otherwise, the doctor will prescribe Antidepressant drugs, of which there are evidently about 30 different kinds.
SSRIs (Selective Serotonin Reuptake Inhibitors) - These are drugs based on Prosac, thought to be a 'wonder' drug when it was first introduced in the 1990's [sic]. They are now known to have very serious adverse reactions, which include apathy, nausea and vomiting, drowsiness ... The sexual side effects have been widely commented upon ... But it is the increased risk of suicide in children and adolescents that have been most worrying ...". Five more headings describing conventional treatment for depression followed.
Small footnote text at the end stated "The information on this webpage represents the views and opinion of the author based on his clinical experience. This material is provided for information only, and should not be construed as medical advice or instruction. Always consult with a suitably qualified healthcare practitioner for advice about the treatment of serious or life threatening conditions".
Issue
A complainant challenged whether:
1. the efficacy claims made for the treatment of depression by homeopathy were misleading and could be substantiated and whether the ad discouraged people seeking essential treatment for a condition for which medical supervision should be sought; and
2. the claim that compared the efficacy of homeopathy with fluoxetine was misleading and could be substantiated.
Response
1. Steve Scrutton Homeopathy (Steve Scrutton) said the text was intended for information only and that it did not refer to a product being available for sale. He did not agree that the ad made efficacy claims for homeopathy or that it constituted advice, diagnosis or treatment. He did not agree that it discouraged people from seeking essential treatment for a condition for which medical supervision should be sought and believed that, as a trained, qualified and registered homeopath, he had a right to place information about homeopathy that he considered was legal, decent, truthful and honest into the public domain. He considered the footnote text that stated that the material was for information only was sufficiently prominent.
2. Steve Scrutton said he had used the trial "Homeopathic individualized Q-potencies versus Fluoxetine for moderate to severe depression: double-blind, randomized non-inferiority trial" as a reference source and had provided a summary of the trial's conclusions for readers. He said that, according to the trial, homeopathic Q potencies appeared to be as effective as fluoxetine in the treatment of moderate to severe depression. He believed the words he had used were an accurate summary of the trial's findings.
Assessment
1. Upheld
The ASA noted that the website contained contact information and a link to "Appointments & Fees". Because of that, we considered that the website was intended to market the advertiser's homeopathic services and that the pages were marketing material and within the remit of the CAP Code. We considered that the ad, which included the text "Homeopathy has been treating depression now for over 200 years".,the references to and descriptions of homeopathic remedies, and the positive comparison made for homeopathic treatment in relation to conventional treatment with fluoxetine, suggested that homeopathy was an effective treatment for depression. However, Steve Scrutton Homeopathy had supplied no evidence in support of that claim.
In addition, the CAP Code stated that marketers must not discourage essential treatment for conditions for which medical supervision should be sought, and that that included offering specific advice on, diagnosis of or treatment for such conditions unless that advice, diagnosis or treatment was conducted under the supervision of a suitably qualified health professional. We considered the inclusion of the small footnote text was not sufficient to counteract the overall impression that, rather than being provided for information only, efficacy claims for the treatment of depression were being made for homeopathy. Because Steve Scrutton Homeopathy had supplied no evidence in support of efficacy claims and had not demonstrated that advice, diagnosis or treatment was conducted under the supervision of a suitably qualified health professional, we concluded that the claims were misleading and in breach of the CAP Code.
On this point, the claims breached CAP Code (Edition 12) rules
3.1
3.1
Marketing communications must not materially mislead or be likely to do so.
and
3.3
3.3
Marketing communications must not mislead the consumer by omitting material information. They must not mislead by hiding material information or presenting it in an unclear, unintelligible, ambiguous or untimely manner.
Material information is information that the consumer needs to make informed decisions in relation to a product. Whether the omission or presentation of material information is likely to mislead the consumer depends on the context, the medium and, if the medium of the marketing communication is constrained by time or space, the measures that the marketer takes to make that information available to the consumer by other means.
(Misleading advertising),
3.7
3.7
Before distributing or submitting a marketing communication for publication, marketers must hold documentary evidence to prove claims that consumers are likely to regard as objective and that are capable of objective substantiation. The ASA may regard claims as misleading in the absence of adequate substantiation.
(Substantiation) and
12.1
12.1
Objective claims must be backed by evidence, if relevant consisting of trials conducted on people. Substantiation will be assessed on the basis of the available scientific knowledge.
Medicinal or medical claims and indications may be made for a medicinal product that is licensed by the MHRA, VMD or under the auspices of the EMA, or for a CE-marked medical device. A medicinal claim is a claim that a product or its constituent(s) can be used with a view to making a medical diagnosis or can treat or prevent disease, including an injury, ailment or adverse condition, whether of body or mind, in human beings.
Secondary medicinal claims made for cosmetic products as defined in the appropriate European legislation must be backed by evidence. These are limited to any preventative action of the product and may not include claims to treat disease.
12.2
12.2
Marketers must not discourage essential treatment for conditions for which medical supervision should be sought. For example, they must not offer specific advice on, diagnosis of or treatment for such conditions unless that advice, diagnosis or treatment is conducted under the supervision of a suitably qualified health professional. Accurate and responsible general information about such conditions may, however, be offered (see rule
12.1
12.1
Objective claims must be backed by evidence, if relevant consisting of trials conducted on people. Substantiation will be assessed on the basis of the available scientific knowledge.
Medicinal or medical claims and indications may be made for a medicinal product that is licensed by the MHRA, VMD or under the auspices of the EMA, or for a CE-marked medical device. A medicinal claim is a claim that a product or its constituent(s) can be used with a view to making a medical diagnosis or can treat or prevent disease, including an injury, ailment or adverse condition, whether of body or mind, in human beings.
Secondary medicinal claims made for cosmetic products as defined in the appropriate European legislation must be backed by evidence. These are limited to any preventative action of the product and may not include claims to treat disease.
).
Health professionals will be deemed suitably qualified only if they can provide suitable credentials, for example, evidence of: relevant professional expertise or qualifications; systems for regular review of members' skills and competencies and suitable professional indemnity insurance covering all services provided; accreditation by a professional or regulatory body that has systems for dealing with complaints and taking disciplinary action and has registration based on minimum standards for training and qualifications.
and
12.6
12.6
Marketers should not falsely claim that a product is able to cure illness, dysfunction or malformations.
(Medicines, medical devices, health-related products and beauty products).
2. Upheld
We considered that the text which stated "In other, simpler words, the authors found that individualised homeopathic prescribing using Q (LM) potencies is as effective as fluoxetine in the treatment of patients suffering acute moderate to severe depression" suggested that, for people suffering acute moderate to severe depression, treatment by homeopathy would achieve the same outcome as conventional medical treatment with fluoxetine. We noted that Steve Scrutton said he had used the trial as reference material, but considered that in the context of an ad which spoke positively about the role of homeopathy and which expressed concern about conventional medical treatment, the claim was likely to be interpreted as a positive efficacy claim for homeopathy. Steve Scrutton had not, however, supplied evidence that that was the case.
Because Steve Scrutton had supplied no evidence in support of the claim and also because, as in point 1 above, we considered an efficacy claim for homeopathic treatment for depression, when an advertiser had not demonstrated that treatment was conducted under the supervision of a suitably qualified health professional, discouraged essential treatment for a condition for which medical supervision should be sought, we concluded that the claims were misleading and in breach of the CAP Code.
On this point, the claims breached CAP Code (Edition 12) rules
3.1
3.1
Marketing communications must not materially mislead or be likely to do so.
and
3.3
3.3
Marketing communications must not mislead the consumer by omitting material information. They must not mislead by hiding material information or presenting it in an unclear, unintelligible, ambiguous or untimely manner.
Material information is information that the consumer needs to make informed decisions in relation to a product. Whether the omission or presentation of material information is likely to mislead the consumer depends on the context, the medium and, if the medium of the marketing communication is constrained by time or space, the measures that the marketer takes to make that information available to the consumer by other means.
(Misleading advertising),
3.7
3.7
Before distributing or submitting a marketing communication for publication, marketers must hold documentary evidence to prove claims that consumers are likely to regard as objective and that are capable of objective substantiation. The ASA may regard claims as misleading in the absence of adequate substantiation.
(Substantiation) and
12.1
12.1
Objective claims must be backed by evidence, if relevant consisting of trials conducted on people. Substantiation will be assessed on the basis of the available scientific knowledge.
Medicinal or medical claims and indications may be made for a medicinal product that is licensed by the MHRA, VMD or under the auspices of the EMA, or for a CE-marked medical device. A medicinal claim is a claim that a product or its constituent(s) can be used with a view to making a medical diagnosis or can treat or prevent disease, including an injury, ailment or adverse condition, whether of body or mind, in human beings.
Secondary medicinal claims made for cosmetic products as defined in the appropriate European legislation must be backed by evidence. These are limited to any preventative action of the product and may not include claims to treat disease.
12.2
12.2
Marketers must not discourage essential treatment for conditions for which medical supervision should be sought. For example, they must not offer specific advice on, diagnosis of or treatment for such conditions unless that advice, diagnosis or treatment is conducted under the supervision of a suitably qualified health professional. Accurate and responsible general information about such conditions may, however, be offered (see rule
12.1
12.1
Objective claims must be backed by evidence, if relevant consisting of trials conducted on people. Substantiation will be assessed on the basis of the available scientific knowledge.
Medicinal or medical claims and indications may be made for a medicinal product that is licensed by the MHRA, VMD or under the auspices of the EMA, or for a CE-marked medical device. A medicinal claim is a claim that a product or its constituent(s) can be used with a view to making a medical diagnosis or can treat or prevent disease, including an injury, ailment or adverse condition, whether of body or mind, in human beings.
Secondary medicinal claims made for cosmetic products as defined in the appropriate European legislation must be backed by evidence. These are limited to any preventative action of the product and may not include claims to treat disease.
).
Health professionals will be deemed suitably qualified only if they can provide suitable credentials, for example, evidence of: relevant professional expertise or qualifications; systems for regular review of members' skills and competencies and suitable professional indemnity insurance covering all services provided; accreditation by a professional or regulatory body that has systems for dealing with complaints and taking disciplinary action and has registration based on minimum standards for training and qualifications.
and
12.6
12.6
Marketers should not falsely claim that a product is able to cure illness, dysfunction or malformations.
(Medicines, medical devices, health-related products and beauty products).
Action
The claims must not appear again in their current form. We told Steve Scrutton to ensure he held robust evidence for claims in future and to ensure he did not, in a marketing communication, discourage essential treatment for a condition for which medical supervision should be sought.
