Treat with extreme caution

Homoeopathic medicine is founded on a bogus philosophy. Its continued use is a drain on NHS resource

Two years ago, a loose coalition of like-minded scientists wrote an open letter to chief executives of the National Health Service Trusts. The signatories simply stated that homoeopathy and other alternative therapies were unproven, and that the NHS should reserve its funds for treatments that had been shown to work. The letter marked an extraordinary downturn in the fortunes of homoeopathy in the UK over the following year, because the overwhelming majority of trusts either stopped sending patients to the four homoeopathic hospitals, or introduced measures to strictly limit referrals.

Consequently, the future of these hospitals is now in doubt. The Tunbridge Wells Homoeopathic Hospital is set to close next year and the Royal London Homoeopathic Hospital is likely to follow in its wake. Homoeo paths are now so worried about the collapse of their flagship hospitals that they are organising a march to deliver a petition to Downing Street on 22 June. Local campaign groups are being formed and patients are being urged to sign the petition.

Homoeopaths believe that the medical Establishment is crushing a valuable healing tradition that dates back more than two centuries and that still has much to offer patients. Homoeopaths are certainly passionate about the benefits of their treatment, but are their claims valid, or are they misguidedly promoting a bogus philosophy?

This is a question that I have been considering for the past two years, ever since I began co-authoring a book on the subject of alternative medicine with Professor Edzard Ernst. He was one of the signatories of the letter to the NHS trusts and is the world's first professor of complementary medicine. Before I present our conclusion, it is worth remembering why homoeo pathy has always existed beyond the borders of mainstream medicine.

Homoeopathy relies on two key principles, namely that like cures like, and that smaller doses deliver more powerful effects. In other words, if onions cause our eyes to stream, then a homoeopathic pill made from onion juice might be a potential cure for the eye irritation caused by hay fever. Crucially, the onion juice would need to be diluted repeatedly to produce the pill that can be administered to the patient, as homoeopaths believe that less is more.

Initially, this sounds attractive, and not dissimilar to the principle of vaccination, whereby a small amount of virus can be used to protect patients from viral infection. However, doctors use the principle of like cures like very selectively, whereas homoeopaths use it universally. Moreover, a vaccination always contains a measurable amount of active ingredient, whereas homoeopathic remedies are usually so dilute that they contain no active ingredient whatsoever.

A pill that contains no medicine is unlikely to be effective, but millions of patients swear by this treatment. From a scientific point of view, the obvious explanation is that any perceived benefit is purely a result of the placebo effect, because it is well established that any patient who believes in a remedy is likely to experience some improvement in their condition due to the psychological impact. Homoeopaths disagree, and claim that a "memory" of the homoeopathic ingredient has a profound physiological effect on the patient. So the key question is straightforward: is homoeopathy more than just a placebo treatment?

Fortunately, medical researchers have conducted more than 200 clinical trials to investigate the impact of homoeopathy on a whole range of conditions. Typically, one group of patients is given homoeopathic remedies and another group is given a known placebo, such as a sugar pill. Researchers then examine whether or not the homoeopathic group improves on average more than the placebo group. The overall conclusion from all this research is that homoeopathic remedies are indeed mere placebos.

In other words, their benefit is based on nothing more than wishful thinking. The latest and most definitive overview of the evidence was published in the Lancet in 2005 and was accompanied by an editorial entitled "The end of homoeopathy". It argued that ". . . doctors need to be bold and honest with their patients about homoeopathy's lack of benefit".

An unsound investment

However, even if homoeopathy is a placebo treatment, anybody working in health care will readily admit that the placebo effect can be a very powerful force for good. Therefore, it could be argued that homoeopaths should be allowed to flourish as they administer placebos that clearly appeal to patients. Despite the undoubted benefits of the placebo effect, however, there are numerous reasons why it is unjustifiable for the NHS to invest in homoeopathy.

First, it is important to recognise that money spent on homoeopathy means a lack of investment elsewhere in the NHS. It is estimated that the NHS spends £500m annually on alternative therapies, but instead of spending this money on unproven or disproven therapies it could be used to pay for 20,000 more nurses. Another way to appreciate the sum of money involved is to consider the recent refurbishment of the Royal Homoeopathic Hospital in London, which was completed in 2005 and cost £20m. The hospital is part of the University College London Hospitals NHS Foundation Trust, which contributed £10m to the refurbishment, even though it had to admit a deficit of £17.4m at the end of 2005. In other words, most of the overspend could have been avoided if the Trust had not spent so much money on refurbishing the spiritual home of homoeopathy.

Second, the placebo effect is real, but it can lull patients into a false sense of security by improving their sense of well-being without actually treating the underlying conditions. This might be all right for patients suffering from a cold or flu, which should clear up given time, but for more severe illnesses, homoeopathic treatment could lead to severe long-term problems. Because those who administer homoeopathic treatment are outside of conventional medicine and therefore largely unmonitored, it is impos sible to prove the damage caused by placebo. Never theless, there is plenty of anecdotal evidence to support this claim.

For example, in 2003 Professor Ernst was working with homoeopaths who were taking part in a study to see if they could treat asthma. Unknown to the professor or any of the other researchers, one of the homoeopaths had a brown spot on her arm, which was growing in size and changing in colour. Convinced that homoeopathy was genuinely effective, the homoeopath decided to treat it herself using her own remedies. Buoyed by the placebo effect, she continued her treatment for months, but the spot turned out to be a malignant melanoma. While she was still in the middle of treating asthma patients, the homoeopath died. Had she sought conventional treatment at an early stage, there would have been a 90 per cent chance that she would have survived for five years or more. By relying on homoeopathy, she had condemned herself to an inevitably early death.

The third problem is that anybody who is aware of the vast body of research and who still advises homoeopathy is misleading patients. In order to evoke the placebo effect, the patient has to be fooled into believing that homoeopathy is effective. In fact, bigger lies encourage bigger patient expectations and trigger bigger placebo effects, so exploiting the benefits of homoeopathy to the full would require homoeopaths to deliver the most fantastical justifications imaginable.

Over the past half-century, the trend has been towards a more open and honest relationship between doctor and patient, so homoeopaths who mislead patients flagrantly disregard ethical standards. Of course, many homoeopaths may be unaware of or may choose to disregard the vast body of scientific evidence against homoeo pathy, but arrogance and ignorance in health care are also unforgivable sins.

If it is justifiable for the manufacturers of homoeopathic remedies in effect to lie about the efficacy of their useless products in order to evoke a placebo benefit, then maybe the pharmaceutical companies could fairly argue that they ought to be allowed to sell sugar pills at high prices on the basis of the placebo effect as well. This would undermine the requirement for rigorous testing of drugs before they go on sale.

A fourth reason for spurning placebo-based medicines is that patients who use them for relatively mild conditions can later be led into dangerously inappropriate use of the same treatments. Imagine a patient with back pain who is referred to a homoeopath and who receives a moderate, short-term placebo effect. This might impress the patient, who then returns to the homoeopath for other advice. For example, it is known that homoeopaths offer alternatives to conventional vaccination - a 2002 survey of homoeopaths showed that only 3 per cent of them advised parents to give their baby the MMR vaccine. Hence, directing patients towards homoeo paths for back pain could encourage those patients not to have their children vaccinated against potentially dangerous diseases.

Killer cures

Such advice and treatment is irresponsible and dangerous. When I asked a young student to approach homoeopaths for advice on malaria prevention in 2006, ten out of ten homoeopaths were willing to sell their own remedies instead of telling the student to seek out expert advice and take the necessary drugs.

The student had explained that she would be spending ten weeks in West Africa; we had decided on this backstory because this region has the deadliest strain of malaria, which can kill within three days. Nevertheless, homoeopaths were willing to sell remedies that contained no active ingredient. Apparently, it was the memory of the ingredient that would protect the student, or, as one homoeopath put it: "The remedies should lower your susceptibility; because what they do is they make it so your energy - your living energy - doesn't have a kind of malaria-shaped hole in it. The malarial mosquitoes won't come along and fill that in. The remedies sort it out."

The homoeopathic industry likes to present itself as a caring, patient-centred alternative to conventional medicine, but in truth it offers disproven remedies and often makes scandalous and reckless claims. On World Aids Day 2007, the Society of Homoeopaths, which represents professional homoeopaths in the UK, organised an HIV/Aids symposium that promoted the outlandish ambitions of several speakers. For example, describing Harry van der Zee, editor of the International Journal for Classical Homoeo pathy, the society wrote: "Harry believes that, using the PC1 remedy, the Aids epidemic can be called to a halt, and that homoeopaths are the ones to do it."

There is one final reason for rejecting placebo-based medicines, perhaps the most important of all, which is that we do not actually need placebos to benefit from the placebo effect. A patient receiving proven treatments already receives the placebo effect, so to offer homoeopathy instead - which delivers only the placebo effect - would simply short-change the patient.

I do not expect that practising homoeopaths will accept any of my arguments above, because they are based on scientific evidence showing that homoeopathy is nothing more than a placebo. Even though this evidence is now indisputable, homoeopaths have, understandably, not shown any enthusiasm to acknowledge it.

For now, their campaign continues. Although it has not been updated for a while, the campaign website currently states that its petition has received only 382 signatures on paper, which means that there's a long way to go to reach the target of 250,000. But, of course, one of the central principles of homoeopathy is that less is more. Hence, in this case, a very small number of signatures may prove to be very effective. In fact, perhaps the Society of Homoeopaths should urge people to withdraw their names from the list, so that nobody at all signs the petition. Surely this would make it incredibly powerful and guaranteed to be effective.

"Trick or Treatment? Alternative Medicine on Trial" (Bantam Press, £16.99) by Simon Singh and Edzard Ernst is published on 21 April

Homoeopathy by numbers

3,000 registered homoeopaths in the UK

1 in 3 British people use alternative therapies such as homoeopathy

42% of GPs refer patients to homoeopaths

0 molecules of an active ingredient in a typical "30c" homoeopathic solution

$1m reward offered by James Randi for proof that homoeopathy works

This article first appeared in the 21 April 2008 issue of the New Statesman, Food crisis

Amanda Edwards/Getty Images
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“Never be afraid of stridency”: Richard Dawkins’ interview with Christopher Hitchens

Is America heading for theocracy? How worrying is the rise of the Tea Party? Christopher Hitchens and Richard Dawkins discuss God and US politics.

The 2011 Christmas issue of the New Statesman was guest edited by Richard Dawkins. This is his interview with Christopher Hitchens from that issue. It was to be Hitchens' final interview; he died as it was published. A sensation at the time, it is now available to read online for the first time.

Richard Dawkins (left) and Christopher Hitchens in conversation

Richard Dawkins Do you have any memories of life at the New Statesman?

Christopher Hitchens Not that I want to impart. It seems like a different world and a different magazine and it happened to a different person. I’d love them to interview me one day about it, for an edition about the role of the Statesman, but I’d really rather you and I focus on the pulse of the issue, which is obviously our common cause.

RD I’ve been reading some of your recent collections of essays – I’m astounded by your sheer erudition. You seem to have read absolutely everything. I can’t think of anybody since Aldous Huxley who’s so well read.

CH It may strike some people as being broad but it’s possibly at the cost of being a bit shallow. I became a journalist because one didn’t have to specialise. I remember once going to an evening with Umberto Eco talking to Susan Sontag and the definition of the word “polymath” came up. Eco said it was his ambition to be a polymath; Sontag challenged him and said the definition of a polymath is someone who’s interested in everything and nothing else. I was encouraged in my training to read widely – to flit and sip, as Bertie [Wooster] puts it – and I think I’ve got good memory retention. I retain what’s interesting to me, but I don’t have a lot of strategic depth. A lot of reviewers have said, to the point of embarrassing me, that I’m in the class of Edmund Wilson or even George Orwell. It really does remind me that I’m not. But it’s something to at least have had the comparison made – it’s better than I expected when I started.

RD As an Orwell scholar, you must have a particular view of North Korea, Stalin, the Soviet Union, and you must get irritated – perhaps even more than I do – by the constant refrain we hear: “Stalin was an atheist.”

CH We don’t know for sure that he was. Hitler definitely wasn’t. There is a possibility that Himmler was. It’s very unlikely but it wouldn’t make any difference, either way. There’s no mandate in atheism for any particular kind of politics, anyway.

RD The people who did Hitler’s dirty work were almost all religious.

CH I’m afraid the SS’s relationship with the Catholic Church is something the Church still has to deal with and does not deny.

RD Can you talk a bit about that – the relationship of Nazism with the Catholic Church?

CH The way I put it is this: if you’re writing about the history of the 1930s and the rise of totalitarianism, you can take out the word “fascist”, if you want, for Italy, Portugal, Spain, Czechoslovakia and Austria and replace it with “extremeright Catholic party”. Almost all of those regimes were in place with the help of the Vatican and with understandings from the Holy See. It’s not denied. These understandings quite often persisted after the Second World War was over and extended to comparable regimes in Argentina and elsewhere.

RD But there were individual priests who did good things.

CH Not very many. You would know their names if there were more of them. When it comes to National Socialism, there’s no question there’s a mutation, a big one – the Nazis wanted their own form of worship. Just as they thought they were a separate race, they wanted their own religion. They dug out the Norse gods, all kinds of extraordinary myths and legends from the old sagas. They wanted to control the churches. They were willing to make a deal with them. The first deal Hitler made with the Catholic Church was the Konkordat. The Church agreed to dissolve its political party and he got control over German education, which was a pretty good deal. Celebrations of his birthday were actually by order from the pulpit. When Hitler survived an assassination attempt, prayers were said, and so forth. But there’s no doubt about it, [the Nazis] wanted control – and they were willing to clash with the churches to get it. There’s another example. You swore on Almighty God that you would never break your oath to the Führer. This is not even secular, let alone atheist.

RD There was also grace before meals, personally thanking Adolf Hitler.

CH I believe there was. Certainly, you can hear the oath being taken – there are recordings of it – but this, Richard, is a red herring. It’s not even secular. They’re changing the subject.

RD But it comes up over and over again.

CH You mentioned North Korea. It is, in every sense, a theocratic state. It’s almost supernatural, in that the births of the [ruling] Kim family are considered to be mysterious and accompanied by happenings. It’s a necrocracy or mausolocracy, but there’s no possible way you could say it’s a secular state, let alone an atheist one. Attempts to found new religions should attract our scorn just as much as the alliances with the old ones do. All they’re saying is that you can’t claim Hitler was distinctively or specifically Christian: “Maybe if he had gone on much longer, he would have de-Christianised a bit more.” This is all a complete fog of nonsense. It’s bad history and it’s bad propaganda.

RD And bad logic, because there’s no connection between atheism and doing horrible things, whereas there easily can be a connection in the case of religion, as we see with modern Islam.

CH To the extent that they are new religions – Stalin worship and Kim Il-sungism – we, like all atheists, regard them with horror.

RD You debated with Tony Blair. I’m not sure I watched that. I love listening to you [but] I can’t bear listening to . . . Well, I mustn’t say that. I think he did come over as rather nice on that evening.

CH He was charming, that evening. And during the day, as well.

RD What was your impression of him?

CH You can only have one aim per debate. I had two in debating with Tony Blair. The first one was to get him to admit that it was not done – the stuff we complain of – in only the name of religion. That’s a cop-out. The authority is in the text. Second, I wanted to get him to admit, if possible, that giving money to a charity or organising a charity does not vindicate a cause. I got him to the first one and I admired his honesty. He was asked by the interlocutor at about half-time: “Which of Christopher’s points strikes you as the best?” He said: “I have to admit, he’s made his case, he’s right. This stuff, there is authority for it in the canonical texts, in Islam, Judaism.” At that point, I’m ready to fold – I’ve done what I want for the evening. We did debate whether Catholic charities and so on were a good thing and I said: “They are but they don’t prove any point and some of them are only making up for damage done.” For example, the Church had better spend a lot of money doing repair work on its Aids policy in Africa, [to make up for preaching] that condoms don’t prevent disease or, in some cases, that they spread it. It is iniquitous. It has led to a lot of people dying, horribly. Also, I’ve never looked at some of the ground operations of these charities – apart from Mother Teresa – but they do involve a lot of proselytising, a lot of propaganda. They’re not just giving out free stuff. They’re doing work to recruit.

RD And Mother Teresa was one of the worst offenders?

CH She preached that poverty was a gift from God. And she believed that women should not be given control over the reproductive cycle. Mother Teresa spent her whole life making sure that the one cure for poverty we know is sound was not implemented. So Tony Blair knows this but he doesn’t have an answer. If I say, “Your Church preaches against the one cure for poverty,” he doesn’t deny it, but he doesn’t affirm it either. But remember, I did start with a text and I asked him to comment on it first, but he never did. Cardinal Newman said he would rather the whole world and everyone in it be painfully destroyed and condemned for ever to eternal torture than one sinner go unrebuked for the stealing of a sixpence. It’s right there in the centre of the Apologia. The man whose canonisation Tony had been campaigning for. You put these discrepancies in front of him and he’s like all the others. He keeps two sets of books. And this is also, even in an honest person, shady.

RD It’s like two minds, really. One notices this with some scientists.

CH I think we all do it a bit.

RD Do we?

CH We’re all great self-persuaders.

RD But do we hold such extreme contradictions in our heads?

CH We like to think our colleagues would point them out, in our group, anyway. No one’s pointed out to me in reviewing my God book God Is Not Great that there’s a flat discrepancy between the affirmation he makes on page X and the affirmation he makes on page Y.

RD But they do accuse you of being a contrarian, which you’ve called yourself . . .

CH Well, no, I haven’t. I’ve disowned it. I was asked to address the idea of it and I began by saying it’s got grave shortcomings as an idea, but I am a bit saddled with it.

RD I’ve always been very suspicious of the leftright dimension in politics.

CH Yes; it’s broken down with me.

RD It’s astonishing how much traction the left-right continuum [has] . . . If you know what someone thinks about the death penalty or abortion, then you generally know what they think about everything else. But you clearly break that rule.

CH I have one consistency, which is [being] against the totalitarian – on the left and on the right. The totalitarian, to me, is the enemy – the one that’s absolute, the one that wants control over the inside of your head, not just your actions and your taxes. And the origins of that are theocratic, obviously. The beginning of that is the idea that there is a supreme leader, or infallible pope, or a chief rabbi, or whatever, who can ventriloquise the divine and tell us what to do. That has secular forms with gurus and dictators, of course, but it’s essentially the same. There have been some thinkers – Orwell is pre-eminent – who understood that, unfortunately, there is innate in humans a strong tendency to worship, to become abject. So we’re not just fighting the dictators. We’re criticising our fellow humans for trying to short-cut, to make their lives simpler, by surrendering and saying, “[If] you offer me bliss, of course I’m going to give up some of my mental freedom for that.” We say it’s a false bargain: you’ll get nothing. You’re a fool.

RD That part of you that was, or is, of the radical left is always against the totalitarian dictators.

CH Yes. I was a member of the Trotskyist group – for us, the socialist movement could only be revived if it was purged of Stalinism . . . It’s very much a point for our view that Stalinism was a theocracy.

RD One of my main beefs with religion is the way they label children as a “Catholic child” or a “Muslim child”. I’ve become a bit of a bore about it.

CH You must never be afraid of that charge, any more than stridency.

RD I will remember that.

CH If I was strident, it doesn’t matter – I was a jobbing hack, I bang my drum. You have a discipline in which you are very distinguished. You’ve educated a lot of people; nobody denies that, not even your worst enemies. You see your discipline being attacked and defamed and attempts made to drive it out.

Stridency is the least you should muster . . . It’s the shame of your colleagues that they don’t form ranks and say, “Listen, we’re going to defend our colleagues from these appalling and obfuscating elements.” If you go on about something, the worst thing the English will say about you, as we both know – as we can say of them, by the way – is that they’re boring.

RD Indeed. Only this morning, I was sent a copy of [advice from] a British government website, called something like “The Responsibilities of Parents”. One of these responsibilities was “determine the child’s religion”. Literally, determine. It means establish, cause . . . I couldn’t ask for a clearer illustration, because, sometimes, when I make my complaint about this, I’m told nobody actually does label children Catholic children or Muslim children.

CH Well, the government does. It’s borrowed, as far as I can see, in part from British imperial policy, in turn borrowed from Ottoman and previous empires – you classify your new subjects according to their faith. You can be an Ottoman citizen but you’re a Jewish one or an Armenian Christian one. And some of these faiths tell their children that the children of other faiths are going to hell. I think we can’t ban that, nor can we call it “hate speech”, which I’m dubious about anyway, but there should be a wrinkle of disapproval.

RD I would call it mental child abuse.

CH I can’t find a way, as a libertarian, of saying that people can’t raise their children, as they say, according to their rights. But the child has rights and society does, too. We don’t allow female – and I don’t think we should countenance male – genital mutilation.

Now, it would be very hard to say that you can’t tell your child that they are lucky and they have joined the one true faith. I don’t see how you stop it. I only think the rest of society should look at it with a bit of disapproval, which it doesn’t. If you’re a Mormon and you run for office and say, “Do you believe in the golden plates that were dug up by Joseph Smith?” – which [Mitt] Romney hasn’t been asked yet – sorry, you’re going to get mocked. You’re going to get laughed at.

RD There is a tendency among liberals to feel that religion should be off the table.

CH Or even that there’s anti-religious racism, which I think is a terrible limitation.

RD Romney has questions to answer.

CH Certainly, he does. The question of Mormon racism did come up, to be fair, and the Church did very belatedly make amends for saying what, in effect, it had been saying: that black people’s souls weren’t human, quite. They timed it suspiciously for the passage of legislation. Well, OK, then they grant the right of society to amend [the legislation]. To that extent, they’re opportunists.

RD But what about the daftness of Mormonism? The fact that Joseph Smith was clearly a charlatan –

CH I know, it’s extraordinary.

RD I think there is a convention in America that you don’t tackle somebody about their religion.

CH Yes, and in a way it’s attributed to pluralism. And so, to that extent, one wants to respect it, but I think it can be exploited. By many people, including splinter-group Mormons who still do things like plural marriage and, very repulsively, compulsory dowries – they basically give away their daughters, often to blood relatives. And also kinship marriages that are too close. This actually won’t quite do. When it is important, they tend to take refuge in: “You’re attacking my fundamental right.” I don’t think they really should be allowed that.

RD Do you think America is in danger of becoming a theocracy?

CH No, I don’t. The people who we mean when we talk about that – maybe the extreme Protestant evangelicals, who do want a God-run America and believe it was founded on essentially fundamentalist Protestant principles – I think they may be the most overrated threat in the country.

RD Oh, good.

CH They’ve been defeated everywhere. Why is this? In the 1920s, they had a string of victories. They banned the sale, manufacture and distribution and consumption of alcohol. They made it the constitution. They more or less managed to ban immigration from countries that had non-Protestant, non-white majorities. From these victories, they have never recovered. They’ll never recover from [the failure of] Prohibition. It was their biggest defeat. They’ll never recover from the Scopes trial. Every time they’ve tried [to introduce the teaching of creationism], the local school board or the parents or the courts have thrown it out and it’s usually because of the work of people like you, who have shown that it’s nonsense. They try to make a free speech question out of it but they will fail with that, also. People don’t want to come from the town or the state or the county that gets laughed at.

RD Yes.

CH In all my tours around the South, it’s amazing how many people – Christians as well – want to disprove the idea that they’re all in thrall to people like [the fundamentalist preacher Jerry] Falwell. They don’t want to be a laughing stock.

RD Yes.

CH And if they passed an ordinance saying there will be prayer in school every morning from now on, one of two things would happen: it would be overthrown in no time by all the courts, with barrels of laughter heaped over it, or people would say: “Very well, we’re starting with Hindu prayer on Monday.” They would regret it so bitterly that there are days when I wish they would have their own way for a short time.

RD Oh, that’s very cheering.

CH I’m a bit more worried about the extreme, reactionary nature of the papacy now. But that again doesn’t seem to command very big allegiance among the American congregation. They are disobedient on contraception, flagrantly; on divorce; on gay marriage, to an extraordinary degree that I wouldn’t have predicted; and they’re only holding firm on abortion, which, in my opinion, is actually a very strong moral question and shouldn’t be decided lightly. I feel very squeamish about it. I believe that the unborn child is a real concept, in other words. We needn’t go there, but I’m not a complete abortion-on-demand fanatic. I think it requires a bit of reflection. But anyway, even on that, the Catholic Communion is very agonised. And also, [when] you go and debate with them, very few of them could tell you very much about what the catechism really is. It’s increasingly cultural Catholicism.

RD That is true, of course.

CH So, really, the only threat from religious force in America is the same as it is, I’m afraid, in many other countries – from outside. And it’s jihadism, some of it home-grown, but some of that is so weak and so self-discrediting.

RD It’s more of a problem in Britain.

CH And many other European countries, where its alleged root causes are being allowed slightly too friendly an interrogation, I think. Make that much too friendly.

RD Some of our friends are so worried about Islam that they’re prepared to lend support to Christianity as a kind of bulwark against it.

CH I know many Muslims who, in leaving the faith, have opted to go . . . to Christianity or via it to non-belief. Some of them say it’s the personality of Jesus of Nazareth. The mild and meek one, as compared to the rather farouche, physical, martial, rather greedy . . .

RD Warlord.

CH . . . Muhammad. I can see that that might have an effect.

RD Do you ever worry that if we win and, so to speak, destroy Christianity, that vacuum would be filled by Islam?

CH No, in a funny way, I don’t worry that we’ll win. All that we can do is make absolutely sure that people know there’s a much more wonderful and interesting and beautiful alternative. No, I don’t think that Europe would fill up with Muslims as it emptied of Christians. Christianity has defeated itself in that it has become a cultural thing. There really aren’t believing Christians in the way there were generations ago.

RD Certainly in Europe that’s true – but in America?

CH There are revivals, of course, and among Jews as well. But I think there’s a very longrunning tendency in the developed world and in large areas elsewhere for people to see the virtue of secularism, the separation of church and state, because they’ve tried the alternatives . . . Every time something like a jihad or a sharia movement has taken over any country – admittedly they’ve only been able to do it in very primitive cases – it’s a smouldering wreck with no productivity.

RD Total failure. If you look at religiosity across countries of the world and, indeed, across the states of the US, you find that religiosity tends to correlate with poverty and with various other indices of social deprivation.

CH Yes. That’s also what it feeds on. But I don’t want to condescend about that. I know a lot of very educated, very prosperous, very thoughtful people who believe.

RD Do you think [Thomas] Jefferson and [James] Madison were deists, as is often said?

CH I think they fluctuated, one by one. Jefferson is the one I’m more happy to pronounce on. The furthest he would go in public was to incline to a theistic enlightened view but, in his private correspondence, he goes much further. He says he wishes we could return to the wisdom of more than 2,000 years ago. That’s in his discussion of his own Jefferson Bible, where he cuts out everything supernatural relating to Jesus. But also, very importantly, he says to his nephew Peter Carr in a private letter [on the subject of belief]: “Do not be frightened from this inquiry by any fear of its consequences. If it ends in a belief that there is no God, you will find incitements to virtue in the comfort and pleasantness you feel in its exercise and the love of others which it will procure you.” Now, that can only be written by someone who’s had that experience.

RD It’s very good, isn’t it?

CH In my judgement, it’s an internal reading, but I think it’s a close one. There was certainly no priest at his bedside. But he did violate a rule of C S Lewis’s and here I’m on Lewis’s side. Lewis says it is a cop-out to say Jesus was a great moralist. He said it’s the one thing we must not say; it is a wicked thing to say. If he wasn’t the Son of God, he was a very evil impostor and his teachings were vain and fraudulent. You may not take the easy route here and say: “He may not have been the Son of God and he may not have been the Redeemer, but he was a wonderful moralist.” Lewis is more honest than Jefferson in this point. I admire Lewis for saying that. Rick Perry said it the other day.

RD Jesus could just have been mistaken.

CH He could. It’s not unknown for people to have the illusion that they’re God or the Son. It’s a common delusion but, again, I don’t think we need to condescend. Rick Perry once said: “Not only do I believe that Jesus is my personal saviour but I believe that those who don’t are going to eternal punishment.” He was challenged at least on the last bit and he said, “I don’t have the right to alter the doctrine. I can’t say it’s fine for me and not for others.”

RD So we ought to be on the side of these fundamentalists?

CH Not “on the side”, but I think we should say that there’s something about their honesty that we wish we could find.

RD Which we don’t get in bishops . . .

CH Our soft-centred bishops at Oxford and other people, yes.

RD I’m often asked why it is that this republic [of America], founded in secularism, is so much more religious than those western European countries that have an official state religion, like Scandinavia and Britain.

CH [Alexis] de Tocqueville has it exactly right. If you want a church in America, you have to build it by the sweat of your own brow and many have. That’s why they’re attached to them.

RD Yes.

CH [Look at] the Greek Orthodox community in Brooklyn. What’s the first thing it will do? It will build itself a little shrine. The Jews – not all of them – remarkably abandoned their religion very soon after arriving from the shtetl.

RD Are you saying that most Jews have abandoned their religion?

CH Increasingly in America. When you came to escape religious persecution and you didn’t want to replicate it, that’s a strong memory. The Jews very quickly secularised when they came. American Jews must be the most secular force on the planet now, as a collective. If they are a collective –which they’re not, really.

RD While not being religious, they often still observe the Sabbath and that kind of thing.

CH There’s got to be something cultural. I go to Passover every year. Sometimes, even I have a seder, because I want my child to know that she does come very distantly from another tradition. It would explain if she met her greatgrandfather why he spoke Yiddish. It’s cultural, but the Passover seder is also the Socratic forum. It’s dialectical. It’s accompanied by wine. It’s got the bones of quite a good discussion in it. And then there is manifest destiny. People feel America is just so lucky. It’s between two oceans, filled with minerals, wealth, beauty. It does seem providential to many people.

RD Promised land, city on a hill.

CH All that and the desire for another Eden. Some secular utopians came here with the same idea. Thomas Paine and others all thought of America as a great new start for the species.

RD But that was all secular.

CH A lot of it was, but you can’t get away from the liturgy: it’s too powerful. You will end up saying things like “promised land” and it can be mobilised for sinister purposes. But in a lot of cases, it’s a mild belief. It’s just: “We should share our good luck.”

RD I’ve heard another theory that, America being a country of immigrants, people coming from Europe, where they left their extended family and left their support system, were alone and they needed something.

CH Surely that was contained in what I just . . .

RD Maybe it was.

CH The reason why most of my friends are non-believers is not particularly that they were engaged in the arguments you and I have been having, but they were made indifferent by compulsory religion at school.

RD They got bored by it.

CH They’d had enough of it. They took from it occasionally whatever they needed – if you needed to get married, you knew where to go. Some of them, of course, are religious and some of them like the music but, generally speaking, the British people are benignly indifferent to religion.

RD And the fact that there is an established church increases that effect. Churches should not be tax-free the way that they are. Not automatically, anyway.

CH No, certainly not. If the Church has demanded that equal time be given to creationist or pseudo-creationist speculations . . . any Church that teaches that in its school and is in receipt of federal money from the faith-based initiative must, by law, also teach Darwinism and alternative teachings, in order that the debate is being taught. I don’t think they want this.

RD No.

CH Tell them if they want equal time, we’ll jolly well have it. That’s why they’ve always been against comparative religion.

RD Comparative religion would be one of the best weapons, I suspect.

CH It’s got so insipid in parts of America now that a lot of children are brought up – as their parents aren’t doing it and leave it to the schools and the schools are afraid of it – with no knowledge of any religion of any kind. I would like children to know what religion is about because [otherwise] some guru or cult or revivalists will sweep them up.

RD They’re vulnerable. I also would like them to know the Bible for literary reasons.

CH Precisely. We both, I was pleased to see, have written pieces about the King James Bible. The AV [Authorised Version], as it was called in my boyhood. A huge amount of English literature would be opaque if people didn’t know it.

RD Absolutely, yes. Have you read some of the modern translations? “Futile, said the preacher. Utterly futile.”

CH He doesn’t!

RD He does, honestly. “Futile, futile said the priest. It’s all futile.”

CH That’s Lamentations.

RD No, it’s Ecclesiastes. “Vanity, vanity.”

CH “Vanity, vanity.” Good God. That’s the least religious book in the Bible. That’s the one that Orwell wanted at his funeral.

RD I bet he did. I sometimes think the poetry comes from the intriguing obscurity of mistranslation. “When the sound of the grinding is low, the grasshopper is heard in the land . . . The grasshopper shall be a burden.” What the hell?

CH The Book of Job is the other great non-religious one, I always feel. “Man is born to trouble as the sparks fly upward.” Try to do without that. No, I’m glad we’re on the same page there. People tell me that the recitation of the Quran can have the same effect if you understand the original language. I wish I did. Some of the Catholic liturgy is attractive.

RD I don’t know enough Latin to judge that.

CH Sometimes one has just enough to be irritated.

RD Yes [laughs]. Can you say anything about Christmas?

CH Yes. There was going to be a winter solstice holiday for sure. The dominant religion was going to take it over and that would have happened without Dickens and without others.

RD The Christmas tree comes from Prince Albert; the shepherds and the wise men are all made up.

CH Cyrenius wasn’t governor of Syria, all of that. Increasingly, it’s secularised itself. This “Happy Holidays” – I don’t particularly like that, either.

RD Horrible, isn’t it? “Happy holiday season.”

CH I prefer our stuff about the cosmos.

***

The day after this interview, I was honoured to present an award to Christopher Hitchens in the presence of a large audience in Texas that gave him a standing ovation, first as he entered the hall and again at the end of his deeply moving speech. My own presentation speech ended with a tribute, in which I said that every day he demonstrates the falsehood of the lie that there are no atheists in foxholes: “Hitch is in a foxhole, and he is dealing with it with a courage, an honesty and a dignity that any of us would be, and should be, proud to muster.”