Bad Science, Bad Medicine and Bad Faith

 Posted by on December 12, 2011  Add comments
Dec 122011
 

Who among us would not go to the ends of the earth to save their children from a life-threatening illness?

I know I would, and I’d cling to every last vestige of hope, no matter how remote.  Despite my usual insistence on rigorous thinking, I’d abandon logic, reason and rationality if I thought there was the slightest chance of finding a cure, even in the craziest of crazy quack medicine.  I might even take up religion in my desperation, and all of that would be fully understandable, just as it is in so many parents whose children are facing exactly that predicament.

It would also make me a very unreliable witness.

That’s why, when Roger Daltrey claims that homeopathy saved his son, or a mother says she still believes in the Burzynski Clinic, I have every sympathy for them as a parent, while at the same time remembering that we are all prone to magic thinking, and none more so than a parent in terror of losing a child.  When all hope is gone, that’s when people turn to religion, so maybe we should have a look at that and see what religion has in common with alternative medicine, but before doing that, perhaps we should examine how people conduct their normal lives.

If I suggested to you that I had a new treatment for back pain that involved facing Memphis Tennessee and singing the Armenian national anthem backwards, you’d probably have some doubt, even if your back was in agony.   You’d want evidence.

Show me, you’d say.

Well, I’d tell you, the evidence is that I say it works.

That’s not evidence, you’d tell me.  You made it up.

All right then, I’d say.  What sort of evidence do you want?

Well, you might say.  Who else has done it?

Nobody, I’d say.  It’s a secret.  But I have a good witness.

Who?

See him over there?  That’s Ron.  He’s got very bad lumbago, and he firmly believes I can fix him.  So there!

Did you fix him yet?

No.

Right.  In that case, fix him now.

No.

Why not?

See what you’re asking there?   You’re asking for evidence with reasonable enough questions, but guess what — those questions are science, pure and simple, or as our grandparents used to call it, common sense.  Science is nothing more than applied common sense, and yet increasingly among the ignorati, I see it being used almost as a term of abuse.  As if somebody who has devoted their life to clear thinking is somehow diminished by that effort, and inferior to someone who’s prepared to believe any old bullshit, provided there are some crystals involved.

Common sense was always sceptical: ask anyone who tried to persuade their mother they got home at a reasonable hour.  And yet time and time again, I come across people who never studied anything in their lives denigrating science as if it was some sort of belief system, instead of what it really is: common sense.

They can snow all their clients by talking about science.  Love it.

Religion is belief without question and so is pseudoscience.  You accept what the priest or pseudopriest tells you, pay your money and be quiet.  Religion requires you to suspend your disbelief, to set aside your natural scepticism and instead to accept whatever you’re told.  Pseudoscience requires you to do the same.  Both demand that you stop asking diffult questions and just accept that you believe whetever you’re being told.

This is where pseudoscience and religion overlap.  Neither has any supporting evidence.

Science, as I keep saying, is nothing more than clear thinking written down.  What has happened to our society when people who dedicate their lives to rational thought are somehow the suspects?  Is it the rise of the Know-Nothings?  The X-Factor generation?  All life is evidence-based.  All our actions are driven by statistics.  That’s why you decide to risk your life crossing the road but might not be so keen to go sky-diving.  You make a scientific assessment of the danger and act accordingly.

Scientific thinking is hard-wired into the nature of human beings and anyone who suggests otherwise is either lying or not capable of understanding that fact.  Either way, I have no respect for people who dismiss an argument on the grounds that it’s scientific.  They’re saying that because you thought it out carefully, it’s wrong.  Nonsense.

Science is the habit of asking for evidence.  It’s that simple.  If you have the evidence, we’ll all agree with you.  If you don’t, go away until you find it instead of trying to shout down the people who ask for it.

I suppose there’s nothing new about any of this.  Throughout history, people have wished for the magic answer instead of the hard slog, but this intellectual laziness has reached a new low with alternative medicine., which seems like the ultimate contradiction in terms.  If something works, it’s medicine.  If it doesn’t work, it’s nothing.

How do we know the difference?  Test it and see.  Obviously.

Let me enter a caveat here: I don’t care how the medicine works.  This is not a plea for the drug companies.  If standing on one leg and singing the Armenian national anthem can be shown to work, I’m all for it, but I want to see the figures.  If Ron got better after doing it, I want to see the figures for how many other guys got better spontaneously without singing the anthem.   Then I can tell if the anthem made any difference.

What I don’t want to hear is Ron telling me that the Anthem treatment cured him.  He doesn’t know, any more than he’d know if his knee got better after a trip to Lourdes.  He’s the patient, not the researcher, and so, tragically, are the parents of sick children who can often fall victim to extravagant claims from less-then-ethical doctors.

Society at large has been conditioned to be suspicious of science, and I’d have to say that this is due to poor teaching in schools and compartmentalisation of subjects.  It’s as if society had been taught to resist clear thinking.  Pause.  Light-bulb on!  Is that why our country is in its current state?  Maybe if we had a few scientists thinking their way through our fiscal crisis instead of an uneducated fool like Bertie Ahern, we might not find ourselves in our current predicament, but that’s a by-the-way.

More importantly, we need to ask ourselves why we have such an aversion to clear thinking and such an attachment to magic.

This is not healthy.

  33 Responses to “Bad Science, Bad Medicine and Bad Faith”

Comments (33)
  1.  

    Partially because those that perform the “magic” are the most vocal and are experts at getting their message across. They speak in a language that’s accessible to the masses. E.G. Gillian McKeith, an professional waffler Someone very close to me thinks she is God’s gift to being healthy. In my house, when I query her twaddle I get shown the door. I’m proud to say that I’m a science graduate of the Open University and I can detect this waffle a mile away but most people don’t have this privilege and are therefore gullible through no fault of their own in many cases. http://en.wikipedia.org/wiki/Gillian_McKeith

    Conversely, the providers of scientific and clear thinking have a major problem communicating their message because it’s difficult to cut it down to simple language.Although a few, like Prof. Brian Cox does an excellent job of reducing physics to something that I can actually relate to.

    If you want an insight to some of the BS that is taken as gospel in the modern world have a read of Ben Goldacre’s’ “Bad Science”. The story of Vitamin C is an excellent example of what we take for granted.

  2.  

    The ‘Magic’ does ‘work’ sometimes: insomuch as a sugar-pill placebo can have a positive effect, ( in spite of being demonstrably impotent in a physical sense,) the psychological reaction to meeting a ‘doctor’ and ‘taking medicine’ as opposed to doing nowt, can cause improvement.
    Mind you, one can’t help noticing that it’s not that effective at growing back a limb or curing aids…
    I spose what I’m getting at is— that where a person is at psychologically can sometimes make the difference between recovery and relapse and if ‘water-with-memory’ or ‘crystals’ or voodoo dolls or praying to L.Ron feckin’ Hubbard help them get there then it’s really no skin off my personal proboscis.

  3.  

    Indeed. And that’s why double-blind randomised tests are so important in telling the difference between direct effects and placebo.

  4.  

    Do you think that when everyone is told to believe in creation myths and that privately speaking to an omnipotent being might solve all their problems, they are more likely to believe in quackery? Especially when promoted by people who want to make money off the ‘cure.’ If prayer really worked, Pfizer would have it in a pill form by now, along with a homeopathic line and do-it-yourself Gillian Poo Tests. When taught from birth to believe in the non-rational, logic seems like voodoo. Case in point: I just got a job after nearly two years of looking. I’m sure my mother in law prayed for me a lot in that time. It didn’t work. Or did it? She made sure to tell me the day I got the job that she’d been praying for me the night before. That’s a pretty shitty sucess ratio, but I’m sure she’s thanking her god and not my efforts or my new employer.

  5.  

    When people want something to work, they invent it. And then they call it “alternative”. And then they work their arses off to make others believe in it.

  6.  

    My niece’s husband was diagnosed with testicular cancer. After successful surgery, he was declared out of danger. Husband received ecstatic email from said niece extolling the power of prayer, and how god had walked with them through the ordeal. Forwarded it to me with the comment “Was it not because well-trained surgeons cut off his left nut?” But no point in trying to convince niece and her krazy kristian family of that.

  7.  

    Exactly. People prayed. Surgeon cut. Therefore, prayer solved problem.

    That’s the sort of stupidity we’re dealing with.

  8.  

    Just an anecdote, was at a medical presentation by a doctor last week and i asked him if positive thinking resulted in better clinical outcomes. He confirmed that studies and tests have now shown that it does.

  9.  

    Of course it does. That’s the whole basis of the placebo effect. Without that, fake medicine would collapse.

  10.  

    Should have added that according to said doctor, one of these tests was based on test subjects in one group being given carefully selected films to watch over a period of time. The second group (on the same medication) were not given the films and apparently has less positive outcomes. All along the same lines as you speak of, but did find it interesting that something as simple as the above had a measurable effect.

  11.  

    If alternative medicine works why is it not called medicine!

  12.  

    On a certain level, science is applied common sense (when working within a particular paradigm), but breakthroughs in science often involve incredibly counter-intuitive proposals. Think of the transition from the earth-centered universe to the heliocentric view with a moving Earth, the relativity of time or the almost completely bizarre properties of quantum particles.
    We are not natural statisticians. Two Nobel laureates, Kahneman and Tversky conducted many surveys involving seemingly simple questions with probabilistic answers. Most peoples “common sense” led them badly astray.
    Those with university degrees were also often prone to such erroneous thinking.
    One theory why this is true is that we are the descendants of those who took no chances when they perceived a potentially life-threatening event. Our ancestors happened to have an over-active imagination in such situations. Those with excessive curiosity, (or perhaps, less susceptibility to magical thinking) were more likely to be killed, therefore, they were less likely to pass on their genes.

  13.  

    In winter I sometimes drink how whiskeys as an antidote to or cure for the common cold. You know the formula: a double measure of uisce beatha (water of life), cloves, brown or unrefined cane sugar, sliced lemon and boiled water. Stir well and down the hatch slowly.

    I don’t know if hot whiskeys have much scientific medical value apart from the vitamin C in the lemon and the energy content of the sugar. I don’t know if they really cure the undignified,sniffling common cold. But by golly hot whiskey tastes fine and is a great comfort when I’m under the weather.

    Maybe we are not always expecting a cure for certain ilnesses. If prayer, faith healing, shamanic rituals and alternative herbal treatments bring comfort to patients, then I say good luck to them. Hardly anybody feels emotionally detached towards life-threatening illnesses, such as cancer. Scientifically trained medical people offer scientifically tested clinical therapies for sure, and sometimes there are unexpected cures; but other people from nonscientific backgrounds offer untested emotional supports that sometimes generate attitude changes that pave the way for psychosomatic cures. Other rare cures have no rational explanation. The archives in Lourdes testify thus. Believers call them miraculous and nonbelievers prefer to call them inexplicable. The occasional human happiness is the result whatever the cause of the cure.

  14.  

    I have to take issue with you on one thing. Somebody who calls a Lourdes cure inexplicable is a believer. Nothing is inexplicable, although some things are as yet not fully investigated.

    I have no doubt that Lourdes has produced many placebo-driven cures, but none of them are supernatural. Lourdes has also produced some illnesses due to contaminated water.

  15.  

    Ah sure some whiskey drinkers have become ill when the ice cubes were made with contaminated water.

    I’d say many claims for cures at Lourdes have been examined by medical experts, a minority of them not believing christians, who have concluded that psychosomatic and other known medical causes were not the reasons for the cures. In that sense the causes of the cures are inexplicable. Saying that something cannot be scientifically explained doesn’t make one a believer or nonbeliever. It’s just admitting current limits to one’s knowledge.

  16.  

    “All our actions are driven by statistics.”

    While a great deal of our action may well be the result of subconscious risk determination, I’m not sure I’d agree that all of our actions are driven by statistics. In many ways that would be the ideal, where by we decide the risk based on the knowledge available but unfortunately we make far more of our decisions, and thus actions, based on illogical emotional responses, hence why the deepest, darkest circle of Hell is reserved for marketers. If we can be made to believe that a certain course of action will bring us that which we desire we have an enormous tendency to put aside any kind of statistical reality. The Lotto for example, or eternal happiness in the after life.

  17.  

    Benno — My understanding of the word inexplicable is it means something is incapable of explanation. That’s otherwise known as magic.

    I’d be interested to see your references to the reports of those medical experts.

  18.  

    I suppose I should have said all our actions that contain an element of danger, unless we’re beiong completely stupid, which can and does happen. But even then, we know the danger. We automatically carry out little scientific studies on things.

    Does this usually work? Does that only work some of the time? We look for evidence, except when it comes to quack cures and religious magic jiggery-pokery. Then we’re prepared to believe any old horse-shit with no evidence whatever to support it.

  19.  

    I think there might be conservation of credulity at work. When people used up all their gullibility on religion, there was none left for crystal healing or magic water, the new age medicines have rushed in to fill a belief vacuum. On the other hand, it is possible that convention medicine is patronized for similarly magical reasons. People believe the doctor, just because; not on account of the research underpinning the treatment. Just as well perhaps as medicines own magical thinking will get cancelled out by the placebo effect. The more rational and discriminating consumer of medicine would be wise to keep their sceptic’s hat to hand even if their caregiver is a scientist. Remember lobotomies, remember cupping and bleeding, remember thalidomide. Some of what is evidence based practice today is tomorrow’s barbarism.

  20.  

    It’s hard to disagree with anything you say there. Human nature is such that people who get into a position of power cana sometimes become arrogant. This is as true of those who practise untested medicine as it is of conventional physicians. And it’s also true that individual practitioners can become irrationally attached to their inventions, but that’s where peer-review and scientific examination come in. Lobotomies, cupping and bleeding, and thalidomide are now things of the past. Why? Because the evidence showed they were either useless or downright destructive and the collective wisdom abandoned them. You won’t find the same self-criticism in the water industry (sorry, the homeopathy industry). All you’ll find there, and in chiropractic, are lawsuits instead of rational discussion, and that’s the dead giveaway that they know full well what a load of nonsense it is. If you’re confident of your case, argue it out. If you’re not, sue your critic.

    This is because the likes of homeopathy will never subject itself to independent scrutiny, and the reason is simple. It’s bullshit.

    By the way, you might say that Distillers acted disgracefully in the case of thalidomide, and I’d agree, but that was due to their heartless, unethical business practices. In many ways, their ethics would remind you of some alternative practitioners who squeeze money out of desperate people by providing them with false hope.

    Ironically, thalidomide has received an opportunity to redeem itself. It’s back on the market as a treatment for cancer of the plasma cells and it seems to be effective.

  21.  

    Magical reasoning is a product of superstition. If there is blanket state sponsored indoctrination in superstition and ritual designed to promote belief
    in the supernatural,widespread mental illness follows when the bubble pops and
    the individual’s world view has lost one of its certainties.

  22.  

    Thalidomide was an accident waiting to happen. The rapid growth of the “medicines” industry of the time was not properly controlled by equal improvements in independent testing procedures. Thalidomide is racemic , there are two mirror images of the same molecule. One was safe and effective, the other had lethal consequences. I’m certain this type of tragedy was going to happen at some point in pharmaceutical evolution due to the lack of proper testing and research. The Thalidomide tragedy is still one of the most powerful reasons for the very long development time and huge costs associated with new drug creation. It should also be a very good reason NOT to put our blind faith in untested “herbal remedies”. We just don’t know what we are consuming. At least water therapy ( as Bock calls it) is harmless………. but totally useless.

  23.  

    I wouldn’t call it harmless. If somebody with a treatable condition is persuaded to forsake effective treatments in favour of water, it can be lethal.

  24.  

    I should have clarified, harmless in it’s efficacy. I take your point.

  25.  

    A friend in work has this flowchart pinned to his wall, (without the header) seems apt for here if I may. http://4.bp.blogspot.com/-0sflOXxFHQ4/TtvUrj6tUHI/AAAAAAAAAC8/A8J5_LaqrH8/s1600/Debate-Flow-Chart1.jpg

  26.  

    Steve Jobs had a very treatable form of cancer but he wouldn’t take the operation. Thought he could cure himself with diet and meditation. Went running back to the docs went that turned to custard. But by then it only held off the inevitable for a few years.

  27.  

    Unfortunately, statistics reveal that at least in the united states, mainstream medicine often does more harm than good. Women were more likely to die as a result of mammograms than women who never had them. This is because of the false positive rates in mammography, poorly understood by US doctors, which often led to unnecessary surgeries.
    According to this very interesting interview on US healthcare,
    http://trainradio.blogspot.com/search/label/Barbara%20Starfield,
    the third leading cause of death in the US after heart disease and cancer is medical error.
    Ben Goldacre’s brilliant book “Bad Science” has a chapter devoted to showing how statistical methods are routinely abused to give misleading results during clinical drug trials. He considers this to be at least as serious as the untested claims of “alternative” medicine.
    Drug company researchers may have a much better understanding of statistics than the general public, but this means that they also best know how to fiddle the results of a trial when under market pressures.

  28.  

    Anthony, using enantiomerically pure Thalidomide is not safe and effective. It’s true that one of the enantiomers is effective against morning sickness, and that the other causes fetal malformations, but it racemizes in vivo. Thalidomide is hydrolyzed and the two molecules interconvert. Whats worse is that the ‘good’ molecule gets excreated faster leaving the patient with a higher concentration of the ‘bad’ lying around.

  29.  

    I love it when you talk like that.

  30.  

    Thats what she said.

  31.  

    Irate Chemist. Yes, I fully understand Thalidomide racemizes in vivo. My point was based purely on the fact that there are two stereoisomers of Thalidomide and proper testing didn’t take place during development….. a fact that I’m certain(?) wouldn’t happen again.

  32.  

    Irate Chemist — Check email.

  33.  

    Apologies, the old account is offline. See new account.

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