Reader Feedback #1: I’m a Closed-Minded Denialist

I recently received the following response on the “About Red Stick Skeptic” section of my blog:

“I totally understand the need for skeptism and critical thinking in this day and age. We have become much more focused on the almighty $ than anything else. However, to lump all alternative medicine practioners/practices into the category of pseudoscience is not only shortsighted but misleading. Some of these therapies have been around longer than medicine and have stood the test of time.

I know that we are all essentially wired the same, however, how we respond to certain things can be completely different. So just because one person does not respond favorably to a particular therapy does not mean the next person won’t.

Skepticism is healthy, denial is not. Millions of people have been helped in some way, shape, or form from alternative therapies. Have an open mind and ask questions, but try things for yourself and let your body determine what’s right for you.”

This may seem like a reasonable criticism at first glance. Skepticism, the commentor remarks, is healthy while denial(ism) is not. That is probably very true, although I have a feeling that we disagree on just what defines these terms. I doubt that the commentor understands the practice of skepticism, which is more than just having and open mind and asking questions, although both are important. He is a pseudoskeptic. Like the pseudoscientist who makes use of the trappings of science to give the appearance that legitimate investigation is taking place, he uses skeptical terminology and professes his appreciation for critical thinking. He knows some of the lingo, but this is merely subterfuge.

Psuedoskepticism is sometimes an intentional act employed to fool others by giving claims an air of undeserved legitimacy. “Hey, I’m a skeptic and I really believe in this stuff!” Many people intuitively know to be wary of obvious salesman, although they do tend to leave this inherent skepticism at home when they seek relief for what ails them.  Or it occurs as a mechanism to avoid cognitive dissonance, to better convince oneself that the bunk they are spouting is the real deal.  I suspect that the commentor falls into the latter category and is himself denying the robust evidence that exists refuting the personal belief in alternative medicine that he is so invested in emotionally, and likely economically. But I’m an optimist.

Skepticism calls for the provisional acceptance of claims based on scientific evidence and plausibility. The greater the evidence, the less plausible a claim must be to be accepted. Some seemingly outlandish hypotheses have come to be accepted because the evidence is clear and powerful. (An expanding universe? My ancestors were apes? What the heck?) The greater the plausibility, the less robust the evidence needs to be for the skeptic to tentatively accept the claim.  But there must still be evidence, however, and that evidence must still be scientifically sound. 

We place greater or lesser importance on evidence based upon its type. Trying things for oneself and letting one’s body determine what is right, as was recommended in the above comment, is anecdotal and subject to being impacted by countless biases and confounding factors. Not suprisingly, it is the weakest form of evidence when it comes to figuring out whether or not a treatment works. Calling for me or my readers to base acceptance on this is a huge red flag indicating that we are dealing with a believer rather than a skeptic. Regardless, there is always the risk of improperly including individuals or practices in one classification if you overgeneralize or make straw man arguments. We should always remain open-minded to new ideas. We shouldn’t ignore evidence because of an idealistic or dogmatic set of beliefs. All of these are valid points, all true sentiments. And all are clearly empty words when read in the context of the entire comment.

It is implied that I am unfairly claiming that all alternative medicine modalities are pseudoscience and their practitioners frauds. He claims this is shortsighted because some of these therapies have been around for hundreds of years and have stood up to the test of time. Millions of people, he reveals, have been helped in “some way, shape, or form” by alternative therapies. That is rather nebulous but that many people can’t be wrong. Right? Well, how have they been helped exactly? Make a specific claim and I’ll address it. There are many examples throughout history of lots of people being fooled and the bottom line can be summed up with the well worn skeptical axiom, “The plural of anecdote is anecdotes, not evidence.”

It is ironic, and just plain wrong, for a skeptic to use an argument from antiquity or an argument from popularity as support for my being shortsighted. These supposedly ancient therapies, acupuncture often coming up in this context, have had centuries or longer to prove themselves and continued existence is a poor marker for true efficacy. Physicians and other healers bled patients for more than a thousand years, all claiming just as vehemently that the benefit was clear. They did so in pre-scientific times and thus have somewhat of an excuse for killing their patients in an earnest attempt to save their lives. But times have changed and the age of science has brought a better understanding of the natural world. Bloodletting was a casuality of this advanced ability to lift the veil of ignorance, along with the humoral system of medicine that birthed it.

A healing therapy can survive and manitain popularity for a variety of reasons, even when it is ineffective. The only way to root out therapies that work from the countless examples of those that at best serve as placebos, or at worst cause harm, is the scientific method properly applied. Good science has been used to investigate these therapies and the verdict is in: There are no alternative medical therapies that have proven benefit for any human ailment beyond that of placebo. A great deal of bad science has unfortunately been used to propel these modalities further into public awareness and even into hallowed halls of many academic institutions. This is a trend that has worsened over the past few years and shows no signs of slowing down. It is quite accurate to refer to therapies as pseudoscientific that are bolstered with bogus and meaningless scientific jargon (human energy fields, cellular vibrational frequencies, etc) and badly designed studies (no placebo control, anomaly hunting, etc).

It would be quite unfair, however, for me to lump all practitioners of pseudoscientific therapies into the category of fraudulent hucksters and snake-oil salesman. I don’t know what is truly in the hearts of these folk. I have no doubt that some of them are dishonest and know that they are selling lies but I am equally sure that some honestly believe in their practice or product. It is easy to be fooled into thinking that something works when it doesn’t. I don’t attack the person, I focus on the idea, and in the world of alternative medicine the idea is rotten and needs to be thrown out with yesterday’s copy of Fortean Times.

There is good science taking place every day that focuses on areas considered, wrongly, to be alternative medicine, and there have been many great successes. Many of the effective components of our pharmaceutical armamentarium originated from the plant world, for instance. Study in this area continues and will likely yield future advances in medicine. Proponents of alternative medicine are quick to hold these successes up as evidence for the worth of alternative medicine in general but this is absurd and highlights the risk inherent in having a category of medicine which includes modalities as disparate as medicinal herbs and reiki. Imagine if I decided to treat a patient’s abdominal pain with an antihypertensive agent because penicillin is an effective treatment for strep throat. It is equally ridiculous to imply that because aspirin was derived from the willow that iridology is a legitimate modality for diagnosing lung cancer, or that echinacea is effective in treating the common cold. But this kind of reasoning takes place every day and my critic’s comment is saturated with it.  Using the sucess of one treatment labeled as alternative medicine, especially when it shouldn’t even be included in the group, to give legitimacy to another may be effective if your objective is widespread acceptance, but it is a dangerous double standard. 

Herbs, even if touted as safe and natural alternatives to conventional medicines, are merely drugs. Crude, unrefined and sloppy drugs. Of course there are likely to be herbs that have the ability to effect the physiology of the human body, and the low hanging fruit have been collected over the past couple of hundred years. The overwhelming majority of what is left over will have no effect, or will have a deleterious one. But there may be a supplement on a GNC store shelf somewhere that might hlep with a particular condition. The reality is that those who take that supplement are just as subject to the potential risk as they would be taking amoxicillin for an ear infection. Ephedra comes to mind quite easily. Without proper scientific investigation, it is a roll of the dice and that is assuming the contents actually match what is on the label. Many supplements have been found to contain pharmaceuticals. Viagra in male enhancers, for instance. There is nothing alternative about studying the natural world scientifically for possible benefit to mankind. It is alternative, however, when herbs or supplements are touted as natural and risk free cures when evidence is lacking or, as in many cases, after scientific evidence is clearly unsupportive.

The commentor agrees with me, and others who are decidedly smarter than me, that humans share some hardwiring. I don’t think he quite understands what we mean, however, but he certainly provides a fantastic example of it. When I say that the human brain is hardwired to respond to certain situations in fairly reproducible ways, I am talking about mental behaviors. We all employ certain heuristics, or rules of thumb applied to thinking, that help us efficiently make sense of our environment. This is an advantage in many instances, and helps set us apart from the rest of the animal kingdom, but it has its downside. We often sacrifice accuracy for efficiency. We jump to conclusions when we apply these mental shortcuts too broadly or place more importance on our gut conclusions than on scientific evidence. Logical fallacies, such as the appeal to antiquity and the argument from popularity, are examples of hardwiring that hinders our ability to correctly assign cause and effect relationships.

We are also similarly hardwired, although I don’t typically use that term in this setting, in the sense that we share a physiology that responds in a very predictable pattern to changes in our environment, to injury and illness and to foreign substances such as toxins or medications. This is one of the foundations upon which the scientific investigation of medical therapies relies upon to determine safety and efficacy. It all comes down to the basics of our physiology, which we have an impressive, although admittedly incomplete, grasp of. One of the findings of proper scientific inquiry into the treatment of human illness is that the more we treat every patient the same, the better the outcomes tend to be. 

Naturally we must take into account a number of psychosocial factors in addition to the biological ones, and there are ranges of variable response to our interventions. But much of this is due to factors that we have discovered and understand through the use of science. To claim that humans respond to treatments completely differently, however, is misleading. And to use that claim as impetus to seek out implausible and unproven remedies is risky. Where does one draw the line? How do we measure response and decide if it is favorable? How would we decide that any one treatment is not effective? If science is to be ignored, how would we decide what treatments should be attempted first, or which are too dangerous? Pseudoskeptics tend to avoid following this kind of thinking out to its logical conclusion, an approach to healthcare which would be a nightmare for patients and would quickly fail because of enormous expense and increases in morbidity and mortality.

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