My Body is the Knife: Skepticism and the Reality of Medical Uncertainty

This piece was originally published in AlterNet.

The cutting edge of science is hard to accept when your body is the knife.

person asking question“If we don’t know the answer to a question, it’s better to just say, ‘We don’t know.’ And then, of course, investigate and try to find an answer. We shouldn’t jump in with an uninformed answer based on our cognitive biases. And we definitely shouldn’t assume that, because we don’t know the answer to a question, the answer is therefore God, or something else supernatural.”

Skeptics and atheists say this stuff a lot. It’s all very well and good: I totally agree. But what do you do if the question on the table is one you really need an answer to? What if the question isn’t something fairly abstract or distant, like, “Why is there something instead of nothing”? What if the question is one with an immediate, practical, non-trivial impact on your everyday life? Something like… oh, say, just for a random example, “What are my chances of getting cancer, and what should I do to prevent it and detect it early?”

Here’s what I mean. I’ll start with my own story, and get it out of the way. I recently got a presumptive diagnosis of Lynch Syndrome. This is a genetic syndrome that gives you about an 80% chance of getting colon cancer (a cancer I’ve sort of had — my last two colonoscopies found pre-cancerous adenomas which would have turned to cancer if they hadn’t been removed); a 20% – 60% risk of endometrial cancer (a cancer I definitely had, it’s the cancer I had surgery for last fall); and a somewhat increased chance of some other cancers, including an as-yet-unknown-but-possibly-as-high-as-ten-or-twenty percent chance of stomach cancer.

I say I got a presumptive diagnosis, because they didn’t actually find the genetic markers that normally point to Lynch Syndrome. But this doesn’t mean I don’t have it. According to the genetic counselor, it’s entirely possible — likely, even — that there are other genetic markers associated with Lynch Syndrome, ones that researchers don’t know about yet. And my family/ personal history of Lynch Syndrome cancers is strongly suggestive of it. It’s pretty much a textbook case of “Lynch Syndrome family history.” So we’re proceeding on the assumption that I have it… even though we don’t know for sure.

So in addition to my now-annual colonoscopies (oh, joy), we had to decide if I should get stomach endoscopies. I have an increased chance of getting stomach cancer… but my genetic counselor said there currently aren’t any agreed-upon medical guidelines on stomach endoscopies for people with Lynch Syndrome, and suggested that I consult with a gastroenterologist. So I talked to a gastroenterologist… who said that there currently aren’t any agreed-upon medical guidelines on stomach endoscopies for people with Lynch Syndrome, and that the two of us would have to make whatever decision seemed right to us, updating it as new information comes in.

You may be noticing a pattern here. Presumptive diagnosis. As yet unknown. No medical guidelines. It’s possible. It’s likely. As new information comes in. Whatever decision seems right. Proceed on the assumption, even though we don’t know for sure.

science journal coverThis is often the reality of science. There are questions that are pretty much settled: questions we hypothetically might re-visit if giant heaps of new contradictory evidence came in, but that have had an overwhelming body of evidence for decades or centuries pointing to one answer. (Questions like, “Does the Earth orbit the Sun?”) There are questions where the general broad strokes are mostly settled, but where we’re still figuring out many of the finer points. (Questions like, “What the heck is happening on the subatomic level?”) And there are questions that we’re very much in the process of answering, questions on which scientific consensus hasn’t been reached, questions for which the data that’s giving us answers is still coming in, questions we’re still making educated guesses about based on limited information, questions for which our “best educated guess” answers are changing on a yearly and even monthly basis. Questions like… oh, say, just for a random example, “How exactly do genetic factors influence people’s likelihood of getting certain kinds of cancers — and what are the best ways to address these factors to improve prevention, early detection, and treatment?”

Those of us who value science understand this. In fact, we more than understand it. We embrace it. We see it not as a weakness, but as a strength. Science isn’t a body of knowledge so much as it is a process, a method of gathering knowledge. And the way that this process self-corrects with new information is one of the main reasons it’s so jaw-droppingly successful. (If you think science isn’t jaw-droppingly successful, think for a moment about the device you’re reading this on.)

But if you’re living your life in the middle of one of those unanswered questions, this uncertainty and shifting ground can be a hard reality to take. The cutting edge of science is hard to accept when your body is the knife.

And I think this is one of the reasons many people are so skeptical of science, so dismissive of it, so ready to say, “Oh, what do those scientists know? They keep changing their minds! Last year they told us not to eat carbs, now they’re telling us carbs are okay! They can’t even make up their own minds — why should we believe anything they say?” On a practical, day-to-day basis, the cutting-edge, not-yet-answered science that most people are intensely engaged with, the one that most people deeply care about, is medicine. And the reality of uncertainty in medicine is often frightening, upsetting, depressing, and even enraging.

The cutting edges of astronomy, of botany, of quantum physics? Most people aren’t even aware of them. Their immediate effects on people’s lives don’t generally start until the science is fairly settled. Even with computer science — another science that affects our lives profoundly on a day-to-day basis — most of us don’t even touch the technology until it’s more or less hammered out.

But medicine is different. With medicine, a significant amount of research is being done on human beings. A case could be made that all medicine is research being done on human beings: medical protocols and best practices are constantly being updated and refined, even in areas that are pretty well understood. And when it comes to terminal illnesses, it would be irresponsible not to pursue uncertain, incompletely understood avenues of treatment that have highly unpredictable outcomes. If the choices are “try something that might or might not work” or “die”… well, most of the time, that’s a no-brainer. (My wife Ingrid got arrested nine times for demanding, among other things, that the FDA grasp this simple principle and shorten the research protocols for experimental AIDS drugs.)

knife-in-handIn the cutting edge of medical science, human lives are the knife.

And that can make people feel very freaking cranky about medical science.

Boy, howdy, do I understand that. I hate this uncertainty about my Lynch Syndrome. I would much rather just have the bloody diagnosis. I would much rather know for sure that I have this syndrome, instead of having to act on the assumption that I have it even when I don’t have a test result confirming it. If for no other reason: The fact that they didn’t find the genetic marker? It means that my family can’t get tested for that marker to see if they have it or not… so they now have to work with this vagueness as well, this not-very useful information that “You may or may not have a 50% chance, or a 25% chance, of having this syndrome, but we have no real way of knowing, so maybe you should be getting more frequent colonoscopies than you normally would. Or something.”

This is frustrating as hell.

But here’s the thing.

Medical science is the reason we even know about Lynch Syndrome. Medical science is the reason I’m getting colonoscopies every year instead of every five years, and am getting my pre-cancerous adenomas scooped out every year before they turn into cancer. Medical science is the reason we know that the tendency to get some cancers is heredity: it’s the reason that, even before my doctors knew anything about Lynch Syndrome specifically, they were looking at my mom’s cancer history, and insisting that I get colonoscopies early. Medical science is the reason millions of people are getting regular colonoscopies and mammograms as a standard part of their medical care, and are getting cancers and pre-cancers detected and treated early. Medical science is the reason colonoscopies and mammograms even exist. If we’d known about Lynch Syndrome forty years ago, my mom could have caught her cancer before it ate her up at age 45. It’s painful to think about that. But I can’t be sorry that the current medical science, imperfect as it is, is keeping me alive.

When I was growing up, people used to talk about finding “a cure for cancer.” As if cancer were one disease, and we were going to find one magic-bullet cure for it. I think some people are disappointed that this magic bullet hasn’t happened: that cancer is turning out to be hundreds of different diseases, and that after all these decades, after millions of dollars and millions of person-hours poured into it, cancer research is still about prevention and early detection and improved treatments and increased lifespans, much more than it is about a “cure.”

But the reality is that cancer is a much more survivable disease than it was when I was growing up. More people with cancer are getting it caught early. More people with cancer are living longer. More people are getting their cancer fully treated, and are living full lifespans and dying of something else. More people with cancer who can’t get it fully treated are living longer, and better, than they would have fifty years ago, or twenty, or even ten. More people with cancer are getting treatment that isn’t excruciating and doesn’t completely screw up their lives. More people with cancer are getting treatment that’s less excruciating, and is screwing up their lives less completely, than it would have fifty years ago, or twenty, or even ten. And some people aren’t getting cancer at all… because they’re eating their fiber, because they quit smoking or never started, because they’re getting regular colonoscopies and are getting their pre-cancerous doodads scooped out before they turn cancerous. Oncology is an imperfect, inexact science… but it’s getting better all the time. Prevention and early detection and improved treatments and increased lifespans are not trivial. Millions of people are alive today because of them. I’m one.

And I’m not going to embrace the results of the scientific process that’s keeping me alive — the messy, uncertain, unpredictable, loaded-with-false-starts, “try a hundred things with no idea which one, if any, will pan out” scientific process — and then piss all over it because it isn’t perfect.

LLS-logoGreta Christina is the 2013 Honored Hero of the Foundation Beyond Belief for the Leukemia & Lymphoma Foundation’s Light the Night Walk. To participate in the Light the Night Walk, go to the LL&S website. To participate under the Foundation Beyond Belief banner, find out how to join an existing team — or start one of your own.

Angry Atheists and Equality: Greta’s Podcast Interview with “Life, the Universe & Everything Else”

LUEE logoPodcast time! When I was at the SkepTech conference earlier this year, I gave a podcast interview to Gem Newman of the “Life, the Universe & Everything Else” podcast, hosted by Winnipeg Skeptics. That interview is now up — along with the rest of a very interesting show.

In the interview, we discuss angry atheism, the role religious believers can play in fighting the harm done by religion, strategies of arguing religion with believers, the importance of coming out and atheist visibility, internalized atheist stigma, my favorite arguments against religion, challenging entrenched biases within skepticism, hyperskepticism (or what I’m now calling denialism) and treating ordinary claims as extraordinary ones, straw Vulcans and the notion that being unemotional about an issue makes you more rational, tone-trolling about misogyny, coming out bisexual versus coming out atheist, Twitter walls, self-publishing, and more. Enjoy!

Coping with Life Under a Cloud of Medical Uncertainty

question mark sign“If we don’t know the answer to a question, it’s better to just say, ‘We don’t know.’ And then, of course, investigate and try to find an answer. We shouldn’t jump in with an uninformed answer based on our cognitive biases. And we definitely shouldn’t assume that, because we don’t know the answer to a question, the answer is therefore God, or something else supernatural.”

Skeptics and atheists say this stuff a lot. It’s all very well and good: I totally agree. But what do you do if the question on the table is one you really need an answer to? What if the question isn’t something fairly abstract or distant, like, “Why is there something instead of nothing”? What if the question is one with an immediate, practical, non-trivial impact on your everyday life? Something like… oh, say, just for a random example, “What are my chances of getting cancer, and what should I do to prevent it and detect it early?”

Here’s what I mean.

*****

Thus begins my latest piece for AlterNet, Coping with Life Under a Cloud of Medical Uncertainty. Go find out more about having a “presumptive” diagnosis of a genetic syndrome that increases your odds of getting cancer; the difficulties of living with medical uncertainty; how this difficulty contributes to people’s frustration with science; and why we should embrace science anyway… read the rest of the piece. Enjoy!

PZ Myers’ Grenade, and Anonymous Accusations vs. Unnamed Sources: The “Deep Throat” Analogy

When we’re considering accusations of seriously bad, possibly criminal behavior, should we take anonymous accusations seriously?

What about unnamed sources?

Much has been said about PZ Myers’s post on Pharyngula, What do you do when someone pulls the pin and hands you a grenade?, in which he re-posted an email from a woman he knows — but whose name he did not disclose — saying that Michael Shermer coerced her into a position where she could not consent, and then had sex with her.

Much of what has been said about this is along the lines of, “We can’t trust anonymous accusations! Anyone could accuse anyone of anything anonymously! Anonymous accusations are just gossip! McCarthyism! Witch-hunting! Moral panic!”

So I want to clear something up:

This is not an anonymous accusation.

It is an accusation from an unnamed source.

There’s an analogy I’ve been making to some friends who I’ve been discussing this with. The analogy is with Watergate, and reporter Bob Woodward, and his confidential source popularly known as “Deep Throat.”

all-the-presidents-menThink back, for a moment, to Watergate. Think back to Bob Woodward and Carl Bernstein. And think about “Deep Throat,” Bob Woodward’s high-level secret informant, from whom Woodward got much of the information about the numerous, highly illegal activities going on in the Nixon White House, and the high level at which these activities were going on.

These weren’t anonymous allegations. They were allegations from an unnamed source.* Woodward didn’t disclose who they came from — but he knew who made them.

And Bob Woodward — along with his colleague, Carl Bernstein — had a reputation for rigorously caring about the truth. The reporters paid attention to the reliability of their sources. They got as much corroborating documentation for their stories as they could. On the few occasions when they got information wrong, they said so publicly.

Woodstein trusted their sources… and people trusted Woodstein.

Do you think people should have dismissed Woodward and Bernstein’s reporting about Watergate, simply because it came from unnamed sources?

Do you see where I’m going with this?

PZ’s re-posting of an email from a woman he knows… this is not an anonymous accusation. It an accusation from an unnamed source. PZ knows who it is. And PZ has a reputation for rigorously caring about the truth. He has a reputation for paying attention to the reliability of his sources. He has a reputation for getting corroborating documentation when he can. On the occasions when he gets stuff wrong, he says so publicly.

But even if you don’t trust PZ, and don’t agree that he’s trustworthy and reliable? It still makes no sense to reflexively dismiss the entire notion of trusting unnamed sources for a story. Argue, if you like, that PZ isn’t reliable. Make that case if you like. (Many people certainly made that case against Woodward and Bernstein: many people said they were commie pinko liberal agitators, hell-bent on tearing down the Nixon presidency, and that their reports weren’t worth the paper they were printed on.) But unless you’re willing to wholly reject the very idea of reporting based on unnamed sources, you can’t just say, “These stories are anonymous — and therefore, we can and should ignore them, and can and should revile the people who take them seriously.”

Now, it’s true that in the Watergate reporting, one of the things that made Woodward and Bernstein trustworthy and reliable was that they didn’t rely on just one source. A single unnamed source could, in fact, all too easily be someone with an axe to grind just trying to stir shit up. So they wouldn’t publish a story based on unnamed sources unless they had at least two of them saying the same thing. More than two, in the case of highly explosive stories.

So in this situation? As of this writing, August 20 2013, 12:19 Pacific time, according to Jason Thibeault’s timeline: We have one unnamed source reporting that Shermer, to use her own phrasing, coerced her into a position where she could not consent, and then had sex with her. We have one unnamed source reporting that this first unnamed source told them about this incident shortly after it happened, and was visibly distraught. We have one unnamed source reporting, not that Shermer assaulted her, but that he deliberately got her very drunk while flirting with her — a story that corroborates a particular pattern of sexual assault. All of these are people PZ knows, and whose reliability he is vouching for.

In addition: We have a named source, Carrie Poppy, stating that she knows the woman who said that Shermer coerced her, that she knew about the assault, and that she’s the one who put her in touch with PZ. We have one pseudonymous commenter, Miriamne, reporting in 2012 that she was harassed by Shermer. We have one pseudonymous source, delphi_ote, reporting that they personally know a woman who was assaulted by Shermer. (Important note: These other reported assault victims may be the woman who said that Shermer coerced her, or they may be different people: since they’re unnamed or pseudonymous, we don’t at this point know. It’s deeply troubling in either case: these are either multiple independent corroborations of the same assault, or they’re multiple independent reports of different assaults.) We have one named source, Brian Thompson, saying he personally knows a woman who was groped by Shermer.

In addition: We have one named source, Elyse Anders, reporting on behavior from Shermer that wasn’t assault but was inappropriately and uninvitedly sexual. We have another named source, Naomi Baker, reporting on behavior from Shermer that wasn’t assault but was inappropriately and uninvitedly sexual. (CLARIFICATION: The report from Naomi Baker is not of an incident that happened to her: it is a first-hand report of harassment told to her by the victim.) We have a pseudonymous source, rikzilla, reporting on behavior from Shermer that wasn’t assault but was inappropriately and uninvitedly sexual. To be very clear: By themselves, these wouldn’t be evidence of anything other than creepiness. But added to all these other reports of sexual assault, they corroborate a pattern.

Do you think this would be good enough for Woodward and Bernstein?

Not for them to report, “Michael Shermer committed sexual assault”… but for them to report, “Serious, credible accusations are being made that Michael Shermer committed sexual assault — accusations that are corroborated by multiple sources”?

Washington Post Front Page Nixon Denies Role In CoverUpThe analogy isn’t perfect, of course. No analogy is: if it was perfect, it wouldn’t be an analogy, it would be the exact same thing. For one thing, it wasn’t just Woodward and Bernstein that people trusted, and were being asked to trust. It was the entire institution of the Washington Post. People trusted that the editors of the Washington Post wouldn’t have hired Woodward and Bernstein if they hadn’t thought them to be reliable. They trusted the Washington Post’s track record of hiring reliable reporters. They were relying on the reputation and track record of the Washington Post, as much as the reputation of Woodward and Bernstein. Probably even more.

But it’s also the case that the Washington Post had to place an immense amount of trust in Woodward and Bernstein. Woodstein didn’t disclose their sources to their editors, any more than they disclosed them to the general public. Ultimately, their editors had to trust Woodstein. Ultimately, the web of trust was centered in Woodstein, and in their ability to decide that their unnamed sources could be trusted.

I’m not saying that these accusations are definitely true. And I’m definitely not saying that these reports would be enough evidence to convict someone in a court of law. Like I said the other day, in my piece Harassment, Rape, and the Difference Between Skepticism and Denialism: We’re not talking about what kind of evidence would support publication in a peer-reviewed journal, or a judgment in a court of law. We’re talking about what kind of evidence would support judgment in the court of public opinion. The legal standard of evidence isn’t the issue here.

I’m saying this: This idea that we should completely ignore these accusations — and deride the people who are taking them seriously — simply and entirely because they come from unnamed sources? It’s ridiculous. We don’t apply that standard to any other reporting, on any other topic.

There are reasons that unnamed sources stay unnamed. Especially when they’re making accusations against powerful people. So think, once again, about Deep Throat. Unless you’re willing to automatically discount Deep Throat, and the dozens — probably hundreds — of other unnamed sources in the Watergate reporting, and the thousands upon thousands of other unnamed sources on other stories who told reporters and bloggers things they couldn’t tell anyone else about… then don’t discount this. Believe it; don’t believe it; be on the fence about it for now; decide for yourself whether the reporters are credible and the sources are credible and whether there are enough of them. But don’t reflexively reject these stories, simply because they’re “anonymous.” They’re not.

I strongly suggest that you look at this excellent piece by Jason Thibeault, The web of trust: Why I believe Shermer’s accusers, which gets into similar concepts more thoroughly.

*Yes, I know that Deep Throat was technically not an unnamed source. He was on deep background (hence the nickname): not letting himself be cited as a direct source of information, but instead corroborating or disconfirming information from other unnamed sources, pointing Woodward in fruitful directions, and giving background and big-picture information to put the information Woodward already had in a comprehensible context. Both Woodward and Bernstein did have plenty of unnamed sources, however, who they did cite more directly in their reporting. As has pretty much every other investigative journalist in the known universe. I’m using Deep Throat as my analogy because he’s so widely known, and his story is so recognizable.

A Timeline of the Sexual Harassment Accusations

At the Lousy Canuck blog, Jason Thibeault has put together a timeline of the major events of the sexual harassment accusations in the skeptical and secular communities. This is a living document: he is updating it as new information comes in and as new events unfold.

This is hugely helpful. For people who have been following these stories and want a clear document of everything that’s happened; for people who have been following these stories and want to show other people exactly what’s been happening; for people who haven’t been following these stories because it’s confusing and new things keep coming out every day; for people who are writing or commenting on these stories and want to make sure they’re getting their facts right… this is enormously helpful

Also — when all the reports are put together like this, it’s really, really telling.

If you care about this issue, I urge to to go look at it.

Harassment, Rape, and the Difference Between Skepticism and Denialism – UPDATED

UPDATE: There is now a timeline of the major events in these accusations, and the responses to them, on Jason Thibeault’s Lousy Canuck blog. It includes several additional reports of harassment and sexual assault, and several additional pieces of corroboration of these reports. It is being updated as new information comes in and as new events unfold.

So I got this comment on my blog from Hannah Barnhardt:

I have a question about how to handle allegations of rape and sexual harassment. In the local atheist group that I am only now tenuously connected to (because so many members display open disdain for women and feminists), Karen’s allegations have been discussed only briefly, and with criticism and disbelief. Basically, they’re saying: “Well we ARE skeptics after all, and skeptic means we need PROOF! DUURRRR”

But with something like rape, or the kind of sexual harassment Karen experienced (and I do understand Karen has lots of proof, but I’m talking about a case where perhaps, like many cases, there’s not much proof beyond the victim’s testimony), what is the best way to handle cases where there’s not much physical proof? Because I understand how little rape/harassment is actually prosecuted and how difficult it is to accuse someone, I favor giving the accuser the benefit of the doubt.

I guess I’m asking: what’s the best way to respond to these people, who say that there must be ample physical evidence in order to actually DO something about harassment or rape? In the real world, it would be awesome if every person who experienced this kind of abuse had ample physical evidence, but it just doesn’t happen that way. I don’t for one second believe that that means we shouldn’t believe the victim. What do you think?

A good question, and one that has been much on my mind in the last few days.

Here’s what I think, what I want to say to people who are saying this sort of thing: I think you should be really careful about not letting your skepticism turn into denialism.

Here’s what I think:

1: Extraordinary claims require extraordinary evidence. But claims of sexual harassment, abuse, assault, and rape are not extraordinary. They are depressingly ordinary. So the level of evidence we should need to believe a claim about sexual harassment, abuse, assault, or rape is substantially lower than the level of evidence we should need to believe a claim about, say, Bigfoot.

2: Sexual harassers, abusers, assailants, and rapists are typically very good at covering their tracks. They don’t generally commit their acts in front of witnesses or video cameras, or leave a paper trail. Depending on the kind of harassment or assault we’re talking about, they often don’t even leave physical evidence (and when they do, it often doesn’t get collected, since collecting it typically requires the victim to report the assault almost immediately, and subject themselves to further emotional and physical trauma). And perpetrators often cover their tracks in other ways — such as getting the victim drunk, which our culture regrettably tends to see as evidence of consent.

So the kinds of evidence we’re likely to find supporting an accusation of sexual harassment or assault are not straightforward, obvious physical evidence. The kinds of evidence we are likely to find are:
* Multiple similar claims made against the same person from different people. Especially when these claims show a similar pattern of behavior.
* Other people saying that the victim told them about the harassment/ assault shortly after it happened — with stories that are consistent both with the accusation and with one another.
* Other people corroborating behavior that falls short of harassment/ assault, but is consistent with it. Example: If an accused assailant is accused of getting victims drunk first, and someone says they’ve seen this person deliberately getting people drunk while hitting on them, or have experienced this themselves — that would support the accusation.
* Paper trails, email trails, or other kinds of evidence that either directly support the claim — or that show behavior that, again, falls short of being direct evidence of harassment/ assault, but is consistent with it.

(Note that this doesn’t refer to the types of evidence we’d accept in a court of law. See #4 below. And note that “support” doesn’t mean “absolutely prove.” See… oh, the rest of this entire post.)

To make an analogy that skeptics should understand: Think about how creationists say, “Where’s your evidence for evolution? I’ve never seen life spontaneously generate from a peanut butter jar! I’ve never seen fish evolve into mammals in one generation!” Or think about how global warming denialists say, “Where’s your evidence for global warming? Why isn’t the Antarctic turning into Florida? Why was it so cold in Minnesota last winter?” No, of course not. That’s not the kind of evidence you’d expect to see to support evolution or global warming — because that’s not how evolution and global warming work. The kind of evidence you’d expect to see to support evolution is exactly the kind of evidence we do find: evidence from genetics, geology, anatomy, fossil records, etc., all consistent with one another. The kind of evidence you’d expect to see to support global warming is exactly the kind of evidence we do find: evidence from long-term studies of weather patterns over years, decades, centuries, and millennia.

So be a good skeptic. Think about how sexual harassment, abuse, assault, and rape usually work. Think about what kind of evidence you’d expect to see for them. And then think about whether that kind of evidence is present in this case.

3: False allegations of sexual harassment and rape are actually very low. The consequences of making allegations of sexual harassment or rape are very high indeed: public shaming, having one’s personal history — especially one’s sexual history — being subjected to extreme public scrutiny and censure, being traumatized by callous law enforcement officials if the crime is reported, harassment, threats, and more. And the consequences are especially high when the person you’re accusing is powerful: if they’re famous, if they’re rich, if they’re influential, if they have political power.

4: In the conversations we’re having about these incidents, we’re not talking about what kind of evidence would support publication in a peer-reviewed journal, or a judgment in a court of law. We’re talking about what kind of evidence would support judgment in the court of public opinion. We’re talking about what kind of evidence would support staying away from people if we’re at an event with them. Exercising caution if we have to deal with them. Warning other people to exercise caution around them. Not inviting them to speak at conferences. Not attending conferences, or speaking at conferences, where they’re speaking. Not buying their books. Not continuing to cite them as shining examples of skepticism at its best. In the most serious case, we’re talking about what kind of evidence would support firing someone. (And yes, for the record, I would want more evidence to support firing someone than I would to support not inviting them to conferences.)

This is a generally well-understood principle. The severity of the consequences affects how much evidence we need to believe an accusation. If several of my friends tell me, “Hey, your friend is a creep, they kept cornering me at your party,” and one person tells me, “Hey, your friend is a serious creep, they cornered me at your party and groped me”… that’s not going to be enough evidence for me to call the police, but it sure is enough evidence for me to stop inviting that person back to any more parties. Even our legal system has different standards of evidence for different situations: there’s a higher standard of evidence for criminal charges, for instance, than there is for a civil case. And the court of public opinion, and of of personal opinion, have different standards as well. Which they should. The standards shouldn’t be trivial, or non-existent — and for accusations of sexual harassment, abuse, assault, and rape, they should be pretty darned high. But there is a wide, wide world between “These accusations could lead to a conviction in a court of law,” and, “These accusations are entirely without merit.” It is a huge mistake to treat these as the only options.

*****

So. Think about the accusations that are being made. Think about the fact that sexual harassment, abuse, assault, and rape are, unfortunately, very ordinary. Think about the rarity of false accusations. Think about what kinds of consequences are being considered here. And perhaps most importantly, think about what kind of evidence you’re actually likely to see with sexual harassment, abuse, assault, and rape… and whether you’re seeing it here.

So.

As of this writing, August 12, 5:21 p.m. Pacific time.

In the Ben Radford situation: There is an email trail. There is independent corroboration from more than one person, who witnessed the behavior or who Stollznow told about it. There is the acknowledgement from CFI, after an investigation from an investigative firm that they hired, that Radford behaved inappropriately at conferences, and harassed Karen Stollznow with unwanted correspondence.

In the Michael Shermer situation: There are multiple reports from different people. There are other people saying that the victim told them about the harassment/ assault shortly after it happened. There are other people corroborating behavior that falls short of harassment/ assault, but is consistent with it (in this case, Shermer getting the person very drunk while flirting with them).

In the Lawrence Krauss situation: I can’t say anything about that right now, because the blog posts reporting on the accusations against him have been taken down, apparently under threat of lawsuits. If you’ve been following the story, you can probably remember what was reported before it was removed, and you can look at these questions — are there multiple claims from different people, are there other people saying that the victim told them about the harassment/ assault shortly after it happened, are there other people corroborating behavior that falls short of harassment/ assault but is consistent with it, is there any sort of paper trail or email trail — and decide how you would answer them.

UPDATE REMINDER: There is now a timeline of the major events in these accusations, and the responses to them, on Jason Thibeault’s Lousy Canuck blog. It includes several additional reports of harassment and sexual assault, and several additional pieces of corroboration of these reports. It is being updated as new information comes in and as new events unfold.

I’m not asking what verdict you’d come to if you were on a jury. I’m not asking what you’d decide to publish if you were the editor of a journal. I’m asking you to pay attention to the difference between skepticism and denialism. And I’m asking you to not be a denialist.

Being a good skeptic doesn’t only mean knowing when to reject claims. It means knowing when to provisionally accept them. It means not demanding more evidence for sexual harassment, abuse, assault, and rape than you would for Bigfoot. It means not continually moving the goalposts of what kind of evidence you’ll accept to believe these reports. It means not telling victims who don’t name names that their vague accusations can’t be taken seriously… and then telling victims who do name names that they’re just trying to ruin reputations, and shouldn’t make public accusations outside of a courtroom. It means not saying to religious believers, “No, I can’t prove with 100% certainty that there is no god, there’s almost nothing we can prove with 100% certainty — but based on the available evidence, I can conclude with a reasonable degree of certainty that there is no god”… and then saying to victims of sexual harassment or rape, “Can you absolutely prove that it happened?”

Skepticism is not denialism. Don’t be a denialist. This shit is too important to be in denial about.

God Won’t Cure Mental Illness: What’s Wrong With Rick Warren’s Sermon

rick_warren“We’re all mentally ill.”

“You have fears, you have worries, you have doubts, you have compulsions, you have attractions…”

So said Rick Warren, founder and senior pastor of the megachurch Saddleback Church and author of “The Purpose-Driven Life,” in a sermon largely about his son’s mental illness and recent suicide.

Warren was clearly trying to help de-stigmatize mental illness, and I commend that. But this is not the way. We are not, in fact, all mentally ill. And saying that we are does not de-stigmatize mental illness. It trivializes it. It contributes to the stigma. And it makes it harder to recognize and treat.

*****

Thus begins my new piece for Salon, God Won’t Cure Mental Illness. To read more about how Warren’s sermon trivializes mental illness, stigmatizes it, dismisses evidence-based treatment, and frames atheism and religious doubt as a mental disorder, read the rest of the piece. Enjoy!

Processing: The Sexual Harassment And Abuse Floodgates In General… And CFI In Particular (UPDATED AND CORRECTED)

FINAL UPDATE (I hope): There is now a timeline of the major events in these accusations, and the responses to them, on Jason Thibeault’s Lousy Canuck blog. It includes several additional reports of harassment and sexual assault, and several additional pieces of corroboration of these reports. It is being updated as new information comes in and as new events unfold. Rather than continuing to update this post as new reports come in or get taken down or whatever, please follow Jason’s post for an updated timeline.

Updated again, to include the anonymous report made to PZ Myers about Michael Shermer. (CORRECTION: PZ wasn’t told this account anonymously. He know the person’s name. He posted the account without revealing it.)

(Updated and corrected, as noted below.)

In case you’ve been on Mars, in a cave, with your eyes shut and your fingers in your ears: The floodgates have started to burst. Reports about sexual harassment and abuse in the atheist and skeptical community are starting to come out… and prominent names are being named. This is kind of a big fucking deal.

A quick recap, pulling some of these together in one place for those who haven’t seen them:

Ashley Paramore released a video describing being sexual assaulted at The Amazing Meeting. She did not name her assailant.

Skeptical writer and speaker Dr. Karen Stollznow, research fellow for JREF and the Committee for Skeptical Inquiry, has written a piece for the Scientific American blog, “I’m Sick of Talking about Sexual Harassment!”, recounting her years-long experience with on-the-job sexual harassment and sexual assault. It has since been reported that the workplace in question was CFI, and the alleged harasser/ assailant in question is Ben Radford, deputy editor of Skeptical Inquirer and host of Monster Talk — both projects of the Center for Inquiry. (CORRECTION: Monster Talk is not a CFI project.) (UPDATE: Forgot to mention that CFI has issued a response to this matter. On which I will almost certainly be commenting.) (UPDATE: Scientific American has taken down Karen Stollznow’s blog post. Here is a cached version.

Carrie Poppy, former communication director for the JREF, has written a post confirming that Stollznow told her about these incidents, and describing how this information was… handled by D.J. Grothe and Chip Denman at JREF. This piece also reports a pattern of misogyny and disrespect for women at JREF. It also — very importantly, in my view — includes copies of correspondence between Karen Stollznow and JREF, informing JREF that CFI “have admitted that Ben has behaved inappropriately at conferences and harassed me with unwanted correspondence.”

Sasha at More Than Men has reported on an incident in which D.J. Grothe “made an hilarious horrendous “joke” about how I should pay him a visit down in Los Angeles so that he could drug me and let some of his friends have some fun with me.” His post details other troubling incidents, including Grothe saying that “the reason everyone loved the Skepchicks was because they ‘want pussy.'”

Ed Cara at The Heresy Club has posted about a widely-discussed-behind-the-scenes incident on a CFI cruise, in which special guest speaker Lawrence Krauss sexually propositioned an attendee — an incident that Cara describes as inappropriate, but which he points out did not qualify as harassment or assault. (UPDATE: This post has now been taken down. The bulk of it has been preserved at Lousy Canuck.)

Jen McCreight at BlagHag has reported — among other things — that “When women come to me to warn me about what speakers to avoid at conferences or confide in me sexual harassment they’ve experienced, Lawrence Krauss is by far the most common name I hear.” She has also reported that Ron Lindsay, president and CEO of CFI, knew about this — because she’s the one who told him, at the first Women in Secularism conference in March May 2012. Before the cruise that was discussed by Ed Cara. (CORRECTION: Women in Secularism 1 was in May 2012, not March; the CFI cruise in question was in May 2011, after and not before before and not after Women in Secularism 1.) (UPDATE: This post has been edited, after McCreight was threatened with a lawsuit. She is currently getting legal advice.)

UPDATE: PZ Myers on Pharyngula posts this, told to him anonymously (CORRECTION: PZ wasn’t told this account anonymously, he know the person’s name, and posted the account without revealing it): “At a conference, Mr. Shermer coerced me into a position where I could not consent, and then had sex with me. I can’t give more details than that, as it would reveal my identity, and I am very scared that he will come after me in some way. But I wanted to share this story in case it helps anyone else ward off a similar situation from happening. I reached out to one organization that was involved in the event at which I was raped, and they refused to take my concerns seriously. Ever since, I’ve heard stories about him doing things (5 different people have directly told me they did the same to them) and wanted to just say something and warn people, and I didn’t know how. I hope this protects someone.” (UPDATE: PZ’s post now includes corroboration of this story from other sources.)

Is there anything I’m missing? I’m going to try to keep updating this if and when new reports are made.

So.

I know that I need to say something about this. Other than just, “This is serious as a heart attack, CFI needs to do the right thing, stat,” which I’ve already said. And other than just a huge “Thank You” to everyone who has been speaking out and telling their stories. It’s hard to do — it typically gets you targeted with a huge load of denialism, trivialization, and outright hostility and hatred, and speaking out against powerful people can have serious consequences — and I want to voice my immense gratitude to the women and men who have had the courage to do it anyway.

I know I need to say something else. I know that many people are expecting me to say something about this: especially after the part I played in the recent CFI controversy. And yes, right now I am thinking very carefully indeed about my future with CFI. (I haven’t had any kind of relationship with JREF in a long time, so that’s a non-issue.)

But I think I need to hold off on any extensive comment for at least a day or two. New reports about all of this are coming in thick and fast; new information is coming out very quickly. I want to hold off on coming to any important conclusions, or making any big, irrevocable decisions, while things are changing so rapidly.

Also… it’s kind of ridiculous that this random thing should be in the mix, but I’m about to undergo this medical procedure, a capsule endoscopy to look at the inside of my stomach. Don’t worry, there’s nothing wrong (we don’t think), this is a precautionary test being done because of my Lynch Syndrome.) But the prep for the procedure is stressful and unpleasant, plus it’s required me to eat nothing but clear liquids all day, and nothing at all for another day. I’m stressed, I’m hungry, I’m going to be even more stressed and hungry tomorrow, and I know I’m not thinking clearly right now. So because I try to be a good skeptic, I try not to come to important conclusions, or make big, irrevocable decisions, when I know that my mind isn’t working at its best.

This is serious as a heart attack. Processing. Processing.

Karen Stollznow’s Complaint About Ben Radford – Do You Have Evidence Backing It?

If you have evidence or personal accounts that will back Karen Stollznow’s complaint about Ben Radford, please send them to CFI — and please make them public if you can.

The CFI Board of Directors can be emailed via the Corporate Secretary, Tom Flynn, at tflynn@centerforinquiry.net. They can also be reached by snail mail, at:

Center for Inquiry Board of Directors
PO Box 741
Amherst, NY 14226-0741

This Needs To Be Handled

In case you haven’t read it already:

Skeptical writer and speaker Karen Stollznow has written a piece for the Scientific American blog, “I’m Sick of Talking about Sexual Harassment!”, recounting her years-long experience with on-the-job sexual harassment and sexual assault.

It has now been reported that the workplace in question was CFI, and the alleged harasser/ assailant in question is Ben Radford.

Assuming that these reports are true, and that Radford is the person discussed in Stollznow’s article: This is serious as a heart attack. CFI needs to do the right thing, stat.