“Alternative Medicine” isn’t

I am not Orac (though at times I wish I had his flair and his work ethic). My involvement in medicine can be accurately described as “tangential”, at least insofar as it comes to my career. That being said, I’m interested in the decisions we make when the stakes are high, and they don’t get much higher than the life and death circumstances we find ourselves in when talking about our health. As a result, I am acutely interested in the discussion around “alternative” medicines.

Alternative medicine, of course, is a propaganda phrase used to describe “treatments” that lie outside of the accepted norms for medicine. It is applied with equal gusto to completely sensible and useful things like modifying diet and exercise; things that seem like they might work but are a little out there like acupuncture and chiropractic; and to things that don’t make any sense and are completely batshit insane like homeopathy or energy healing (although, to be sure, there are way crazier things out there). The problem with such a… shall we say… flexibile definition of “alternative”, is that when someone points out that acupuncture doesn’t work, or that “energy healing” is the same fakery that faith healers exploit, people jump on them and say that they’re against anything that is “natural”.

That’s a distortion of the skeptical position that is so outrageous that it borders on being a lie. Large mainstream science-based organizations like Health Canada and the World Health Organization whole-heartedly endorse the use of diet and exercise modification to reduce the risk of heart disease, diabetes, stroke, and any number of other chronic and acute conditions. Herbal remedies are refined and turned into powerful pharmaceuticals (Aspirin is a commonly-invoked example of such a refinement). Things like yoga, massage, and other types of relaxation therapy are often recommended to reduce stress which can underly a number of health problems. Skeptics are happy to accept something so long as it works. We don’t care if it’s “alternative” or not.

These “alternative medicines” are not alternative in any way – if they work, then they aren’t alternative, they’re just medicine. The other side of the problem is the ones that are truly “alternative” aren’t medicine! They don’t work any better than voodoo or augury or invoking ancestor’s spirits. This wouldn’t be so problematic, except that they still do cause side-effects:

Giving alternative treatments such as homeopathic remedies instead of conventional medicines to children may have deadly side-effects in rare instances, a new analysis says. Australian researchers monitored reports from pediatricians in Australia from 2001 to 2003 looking for suspected side-effects from alternative medicines like herbal treatments, vitamin supplements or naturopathic pills. They found 39 reports of side-effects including four deaths.

Real medicine is regulated, monitored for safety, and must pass through a strict certification process to reach market. Nobody would claim that the process is perfect – some real stinkers get through – but they get caught. All some quack has to do is slap the label “alternative” on her product, and she gets off scot free. This poses a real threat – herbs and supplements are biochemically active substances that have real effects in the body. The liver doesn’t care if something is “natural” or not – it still breaks it down. The metabolites of any substance that enters the body can exert real effects, particularly if they are used in conjunction with pharmaceuticals.

But what about things like reiki or homeopathy? Surely these things that exert no actual effect on the body (above the often-misunderstood placebo effect) don’t cause the liver to do anything. What possible side-effects could they cause?

The answer is that people will often forego real treatments in favour of these so-called “alternative” approaches:

In 30 cases, the issues were “probably or definitely” related to complementary medicine, and in 17 the patient was regarded as being harmed by a failure to use conventional medicine. The report says that all four deaths resulted from a failure to use conventional medicine.

One death involved an eight-month-old baby admitted to hospital “with malnutrition and septic shock following naturopathic treatment with a rice milk diet from the age of three months for ‘congestion'”. “Another death involved a 10-month-old infant who presented with septic shock following treatment with homeopathic medicines and dietary restriction for chronic eczema,” the authors say.

One child had multiple seizures after complementary and alternative medicines (CAMs) were used instead of anti-seizure drugs due to concerns about potential side effects. The fourth death was of a child who needed blood-clotting drugs but was given complementary medicine instead.

These people proceeded in defiance of medical advice to give useless products to children with real health problems. Adults do this to themselves too. It’s not because they didn’t know or weren’t told, it’s because they believed in the lie that is the phrase “alternative medicine”. I can’t put too strong a point on this: “alternative medicine” isn’t alternative, and it isn’t medicine. The stuff that works is just medicine, and the stuff that doesn’t work is nothing other than voodoo.

I have friends who are voodoo practitioners. A woman I did my undergraduate with is training to be a chiropractor (much to the face-palming chagrin of the rest of our class); two of my close companions here in Vancouver use acupuncture as part of their otherwise science-based rehabilitative toolkit; another friend is into “energy work”, whatever that means. This is not an abstract concept to me, nor should it be to you. If you buy into the idea that there is such a thing as “alternative medicine”, you’re helping contribute to the climate that puts completely decent things like healthy lifestyle factors in the same category as crystals and “psychic surgery”.

There is no “alternative medicine” – there’s just medicine and bullshit.

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What would happen if… (evolution vs. creation)

I sometimes forget that not everyone gets into fights on the internet about stuff. While I’ve been observing the debate over climate change and evolution and the existence of God and alt-med pseudoscience and any other number of skeptical hot topics for a while now, I often make the faulty assumption that other people are a) as interested and b) as skeptical as I am about these things. As a result, I tend to regard people who believe in astrology, or ghosts, or biblical creation,  as being curious oddities when they are in fact, more often than not simply people who aren’t particularly experienced in skeptical inquiry.

It is for this reason that this blog has, from time to time, become a dumping ground for my handful of skeptical tools, thought experiments, critical arguments, and whatever other devices I use on a day-to-day basis when I’m trying to navigate the morass of contradictory claims that are at the heart of most of these “controversies”. Today will be another one of those.

Whenever I am confronted with a new idea or a theoretical framework, I like to ask myself the question “What would the world look like if this were true?” It’s a useful thought experiment in which you are invited to re-start the world from scratch and, while keeping all the other variables the same, imagine what the outcome would be if a certain rule were true. It’s the inverse of the usual scientific process wherein we look at the evidence in aggregate and then try to figure out what the rules are; in this thought experiment we assume the rule to be true and then imagine what the world would look like as a result.

Rule #1a: Creationism – the Earth was created by a supernatural force in (more or less) its present form about 10,000 years ago. Current geological and geographical features that appear to be due to the effect of much more than 10,000 years of time are in fact caused by a massive flood.

What would the world look like if Creationism was true?

It is entirely possible that different species were created using the same set of rules, so the existence of a single mechanism underpinning living organisms (DNA/RNA transcription) is neither ruled out or necessitated by this rule. Types of animals (called “kinds” in Creationist jargon) would not show anything but trivial similarities in terms of their underlying physiology, microbiology, genetics, since they have all been created separately and are not designed to interbreed. There would be no need for wasted or vestigial organs, since these organs would only waste energy. A consistent fossil record would exist that shows only superficial changes over time, consistent with the observed rate of change in physiology in the current time (within reasonable error bars). Species would show evidence of physical migration from a single point of of origin (in the Middle East), spreading out to their current locations, and the same types of animals would occupy ecological niches everywhere (birds are the only ones that fly, fish are the ones that swim, etc.) since there is no reason to change a working pattern. Species would not acquire new characteristics over time, since they were created perfect the first time. Floods would exhibit similar effects (albeit to a smaller degree) on geology that can be observed and extrapolated.

Rule #1b: Evolution – all existing life has a common origin, having reached its present form via a process of change due to a combination of genetic mutation and changes in environment that favors certain trait changes over others.

What would the world look like if evolution were true?

Different species would have many genetic commonalities – no species would use a completely unique process of gene replication, and similarity between different types of species would be on a gradient rather than randomly distributed. Similarities would also be seen in embryology, comparative physiology, and microbiology since they all came from a single source rather than being created different. There may (or may not) be gene sequences and organ systems that are completely useless or have trivial utility in one species, but have working analogues in other species – these would be caused when two different species diverge from a common ancestor due to environmental differences. Fossil records would show animals that are similar to a number of different species but are no longer in existence, as well as some that are still in existence (since environmental changes happen with different frequency and magnitude). Species would exist only in certain areas, while there would be no evidence of them in others, as their ancestors might have had common habitat but have left that area, went somewhere else, and adapted to the change in environment. By the same token, ecological niches would be filled by many different kinds of animals – there would be mammals that fly and birds that swim, plants that eat flies and insects that fertilize soil. Species would, if given sufficient time and divergent enough environments, gradually change and become different enough as to be considered two different species.

The last step of this process is to look at the world that exists and decide which rule best resembles our observed reality. If the rule is in conflict, there are two possible explanations: 1) the rule is false, or 2) there are other forces at work underlying reality that are not fully caught by observation, and further observation will expose them. Of course creationists are loath to accept #1, and will rush to find exceptions and “explanations” for why the rule is still valid (Ken Ham’s floating log bridges, for example). This, however, is simply back-filling – throwing up hastily-assembled assertions to prop up a preconceived conclusion rather than following the existing evidence.

I was going to do a few more examples, but I’m on vacation and I’m coming dangerously close to my 1000 word limit, so I’ll do another one of these another time.

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Backfilling – when to ignore someone (pt 3)

Back in September I unveiled my first takedown of arguments that I see popping up in online discourse – namely, appeals to “my own research” and “common sense”. I followed that up by expressing my scorn for any assertion that begins with “I believe…”, a statement that is simply a declaration of personal preference and that has no bearing on anyone else. Today’s post continues this series, albeit with a slightly different, more subtle spin.

Have you ever noticed that your nose is the perfect size and shape to hold up a pair of glasses? Isn’t it remarkable that the placement of the ears relative to the nose support the arms of the glasses? How wonderful is the design of the face! Surely this is proof that the human face has a designer.

Of course you’re smarter than that. You know that it’s exactly the other way around – glasses were designed to fit the face. If our noses had been on our foreheads, we’ve have designed glasses to be an entirely different shape. Of course, this says absolutely nothing about the shitty “design” of the eye that makes us need glasses in the first place.

This practice of assuming the truth of your premise and then cherry-picking and distorting facts to fit that premise is a practice I call “backfilling”, although I am sure it has a real name. I use a creationist example here not because it is used exclusively by the religious, but because it is perhaps most obviously and conspicuously on display when people attempt to bully facts into a literalist biblical account of creation. To be sure, everyone (myself included) uses this tactic from time to time. The psychology behind it is pretty obvious – you believe something to be true, and when it is challenged your mind looks for a rational basis for that belief.

This is similar to appeals to “common sense” or statements of belief – we as listeners are exhorted to believe an asserted statement that strains credulity. The important difference between this tactic and the aforementioned fallacies is that at least the veneer of evidence is presented. That is, we are given something that looks like evidence, provided we don’t take too long to actually look at it critically. Sometimes this comes in the form I have presented above, where cause and effect are reversed. Other times it comes from ignoring or failing to recognize confounding factors and thus jumping to an erroneous conclusion (black people must be more prone to commit crimes – look how many of them are in jail!).

The most frustrating form of this tactic I encounter happens when people make statements and then staunchly refuse to define their terms. Not too long ago, I butted heads with one of the other authors at Canadian Atheist, who seems to have some kind of unhealthy obsession with haunting my posts and writing ridiculous nonsense. One of his favourite tactics is to make some blanket statement, and then when you ask him to define what he’s talking about, he retreats into some mushy nonsense that bears a slight resemblance to the word he’s using, albeit a definition that nobody else would agree with. Thus swimming in the water of muddy incomprehensibility, he is free to make ridiculous and unsupported statements to his heart’s content.

There is a danger in using backfilling to support an argument, namely that unless someone already agrees with your premise, your argument will fail to persuade others. It’s easy to find things that will confirm your own beliefs, but as soon as you step outside a sympathetic audience, you’ll find it increasingly difficult to convince all but the most credulous listener. This is why skepticism is such a useful tool to have – it requires someone to actually define their terms rather than just getting away with blanket nonsense and vauge “well everyone knows what X is” statements.

Because it is so tempting to use this technique in an argument you’re not prepared for, we have to be particularly wary of it when we’re talking outside our depth. Similarly, it might require us to go a bit easier on someone when they’re using it. Unless they’re like Joe and they do it on a repeated basis whilst simultaneously accusing everyone else of being ‘irrational’. Then you know you’ve found a professional idiot, and you should adjust your debate style accordingly.

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Do me a favour?

I have heard that Ms. Tinkham has died of her cancer as of 3:30 pm PST. I am deeply saddened by this, more so because this death was, in all probability, preventable.

I enjoy blogging, I really do. However, sometimes it’s a struggle to find the inspirado to write. Since I started this for serious back in March, I’ve posted at least one new story every morning at 6 am (Vancouver time). Mondays I have reached deep into my psyche and pulled out a completely organic essay (what I’ve taken to privately referring to as my “think pieces”), and Fridays I have scoured the interwebs to find you a pithy or humorous video to entertain you.

I have yet to miss an update (I came perilously close this past Friday, but I still got it out).

I love blogging, but on those days when I just don’t feel like writing, I am spurred on by the thought that somewhere out there in the world, there is someone (maybe even a few someones) who read these things and get something from them. Maybe it’s just mindless entertainment as part of your morning routine, maybe it means something more than that; regardless, the thought of you going “where the fuck is today’s article?” is what chains my ass to the desk and gets my fingers a-typin’.

I say all this because the time has come for me to ask a favour from you. Over at Respectful Insolence, Orac has put out this plea:

I’m still perturbed that a cancer quack was able to convince a woman who had everything to live for that he could cure her of her breast cancer without surgery, chemotherapy, or radiation. I’m still perturbed at this particular cancer quack’s attitude, where he tried to claim that he didn’t know the woman who is dying, Kim Tinkham, and imply that her cancer recurred because didn’t follow his regimen carefully enough, that she had stopped living the quack’s “alkaline diet.” I thought of my mother-in-law, who died in 2009 of metastatic breast cancer, and watching her decline.

And then I thought of Oprah Winfrey and her role in what ultimately happened to Kim Tinkham.

Oprah needs to know what can happen when people choose quackery and woo instead of effective science-based medicine.

Because I know how hard Orac works to get his lengthy and in-depth analyses of science-based medicine and medical skepticism out there, I was happy to contribute my voice to what I hope is a chorus of people saying the same thing: people who give bad advice about medicine have to live with the consequences of their words. This Kim Tinkham woman was told that cancer was an “acid” that was caused by feelings of resentment – a steamier pile of bullshit there has never been. Based on this faulty premise, the exposure and publicity that she got on the Oprah show, and Oprah’s whole-hearted endorsement of nonsense like The Secret, Ms. Tinkham eschewed conventional treatment and attempted to “alkalize” her body to get rid of cancer.

To be sure, with a stage III cancer she had roughly 50% odds of succumbing to the disease even with conventional treatment. However, that is a full 50% better chance than if she just slowly lets the cancer kill her. If we found some other treatment that improved your odds of surviving cancer by 50%, we’d be trumpeting it from the skies. Ms. Tinkham, with encouragement from Oprah, decided to opt instead for witch-doctor treatment from a quack who thinks that cancer is made up of acid. I have, with my own two eyes, seen a cancerous tumour – it looks nothing at all like acid. Furthermore, I have seen positive, happy, well-balanced people die of cancer – to suggest that it’s their own fault for having too much “resentment” is a disgusting insult to anyone who has seen a loved one die of cancer.

And so I am asking you, my dear readers, for whom I work so hard to provide regular (and hopefully interesting) content 5 days a week, to do me this favour: please write in to the Oprah show and tell them that it’s not okay to encourage vulnerable sick people to slowly commit suicide under the “care” of people who would exploit them first, then blame them later when their voodoo “cures” don’t work.

Please also feel free to copy and paste your submission to Oprah in the comments section.

Like this article? Write in to the Oprah Show then, dammit!

P.S. WordPress helpfully tracks the number of clicks the links that I post yield, so if you read this and don’t write the show, I’ll know.

MS procedure claims its first(?) victim

I like lots of things. I like dogs, I like children, I like rainstorms, I like canoeing (although I haven’t gotten my act together to go in a long time). Another thing I like is being right. I am unashamed to say that I get a giddy little thrill when I can clarify a position and bring someone around to my way of thinking. It’s not particularly humble or diplomatic of me, but I figure as long as I don’t throw it in anyone’s face I am okay.

There are some times I wish I wasn’t right:

An Ontario man with multiple sclerosis died of complications after a controversial treatment in Costa Rica to open up his neck veins, CBC News has learned. Mahir Mostic, 35, of St. Catharines died on Oct. 19, one day after doctors in the Central American country tried to dissolve a blood-clot complication.

Let’s back up for a second. Back in April, I wrote a post about a new proposed therapy for the treatment of Multiple Sclerosis. This therapy involves inserting an angioplastic balloon into a neck vein and inflating it. The proposed mechanism violates the current scientific understanding of MS, but patients have reported dramatic symptom improvement after receiving the procedure, so it was worth investigating. However, the rules of skepticism must be particularly adhered to when a new “miracle” procedure appears that completely changes the current understanding of any phenomenon. If someone, for instance, claimed that they had invented a ‘gravity beam’ that could attract objects by firing gravity at them, we’d probably be more skeptical than if someone had said they’d invented a ‘sound beam’ that could fire sound over long distances – the latter requires a slight tweaking of current understanding, whereas the former requires a complete re-imagining of how gravity works.

So, by the same token, I was concerned at the flood of patients demanding access to this procedure without adequate testing beforehand. Even the doctor who invented the procedure cautioned people to wait until it had been evaluated. However, out of their (totally understandable) desperation to alleviate their symptoms, patients demanded that the approval for the surgery be fast-tracked. When the various health authorities said that they needed to have actual testing before they would approve it, the predictable happened: a private company began shipping people to countries that don’t care about health regulations.

The problem with failing to regulate health care is that it allows quackery to go on unmonitored. These patients who circumvent the system do not receive adequate follow-up:

Suddenly, after nine weeks, [patient Brandon] Layh began to deteriorate. His neurologist said he had two blood clots near the stent, and he was prescribed more blood thinners. The couple fears what could happen if the clot moves. “If it lets go, we were informed that he could have the clot move into his brain, which would cause a stroke,” said his wife, Sindy Layh. “I know they can fix it. He shouldn’t have to wait to get into a dire situation where he is on death’s door to be treated.”

The couple is now exploring whether to seek treatment in the U.S. to dissolve the clot at a cost of $20,000.

Stents increase blood turbulence, which promotes the formation of clots. The problem with clots is that there is a “damned if you do, damned if you don’t” scenario: a clot can become dislodged and cause a stroke, but prescribing clot-busting drugs when the clot itself is that far advanced makes such an event more likely. Blood thinners are prescribed to prevent the clot from growing and reducing turbulence, but at any point the clot could break off. Proper follow-up and monitoring may have been able to prevent this from happening, but so would not having the procedure in the first place.

And now, thanks to patient zeal and the happy willingness of the private sector to exploit that zeal, a man has died. Apparently his isn’t an isolated case either:

[Vascular surgeon Barry] Rubin said Mostic isn’t the first case of a serious complication in an MS patient who has sought treatment outside Canada. Last week, he treated a woman who had the vein procedure in Mexico.

“We found extensive clotting in the left arm reaching into the chest veins, and some of the clots had broken off and travelled to her lungs, which is called a pulmonary embolus, which is life threatening, potentially life-threatening complication.”

This is what happens when you skip steps and jump right into a risky procedure. This is why science works in small, incremental steps. This is why it’s a good thing that such studies take time. None of this means that the procedure doesn’t work, it just means that there are significant risks to the patients, and we don’t know if the benefits are worth it.

I have friends whose careers tip-toe into the realm of woo-woo, who often chastise me for my skeptic approach. “If it gives people hope and makes them feel better, what’s the harm?”

This is the harm.

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“How do you know that?” – the ultimate nullifier

In Marvel comics, there is a device known as “The Ultimate Nullifier” –  a weapon that is apparently capable of utterly destroying any target the user chooses, as well as the user her/himself if her/his mind is not sufficiently focussed (those of you who don’t read comics will probably find this idea a bit ridiculous; those of you who do read comics will think it’s not ridiculous enough).

Back in July, Vancouver was visited by PZ Myers, author of one of my favourite science and atheism blogs, Pharyngula. During his talk, PZ brought up the role of skepticism in evaluating any claims about the world, particularly religious ones, and invited us to ask an important question when facing a claim that you’re not sure about: “how do you know that?” This question is, within the realm of science, the ultimate nullifier… of sorts.

Let’s pretend I have a friend who is really into reiki – a form of Japanese faith healing. She tells me that she can heal my diseases by passing her hands over me and directing positive energy into my body. I, of course, am skeptical – probably more so than I would be if she had told me that she was going to massage away my stress or something that at least has a biologically plausible mechanism. And so I ask her “how do you know that?”

She tells me about chakras and meridian lines and The Goddess Breath Method (those of you who aren’t familiar with “alternative therapies” will probably find this idea a bit ridiculous; those of you who are familiar with this kind of woo will think it’s not ridiculous enough). She tells me that by directing energy into my chakras that I will rebalance my energy flows and expel the foreign energy that causes my dis-ease (yes, they actually do spell it like this). I’ve studied human anatomy, and there ain’t nothing like a “chakra” or a “meridian line” anywhere to be found. And so I ask her “how do you know that?”

She shows me a bunch of websites and testimonials from the millions of patients who have been treated with reiki. As an epidemiologist, I point out that showing the numerator without the denominator is useless – how many people were treated and didn’t get better? Is it an equivalent number? Is it less? Is it more? Surely there are “dis-eases” that resolve themselves on their own – how does she know that people aren’t just responding to a sham treatment because they believe in it?

As we go father down, I learn that every time someone takes a controlled look at reiki (or acupuncture, homeopathy, intercessory prayer, rolfing, crystals, psychic surgery, or distance healing), they find no reason to support my friend’s claim that it will heal anything. The few studies that do suggest that it works either have a small sample size, lack proper blinding, or have no control group – common ways of finding effects that aren’t actually real. Basically, her claim of magic healing powers is based on nothing but personal belief and junk science – not exactly what I want when I’m in serious medical trouble.

There is a limitation to this question, however. Many people like Deepak Chopra and Ray Comfort abuse the word “know”, taking it to mean “believe very strongly”. They insist that science isn’t the only “way of knowing”, and that human intuition or divine revelation (sometimes through scripture) are just as good as science at determining reality. There’s certainly an appeal to this kind of statement – after all it is pretty arrogant of scientists to claim that theirs is the only version of the truth.

The problem with this kind of reasoning is that, if it were true, we’d see far more overlap between intuition, revelation and science. Revealed wisdom (for example), when tested through observation, would consistently give similar results to those determined according to non-revealed scientific “wisdom”. It would certainly be at least internally consistent – many different groups of people would achieve similar insights, and have overlapping revelations. However what we see instead are diverse groups claiming to have “truth”, but having very different versions of it.

A better question, perhaps, is “why should I believe you?” Ray Comfort is free to assert (without evidence) that he knows that Jesus is the supreme being who watches and judges mankind (but not other animals). Why should I believe that just on his say-so? To avoid everlasting torment? Maybe, but that threat is really only credible if I believe him already – if I reject his imaginary friend then I most certainly reject the punishment that imaginary friend has in store for me. Why should I believe Ray more than my Hindu neighbour down the street – both can point to ancient holy books, miracles, millions of followers; what makes Ray’s “truth” more true than Raj’s?

All claims should be held to an external standard – some kind of way of measuring them against observed reality. It doesn’t matter if they’re claims about magic energy healing or invisible sky genies or political theories – if they aren’t borne out by some kind of controlled, observable evidence, then they’re just statements of belief. It’s fine to have beliefs (I think it’s preferable to have ideas, but whatever), but a statement of a belief is nothing more useful than a personal preference. I think that Radiohead peaked with OK, Computer; my buddy Stu thinks that they’ve gotten steadily better after that – they’re just statements of belief.

Saying that I believe in chakras doesn’t make it any more true than if I say I believe in phrenology or caloric theory or the four elements of matter. Saying that I believe it so much that I know it certainly doesn’t change that. My believing in it doesn’t grant it some kind of legitimacy – it just makes it harder to give me actual medicine.

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An atypical side-note

I don’t talk about my job on this blog, and today will be no exception. However, I am (as reported on the sidebar) a scientist who works in the medical field (kinda). As such, I feel it appropriate to comment on this story I saw in the news:

Doctors have sharply cut some financial ties to drug companies, thanks to increased scrutiny about relationships that critics allege improperly influence medical treatment, a survey suggests. The biggest change occurred in the number of doctors who accept drug company money for attending medical meetings, including covering travel to sometimes exotic locations. That fell from 35 per cent in 2004 to 18 per cent in last year, the survey found.

There is a near-constant din that comes from advocates of alt-med that medical doctors are “in the pocket of Big Pharma”, and that anyone who advocates science and opposes superstitious nonsense must be getting paid for their position. Anyone who has been to my apartment or seen the way I dress will be able to attest that if I get money from Big Pharma, it’s not enough (full disclosure: my employer does receive research money from pharmaceutical companies, under contracts that strictly bar those companies from interfering with our research in any way. I have not personally received a cent from any corporate interest).

I will give the alt-med crowd one accolade to hang their hat on – they changed the conversation. It used to be the case that doctors were very much in bed with the pharmaceutical companies, and it was repeated and consistent criticism of this practice that led to findings like the one above. It was a legitimate criticism of a shady practice, and it forced regulators to police the kinds of remuneration that physicians were allowed to (or felt entitled to) accept. This didn’t happen spontaneously; many doctors initially denied that the gifts exerted any influence over them whatsoever. Of course the evidence suggested otherwise.

It’s good to see when a small group of people can raise public consciousness about a serious ethical issue and see meaningful results. I applaud the alt-med crowd for a job well done, and look forward to the day when my merry band of skeptics can return the favour and stop the egregious abuses of trust that alt-med practitioners are allowed to get away with every day.

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What is my goal?

I’ve just finished a frustrating week banging my head against the wall dealing with a conservative Christian commenter (please remember that I write these posts about a week before they appear on the site – if grassrute has disappeared in this past week, this last sentence won’t make much sense). Despite taking careful pains to predict, explain away, and thereby defuse the predictable “rebuttals” to the discussion of privilege, this person decided to make the arguments anyway. So I responded to those, in spite of my irritation at having to repeat myself (in text… you could have just scrolled up to see why you were wrong!). And then through a combination of goalpost-shifting and selective interpretation of history (almost all of it demonstrably wrong), the fallacies stacked up apace.

It’s frustrating and emotionally draining to have to spend my free time (what little there is) refuting poor arguments. This is, however, my personal blog, and I feel that anyone who bothers to come here and comment deserves recognition for their efforts. My tone may become grumpy sometimes, but I get a giddy thrill every time someone new shows up here. After all, I’m just some asshole with a keyboard and a basic grasp of the English language – why should anyone read what I write? At the same time, the few conservative commenters who have shown up here at various points do irritate me – not because they disagree with me, but because (with few exceptions) their arguments are horrible. They only work if you are prepared to suspend history, psychology, sociology, and the basic rules of logic. I am not.

My colleagues over at Canadian Atheist (two of them in particular) would likely admonish me severely for being so unfriendly to someone with whom dialogue is possible. The problem with me, they’d say, is that I’m too willing to use mean language, which drives away those who disagree with me. This, they say, cements my position as an “angry atheist”, and deepens the stereotype. I’ve already explained why this line of reasoning is crap, so I won’t bother to do away with this argument here. However, it does raise an interesting question: do they think I write this stuff to convince people who disagree with me?

I’ve tried to make it clear from the outset that this blog exists for the sole purpose of throwing my ideas out there, ideas that are open for debate. This is not an attempt to find middle ground with people who disagree with me, or to coax opponents out by cooing sweetly to them in the hopes of using sugar and light to bring them over to my side. I wield a variety of rhetorical tools, but my go-to weapon of choice is (what I hope is) high-minded polemic. In addition to saying what I think, I do my best to show why I think it. This is done as much for me as it is for anyone who happens to stumble across the site – writing my thoughts down in a systematic manner helps me to clarify and shore up any inconsistencies in my beliefs.

My attempt is to persuade, undoubtedly; but I have no illusions that a deliberate, reasoned approach will bring over those who strongly disagree with my position. There are important differences in cognitive frameworks between someone like me and someone like grassrute – I start from a position of doubt and then apportion my belief in any idea to the level of evidence supporting it. If someone could demonstrate to me that a position I hold is either illogical or unsupported by evidence, I will abandon that position; it might take me a bit of time, but I can be convinced. The other cognitive framework is to start from a position of certainty and then look for things that confirm your a priori conclusions. A person operating within this mindset cannot be convinced or persuaded; she/he is convinced of her/his rectitude, and will always find a crevice to hide in when challenged. Attempting to use logic, persuasion, or even sugar and light to move a person like this out of her/his position is, in my opinion, rather a waste of time. No one-on-one discourse will do anything to change that person’s mind.

These two cognitive frameworks are philosophically opposed, but by no means does that mean that an individual is incapable of using both. There are any number of things that I believe in the absence of rigorous evidence, just as I’m sure there are some things that grassrute comes to believe based on facts and evidence. The difference is what happens when our backs are against the wall, so to speak. When my position is challenged, I will be persuaded by evidence (if not by asserted opinion and anecdote). The evidence has to be high quality, obviously – “something a guy told me once” is insufficient to put even a dent in my skepticism, but I can be – and have been – turned around in my stance on feminism, religion, race, pretty much everything I talk about on this blog. I recognize that, on the other hand, people who are not amenable to revising their views will not tolerate being turned around and will find any scrap of pseudo-logic to prop up a failed position. C’est la guerre.

I am not writing for grassrute. I am happy to discuss and clarify my position, using grassrute (or Scary Fundamentalist, or Natassia, or whoever shows up) as a whetstone, but I hold no hope of prevailing over people who fix their opinions first and then justify them later. Some of these stones are rather more dull than others. I am writing for myself primarily, and for those who haven’t given the issue a lot of concerted thought secondarily. I have heard from people – in person, by e-mail, in comments, on Facebook – that I am articulating arguments that they hadn’t really considered before, and their thinking has been subtly shifted. I am intensely gratified by these stories, as it means that I am at least partially successful. However, I am not aggrieved much by my dissenters (especially since they have, almost without exception, failed to articulate a clear and coherent position that isn’t trivially easy to disembowel). My frustration with them has more to do with the poverty of their argument, coupled with the magnitude of their certainty. I am not trying to “reach out” to people who don’t use logic – I am trying to stimulate thought among those of you who do.

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The scourge of “scientific” racism

As a scientist and a black man, I cannot describe to you how weary I am of having people throw “scientific racism” in my face. I don’t mean that people try to prove to me that black people are scientifically inferior; we’ve pretty much debunked that already. No, the thing I resent is when people say stupid things like “science used to say that black people were inferior – therefore everything that science says is suspect.” It is a wearying argument, because not only is it inaccurate, it is actually self-refuting.

First off, science never said that black people were inferior, at least not science in any way that I have described it in the past. Science is a process involving explanation based on observed data, controlling for alternative explanations. Scientists are people who purport to use that method. However, like all people, scientists are subject to human failings, and have been known to say some bullshit-stupid things. Luckily, we have a process for evaluating bullshit-stupid claims – it’s called science. The reason that we know that racial differences are largely sociologically-constructed (as opposed to genetic) is because of science. We didn’t use meditation or divine revelation or any of these “different ways of knowing” to figure that out – we used science.

As I said, the claim is both inaccurate and self-refuting. Scientists did, at one point, make claims about the inferiority of The Negro. They did not, however, base those claims on science. They made the claims, then looked for evidence to support their conclusions. That is not the scientific method; that is the religious method. The doctrine of white supremacy was not based on evidence, but on a supernatural belief in the manifest will of the Creator, who endowed white people with superior qualities. The doctrine absolutely did co-opt the scientific establishment into supporting its assertions, but when the shine was off the apple and real investigation was done, no differences were found. It didn’t have to be so – we could have found a great deal of genetic differences between different ethnic groups. The evidence, however, does not support any doctrine of supremacy (and yes, I have met actual black supremacists – they’re just as bereft of science as their white counterparts).

However, we cannot simply ignore the history that the scientific establishment played in the legitimization and mainstreaming of racism, as Ghana is teaching us:

The Council For Afrika, a UK-based think-tank has commemorated the third global campaign to combat scientific racism, reiterating its commitment to counter the marginalisation and dehumanisation of Africans. The council used the anniversary, which coincided with the first decade of the 21st Century, to draw attention to the escalation of afrophobia, attributed to the global recession. A statement issued to the Ghana News Agency in Accra, by Dr Koku Adomdza, President of the council, said: “Afrophobia has escalated based on discrimination against name, ascent, physical appearance, ethnicity and African ancestry in all spheres of life in the Global North.”

“Scientific” racism (I feel obligated to use quotations here, because it’s not scientific) is not a spectre of the past that we’ve thankfully moved beyond. The campaign started in response to bizarre comments made by James Watson (yes, that James Watson):

“[I am] inherently gloomy about the prospect of Africa [because] all our social policies are based on the fact that their intelligence is the same as ours—whereas all the testing says not really.”

Dr. Watson said he hoped everyone was equal, but added: “People who have to deal with black employees find this not true.”

Stay classy, Dr. Watson.

Dr. Watson was making those claims based on “scientific” research that had been done into intelligence among different racial groups. Of course, like the phrenology studies of the early 19th century, this research was based on faulty assumptions and poor methodology. It has since been largely discredited. It becomes problematic when preeminent scientists start making recommendations about policy based on bad science, which is what happened here.

It is for reasons like this that I am a skeptic. Whenever someone tells me “well X and Y are true”, my first thought is “how do you know that?” Most of the time I ask out of genuine interest, particularly when it’s a topic I’m unfamiliar with. However, other times it comes out of a deep suspicion that the claim being presented is bolstered by nothing other than confirmation bias and anecdote. “Scientific” racism definitely falls under this category.

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Tanzania elects albino to parliament

Last week I talked about the dangers of believing superstitions, and confusing superstition with culture. I also illustrated the specific plight of albino people, who are particularly targeted with violence for the supposed magical properties of their limbs. Of course, albinos have no magical properties – albinism is a single-gene mutation affecting pigmentation. But that doesn’t stop people from kidnapping and maiming albinos.

Tanzania has taken one small step toward correcting this practice:

An albino has been elected as an MP in Tanzania for the first time. “This win is a victory not only for me but also for all the albinos in this country,” Salum Khalfani Bar’wani, from the opposition Cuf party, told the BBC. “My joy has no end,” he told the BBC Swahili Service. “The people of Lindi have used their wisdom and have appreciated clearly that albinos are capable. I am so touched that this is the first time in the electoral history of this country for an albino to be elected by the people in a popular contest to be their representative in parliament – and not through sympathy votes or decisions.”

This is a great feed-forward mechanism that could have real positive effects. An albino MP is a recognizable, prominent public figure that challenges the commonly-held narrative around albinos. A greater level of awareness about albinism can start to take hold in the public consciousness. Of course such a shift will take a long time, so strong is the staying power of superstitious beliefs. However, the fact that Mr. Bar’wani was popularly elected suggests to me that such a shift has already began.

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