Blue Collar Scientist

Science Daily reports on a study looking into inaccurate information about breast cancer online. The study was devoted to finding out whether web pages were reliable sources of breast cancer information, or not. Emphasis mine:

[The study] determined that while most breast cancer data found online was accurate, one in 20 breast cancer Web pages featured inaccuracies and sites displaying complementary and alternative medicine were 15 times more likely to contain false or misleading health information.

It comes as no surprise to me or millions of other rational thinkers that sites that purvey “complementary and alternative medicine” were so much more likely to purvey false information about a potentially deadly cancer. It isn’t surprising, because we’re used to it. Almost all of us have either experienced health problems personally, or know someone who has had health problems, and have encountered a veritable storm of woo and crank beliefs about the disease at issue, almost always at the hands of someone trying to cure it with “complimentary and alternative medicine” and keep you away from the “chemicals” that doctors prescribe, to boot.

The term “complimentary and alternative medicine” (CAM) itself is misleading. The term might have a place if it were used of procedures and substances that are unproven but do have some physical mechanism that has some small hope of working, but this is generally not the case. For example, CAM is a term used to describe homeopathy, which doesn’t work. Period. It is as simple as that. We know this because every study that has been done has shown that it does no good. Even without the benefit of clinical trial, we can be pretty sure of this because homeopathy’s methods - which basically amount to selling water or sugar preparations having no other ingredients - have no remotely plausible mechanism by which they might work. And finally, we can get a big hint about this because homeopathy has wealthy trade organizations that work hard, with PR, lobbying, and litigating, to preserve a quarter-billion dollar industry in the US and a multi-billion dollar business globally. The Society of Homeopaths has even gone so far as to respond to criticism by threatening legal action against ISPs when their users write facts that are uncomplimentary to the industry.

Not that protecting your market is a sign of illegitimacy. But protecting your market aggressively, stomping on peoples’ civil rights in the process, and suppressing and covering up evidence that your product doesn’t work? That’s a sign of illegitimacy.

The same calling-out can be done of dozens of other “complimentary and alternative medical” practices: colloidal silver, chelation “therapy,” ear candling, iridology, vaccine denialism, exorcism, faith healing, repressed memory therapy, and dozens of other popular, and expensive, “treatments” for what ails you. All of which have been shown either not to work, or not to work nearly as well as, you know, real medicine.

Sure, we’ll all grant that colloidal silver does have microbe-killing properties, but anyone doing a minimum of research will find that antibiotics from your local pharmacy are far more powerful, and have much less severe side effects.

The question I have is, why are we using the term “complimentary and alternative medicine?” There are many things I’ve learned doing science outreach, and one of them is this: The words you use convey values. The phrase “complimentary and alternative medicine” conveys the warm and positive values of health, healing, and peace.

That is not what people promoting these practices bring to their victims, though. What they bring is ineffective, often outright silly treatments, which keeps the patient sick so that they may make ever more money on a chronic disease. They bring their patients great expense. They bring their patients pain. They bring their patients dangerous “side effects” without giving them therapeutic benefit.

It is time to ditch the phrase CAM and recognize that there is only one kind of medicine: The kind that works, regardless of who is selling it. We can figure out what works and what doesn’t by doing correctly designed experiments. In humanity’s ongoing quest for knowledge, at any given moment any particular health preparation or practice might fall into one of three categories, depending on what we know about it:

1. It has been proven to work. It’s medicine.
2. It has been proven to not work. It is quackery. And it should be considered malpractice if a doctor, nurse, hospital, or similar entity practices it.
3. It may or may not work - it either hasn’t been studied, or experiments were inconclusive. It is an unknown.

It’s time to start being clear about some of these things by eschewing language that gives legitimacy to items in the second category. We shouldn’t refer to “homeopathic medicines.” We should call some of them “dilute industrial chemicals.” For others we should use some phrase that doesn’t give away the farm. We shouldn’t call it “Ayurvedic medicine,” we should call it “Aayurvedic imagination,” and we ought to mention that in the US at least, it seems to be a fast-track path to lead poisoning as well. And so forth.

All of which leads to the real point of this post. If you are doing outreach, you’re going to encounter these people. Most of them maintain their “thing” works, whatever their thing is - the last time I encountered this, it was a reiki practitioner. So you have the discussion, and you put the evidence out their that their “thing” doesn’t work, and they pull an all-too-familiar rhetorical maneuver. Dodging the problem of their woo not working, they ignore efficacy and pull the wool over the audience’s eyes by saying something like, “well, maybe we don’t have all the complicated science behind us yet, but even if it doesn’t work, what’s the harm?”

As a skeptic, I think that being disconnected from reality is harmful in and of itself. But it is also obvious that the harm is (a) it takes money out of the pockets of innocent victims¹, and (b) it causes people to eschew treatments that really work.

Here’s the thing: if you say this, you’ve basically lost the argument. Audiences do not find this theoretical consideration very compelling. The prospect that someone might fail to seek real treatment for their problems isn’t compelling. Too many people in the audience are willing to condemn such imagined people as stupid for doing that, and deserving of whatever happens to them. Others will tell you they believe people won’t be so foolish. Others will simply dismiss what you’ve said because it is theoretical - unless you can give them a concrete example, it simply doesn’t exist for them. In any case, your task - which is winning over the audience, the people that are watching you argue with the true believer² - is failing. You are at this point looking weak and kind of petty, and it is quite possible that someone in the audience will say you have some sort of stick or rod inserted in a certain part of your anatomy.

But now, there is a new resource - an aggregator of instances of harm to individuals caused by false beliefs, called What’s The Harm? And sadly, this is going to be immediately helpful to outreach on these issues. The site has a long list of children who have been victims. This is sad and tragic - nobody will say a child deserved a death or disability that resulted from woo forced upon them by adults. And this provides an obvious, and in my opinion much-needed opportunity for dealing with the dishonest and misleading rhetorical devices of the woo-meisters. Now when we are asked “what’s the harm,” it will be a good deal easier to answer that question as though it were an honest one. Maybe by taking such questions seriously, and offering stark, clear-cut examples in response, we can help prevent the list of victims getting longer.

1. innocent, because a powerful marketing campaign is used to defraud these people of their money, and nobody who is being deliberately deceived with sophisticated methods can be said to be guilty [↩]
2. You can count on never being able to convince the true believer. Never. The purpose of the argument is to convince the undecided onlookers. Never forget that - it should be considered Rule One of science outreach. [↩]