Part 4 Alt Med Skeptics I
July 24, 2020Part 6 The Danger with Default Skepticism
August 7, 2020Part 5 Alt Med Skeptics II
Pharmaceutical Side Effects
One of the biggest criticisms launched by “alt-med” skeptics is that pharmaceutical drugs often come with serious side effects. This is true, as most drugs do indeed have side effects for some portion of the population. Critics go on to argue that because drugs have side effects and are often not 100% effective on 100% of the people, that “alternative therapies” should be pursued instead.
This is a legitimate concern, which leads to an illogical conclusion. The net benefit of treatment should be determined by its effectiveness, in contrast to the cost and potential for harm. By proposing that “alternative therapies” are safer and sometimes cheaper, and thus should be used in a widespread manner, proponents are ignoring one of the three key considerations: effectiveness, while only acknowledging the other two factors in safety and cost. Most alternative therapies have not been proven to work or have been proven not to work. That is precisely why they are considered “alternative” and not standard. Some alternative therapies come with their own, considerable dangers and risks, and considerable price tags. Even the safest alternative therapies, such as homeopathy and acupuncture, still have potential risks (such as contaminated needles), significant costs, and importantly, many of them have been demonstrated by extensive research to have no benefits above placebo.
A pharmaceutical drug, even one with considerable side effects, is still preferable over something that doesn’t work at all but is safe, so long as the benefits outweigh the side effects.
Even if said drug costs 100x more than the alternative therapy, its value is exponentially greater. This is demonstrated by the multiplication of 0, which always results in 0. If therapy has zero benefits, no matter how safe or cheap it is, it still has no benefit, so it has no tangible value. As I discussed in my article regarding mainstream skeptics, the bar for acceptable evidence to determine value is up for debate. However, this is not the matter at hand here. I am specifically speaking with regards to therapies that either are demonstrated beyond any reasonable doubt to not work or have no evidence whatsoever to suggest they do.
Appeal to Popularity Fallacy
One popular statement is along the lines of “A billion “x people” can’t be wrong”, or “millions or billions of willing customers flock to this treatment, so it must work”. Edzard Ernst said it better than I could in his book “A Scientist in Wonderland”:
“A belief- even mass-belief- can be wrong; a widely accepted practice, habit, or tradition can still be misguided. Popularity is certainly not a reliable barometer of effectiveness. The history of medicine is littered with examples demonstrating how dangerous this fallacy can be. Bloodletting, purges, mercury cures were all, at one time or another, widely practiced and believed to be effective- and yet these treatments undoubtedly killed more patients than they ever cured. If we followed the logic of proponents of alternative medicine and allowed medicine to degenerate into a popularity contest, we would automatically jeopardize all the remarkable achievements that have been made in the last 150 years.”
Appeal to Nature Fallacy
Further, many “alt-med” skeptics will criticize pharmaceutical drugs for being “harmful,” while touting natural molecules, typically herbs, as effective and “natural.” First off, whether a molecule is synthetic or natural has absolutely no bearing on its safety or efficacy. For instance, apple, pear, and grape juice all contain arsenic and apple seeds contain cyanide.
This also disregards that many drugs are taken or derived from natural origins. Aspirin, or acetylsalicylic acid, for instance, comes from the bark of a willow tree and has been used as an herbal remedy for at least 2400 years. Of course, acetylsalicylic acid comes with many benefits, but it also has several potential side effects and long-term consequences. This may be true for many natural and herbal remedies. They may come with pharmacologically beneficial properties, meaning they also may come with potential hazards, side effects, and contraindications. This is why “safe & effective” should be the mantra for any molecule or treatment, both equally as important. Again, the minimum criteria for safety and efficacy is up for debate, but to argue that natural herbs and remedies do not come with the same inherent risks as pharmaceutical drugs do is false and preposterous.
Making matters worse is the fact that there is little regulatory oversight into natural herbs and remedies. There is considerable expense and risk with little to no incentive for suppliers of supplements, natural foods, and remedies to conduct their own clinical research and safety evaluations. This is something that I am vehemently fighting for, as I believe it is the industries’ responsibility to police bad actors, and promote ethical behavior, in the absence of any enforcement from governmental departments.
Holistic Healing and Individual Patient Approach
Many alternative health practitioners and proponents will claim that established, or “western” medicine, and pharmaceuticals, only treat symptoms and do so based on data across large populations, not the individual. This is partially true, as while some drugs and therapies are designed for symptom relief, many others target curing the actual disease or ailment. Further, obtaining trends in what works across large segments of the population is the reason why our understanding of physiology has advanced to such an extent over the last century. The future may be in individualized medicine; however, we are getting to that future by way of data collection over large groups.
This argument unravels into rank hypocrisy when considering the many alternative health proponents that posit that every individual, and many, if not all, conditions, can be “cured” by their favored treatment method. Same dose, protocol, etc., no matter the individual or what is wrong with them. Consumers who are duped by this bait and switch, in which consumers are sold on individualized attention and then given the same generic all-encompassing advice given to all others is evidence for the need for critical and analytical teaching to be taught in schools.
Of course, most of the better established alternative health skeptics don’t trumpet this line or tactic, instead advising on numerous alt-med and lifestyle practices and not just one, but they also rarely attack the allies within alt-med who make these statements, and they also often state the initial assertion that western medicine and big pharma only target symptoms, with no care of the individual or getting to the bottom of why the symptoms arose. By repeating this mantra, and not calling out the hypocrisy of their allies literally perpetrating it to the highest order (and with ineffective solutions I may add), these individuals are complicit in the crime.
Confirmation Bias and Anecdotal Evidence
One of the most curious cases of doublethink that I have witnessed by “alt-med” skeptics is the rightful criticism of privately funded science, a topic in which I have written extensively on and suggested reforms for, juxtaposed against their own presentation of evidence, often in the form of anecdotes from their followers. Privately funded research can have an inherent bias, corrupting the data, and this is an irrefutable fact. I cannot begin to comprehend how, other than hypocrisy and corruption, or, emotions, any rational person can, on one hand, criticize the issues with science, not having bothered to educate themselves on the subject to form the criticisms, while simultaneously disregarding all other controls, from placebo to confirmation bias, etc., when it concerns their own practices. Those “skeptics” which criticize and outright dismiss privately funded science, while promoting their own anecdotal evidence as borderline infallible, are either dangerous con artists or lack any semblance of self-awareness. This is a trait that readers should look out for. If an influencer routinely criticizes the corruptions in science, and rather than committing to better science, offers observations and anecdotes in its stead, this person is not to be trusted as a source of critical or analytical thought. This is true regardless of the individual’s intentions.
Dangerous Allegiances
Another curiosity regarding rank hypocrisy exists in the alliances formed between many alt-med skeptics and influencers. One of their biggest battle cries is conspiracy. Big Pharma, the media, mainstream doctors, etc., all conspire to undermine them and withhold the truth. They yell this out, on one hand, while hiring their own PR firms, setting up their own organizations, and holding their own conferences, in which they form allegiances, on the other hand.
I’ve mingled at some of these “alt-med” conferences and in their backrooms with influential figures. In addition, I’ve overheard phone calls, been cc’d on email chains, and repeatedly observed the sentiment “This is war; we have to stick together.” This mentality leads to a refusal to criticize allies, something I criticized mainstream skeptics for and ironically makes the alt-med skeptics part of a conspiracy of their own. They are literally conspiring to control messaging through their own assets, influence, and allegiances.
Logical Leap to Logical Leap
This practice also strikes me as quite ironic. Often, the so-called skeptics from the alt-med community will decry a treatment, food, or technology as being potentially dangerous. They will typically have no valid evidence for this and will lean on the fact that we can’t possibly know everything. Future dangers could exist. Simultaneously, on their preferred treatments, they are more than happy to make massive logical leaps to tie conclusions into their overall theme and belief, without any evidence. If there is never enough evidence to demonstrate something is safe, how, when there is a dearth of evidence, can extrapolation and hypothesis be used to proclaim a benefit? Also, why does the onus to demonstrate safety to the same extent not exist in these situations?
Jumping to logical leaps and being excited at connecting potential outcomes is a common trait in anyone that can be defined as a “generalist,” or someone with knowledge in numerous areas. I admit this is something I am often guilty of myself. The key difference is, I attempt to maintain a Rolodex of experts in areas, to attempt to find out when I have made critical errors in judgment or lacked sufficient understanding to accurately develop my hypothesis. Missing a key piece of understanding in one aspect can ultimately invalidate the entire thought. Many of the alt-med skeptics happen to be generalists, but, unfortunately, fail to understand this massive shortcoming. I’ve curiously listened as some of these individuals have expressed contempt at experts for lacking basic knowledge in other areas. This sense of superiority, and arrogance, leads many generalists to disregard the opinions of experts, even on the subject of the expert’s expertise. Generalists need to work with experts to put pieces together, not dismiss them for their lack of knowledge in other areas.
Esoteric Gish Gallop
This leads me to the most dangerous trait that I see many “alt-med” skeptics develop, and that is the habit of combining logical leaps with esoteric, or downright fraudulent, subjects. This trait truly defines “new pseudoscience.” Many of the most influential figures in alt-med have begun leaning on “experts” who specialize in esoteric areas that often have no firm evidence or understanding, as well as experts who hold widely criticized and controversial views which differ dramatically from their peers.
I have watched as several conmen, or perhaps some are just dangerous idiots, have woven together esoteric positions, beliefs, and limited research into grand theories. This is a form of Gish gallop, which is presenting numerous shaky arguments to overwhelm critics rather than forming one solid argument, made worse by how esoteric some of the points are. Many of these fringe subjects are so devoid of real expertise, that there is no one to roundly dismiss what is being stated. An expert here or there may be tempted to criticize the section concerning their own area, but also may not, as they will perhaps be dissuaded by the lack of knowledge they have in the other areas.
This technique gives the illusion to many individuals that these hucksters, or idiots, are geniuses, bordering on magicians, for their ability to piece together all of this “fascinating” information. Of course, when numerous parts encompassing the hypotheses are unknown, as the hypotheses themselves, it renders the entire thought to be little more than imagination.
Conclusion
“Alt med skeptics” have some valid criticisms, but often do not turn the microscope on their friends, let alone turn the microscope back on themselves, self-reflecting on their own beliefs and actions. Unfortunately, much of what many of them believe, and the actions they undertake are worthy of significantly more criticism and skepticism than the actions, thoughts, and crimes on the truth that they rightfully point out.
Next week, “The Dangers of Default Skepticism”