Up@dawn 2.0

Thursday, May 2, 2013

A short comment on anti-science and its relation to public health

I apologize in advance for the crude style I employed when writing this.

When you were last severely diseased or injured, from where did you seek treatment? Most likely, you were treated by a trained and licensed medical professional. Your treatment was backed by evidence of current scientific medical knowledge. Unfortunately, this does not ensure perfect recovery, and in some cases, such as cancers, cannot ensure survival. Most drugs carry a plethora of undesirable side-effects. Medical knowledge is not complete, and these “blind spots” in it are being researched to create better treatments. However, some may view medicine's ignorance not as a temporary problem being progressively solved, but as an indictment against the institution as a whole. When one or a loved one is not cured or dies despite receiving the best available treatment, antipathy can be inspired in those who believe medicine ought to be perfect (a goal, to be sure, but not feasible for now). Medicine as an economic market exacerbates such antipathy by tainting medical research's reputation: “Are they trying to cure me or make me into a life-long customer?”, but the intersection between medicine and economics is another discussion. It is enough to say here that healthy skepticism of corporate incentives can be fanned into paranoia towards all of medicine. So, where do these people go when they have health concerns? Now enters anti-science.
It comes in myriad forms and appeals to wide ranges of people. It is perpetuated by anecdotes and testimonial. Often, it attempts to both cloak itself in science's credibility while simultaneously attempting to discredit science. For instance, Kevin Trudeau's well-selling book, Natural Cures They Don't Want You to Know About, encourages the reader to distrust conventional forms of medicine as conspiracy against your health and props itself up with these insinuations, as though his pay-walled “natural cure” for cancer is the true evidence-based remedy. Homeopathy and faith healing are just a couple of examples which find their niche in distrust of scientific medicine. Homeopathy essentially amounts to selling sugar or water pills to cure nearly any symptom, such as headaches or nausea. Sellers claim it works by “water memory” and dilution, whereby water comes into contact with a substance and “remembers” it and is then diluted to a level at which none of the substance remains. Supposedly, the dilution is what amplifies homeopathic pills' efficacy. In his video, CoolHardLogic explains homeopathy in more detail, debunking its claims along the way:

Faith healing is a religious alternative to scientific medicine which derives its base from the willingness of believers to “let go and let God”. The popular image of a faith healer is that of a preacher before a large audience, loudly and passionately invoking their deity's name and commanding demons or ailments to vacate a patient's body thereby. Patients are then declared healed via miracle. To show that they receive information from their deity, they produce specific ailments and other bits specific to individuals, such as addresses. Peter Popoff was a prominent faith healer during the 1980s until James Randi and Alec Jason exposed his fraudulent methods (he was receiving the information about those in the audience from his wife through radio transmission).

If these methods are indeed only charlatanism, why might many people experience some relief when using them? The answer comes in the form of a well-known, well-forgotten phenomenon: the placebo effect. The placebo effect is the ability of the body to respond to positive expectations a person has with regard to some treatment (the opposite is the nocebo effect, pertaining to negative expectations). What a person thinks a substance will do to them demonstrates a remarkable effect on their condition, potentially relieving patients and aiding recovery. Placebo conditions, in which participants are apparently given treatment but do not actually receive the drug being tested, are used in research to discern whether a drug has an effect greater than what can be explained by the patients' expectations. Thus, vague or general symptoms, such as headaches, nausea, pain, etc., which respond more to placebo than diseases, such as AIDS, can be “cured” by homeopathy or faith healing. In the case of faith healing, the vague symptoms of more serious conditions appear to temporarily wane, as seen with the arthritic woman with Popoff.
Some might argue that the scrutiny and anger spurred in scientific communities is unwarranted. Although they do not work on more serious diseases, they can relieve those general symptoms and those who use these methods are provided comfort in the process. Certainly, if an individual is aware of all the information pertaining to their chosen alternative medicine, they should have the freedom to choose it. However, those who argue along this line have forgotten that humans and choices are affected by other humans and choices. If a person is convinced homeopathy or faith healing is effective, because it worked on their headaches or pains, they may be more likely to forgo scientific medicine for the same methods when they have been afflicted with something graver, like cancer. When they do this, they are likely to die. Steve Jobs is a high-profile example of unnecessary death (or early death) due to ineffectual alternative treatments.
Our decisions can be influenced by the decisions of those with whom we associate, as well. If you know people who provide anecdotes and personal experiences which claim homeopathy or other anti-scientific positions are credible, you may be more likely to accept those positions.
The most egregious effect of anti-science, though, is with parenting. Children cannot seek or have great difficulty seeking treatment outside of their parents' methods, if they are even aware that they need it. Now, alternative healing is not the choice of the individual, but the only available mode of treatment. Recently, the child of a couple in Pennsylvania died after they decided to pray for the child's healing rather than seek scientific medical treatment. This was the second child of theirs to die, experiencing similar symptoms, left only to prayer for help.
Anti-vaccination supporting parents have also caused difficulty, endangering their children by refusing vaccination against mumps, measles, and rubella, among other viruses. This also risks the health of those around them by potentially exposing more people to these viruses, leading to possible resurgences of currently controlled diseases. Anti-vaccination movements have even halted the eradication of polio in some countries, such as Nigeria.
The confident statistics and claims by the progenitors of anti-scientific treatments become disquieting when one understands the implications.
We can begin to address the issue by at least eliminating state funding and propagation-through-classes of anti-science. This, along with promoting scientific literacy, is necessary to minimize public health risk due to misconceptions and involuntary use, as in children, but we cannot expect anti-science to completely disappear.  In the same way, some still dogmatically advocate geocentrism or even a flat Earth in the face of photographs of the Earth and Solar System from the International Space Station and the Voyager missions.
Interestingly, those who stand to benefit most from anti-science have the same motivation as those whom supporters fear in the pharmaceutical industry.  They are the burgeoning alternative healing industry and they want to be profitable.

-Alexander Thorne

1 comment:

  1. Your style's not all that "crude," Alexander. Maybe rude, a bit, sometimes. In an endearing way.

    I agree that alt-med is rife with charlatans. Just be aware that there are also practitioners of conscience and competence in various non-conventional health professions. They're not all out just to make a buck. I can testify to this at first hand.

    Mainstream medical science is wonderful and getting better, but it also suffers its share of paranoids and turf-guarders. It does not have all the answers but is reluctant to acknowledge its limitations; it's too dismissive of some patients' "untreatable" or "psychosomatic" symptoms ("in your head") and is too quick to prescribe medications that, surprise, are profitable to physicians as well as drug companies.

    I'm with you, I'm with medical science, but I'm also with the sufferers who find no solace from their MDs. If we believe people are entitled to take responsibility for their own health, we have to make room for alternatives too.

    But as you point out, we also need to keep vigilant watch on the hucksters and snake oil salesmen.