What should they have known and when should they have known it?

One of the recurring themes in the wacky world of "alternative" medicine (and "alternative" biology) is the use of "authorities" as unimpeachable sources of information. As far as I can tell, the irony of their behavior is completely lost on the "alternative" medicine crowd, most of whom will rant long and loud about not trusting doctors, scientists, "the government", "Big Pharma", the AMA, the CDC, the FDA.... you get the picture.

Yet, despite this stated (and restated and restated...) aversion to "authorities", they seem perfectly willing to suspend their suspicions and disbelief when someone in a position of authority on their side (e.g. a journalist, like David Kirby) tells them something. Granted, many of these "authorities" are telling them not to trust doctors, scientists, "the government", etc., which is exactly what many of the "alternative" medicine crowd already fervently believe.

Where it all gets a little strange is when the "authority" is a doctor - the "real" MD/DO kind, not one of physician wanna-bes, like chiropractors, naturopaths, homeopaths and whateveropaths. These people are trusted - I assume - because they have broken from the herd, turned their back on "entrenched dogma" (a phrase I borrowed from a Post-Modernist lecture I attended) and have joined the forces of enlightenment and....well, you get the idea.

Seeing how some people have turned these "renegade" physicians (e.g. Joseph Mercola [also see here], Jeff Bradstreet, Andrew Wakefield, Rashid Buttar, Andrew Weil and Deepak Chopra) into saints (occasionally martyrs), gurus and even saviours has left me wondering. Clearly, these physicians have tapped into a unmet need in the people they....... I suppose the polite term would be "treat". This is fascinating in its own right, but should be dealt with by someone with greater knowledge of the human psyche. What I'm interested in is the following:

These people have all had a scientific education - with at least a passing familiarity with scientific method - and should know that what they are saying is, at best, untested and, at worst, known to be false.

So, we come to the title of this posting. There is, I am told, a provision in law that holds a person liable for false statements if they knew or should have known that the statement is false. Now, I'm not a lawyer and I have no pretensions about my legal knowledge, but it seems to me - humble biologist that I am - that there is at least a moral responsibility (if not a legal liability) for making authoritative, emphatic statements that you either know or should know - because of your education and training - aren't well supported (or are, in fact, disproven) by the data.

One of the reasons that "alternative" medicine and "pseudoscience" appeal to the "average person" (i.e. people with little or no formal education in the sciences) is that they offer simple (some might say simplistic) answers to difficult and complex questions. People who find science intimidating and impenetrable (i.e. most of the population) want a simple answer to their questions. They don't like long, complicated answers riddled with probabilities and conflicting or ambiguous data. And they especially don't want to be told that nobody knows the answer yet. Regretably, most simple answers to complex questions are also wrong.

If you ask one of these "renegades" how to slow (or even stop!) aging, what causes autism or how to "cure what ails ye", they almost always have very concrete, definite anwers. Many of them will also sell you the goods you need to carry out their advice. What they won't tell you is that they have no data - other than their own "clinical experience" - to support what they say.

If what these "renegades" were doing (or advising you to do) was the "norm" in the medical community, then you would be at least no worse off for following advice that had not been scientifically tested. Quite a bit of medicine - even today - is based on the collective "clinical experience" of thousands of physicians. Periodically, one of these practices gets picked off by a scientific study, in which case the medical community adopts a new "norm".

However, if your physician is one of the "renegades", you have no such reassurance. Occasionally, the lone maverick who stands alone and refuses to follow the herd is the vanguard of a new breakthrough in medicine (or science). Most often, however, they are simply wandering aimlessly off the trail and into the wilderness. Taking you with them.

However, if asked, most (if not all) of these "renegade" physicians will tell you that the treatments they recommend are both safe and effective - they have seen them work on dozens/hundreds/thousands of patients. If pressed, they will often offer up pages of glowing testimonials. They may even be able to tell you about a well-respected physician in New York/Europe/Asia who has done a large study showing how well it works - although they usually can't cite a literature reference. These sorts of studies are often (lamentably) unpublished, owing to the dastardly machination of "Big Pharma" and the AMA.

Yet, at some level, these physicians must know that they are working outside of the realm of science. Some of them - Weil and Chopra spring to mind - don't care. Others - such as Bradstreet - have apparently convinced themselves that their own clinical experience is a sufficient substitute. But they all should know better.



Prometheus


Note: Prometheus will be spending the next week communing with the waves and absorbing photons. Feel free to post comments, but don't expect a quick response - this will be a decidedly low-tech trip.