Oh, no! Orac the “Scientific Fundamentalist” has been too insolent!

Last week, I wrote about how Senator Tom Harkin is up to his old shenanigans again, trying at ever turn to do for the actual practice of quackery what he did for the research of quackery by creating the National Center for Complementary and Alternative Medicine (NCCAM) and what he still does to promote quackery by berating NCCAM for in essence being too scientific in not having validated enough of his cherished woo. In essence, Harkin has slipped a provision into the Senate version of the 600+ page health care reform bill that is currently taking shape in Congress that included funding for “community wellness programs,” which, if science-based, would be a good thing, but which, when sponsored by a quackery supporter like Tom Harkin, is usually woo-speak for including all manner of unscientific “alternative” medical modalities and dubious dietary advice, usually with supplements. As I’ve characterized it before, you can look at it as a “bait and switch,” in which CAM advocates appropriate sensible, science-based modalities like diet and exercise as being “alternative” (the bait) and then use that to argue that the woo they associate with such modalities (up to even pure woo like reiki or homeopathy) is effective (the switch).

Another provision that laid bare Harkin’s true plans, however, was the one he also slipped into the bill that includes “alternative” medicine practitioners as part of the bill’s definition of the “health care workforce.” That’s part of the Trojan Horse aspect of what Harkin’s trying to do. In the belly of a sturdy-looking offering lurks a whole lot of pseudoscience. It doesn’t take too much consideration to realize that the reason for this provision is almost certainly to lay the groundwork for requiring the government to pay for “alternative” medicine services, and, as the government goes, so too goes the private health insurance industry, at least when it comes to what health care services will be funded. As you might imagine, I was not too happy about this. Indeed, I was a bit snarky. Probably no more snarky than usual on this topic, but entertainingly snarky enough.

Apparently I hurt someone’s feelings, or at least riled him up.

Here’s one kind of science I despise, the smug up-its-own-ass kind that thinks all you have to do is go around being a smart-arse and everyone will realise what idiots they’ve been and come and sit at your feet with rapt attention…

Um, well, no, not exactly. I mix the smart-arse stuff with a lot of scientific evidence. On one day, I may be a smart-arse, so to speak, and on another day I’m analyzing the latest cancer research. I like to think that variety is what keeps this blog traffic up there as consistently number three or four among ScienceBloggers, behind P.Z. and Ed (and the occasional interloper). I have a distinct viewpoint, a science- and evidence-based approach to medicine, and a niche that I filled four years ago. The main topics generally include alternative medicine, science-based medicine, anti-vaccine lunacy (which, shockingly, I haven’t written much about in a while; I may have to remedy that), skepticism and critical thinking, with a coterie of less frequent topics, such as evolution versus creationism. I’ve built up my blog and my “brand” over four years. I certainly didn’t get to where I am now by simply being a smart-ass and hoping to get people to sit at my feet with rapt attention. Indeed, although I like the traffic as much as anyone, I’d probably still be doing this if I had even 1/10 of the traffic, which is what I did have at about the one year mark after starting this blog.

But let’s see what our friend’s real complaint is:

I have to say here that I’m not a person who’s impressed by reiki or homeopathy but I’m pretty sure most of us consider chiropractors to be a useful therapy. And some would even go so far as to include the above-mentioned and add acupuncturists as well. After all, it’s what works for you, right? That’s why I can’t stand the tone of this guy’s article and am pushing this article out. If the Catholic church had its way, we’d still be curing our ills by holding prayer sessions and subsisting on bread and water to toughen us up… Similarly, if this guy has his way, we’ll just stick with Big Pharma using us as guinea pigs for newer drugs with ever more “interesting” side effects…

There we go. Now, we’re talking! Get it all out. Liken science-based medicine to a religion and “alternative” medicine to Galileo! I knew he wanted to, and he’s finally made his belief plain. Note first how he tries to show us how seemingly reasonable he is by disavowing the more ridiculously implausible bits of alt-med, such as homeopathy and reiki. It’s the old “because I don’t believe total nonsense believe me when I support this other, less egregiously nonsensical nonsense” ploy. He’s also pulling the old “mean,” “hateful,” and “arrogant” doggerel, with a dash of the “science is just another religion” thrown in for good measure. Of course, one could point out that at the time of Galileo, pretty much all that could be done for serious illness was to pray. Oh, and bleeding, leeches, and purges with toxic heavy metals or the placement of nasty poultices to draw out the evil humors. That was the medicine of the time. It was science that overcame that. It took hundreds of years, but we actually have effective medicines and treatments for many illnesses and vaccines to prevent other illnesses. And, yes, a huge part of scientific medicine is effective pharmaceutical drugs, but it’s far more than just drugs. Our unhappy friend falls into the common trap that alt-med mavens fall into, namely that “science-based medicine = pharmaceuticals.”

Our friend also loves him some straw men:

But something I’m even more afraid of than someone like Sn Harkin, though, is the kind of person who sneers and thinks just calling something “woo” means that’s it, the end of the matter, everyone has to agree with me now, thank you all very much you poor misguided shills you.

Uh, no. If you read my blog, you’ll find copious examples where I explain exactly why I consider something to be pseudoscience or, as I like to call it, “woo.” Provide me with evidence to show my characterization to be wrong, and I’ll reconsider. Whining about my characterizing it as “woo” as though I’m trying to shut off debate is just silly. Our friend also doesn’t understand the scientific method:

What I’m saying is – where does your “respectful insolence” stop? My grandma prescribed camomile tea for certain ailments, other herbs for others. Her knowledge was not learned in a University, it was passed down from one generation to the next – generations that had little better to do than exist, work, and observe the effects of certain herbs on certain illnesses and pass that knowledge on to their offspring. It’s how all our advances were made at one stage. It’s how pharmacology came to exist.

Is that “woo?”

Ah, yes, the appeal to ancient wisdom, also known as the appeal to antiquity. My grandma does it; so it must be as good as science! All those ancient people did it; so it must be comparable to modern science. Here’s the problem. As I’ve explained time and time again, anecdotal evidence can be very deceiving, and the plural of “anecdotes” is not “data.” Those ancient healers also thought for hundreds of years that bleeding was a great treatment for what ails you. They did it by working, observing the effects of bleeding on various ills, and then passing that knowledge on. True, if an effect is really marked, such as a poison that kills, anecdotal evidence can be fine. Give a couple of people a poisonous herb and see that they immediately got really sick, and that’s pretty good evidence that it’s toxic. However, most illnesses and most treatments aren’t that black and white. The placebo effect, regression to the mean, and the self-limited nature of many illnesses can easily make it appear that a useless remedy (homeopathy, anyone?) or even a potentially harmful remedy (purging with antimony or arsenic, anyone?) actually does some good. That’s why it became increasingly appreciated that the scientific method, with proper controls and blinding, is necessary to determine what really works better than a placebo. As I’ve tried to school a certain anti-vaccine pediatrician time and time again, humans are easily fooled. They easily confuse correlation with causation. It takes a certain humility to realize how easily we can be fooled and why the scientific method is so necessary. Many alt-med mavens either don’t understand that or, like the aforementioned pediatrician, refuse to accept it.

But the grand finale really cracked me up:

What about we say that “proper” pharmaceutical companies are the only thing that doesn’t constitute “woo.” Oh dear, they actually have a worse record than the animals and my granny. Because my granny never prescribed anything to me that caused severe side effects or death. And yet, every year, we hear about another drug from big pharma that has caused a spate of deaths or injuries or disablements…

Your granny also never prescribed anything to you that would cure a serious illness, either. It’s all a matter of risk versus benefits. The reason we tolerate worse side effects for cancer treatment is because, well, many cancers will kill you if left untreated. I don’t hear granny saying that her soup will cure cancer. I do hear a lot of quacks claiming that their brand of pseudoscience or mystical rearrangement of the flow of your qi will cure cancer.

I love this last part, a total tu quoque logical fallacy:

Are surgeons the only medical people that aren’t “pitching woo?” In my experience and reading, their success rates are not all that crash hot either. They kill more people by direct action than all the faith healers kill by “wooing” someone into ignoring symptoms. Oh yeah – and they come from a long line of bloodletters, “animal magnetists,” and people who thought leeches and maggots would cure blood problems and infections. Oh wait, they’re bringing those back in mainstream medicine, aren’t they?

Oooh, I’m so insulted. Of course, I’ve been critical of my profession when it is too slow to stop doing procedures that don’t work; but let’s get one thing straight. There are some problems that only surgery can fix and some diseases that only surgery can cure. Once again, it’s a matter of risk versus benefit. But nice try. Our friend apparently thinks it’s not so bad for quacks to “woo” someone into eschewing effective therapy because scientific medicine, in his mind, is so much worse. As for maggots and leeches, if science can show them to be useful for medical purposes, I have no objection.

Finally, our friend reiterates his science as a religion meme. He even pulls out the F-word:

And yes I in general agree with scientific rationalism, agree that science has most of the answers. What I don’t agree with is the schoolboy name-calling, the slightly pious and fervent tone of moral rectitude. That’s not rational.

That’s how fundamentalists protect their desmesnes and their beliefs. And there’s few things as dangerous as a fundamentalist, especially a Scientific Fundamentalist.

A “scientific fundamentalist.” What on earth is that? Science is not religion. Unlike religion, it is inherently self-correcting in that it ultimately throws out ideas that the evidence doesn’t support. True, it may take a lot longer than we would like. It may be a lot messier than we like, and this messiness gives supporters of woo endless ammunition to paint science as being wrong all the time, leading them to ask how science can dismiss pseudoscience when it changes its precepts seemingly so often.

As for “schoolboy name-calling,” if our friend is so upset by my labeling acupuncture and aspects of chiropractic “woo” and promoters of such modalities, “woo-meisters,” he really does have a thin skin.