Are one person’s iconoclastic views another person’s denialism?

I’ve had a lot of fun thus far this week expressing more than a bit of schadenfreude over Andrew Wakefield’s being ignominiously stripped of his medical license in the U.K. by the General Medical Council, not to mention pointing out the quackfest that is Autism One, I feel the need for a brief break from the anti-vaccine craziness. This is as good a time as any to take care of some leftover business from last week that I had planned on writing about but gotten distracted by all the deliciously bad news for the anti-vaccine movement. Besides, what will be going on in Grant Park in Chicago this afternoon fits into this topic perfectly, because the anti-vaccine movement is but one “flavor” of this particular problem.

I’m referring to denialism, of course.

I must admit, I’ve had a bit of a love-hate relationship with the term denialism. The reason is simple. As many regular readers may know, my first real foray into online debate involved combatting the particularly pernicious form of denialism known as Holocaust denial. Indeed, an early post on this blog written for the 60th anniversary of the liberation of Auschwitz describes how I discovered Holocaust denial and why I’ve come to despise this particular form of denial, and Holocaust denial is a topic that, evne now, I still revisit from time to time. It’s just that I don’t do it as often as I used to, mainly because discussing science in medicine has become my primary focus. Still, my ongoing association with combatting Holocaust denial has colored my subsequent activities in combatting quackery and pseudoscience in that I never liked the word “denial” applied to anything other form of pseudoscience or pseudohistory than Holocaust denial because the word’s association with Holocaust denial, which is further inextricably linked to Hitler apologia, anti-Semitism, and Nazi-ism, both old school and neo-Nazi.

Indeed, sometimes I think the very word “denialism” hurts the cause of science because of its association with Holocaust denial. This association makes it very easy for vaccine denialists, evolution denialists (i.e., creationists), HIV/AIDS denialists, anthropogenic climate change denialists, or denialists of scientific medicine (i.e., supporters of unscientific or pseudoscientific “alternative” medicine) to retreat to the cry of the wounded self-righteous, where they claim that the label is in fact tarring them with Holocaust denialism, and all the bigotry and evil that is associated with Holocaust denial. Indeed, the very term “denialism” appears to be an attempt to keep using the term “denial” but to distance it from the the “denial” in Holocaust denial. It doesn’t work. In fact, it sometimes even sucks in people who really ought to know better.

People like Dr. Michael Fitzpatrick in the U.K., scourge of Andrew Wakefield and anti-vaccine loons everywhere, not to mention quackbuster extraordinaire, who has written an article for the New Scientist that is so misguided it was painful for me to read it.

I suspect that you’ll be able to get an inkling why reading this article caused me pain last week from just its title Living in denial: Questioning science isn’t blasphemy. Here’s a hint. Whenever you see someone use the word “blasphemy” this way in relation to science in the title of an article about cranks like anti-vaccinationists and HIV/AIDS denialists, you know that it’s probably a thinly disguised invocation of Galileo and that the article is likely to contain a lot of amazing nonsense.

In this case, it’s a massive straw man argument.

Questioning science isn’t “blasphemy”? No scientist I’m aware of says it is. What Dr. Fitzpatrick appears to be doing is conflating the very label of “denialism” with that of a church hierarchy enforcing orthodoxy. As I said before, he really ought to know better. It would save him the embarrassment of writing things like this:

The epithet “denier” is increasingly used to bash anyone who dares to question orthodoxy. Among other things, deniers are accused of subordinating science to ideology. In his book Denialism: How irrational thinking hinders scientific progress, harms the planet, and threatens our lives, for example, Michael Specter argues that denialists “replace the rigorous and open-minded scepticism of science with the inflexible certainty of ideological commitment”.

How ironic. The concept of denialism is itself inflexible, ideological and intrinsically anti-scientific. It is used to close down legitimate debate by insinuating moral deficiency in those expressing dissident views, or by drawing a parallel between popular pseudoscience movements and the racist extremists who dispute the Nazi genocide of Jews.

Not exactly. First off, note how Dr. Fitzpatrick is apparently intentionally using the more inflammatory word “denier” rather than the more commonly used term “denialist,” as if he is purposely trying to draw a line between Holocaust denial and the very term (“denialism”) that was meant to soften the connection between the two. Second, the concept of “denialism” is not inflexible, ideological, or anti-scientific. Far from it! Denialism describes how ideology trumps science, specifically, how ideologues use evidence and science fallaciously to support their ideology. It does not describe any specific outcome or what science says; it describes how ideology drives people to deny science, often without even knowing that that’s what they’re doing. Calling someone a “denialist” is not shutting down debate; it’s a shorthand for describing unsound techniques of argumentation and presenting evidence. Denialism is a set of techniques of fallacious argumentation used to support ideas that are not supported by science. It is far more than just “questioning” science, and in buying into that particular framing (yes, I’m invoking the dreaded F-word), Dr. Fitzpatrick in essence buys into the crank’s world view and then defends it against reality.

More importantly, we’re not talking about genuine scientific controversies here. There is no legitimate controversy over whether the theory of evolution is the best current explanation for the diversity of life in the scientific community. There may be a lot of legitimate controversy over elements of evolution: how it happens, the mechanisms by which it happens, what influences it the most. There isn’t, however a scientific controversy over whether it happens and whether natural selection and various other forms of selection (such as sexual selection) play a major role in guiding it. There is no serious scientific controversy over whether evolution best explains the diversity of life. Similarly, there is no real scientific controversy about whether vaccines cause autism. The evidence is overwhelming that they do not or, if they do, they do so in such a tiny proportion of the population that huge epidemiological studies have not been able to detect it. The story is the same for other denialisms: HIV/AIDS denialism, support for “alternative medicine” and various other quackery, 9/11 Truthers–the list goes on. There is no real scientific controversy. There is, however, a manufactured controversy, a “manufactroversy.”

The problem at the heart of combatting denialism is that many, probably most, people engaging in it are actually quite intelligent and have no idea that they are engaging in denialism. Of course, that’s also part of what drives denialism. People who are that intelligent all too often suffer from the “arrogance of ignorance,” where they think their self-taught “Google University” knowledge trumps that of scientists. They’re often completely sincere about it too, although in some cases promoting denialism is a tool of business interests and ideologues to counter “inconvenient” science. That is what makes education about what represents good science and, more generally, what makes a good argument, is critical. The flip side is showing what represents bad argumentation and pseudoscience is even more important, as is showing why the fallacious arguments used to support various denialist ideas is not sound and not worth taking seriously. Most people, even highly educated and intelligent people, don’t “grok” the scientific method very well. Like most humans, they value anecdotes over dry and dull scientific evidence because anecdotes engage them emotionally. As a result, they don’t understand and/or accept how easy it is to be misled by anecdotes or one’s own personal experience, given how memories and experiences are filtered through our personal biases.

I have a hard time seeing what Dr. Fitzpatrick is arguing next, but I sure find it disturbing to see coming from a person whom I would normally consider an ally in the fight to educate the public about what is good science and what is pseudoscience. First, he describes how scientists failed to respond adequately to the anti-vaccine and HIV/AIDS denialist movements:

In both cases, scientists were dilatory in responding, dismissing the movements as cranks and often appearing to believe that if they were ignored they would quietly disappear. It took five years before mainstream AIDS scientists produced a comprehensive rebuttal of Duesberg. Though child health authorities were alert to the threat of the anti-vaccine campaign, researchers were slow to respond, allowing it to gather momentum.

All of which is more or less accurate, but appears to have little relevance to the argument he appears to be making. What is Dr. Fitzpatrick saying here? What is his point? That we as scientists ignored these movements too long? That’s probably true. Scientists have a hard time accepting that anyone could believe pseudoscientific nonsense, such as anti-vaccine views or homeopathy and often view them with deserved contempt. Alternatively, many of them take on a “shruggie” attitude, where they dismiss the possibility that such ideas could catch on and just shrug their shoulders in disbelief. Understandable, but, as we have found out, profoundly misguided. Unfortunately, this confused paragraph is just the lead-in to Dr. Fitzpatrick’s apparent attempt at a coup de grace against the concept of denialism. Those who call a denialist a denialist, you see, are suppressing free speech:

Social psychologist Seth Kalichman of the University of Connecticut in Storrs mounts a typical defence of this stance in his book Denying Aids: Conspiracy theories, pseudoscience, and human tragedy. According to Kalichman, denialists often “cross the line between what could arguably be protected free speech”. He justifies suppression of debate on the feeble grounds that this would only legitimise the deniers and that scientists’ time would be better spent on research.

Such attempts to combat pseudoscience by branding it a secular form of blasphemy are illiberal and intolerant. They are also ineffective, tending not only to reinforce cynicism about science but also to promote a distrust for scientific and medical authority that provides a rallying point for pseudoscience.

Here we go with that “secular form of blasphemy” nonsense again! But what about Professor Kalichman? did he really say that? If he did, I’d be profoundly opposed to such an idea. For those of you who don’t believe me, let me remind you of my frequent broadsides against laws criminalizing Holocaust denial in the past and my harsh criticism of the imprisonment of David Irving for Holocaust denial in Austria. But Did Kalichman actually say that denialists often “cross the line between what could arguably be protected free speech”?

He did say it, but, when what he said is taken in context, no, he did not really appear to say what Dr. Fitzpatrick thinks he said. Part of Seth Kalichman‘s book is online in Google Books, and this is the relevant passage:

Most AIDS pseudoscientists argue against treating people with HIV medications because they believe that HIV does not cause AIDS. In some cases, it appears that the aims of the pseudoscientits are to make a name for themselves. Others seem to just enjoy being contrarians, gaining attention by swimming against the mainstream. It also seems that some pseudoscientists are simply trapped in a level of suspicion that filters evidence to arrive at preconceived notions. Still others may be playing out some grudge against the scientific establishment. Indeed, some may just be misguided. In any of these cases, pseudoscientists are not evil. If anything, the sense of disrespect and professional isolation experienced by AIDS pseudscientists is sad. But then there is one class of pseudoscientist that is malevolent, perhaps even evil. It is those who profit from quackery and exploit the psychologically vulnerable, such as people who diagnosed with HIV infection who are in denial. Specifically, those pseudoscientists who dissuade people with HIV from taking medications that can help them, only to sell untested remedies, vitamins, and potions cross the line between what could arguably be protected free speech and are perpetrating harm to public health.

Kalichman then goes on to describe how HIV/AIDS quacks sell ozone therapy, and all sorts of quack nostrums. He even mentions Hulda Clark and her book Cure for all HIV and AIDS, as well as Matthias Rath and Gary Null. I daresay that there is nothing in this passage from Kalichman’s book that many reading this blog would disagree with. That’s because he’s talking about quacks who are committing fraud by selling ineffective HIV treatments to people with HIV, adding later in the chapter:

It is Null, Clark, Rath, Rasnick, and Giraldo, who deserve the most severe attention because the balance between protecting free speech and protecting public health is so obviously breached.

He adds later:

Beyond the potential harm of the prodcuts themselves, taking money from the poor for bogus treatments is beyond criminal. Unlike the Loch Ness Monster and your friendly neighborhood alien abductor, vitamin pushers and AIDS quacks play a truly lethal role in denialism.

In a later chapter, Kalichman even describes some of the techniques of HIV/AIDS denialism, such as cherry picking studies, portraying science as religion (a particularly annoying and pernicious fallacy to which, quite frankly, Dr. Fitzpatrick falls victim), misrepresenting science, and a particular favorite of anti-vaccine loons, the single study fallacy. This is one where denialists will ask defenders of science to “show them one study” that, to name a few examples, proves that evolution is true; that vaccines are safe and effective; that vaccines don’t cause autism; that Hitler knew about the Holocaust; that HIV causes AIDS; that chemotherapy works. The list goes on and should be very familiar to readers of this blog.

In other words, Kalichman emphasizes that he is talking about quacks who actually profit off of denialism to the detriment of people with HIV/AIDS when he refers to denialists who may be passing beyond the realm of protected speech. He was not, as Dr. Fitzpatrick was implying, branding denialists as “often” crossing beyond the realm of protected speech. Dr. Fitzpatrick built up a massive straw man argument and then tore it down with gusto. Worse, it’s something he’s done before, for instance, in an article entitled Stop this witch hunt against ‘evil deniers’, even using the same quote from Kalichman. Whether there’s more in Kalichman’s book to justify these attacks, I don’t know. I haven’t read the whole book. I do know that Dr. Fitzpatrick appears to be rather selective in his quotes, which makes me doubt his characterization of what is in the book. Perhaps Dr. Fitzpatrick sees himself as an iconoclast, because, when the GMC was considering bringing action against Andrew Wakefield, Dr. Fitzpatrick wrote an article I don’t recall seeing before that reading now really disturbs me, in which he in essence characterized the GMC action against Wakefield as a “witch hunt” (he seems enamored of that term) and even appeared to downplay the charges that Wakefield had subjected autistic children to medically unnecessary invasive tests as part of his study as not being worthy of major sanctions.

Whatever the case, Dr. Fitzpatrick’s article appears to be a response to an article that had previously appeared in The New Scientist entitled State of Denial, in particular Why Sensible People Reject the Truth. In general, the article is very good and hits a lot of the right notes about what defines denialism. The only really bad note the article hits is this:

The first thing to note is that denial finds its most fertile ground in areas where the science must be taken on trust. There is no denial of antibiotics, which visibly work. But there is denial of vaccines, which we are merely told will prevent diseases – diseases, moreover, which most of us have never seen, ironically because the vaccines work.

And I would postulate that the author of this article, Debora MacKenzie, is incredibly naive and inexperienced if she thinks there is “no denial” that antibiotics work. Heck, as I’ve written before, there are whole branches of “alternative” medicine that deny germ theory itself! Since the use of antibiotics depends on germ theory being true, that necessarily means these branches of alternative medicine also deny the efficacy of antibiotics. Indeed, it never ceases to amaze me the degree to which denialists will deny well-settled science. MacKenzie also ticks me off a bit when she writes:

The conservative character of much denial may also explain its success at winning hearts and minds.

George Lakoff, a cognitive psychologist at the University of California, Berkeley, argues that conservatives have been better than progressives at exploiting anecdote and emotion to win arguments. Progressives tend to think that giving people the facts and figures will inevitably lead them to the right conclusions. They see anecdotes as inadmissible evidence, and appeals to emotion as wrong.

I would point out that a lot of anti-vaccine nonsense comes from “progressives,” as does a lot of support for “alternative medicine” of the very type that denies germ theory and the efficacy of antibiotics. Bill Maher, for instance, has cast doubt on germ theory, trashed vaccines, promoted cancer quackery, and rubbished “Western medicine” time and time again. Liberal blog The Huffington Post is a cesspit of pseudoscience when it comes to medicine. Denialism is not a province of the right; it is bipartisan. The difference tends to be what is being denied, although the anti-vaccine movement can appeal to Tea Party types and Arianna Huffington groupies in equal measures. The difference is science, reason, and understanding evidence; as MacKenzie points out, scientists tend to dismiss anecdotes–and quite rightly so.

Still, MacKenzie regains a lot of points in my book for mentioning JPANDS, which I’ve written a lot about before. Here’s what she says:

Consider, too, the journal of the Association of American Physicians and Surgeons, a lobbying group for private medicine. It showcases nearly all denialist causes. In the past two years it has published articles claiming that HIV tests do not detect HIV, second-hand smoke does little harm, smoking bans do not reduce heart attacks, global warming presents little health threat and proposals for a US vaccination registry are “not really about vaccines but about establishing a computer infrastructure… that can be used for other purposes later”. It repeatedly published discredited assertions that vaccines cause autism.

It is tempting to wonder if activists sympathetic to climate and evolution denial might be grasping opportunities to discredit science in general by spreading vaccine and HIV denialism.

Apparently MacKenzie has heard of the “vindication of all kooks” corollary to the principle of crank magnetism. Discrediting science itself is viewed as a tactic among denialists.

All of this leaves the question of what to be done. Although I have strongly criticized Dr. Fitzpatrick for his straw man deconstructions used to criticize the term “denialism,” I do agree with him that the answer to speech that is pseudoscientific is not suppression but rather refutation. I even agree with him that there is the possibility of overusing the term. Where we part ways is Dr. Fitzpatrick’s apparent belief that telling it like it is (calling denialism denialism) is somehow fascistic (he all but uses the word) and crushes free speech. He is not alone in this. Keith Kahn-Harris voiced similar concerns in less apocalyptic terms in an article in The New Humanist:

A problem soon arises, though, when the term denialism is stretched too far, when it is used to reduce the possibility for debate. Michael Spectre in his recently published Denialism: How Irrational Thinking Hinders Scientific Progress, Harms the Planet, and Threatens Our Lives runs this risk in his treatment of campaigns against vaccination and GM food as well as activism for alternative medicine as forms of denialism. While there is pseudo-science in all these areas, there are legitimate doubts to be raised about aspects of western medicine and biotechnology and many of those who fall into Spectre’s denialism camp are at least initially motivated by reasonable concerns. Similarly, Thabo Mbeki’s AIDS denialism was arguably initially motivated by legitimate reservations about the pharmaceutical industry, though it continued long past the time these concerns had been addressed, with devastating effects on AIDS sufferers in South Africa (as Seth Kalichman argued in these pages in 2009).

But There can be something oppressive and undemocratic about reducing disagreement – however irrational or ridiculous – to denialism. This raises difficult questions about the political and analytical utility of denialism as a concept.

I actually agree that Michael Specter went a bit too far with his rah-rah for genetically modified food in his book to the point that it disturbed me, but much of the rest of it was quite good. However, Kahn-Harris is profoundly misguided when he characterizes activism for “alternative medicine” as merely having “pseudoscience in it” (it is, in fact, infused with pseudoscience through and through) and based somewhat on “legitimate doubts about aspects of Western medicine.” First, there is no such thing as “Western medicine.” There is scientific medicine, which is not inherently Western. Kahn-Harris apparently buys into the false “East/West” characterization of medicine. Moreover, alt-med activists in fact hijack legitimate concerns and then blow them up out of all proportion to their true importance in order to promote their pseudoscience. Kahn-Harris’ characterization of AIDS denialism as initially being motivated by “legitimate concerns” about the pharmaceutical industry is even more off base and offensive. Finally, his mention of the campaign against vaccines as being possibly “stretching the term ‘denialism’ too far.” Take a look, for example, at what is going on in Chicago today at Autism One and the anti-vaccine rally in Grant Park. We can argue about what sorts of attacks on science do and don’t constitute “denialism,” but I would posit that, if the anti-vaccine movement doesn’t represent denialism in its purest form, I don’t know what does.

In the end, I don’t agree with those who would call the term “denialism” unhelpful or counterproductive. It’s a convenient and useful word to describe a specific set of fallacious approaches to science and argumentation. However, I understand that the term can be misused. I even sympathize with Dr. Fitzpatrick to some extent, although I agree with Mark Hoofnagle in thinking he’s carried his dislike of the term to the point of alleging false persecution and attacking Seth Kalichman without a sound justification. It’s depressing, actually, but it is Kahn-Harris’ reaction that is perhaps the most disturbing. While Dr. Fitzpatrick is generally on the side of science but seems to have an iconoclast’s love of the outsider to the point of decrying “witch hunts” even against Andrew Wakefield and a libertarian’s attachment to free speech so strong that he mistakenly labels attempts to uphold professional standards and/or to answer pseudoscientific arguments as “suppressing” free speech, Kahn-Harris illustrates that, even among academics who decry denialist tactics, there can be a great deal of selectivity in what they consider “denialism.” After all, he appears to be all for calling the denialist campaign against the science showing tobacco smoke causes lung cancer and heart disease “denialism” because it was big corporations that fought the science. In marked contrast, to him it’s “stretching” the term “denialism” too far to apply it to the anti-vaccine movement, HIV/AIDS denialists, and promoters of alternative medicine, because to him these pseudoscientific movements are (or were initially) based in part based on “legitimate” or “reasonable” concerns about big pharma. That’s right. To Kahn-Harris, it’s “denialism” if a corporation engages in ideology-driven attacks on science (AGW, tobacco) but not “denialism” if those opposed to big corporations do it (vaccines, alternative medicine, HIV/AIDS denialism), an obvious ideologically-derived double standard.

All of this shows is that, like any term that makes a value judgment, “denialism” can be misused, and people will graft onto it their own political ideology. That doesn’t mean the term should be discarded. It just means that those of us who use it need to be very careful that we are not throwing it around lightly.