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.

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Denier: Someone who plugs their ears and chants as evidence is being presented.

Skeptic: Someone who listens to the evidence, takes notes, checks the arguments against known scientific principles, debates the evidence even with himself, and the comes to a conclusion which may be subject to change should better, more compelling evidence come about.

Disclaimer: A stupid declaration that these opinions are my own, imposed on me by people above my pay grade.

By Rene Najera (not verified) on 26 May 2010 #permalink

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.

So how exactly is one supposed to tell the difference between your run-of-the-mill spittle-flecked crank who can be safely ignored, and the sort of dangerous crank who's going to start a major movement? Seems to me, you can only tell which ones are going to take off after the fact, and we can't spend all our time refuting every swivel-eyed loon on every street corner... Nobody thinks Gene Ray needs to be taken seriously.

I do agree with him that the answer to speech that is pseudoscientific is not suppression but rather refutation.

I think everybody does. I have never seen anyone call for the actual suppression of stupid ideas. I guess since the loss of our favourite totalitarian bogeyman, people have forgotten what real suppression looks like. (Not that there's any shortage of it, but it's no longer being exemplified by an Official Enemy...)

I think many universities ought to sponsor Skeptical Thinking departments. These universities could then take it in turn to refute unsupported ideas. A network of kook watches should be dead easy to setup with the interwebs & all and a round-robin response should be locally, regionally or nationally assigned.

Students in these departments would get instruction in dealing with kooks, writing cogent science based responses, training in researching refuting material and a boost to their writing and presentation skills. Annual contests for the best (worst?) kook and best refutations could be added.

I think many universities ought to sponsor Skeptical Thinking departments. These universities could then take it in turn to refute unsupported ideas.

It's not directly on point, but the late Robert Heinlein had something rather like this in his novel "Space Cadet." (Spare the snickering; it didn't have same meaning then.) Much of the story is set in a sort-of military academy, a bit like Annapolis or West Point, only it's in orbit and is training future officers of the Space Patrol.

One of the required seminars is called "Doubt." The leader of the seminar tosses out a proposition that directly attacks conventional wisdom, and the cadets have to bat it around. The seminar was instituted by the commandant of the academy, to attempt to undermine the conservativism that infests most any military organization. Just to give you an idea, the first one attended by the protagonist of the story has the theme "Resolved: that the Patrol is a detriment and should be abolished."

I think this is a great idea and I'd love to see more of it.

I agree with you that denalism can be misused. Every now and then I get into arguments online about whether cutting government spending always results in a worsening of the recession, and I've noticed that every now and then I get called a denalist or the equivalent of a creationist or something like that. (see Dilan Esper at http://volokh.com/2009/11/09/more-on-california-tax-services-model-will…, if you can bear it).

And this is after the global economic crisis, which I would have thought would have convinced any non-creationist that macroeconomics was not as well-established a science as the law of evolution. (Note, I have a degree in economics, and my macroeconomic lecturer did a very good job of criticising various macroeconomic theories long before the latest global economic crisis).

In both cases, scientists were dilatory in responding

This introductory phrase from Dr. Fitzpatrick [note: Orac, you may want to change references in your post to him as "Fitzgerald" --ORAC NOTE: Brain fart leading to alternating between "Fitzpatrick" and "Fitzgerald," fixed.) set off alarm bells for me.

In my professional career I've had to develop effective ways of determining which experts know what they're talking about and which don't, regarding issues with which I have little personal familiarity. One of the types of "expert" I tend to steer clear of is the person who quickly fastens on a conclusion, while over many years it's been borne out to me again and again that those who take time and demand an extraordinary amount of evidence before they will come to even tentative conclusions are those who in the end are most reliable.

Yes, this habit of long thought and waiting for the evidence to come in before responding can seem dilatory to outsiders, and tends to lose easy debating points in a "sound bite" culture, but funny how these folks are the ones who seem to come up with the correct answers eventually.

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.

I dunno, I think she has a point here. She does not say "only" fetile ground, she says "most" fertile ground, and from that perspective, the contrasting antibiotics/vaccines examples are apt. Antibiotics denialists exists, but are they nearly so pervasive as vaccine denialists? I'm pretty sure it's not even close.

I think she goes a bit to far with the phrase "where the science must be taken on trust", but the rest of the paragraph elaborates what she means: Denialism, while universally pervasive, tends to be most concentrated on issues where there is no visceral day-to-day evidence of efficacy. To check all the hot buttons:

Evolution -- The majority of evolution that can be observed on a human timescale requires a lab or careful observations to detect. Common descent ought to be painfully obvious to anyone who thinks about it, but you know how good people are at thinking...

Global warming -- There's a reason that public belief in AGW spikes during unseasonably warm weather and wanes during unseasonably cool weather, even though those localized changes generally have very little to do with global trends.

Vaccines -- Even most doctors have never seen a lot of the diseases we are vaccinating against.

Second-hand smoke -- It's much easier to intuitively accept that a 3-pack-a-day smoker coughing up a lung each morning is increasing her risk of cancer than it is to accept that someone who has no obvious ill effects from their exposure to SHS is also increasing his risk.

HIV/AIDS -- This one doesn't fit as well, though the time-delay between contraction of HIV and onset of AIDS symptoms provides an assist for the denialists.

Holocaust denial -- This is the only hot button denialist issue I can think of for which damning evidence is visible... though that is changing as the remaining survivors die off.

Anyway, I don't think the author was off-base at all with that paragraph. Denialism can take root anywhere, of course, but it tends to flourish on those topics where people can't get a visceral day-to-day exposure to the phenomenon.

Denialism is an extreme form of confirmation bias. Confirmation bias is an error of thought that everybody, scientists included, is vulnerable to, but science includes a variety of disciplines that are designed to counteract this tendency: statistics, peer review, mathematical modeling, placebo controls, blinded evaluation of data. Even then, an occasional scientist will fall into this trap, falling "in love" with a pet hypothesis, cherry-picking the data that fits, and nit-picking and rejecting anything that does not. Scientists seem to be particularly vulnerable to this when they move out of their "home" field into one in which they are less familiar with the evidence and less aware of the potential biases and artifacts. Also, some scientists seem to lose intellectual flexibility later life, and may become less able to "let go" of an appealing hypothesis that does not fit the evidence.

Often, denialist movements seem to accrete around a "maverick scientist" of this sort. The followers tend to be scientific amateurs who are enthusiastic about science, but who lack the scientific training and practical experience that leads working researchers to be wary of self-deception. Romantic (and often exaggerated) stories of famous scientists who have challenged orthodoxy and turned out to be correct can lead to exaggerated regard for a scientist who espouses an unpopular point of view. Young scientists often start out with this notion, but quickly discover that most of the time, their own orthodoxy-challenging hypotheses do not survive confrontation with the evidence.

As many have noted that engineers and physicians seem to be particularly vulnerable, probably because they are in a field that makes heavy use of scientific knowledge, and may imagine themselves to be scientists, but do not do research themselves and are not fully aware of the intellectual and practical pitfalls. They are thus particularly vulnerable to confirmation bias, especially when it relates to a hypothesis that they find ideologically appealing.

James Sweet - I like your characterisation. I will add in that, while the Internet has let me know of people who deny that we need food (called breatharians), firstly there's a lot fewer of them than of any of the denalist positions you list (admittedly there's an obvious reason for such a shortage).

And secondly I have yet to run across someone, even on the Internet, who denies the existance of heavier-than-air-flying-machines.

It's not directly on point, but the late Robert Heinlein had something rather like this in his novel "Space Cadet."

Along the same lines was the test with some buttons and logic gates where the stated objective was impossible and the REAL objective was to figure that out.

One of my favorite Heinleins...

I like Rene.

I also like that there is good science supporting some dietary supplements. And that information gets twisted by the woo and the commentators on this blog to either amount to salvation or the end of times. Extremes on both end have hijacked this conversation to the point where little progress can be made on establishing safe guidelines on what works, what doesn't and how to best get it out to those who need it. How to best regulate industry so MD's can confidently prescribe things like CoQ10 and Omega-3's PA & DHA; prescribe them knowing that the products are safe, effective and regulated quality wise. It is regulated, it needs more. To say that it isn't so is akin to saying that cars are unregulated and unsafe by looking at a couple models of toyota. Is it 100% perfect, no but neither is the pharmaceutical industry, nor the medical parts industry, hell our food supply has substantial problems as well.

I am not conflating the good with the bad. Gary Null and Hilda clark are wrong. Mercola is about money, his own name and nothing else. Most benefits of supplements are not just overstated, many are flat out wrong. As is the ideas behind how and if they work But to put ALL of them in that basket is the same ideological mistake as putting vaccines in with vioxx, celebrex or even thalidomide. Merck & Co., Inc. (Rahway, NJ) knows better as does the American Heart Association .

Orac is relatively mild when it comes to insulting people, some people have been hurt by surgeons, their pain is real. There are parents who are hurting and have no answers as to why their child has autism, and the vitriol hurled at them is disgusting. They are hurt and mad as hell, and granted they are wrong about vaccinations. There is a reason why researchers shouldn't be primary care physicians. Probably the same reason is why you have not defeated the PR campaign from the anti-vax crowd. You have to address their needs, and to find that out requires investigating, not lecturing. Find out why they the individual have the fears and reservations they have. Antagonizing them and coming off as a smart ass won't help. It feels good, but won't make a difference.

Oh yeah... Huff-po is vaux-gressieve, they are libertarian* market rules folks.

*caveat emptor

Denialism is simply a sloppy term for all the reasons you point out in the early paragraphs. It works well enough for popular, for blogs and for other less-than-precise forms or argumentation, but that's about it. The problem is that no singular term really can be applied reliably to problems of piss-poor thinking in history and biology. It has the danger of becoming a popular term and of being turned against scientists for all the wrong reasons, in much the same way "politically correct" has been turned against good causes that have originated on the left. So be careful in using denialism too much. Even if Holocaust deniers, creationists, and anti-vax nut cases are all in denial about reliable forms of knowledge, they are there for very different reasons and should be insulted for different reasons.

By Gopherus Agassizii (not verified) on 26 May 2010 #permalink

@MikeMa

That's a fantastic idea. I think it should start before university, since critical thinking skills are going to be the foundation of the success of the next generation, but having centres of academic excellence devoted to refuting pseudoscience would be an amazing and powerful tool.

'their self-taught "Google University" knowledge trumps that of scientists.'

Objectively, of course, self-taught skeptics have sometimes proven to be correct when herds of scientists were going the wrong way. Eugenics is one obvious example.

By Harry Eagar (not verified) on 26 May 2010 #permalink

I actually agree with most of what Clayton said, but I have to call you out on this point:

There is a reason why researchers shouldn't be primary care physicians. Probably the same reason is why you have not defeated the PR campaign from the anti-vax crowd.

Really? You're really making that same old argument, that if only we were just nice to her, Jenny McCarthy would stop being anti-vaccine? Please.

On an individual level, if someone is questioning whether they should vaccinate their child, I agree that the approach needs to be one of outreach. Insult and vitriol will always backfire on an individual level. However, on a movement level, it's not clear that outreach does any good whatsoever, a fair amount of anecdotal evidence that it is counter-productive, and even some peer-reviewed evidence that suggests that the "shout louder" technique is the most effective.

So while I think the first sentence I quoted is a fair point, the second sentence does not follow, nor does it bear any relation to reality. Sorry.

Overall, I agree with most of Clayton's post, though. My heart breaks for people whose children have autism or other serious issues and for whom there are no good answers. Dealing effectively with tragedies of unknown cause is something very few humans can manage.

I must object to

There are parents who are hurting and have no answers as to why their child has autism, and the vitriol hurled at them is disgusting.

I very, very rarely see any vitriol hurled at confused parents - and when it happens, whoever did it is called on it. The vitriol is reserved for those who use fraud, lies, and deception against the confused parents - like Wankerfield and McCarthy.

Objectively, of course, self-taught skeptics have sometimes proven to be correct when herds of scientists were going the wrong way. Eugenics is one obvious example.

Yes, and the race is not always to the swift, nor the battle to the strong, but that's the way to bet.

The fact that stopped clocks are occasionally right--and indeed are exactly right more often than most working clocks--is not an argument for consulting a broken clock when you want to know the time.

@ 14:

I don't think that eugenics is such an obvious example. Was it the case that a clear majority of practicing scientists in the relevant fields were advocating eugenics?

You made the claim, you supply the evidence, please.

By Composer99 (not verified) on 26 May 2010 #permalink

Personality predicts success in medical school, says new study by U of Minnesota professor

Sweet james, I see that I made an stretch on my statement about researchers.

And in no way do I think you can reach out to people who have in essence think you are the "enemy". But it may be more of a matter of winning the daily struggle and showing patients that Dr's really do care. Which when they do, they actually help heal wounds. If they act like a Dr I had, who basically walked in, looked at my skin, excised the "thing" on my face, and began to walk out with out really saying much, I asked what it could be, his reaction, well it could be cancer or something harmless. we'll find out in a couple of days.

2 minutes with that guy ruined my week. Luckily it was a weird wart and nothing else. I never went to him again, he could have learned something from my Dr that I grew up with. First smile, talk, and above all care for the patient.

I've also sat for 2 hours in a room waiting to be seen by a physician after my cornea was lacerated. He left the building and never informed the nurses. Pretty nice way to spend an evening in urgent care. Or this other time....get the picture.

Side note, I dated a nurse who had a magnet on her fridge, "Be nice to nurses, we keep doctors from killing you." I laughed when I saw it, and she said it wasn't really a joke; many, if I remember the distinction she made, young Dr's are to arrogant to ask vital questions etc.

Sweat james
listen to the chinese masters,
Part 1 The book of leadership and strategy.
On warfare.

It is all about winning the hearts and minds of the followers, it weakens the leaders.

It's not fast in this manner, and i fear an outbreak of preventable diseases may begin to break their ranks, or if they are conspiracy theorists ...well they will blame anybody but themselves. They will never eat crow, never. All we can hope is that scientific practices combined with humanity and empathy show them how we all want which is best, and are not out to poison their children etc.

I would point out that a lot of anti-vaccine nonsense comes from "progressives,"... 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.

I think the relevant ideological spectrum here is not progressive vs conservative but libertarian vs communitarian/authoritarian. Denialism flourishes in places that have an arguably overdeveloped libertarian tradition (such as the US) or are reacting to past totalitarianism. In medicine the hot button issues are vaccination and the control of infectious diseases including HIV/AIDS because they are to do with public health (which epidemiologist Elizabeth Pisani describes as 'inherently a somewhat fascist discipline').

The fact that libertarianism distributes across the left-right axis makes for some interesting bedfellows. In HIV/AIDS denialism, for example, it's not uncommon to find radical gays from the left rubbing shoulders with fundamentalist Christians on the right. But the ideological commonality is an overdeveloped sense of individual "rights" to the exclusion of collective responsibility, and particularly to government and other authority.

it's not uncommon to find radical gays from the left rubbing shoulders with fundamentalist Christians on the right.

Or lifting their luggage.

Bah-ZING!

There is some great discussion going on about the use of the term "denier" and "denialism".

Climate change "sceptics" are smarting over the use of the label "denier", claiming it's a pejorative term and a simple ad hominim attack. Their preferred term is "sceptic".

But this is a deliberate attempt to co-opt language. Just like the term "climate change" was meant to sound less threatening than "global warming", tyring to label themselves as "sceptics" is an attempt to legitimise their bogus arguments. This is a "debate the controversy" strategy. Make it seem you have a legitimate point and the media and public will think there is a debate.

Why concede to their demands?

Related to this discussion is how does one define a sceptic? Michael Shermer outlines it in his contribution to the New Scientists special:

"WHAT is the difference between a sceptic and a denier? When I call myself a sceptic, I mean that I take a scientific approach to the evaluation of claims. A climate sceptic, for example, examines specific claims one by one, carefully considers the evidence for each, and is willing to follow the facts wherever they lead. A climate denier has a position staked out in advance, and sorts through the data employing "confirmation bias" - the tendency to look for and find confirmatory evidence for pre-existing beliefs and ignore or dismiss the rest..."

http://www.newscientist.com/article/mg20627606.000-living-in-denial-whe…

I think Shermer hits the nail on the head: yes, there are some in the climate sceptic movement who may feel they are genuine sceptics, but in order to maintain that "scepticism" in the face of overwhelming evidence for AGW one must *deny* not only the evidence, but the qualifications and expertise of scientists. In order to maintain denial, one has to wave away thousands of research papers.

This scepticism can only be maintained by desperately holding onto proven falsehoods: No Mrs Nova, you are not a sceptic

http://watchingthedeniers.wordpress.com/2010/05/18/no-mrs-nova-you-are-…

I understand the argument that we can be too liberal in throwing about "denier" as an insult, but let's be frank... The climate is changing, and in ways that are not going to make life comfortable. If we do not arrest CO2 emissions, then there is the potential for things to get very bad.

Already in Tennessee you've seen record breaking rain fall that has claimed dozens of lives. Climate Progress rightfully calls this a "super storm":

"...I have never seen a map like this before, but then that may be because there simply arenât many events to rival this one. Look at the red streak, which is the area hit by a greater than 1000-year deluge. And look at how much of western Tennessee was slammed with a greater than 500 year downpour...."

http://climateprogress.org/2010/05/26/nashville-katrina-tennessee-super…

A "hard rain is gonna fall". Is this climate change? Perhaps. Perhaps not. And yet it's the hottest year on record so far combined with record snowfalls. Arctic summer ice is heading towards it's lowest levels (coverage/thickness). Global "weirding" is here. Now. Not in the future. And it's going to accelerate.

Now, I write a blog called "Watching the deniers" (heh). Obviously I've received flak for that choice of title. I was motivated to begin it for two reasons:

1) the failure of COP15
2) my personal outrage over the manufactured "Climategate" [cough] scandal [cough]

Let's remember there is no scientific debate about AGW. The debate is manufactured. The deniers have been instrumental confusing the public and slowing our response to mitigating climate change. That's what motivates me. And yes, that angers me. We have the evidence, but we are still stuck debating the reality?

I may sound harsh, but spare me the feigned wounded feelings of the deniers.

Individuals like Marc Morano who are PR hacks pretending to engage in a scientific "debate" are intellectually bankrupt spin doctors. Monckton is a compulsive liar.

Show instead of deniers, let's call them "climate change liars". They won't like that either, even though they lie.

The science is understood, we know what is happening and we know how serious an issue is.

We have precedents for this kind of tragedy already.

AIDs denial cost the lives of over 300,000 South Africans. Those who denied the HIV-AIDs connection *are* morally responsible. AGW has the potential to devastate the lives of millions. Those who deny the effectiveness of vaccines *has* cost lives. They *are* morally responsible. How many died due to the tobacco companies strategy to deny the link between cancer and smoking?

Thus, we have a clear line of responsibility between known falsehoods, the general public being confused by their arguments and the dead and injured.

Why do we need to protect the feelings of these people? Should we not name and shame those who deny the reality of AGW? Shouldn't we stop pretending there is a scientific debate, and simply say "You're wrong, and you keep denying the evidence!"

But does it make those of us who use the term "denier" sound shrill, judgemental? Does that not "isolate" the mainstream/undecided?

That's the same charge people throw at Dawkins et.al. for being vocal atheists. Shhhhh, don't be so noisy about your disbelief, you might hurt someone's feelings!

As climatologist Michael Mann said some time ago this is a street fight. Yes, it would be nice to sit down and simply debate the evidence and have everyone arrive at a rational conclusion.

But for 20 years, the denial movement has been calling scientists "frauds", "liars" and charging them with conspiracy theories. They've sent death threats, hacked into university computers and corrupted the debate in the media. They've accepted tens of millions from the like of Exxon.

So, now they retreat into their caves all wounded, tearful at being called "deniers".

Let's call them what they are.

Denier. Liar. Fraud. Hack. Spin doctor. Hired Gun. Mercenary. Mountebank.

Regarding the Fitzpatrick views on the GMC pursuing Wakefield, I too was initially rather uncomfortable with the concept. I thought it was using a hammer to crack a nut.

Fitzpatrick wrote his spiked piece in 2006, and as we know, some of the worst of Wakefield's excesses and duplicitous actions only properly came to light after this time.

So Wakefield really was a nut, just a massive one, and it did need the GMC hammer to crack it. To give them their credit, the GMC did the right thing. Very prescient of them. I am sure Fitzpatrick would not now, 4 years later, with all the evidence in plain sight, call the actions of the GMC a witch hunt.

One of the dangers of using "denialist" is that it has very strong political implications.

A rabid eco-greenie who thinks, despite all the science, that all GM foods are evil is not called a denialist. He might be thought a bit over the top, but "his heart is in the right place".

But a well-educated person who happens to doubt the CO2 warming hypothesis is a full on "denier". Even if no other crank tendencies are exhibited and the doubt is that - doubt.

Holocaust denial = definite denier. Denying that Bolshevism is evil = a bit out of touch, silly sausage.

I can hear some readers spluttering "but GM is evil" and "the Bolsheviks meant well". To me they are in denial. But apparently they are not afforded the term.

When the apologists for Bolshevism and the eco-loony are also called "deniers", then I will believe that the term is used fairly for all those who refuse to accept the obvious.

Until then, I suggest it is a heavily politicized term.

I suggest it is a heavily politicized term.

I agree. And it's a heavily politicised phenomenon that it describes.

The problem comes from failing to recognise that denialism is primarily an ideological activity, and has little or nothing to do with bona fide scientific (or historical) debate. That's just a charade for the benefit of the target constituency.

So Wakefield really was a nut, just a massive one, and it did need the GMC hammer to crack it. To give them their credit, the GMC did the right thing. Very prescient of them. I am sure Fitzpatrick would not now, 4 years later, with all the evidence in plain sight, call the actions of the GMC a witch hunt.

Uh, yes he would, I suspect. He all but uses that term in the first article to which I linked (from just last week, by the way), and is latest article in Spiked is still arguing that the GMC's action against Wakefield is "censoring" him or using the power of the state to shut up "scientific dissent."

When the apologists for Bolshevism and the eco-loony are also called "deniers", then I will believe that the term is used fairly for all those who refuse to accept the obvious.

Until then, I suggest it is a heavily politicized term.

Uh, but Michael Specter, for one, did label GMO loonies "denialists," and correctly as well. Certainly I was not claiming otherwise and had no real quibble with his use of the label. My criticism of Specter's book was that he went way too far in the other direction, namely presenting GMO as a panacea that will feed the world and end hunger with virtually no possibility of serious problems.

Mark P -

Actually, I've used similar terms in relation to Nuclear power, the arguments against which are frequently denialist in style.

But perhaps it's more that - at least online - I rarely find anyone actually claiming that GM foods are evil, or that Bolshevism leads to a equitable relationship between citizen and state. I suppose I could argue both cases if you want a bit of fairness?

By Andrew Dodds (not verified) on 27 May 2010 #permalink

For the antivaxxers, I prefer the Ratbags.com term "anti-vaccination liars"
Just sayin...

By SkydiverIm (not verified) on 27 May 2010 #permalink

No event in human history has been studied more thoroughly and carefully than the Holocaust. Thousands of thesis and dissertations papers have poured over mountains of data, from physical evidence and anecdotal testimony to captured German war documents. Virtually everyone with a PhD in History will stake their career on the fact that millions of Jews were systematically exterminated by Nazi Germany. One can no more "revise" this fact than one can revise the existence of gravity. Wannsee Conference records prove that Nazis planned the extermination of Jews as, "The Final Solution." German concentration camp records prove that it was carried out.

Whenever we stand up to those who deny or minimize genocide we send a critical message to the world. As we continue to live in an age of genocide and ethnic cleansing, we must repel the broken ethics of our ancestors, or risk a dreadful repeat of past transgressions.

Holocaust deniers ply their mendacious poison everywhere, especially with young people on the Internet. Deniers seek to distort the truth in a way that promotes antagonism against the object of their hatred, or to deny the culpability of their ancestors and heroes. If we ignore them, they will twist the minds of countless young people, creating a new generation of those who deny the facts of the worst episode of genocide in history. Freedom of speech and the press is a symbol of a healthy society. Yet, since no crime in history is as heinous as the Holocaust, its memory must be accurately preserved, to protect our children and grandchildren.

Museums and mandatory public education are tools to dispel bigotry, especially racial and ethnic hatred. Books, plays, films and presentations can reinforce the veracity of past and present genocides. They help to tell the true story of the perpetrators of genocide; and they reveal the abject terror, humiliation and degradation resulting from blind prejudice. It is therefore essential that we disclose the factual brutality and horror of genocide, combating the deniersâ virulent, inaccurate historical revision. We must protect vulnerable future generations from making the same mistakes.

A world that continues to allow genocide requires ethical remediation. We must insist that religious, racial, ethnic, gender and orientation persecution is wrong; and that tolerance is our progeny's only hope. Only through such efforts can we reveal the true horror of genocide and promote the triumphant spirit of humankind.

Charles Weinblatt
Author, "Jacob's Courage"
http://jacobscourage.wordpress.com/

Mr. Weinblatt,

While I appreciate the sentiment, I do not appreciate your using my blog to hawk your book. I Googled the first paragraph of your comment and came up with dozens of articles where you commented using exactly the same text. Regardless of the sentiment, this is not cool. It is exceedingly bad manners as far as blog behavior goes. In fact, it's abusive. To me, it's clear that you must have a Google alert set up for the term "Holocaust denial" or something similar, and then you go and post the identical comment with a link to the blog for your book. This might not be so annoying were it not for the fact that your cut 'n' paste comment is at best tangentially related to the topic of this blog post.

You have a post on your weblog about what you learned about book publishing:

http://cweinblatt.wordpress.com/2010/01/25/video-trailer-for-jacobs-cou…

What you clearly didn't learn is what is considered abusive promotion in the blogosphere and what is not. Stop it.

Orac,

I think you have this all wrong. I donât mean to be inflammatory in any way and I hope you can just take this criticism for what it is, âconstructive criticismâ

First off, you seem to disagree with his assessment of the âdenierâ, being ideological and anti-science, but then you immediately write âFar from it! Denialism describes how ideology trumps science, specifically, how ideologues use evidence and science fallaciously to support their ideologyâ Wait, denialism describes how ideology trumps science? This seem to be exactly the same as saying the denier is ideological, and therefore, anti-science. Whatever, this is just a minor point.

Either way, I agree with that statement, but I also agree that the relationship between the âdenierâ and person labeling said âdenierâ can be in some cases, extremely ironic.

Letâs use your situation as an example here. You believe anti-vaccinationists are âdeniersâ, people who let their ideology of ânot vaccinatingâ trump the available science, Right? The ideology that they promote is that of not vaccinating and the thrust of their argument becomes emotional and disconnected from the science.

I think the irony comes from the fact that the counter position âpro-vaccinationâ is also ideological and irrelevant in the context of answering the question as to whether vaccines cause an altered neuro developmental trajectory. Just like the antivaccinationists that you ridicule, devolving your argument into an argument of why people should get vaccinated, how much more terrible the actual pathogens are, how many babies get saved, etc only serves to further disconnect your stance from science and become ideological in nature. Ask yourself, do any of the above mentioned talking points of âpro-vaccinationâ actually have any bearing on the âscienceâ of a possible connection between altered neurodevelopmental trajectories, commonly referred to as autism? No, is the simple answer. You need to actually research the autism literature as well as a plethora of ancillary research to be able to scientifically debate or discuss vaccines and autism in the same context.

I envision the âdenierâ situation described by you and Fitzpatrick much like a spectrum where the ends or extremes are brought together in a circular fashion. Both extremes are embodied by ideology trumping science and a general predominance of âarrogance of ignoranceâ. I think that you can split this circle at its equator and envision anything in the top half dominated by ideology, whereas the bottom half is where âscientific reasonâ predominates. Furthermore, I think you could label the top as unproductive, negative, inert; and the bottom could be labeled as productive, progressive, and positive. This once again is in line with what Fitzpatrick comments.

For evidence of this we need to look no further than the ideological battle playing out between anti and pro vaccination factions. The level of argument has regressed to a purely ideological. The result is a debate that is constantly bombarded with irrelevant rhetoric pertaining to getting vaccinated or not. This is obviously an emotional topic and therefore the impasse quickly turns into a negative bashing fest for both sides. The end result is that the productivity in answering important scientific questions falls to zero and we donât progress, and the reason is, because both sides have become so entrenched in their ideologies that they have forgotten to examine the science in a rigorous and objective fashion.

âIt 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.â

This bit couldnât be more ironic. Orac, you have denied plenty of important science and continually partake in unsound techniques of argumentation and presenting evidence. Do you really think it is a âsoundâ practice to solely base your scientific opinion off of epidemiological evidence? Even when there exist many different lines of evidence, from many disciplines which could play an important part informing your understanding of how vaccines could play a part in dictating neurodevelopmental trajectory?

In my humble opinion, the act of neglecting varying lines of evidence and therefore objectivity, when supporting your position, can only arise when the person arguing takes an ideological approach. Case in point, Orac, maintains the ideological position of âpro-vaccinationâ and therefore is content with what the epidemiological studies tell him, for, they support his ideology. There is no need for him to dig further into the many lines of basic science which would invariably increase his knowledge and objectivity on this subject.

As tough as biomedical research is in cancer[autism], to my mind far tougher is research trying to tease out the relationship between environmental exposures and cancer[autism] risk. If you want complicated, that's complicated. For one thing, obtaining epidemiological data is incredibly labor- and cost-intensive, and rarely are the data clear cut. There's always ambiguity, not to mention numerous confounding factors that conspire to exaggerate on the one hand or hide on the other hand correlations between environmental exposures and cancer[autism]. As a result, studies are often conflicting, and making sense of the morass of often contradictory studies can tax even the most skillful scientists and epidemiologists. Communicating the science and epidemiology linking environment and cancer[autism] to the public is even harder.

I have added in brackets the word âautismâ, because I think this whole paragraph aptly describes the situation one encounters when trying to tease out complex relationships between autism risk and environment using epidemiological data. I would venture to guess, based on the paragraph above, that you would find it unsound to draw inflexible conclusions about the etiological contribution of environmental factors to cancer initiation and progression, based on epidemiological evidence alone. It seems rather self evident that accessing the lines of basic research, animal model research and clinical evidence and synergising these other avenues of research with epidemiological research would be a much more âscientifically soundâ tactic.

Epidemiological studies are necessary, but we have to start to develop methodologies in which there is a rapprochement between the epidemiological study and the basic biological mechanisms underlying altered neurodevelopmental trajectories. It should be noted that since many cases of ASD are still considered idiopathic this is going to be hard to do in the current era. Nonetheless, important advances are being made in the field of neuroimmunology, genetics and epigenetics relating to the etiology of psychiatric disorders, and couple this with the advances that are being made in medical informatics and you find yourself on the brink of a new era in epidemiology.

The key to answering these questions will probably come from very well designed epidemiological studies where biological tissue specimens, genetic and epigenetic data are collected prospectively (pre natally through childhood) and then examined in a ânested case controlâ fashion, where children who do develop ASDâs are compared to children that do not.

I guess this is why I am a bit perplexed why nobody seems to understand that a vaccinated vs vaccinated study could be very informing if designed correctly. It seems that ideology has overwhelmed many of you and in a sense, shut off your âscientific reasoningâ, which in turn brings the needed progress to a grinding halt. So letâs drop the emotional rhetoric and ideology and start becoming, âpassionlessâ in our pursuit of answers. Hey, the irony of all of this is that the future may hold vaccines as a the most promising therapeutic approach for modulating neural immune interactions and either preventing the onset of development disorders or thwarting their progress. This would be a full circle approach that many idealogues probably just wonât swallow (or inject).

â 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.â

This is a good example of arrogance of ignorance. (At least on this subject). As you have stated this is a prerequisite of a âdenier:â Ironically, it is a common fault at the other end of the spectrum, which as I stated before connects to the âdenierâ extreme in a circular fashion. So, once again another attribute of a denier happens to be a mainstay of the person labeling the denier.

Have you really taken the time to stay abreast of all the science that would be required to think about the question of vaccines impacting neurodevelopment? Would you be able to point someone in the correct (objective) direction if they asked you; what is the current state of research pertaining to autism, as an immunological etiology, and a possible role of vaccines?

I will show you an example from a recent article in Neuron (from the esteemed Cell Press) that exemplifies a perception that, to me, would fit nicely in the âscientific reasonâ or bottom part of the circular diagram that I have described. In this way it contrasts nicely with your âarrogantly ignorantâ derived position that there is no real scientific controversy. I have been reading this blog for about a year, maybe a little more, and to this date havenât seen any substantial reference to any relevant âscienceâ (from you or the many regulars that comment here) that would help you to understand the potential avenues of research and scientific debate.

Finally, neural-immune crosstalk also has profound implications for public health policy. Growing evidence that maternal immune activation could increase the incidence of autism or schizophrenia in offspring suggests that healthcare providers should revisit the pros and cons of using anti-inflammatory drugs in pregnancy with the goal of developing drugs that prevent a proinflammatory response in the CNS without damaging the fetus. Another issue for society right now is whether, and when, pregnant mothers should be given the seasonal flu and H1N1 vaccines. While the flu can be extremely harmful to pregnant women, the effects of stimulating the immune response with two flu vaccines during pregnancy are unknown.
Absent the luxury of waiting for large-scale study results, recommendations that pregnant women receive both vaccines
are valid based on current knowledge of the dangers of natural flu infection during gestation. However, since the negative effects of immune stimulation during pregnancy are likely determined by susceptibility factors, our understanding of factors that cause aberrant baseline immune responses in some pregnant women must be improved and better methods for susceptibility screening developed soon. It is also important to note that neuralimmune crosstalk could be affected by the current schedule of childhood immunizations. Although there is some epidemiological evidence that immunizations are
not likely to have a direct role in the ontogeny of autism (Immunization Safety Review Committee, 2004), it is still possible that responses to the number and combinations of vaccinations given at some visits could contribute to cognitive changes in children who may already have altered immune responses. Natural infections in an individual with a dysfunctional immune system might have an equally deleterious effect. Thus, a better understanding of the effects of immune activation during gestation and early postnatal development, especially in the context of increased disease susceptibility, will be critical to either validate our current health policies or modify them for specific populations of individuals.

Notice how the author is able to simultaneously maintain the position that current vaccination recommendations are valid, but there are avenues of research that need to be more thoroughly explored based on a growing body of research in neuroimmunology. Contrast this with the Oracian view that there is no scientific controversy, itâs done dadaâ and you are a crank if you want to bother looking at a possible connection. On top of that you are potentially harming little babies and kids because you may be promoting an anti-vaccine stance that in the long run will maim little kids. This approach seems to rely more on ideology, and emotion, lacking any sort of indication of critical thinking. If you are content with remaining ignorant of the growing body of research into the neuroimmunological aspects of altered neurodevelopmental trajectories (sorry for always using this longhand way of saying âautism spectrum disordersâ) then, so be it, but at least recognize this and make it apparent to your readers that you really donât know âjackâ about current autism research, in particular, research which could and should be discussed and debated openly (which, to your credit, I do believe you strive for this, itâs just that âarrogance of ignoranceâ is paradoxical in that you are not aware of what you donât knowâ)

Once again, IMHO, this position is a clear example of what Fitzpatrick says:

âIt is used to close down legitimate debate by insinuating moral deficiency in those expressing dissident viewsâ

I would implore you to reassess your position and decide if it is truly derived from the rigorous study of the many lines of science, or, what seems to be much more likely, that it is derived from an entrenched ideological position of provaccination. I would be happy to share resources with you that you could read, so that you could promote a more open and honest debate. Once again, this debate wouldnât be about vaccinating or not vaccinating, it would more likely be a discussion to gain:

âa better understanding of the effects of immune activation during gestation and early postnatal development, especially in the context of increased disease susceptibilityâ

You may just have to become a âpassionless droneâ to discuss this without getting caught up in all the anti-pro vax emotional rhetoric. But hey, that is what science is all about, becoming more objective through open discussion, and I have a lot of confidence that if you spearheaded this position many would follow and potentially great progress would ensue. This is only possible if we recognize that conflating anti-and provax positions with the actual âscienceâ of autism, is simply, ideological and non-productive.

By skeptiquette (not verified) on 01 Jun 2010 #permalink

Binstock, you wouldn't know what science is, even if it came up and but you on your posterior.

I think skeptiquette has just managed to use the predictable "rebuttal" strategy of labeling a supporter of science-based medicine who criticizes vaccine denialism as a "denialist."

Gee, like I haven't seen that one before.

Binstock, you wouldn't know what science is, even if it came up and but you on your posterior

Are you talking to me? um, just wondering because I am not Binstock.

Do you really think you are a psychic?

In regards to the part after the reference to Binstock, would you be so kind as to level some specific criticisms as to what I wrote. The general hand waving that âBinstockâ (who you apparently think is me) wouldnât know science, yada yada yada is rather devoid of anything to respond to. I guess I will have to await a more well reasoned response.

By skeptiquette (not verified) on 01 Jun 2010 #permalink

I think skeptiquette has just managed to use the predictable "rebuttal" strategy of labeling a supporter of science-based medicine who criticizes vaccine denialism as a "denialist."

It seems like you missed the entire point and actually proved my point further.

Once again you are conflating vaccine denialism, which is the idea some people have that vaccines are not efficacious, with the scientific question of understanding the neuroimmunological impact of vaccines in susceptible populations. I was not criticizing you because you âcritisize vaccine denialismâ I understand how vaccines work and where the science of vaccines is headed. I was making an argument that we have to seperate this ideological based position far away from the scienctific questions that need to be posed. Otherwise, we get bogged down in irrelevant discussions about vaccines working or not.

Gee, like I haven't seen that one before.

Gee, you missed the point, try again.

By skeptiquette (not verified) on 01 Jun 2010 #permalink

Oh, I didn't miss the point, and I have seen that one before. The problem is that the two issues are both part of vaccine denialism; they are inextricably related by the denialists themselves, who both proclaim that vaccines cause all these neurodevelopmental problems AND that they aren't effective. The two "arguments" are both part and parcel of vaccine denialism because it allows the antivaxers to argue that not only do vaccines cause horrible problems and are too risky, but they're not even that effective! Both have to be countered. There is no conflict.

As I said, I've seen this sort of challenge before. It does not impress me, as I've been at this a long time now.

Oh, I didn't miss the point, and I have seen that one before.

I beg to differ, and I still donât think that you know what you are talking about.

The problem is that the two issues are both part of vaccine denialism;

Sure, itâs a problem when you have entrenched yourself as an ideologue set out to fight vaccine denialism; not so much when you are examing the science, its pretty easy to see that the two donât have any scientific relevance to eachother. In otherwords, the fact that vaccines work, doesnât automatically conclude that they have no bearing on neurodevelopmental trajectories. Likewise, if vaccines have a bearing on neurodevelopmental trajectories, one canât make the conclusion that they are not very effective. Plain and simple, these are just separate scientific issues.

they are inextricably related by the denialists themselves.â

I will reiterate: this has no impact on the validity of the science of either issue.

who both proclaim that vaccines cause all these neurodevelopmental problems AND that they aren't effective.

Yawn, weâve been over this a couple times now.

The two "arguments" are both part and parcel of vaccine denialism because it allows the antivaxers to argue that not only do vaccines cause horrible problems and are too risky, but they're not even that effective!

And apparently it is part and parcel for you to continue to conflate the two issues in a most illogical way because it allows you to evade the science and do exactly what Fitzpatrick stated:
âclose down legitimate debate by insinuating moral deficiency in those expressing dissident viewsâ

âBoth have to be countered. There is no conflict.â

Spoken like a true idealogue

As I said, I've seen this sort of challenge before.

What, to think logically? Great, what did you do that time?

It does not impress me

Youâre not the only one that is not impressed, in fact if you are the paragon of science-based medicine then I donât think I want to join the club.

as I've been at this a long time now.

All the more reason you should have learned why conflating the two issues is illogical and scientifically unproductive.

By skeptiquette (not verified) on 01 Jun 2010 #permalink

Sure, itâs a problem when you have entrenched yourself as an ideologue set out to fight vaccine denialism; not so much when you are examing the science, its pretty easy to see that the two donât have any scientific relevance to eachother. In otherwords, the fact that vaccines work, doesnât automatically conclude that they have no bearing on neurodevelopmental trajectories. Likewise, if vaccines have a bearing on neurodevelopmental trajectories, one canât make the conclusion that they are not very effective. Plain and simple, these are just separate scientific issues.

So what? Both are claims made by vaccine denialists. You seem not to understand the term "denialism." The claim that vaccines cause autism is a denial of the well established science indicating that they almost certainly do not. Denying the efficacy of vaccines is denying the science showing that vaccines work. Pointing this out (or "conflating the issues," as you put it) is not in any way being a "rigid ideologue" or using a label to "suppress dissent." It is simply acknowledging a tactic of anti-vaccine activists themselves.

I will reiterate: this has no impact on the validity of the science of either issue.

Who said it did? And, again, so what?

And I will reiterate: Both contentions, the claims of no vaccine efficacy and the claims of autism and other neurodevelopmental conditions caused by vaccines are based on either no science, pseudoscience, or bad science--as are pretty much all the claims of antivaxers. I will reiterate once again: Both contentions are conflated by antivaxers to frighten parents. When the leaders do it, I believe they do it both cynically and intentionally.

Spoken like a true idealogue

And you speak someone who believes some of the pseudoscientific claims of antivaxers (such as the claims of neurologic injury) but not others (that vaccines don't work). You don't mind labeling those who deny the efficacy of vaccines "vaccine denialists," but you get your knickers all in a bundle when I add to that the denial of the science showing that vaccines don't cause all those horrible neurological outcomes attributed to them by antivaccine loons.