Pharyngula

This is a rather chilling story of academic freedom getting trampled. A whole pile of documentation is available at that link, I’ll try to simplify it down a lot.

UC Davis was sponsoring a public seminar on prostate cancer; specifically, they were actively promoting the prostate specific antigen (PSA) test. One professor, Michael Wilkes, objected — the PSA test is now discouraged as worse than useless. Wilkes is a specialist in prostate cancer; he knew this. Heck, I knew this, and my local MD knows this. He explained to the department that was sponsoring the seminar that it was wrong, and he also published an op-ed in the San Francisco Chronicle that does a very good job of explaining why tests with lots of false positives and false negatives are no good.

UC Davis just announced a seminar for the public on “men’s health.” That title notwithstanding, the program appears to be entirely about prostate cancer and in particular about the prostate specific antigen screening test. Prostate cancer can be devastating, and the PSA is intended to find cancer early – in time to do something about it.

If only it were that simple. Research has shown that there are steps people can take to improve the quality and length of their lives, even before they’re having any symptoms. (That’s what “screening” for disease is.)

Unfortunately, though, the devil’s in the details, and many possible screening programs turn out not to do any good – and in fact some tests like PSA cause harm. That’s why virtually all expert public health panels do not recommend the PSA test.

A blood test that isn’t accurate can fail to find disease that’s present, leading to false reassurance. It can also report disease when it’s not really there, leading to unnecessary use of other tests (like biopsy) that are not so benign. Perhaps most concerning, the PSA test frequently identifies something that qualifies as cancer under a microscope but acts nothing like cancer in real life. That is to say, the large majority of PSA-discovered “cancers” would never cause any problem whatsoever if they went undetected.

But because doctors can’t tell whether one of these “cancers” is benign (as it usually is), or might occasionally be one of the bad actors, finding something through screening invariably leads to treating it.

Most of the men so treated would have been just fine if they never knew about the cancer. But when they’re treated (whether with surgery, radiation or chemotherapy), the majority suffer really life- affecting effects, such as impotence and/or incontinence. That’s why both of the two very large trials of PSA screening published in 2009 found no (or at most a tiny) benefit, but a great deal of harm.

Wilkes was doing exactly what a responsible scientist ought to do, correcting public misinformation about his field of expertise.

Unfortunately, a dean, an associate dean, and the Health System counsel at UC Davis were very upset that a professor was criticizing a public health program that they were putting on. Never mind that they were dispensing unsound health information; he was dissing their turf. Among other things, they responded by threatening Wilkes academic appointment and and taking away his lab space.

The good news in the end, though, is that the UC Davis Committee on Academic Freedom and Responsibility has come through; reviewing the case, they’ve determined that Wilkins’ academic freedom was violated and slapped down the various administrators who’d punished him for being a responsible public scholar.

I’m wondering, though, how often these kinds of cases come up and the scholarly responsibilities are squelched. For a lot of people, these are tough decisions: their livelihood can be threatened and their ability to do the work they love compromised. I’m incredibly fortunate in my case to have tenure at a university that so far has demonstrated a commendable commitment to academic freedom — I can publicly declare that my university’s Center for Spirituality and Healing is a colossal boondoggle and complete betrayal of reason and responsibility, and my job is still safe.

But then, I know of other cases. I have a colleague at another university who learned that they were offering seminars that were far worse than what UC Davis was doing — we’re talking New Age bullshit by a con artist who is promising to teach magic powers — and so wrote a polite letter to the individuals in charge of the program. The response was a complete blow-off, an endorsement of the charlatan, and a gentle suggestion that my colleague’s nose ought to stay out of this affair, or risk being an unemployed appendage. I am itching to scream bloody outrage at this nonsense, but I can’t…it’s not my job that would be on the line.

So tell me…who else is experiencing quackery and bullshit peddled through their place of employment, and can’t speak out because your administration is staffed by pandering ignoramuses? Dish, please. Anonymity will be respected.