Dr. Steven Novella, an academic neurologist, President of the New England Skeptical Society, and organizer of what's become my favorite skeptical podcast, The Skeptics' Guide to the Universe, took the time to weigh in on the Nature Neuroscience article that I discussed the other day and that engendered dozens of comments, as posts about antivaccination irrationality tend to do around here.
Besides my being interested in what a neurologist has to say about these issues, the reason that I want to bring your attention to his article is because he issues a clarion call to arms for those who defend science and rationality against pseudoscience and quackery:
Unfortunately the result is that the crazies are raising a frenzied din that is getting the attention of the media and may even be affecting public policy, while the scientists who know better are cowed into avoidance.[...]
I will also extend the call to all of so-called complementary and alternative medicine (CAM). CAM is nothing less than an assault on the scientific underpinnings of modern medicine. It is an eclectic collection of anti-scientific ideology, new age nonsense, bad science, and discarded notions. It survives by political intimidation, the ad-populi logical fallacy, a misapplication of multi-culturalism and "open mindedness", anti-establishment sentiment, misplaced appeals to freedom, fraud, cons, slick marketing, wishful thinking, scientific illiteracy, and blatant anti-science. The goal of CAM advocates is to create a double standard within medicine - a standard for them in which all of the quality control of evidence, academic and intellectual honesty, and even basic common sense do not apply.
The only thing Steve forgot to mention is that you and I, the U.S. taxpayers, now help to fund this effort through the National Center for Complementary and Alternative Medicine. Meanwhile, skeptics like Steven or me are attacked as "microfascists "(or even worse) for simply insisting that the standards of evidence should be the same for all medicine, whether "alternative" or "conventional."
I think perhaps the largest driving force behind CAM is a fairly widespread perception that the medical industry in general and pharmaceuticals specifically have failed to maintain the best interest of the patients as a priority, and with some justification, exceptions aside.
I work under the assumption that CEOs and industry spokesmen are psychopaths and lie through their teeth. But for all that pharmaceutical companies do find treatments that work. More than that CAM is hardly proof against psychopaths either, nor indeed is religion. The conventional medical establishment at least has some mechanisms, inadequate as they may be, to protect patients from scams (or merely ineffective treatments, as the case may be).
It all comes down to money. It appears that a good woo advertiser can bring in a tremendous amount of cash. How sad is that? Thanks to all you heavy-hitters for fighting the woo.
The rather worn-out CAM canard about pharmaceutical companies ("Big Pharma") being only interested in the money is true to a point. They are interested in the money, because that is what pays their salaries and keeps the factories running and the research happening. And, I suppose, they would disregard human health if it interfered with profits, except that:
[1] People getting sick or dying from your drugs is really bad advertising.
[2] They have to prove that the drugs are safe and affective before they market them - it's the law.
[3] They also have to monitor their drugs after they go to market in order to pick up problems that weren't detected in the Phase III study - it's also the law.
[4] They are legally liable for any injury caused by their drugs.
So, even if the companies were run by money-grubbing sociopaths with no conscience (and some may be), their own best interests (i.e. profit margin) depend on producing a quality product that works and is safe.
CAM, on the other hand, is delightfully free of most (if not all) regulation, without even insurance company oversight to keep it in check. And the profit motive is - alas! - alive and well in CAM, as it is in all human endeavors, as evidenced by their fees and sales of proprietary "medications". If the CAM practitioners were solely interested in promoting "wellness" and "optimum health", they could charge much less than they do.
There is a double-standard in play here. "Mainstream" medicine and "Big Pharma" are suspect because they make money within the framework of a maze of rules and regulations, while CAM practitioners - many of whom are making money hand over fist with no regulation at all - are held up as saviors and saints.
Prometheus
... is patented, requires many applications, and is heavily prescribed (including some situations in which a competitor's drug or no drug at all may have been more appropriate). In short, their interests are only somewhat aligned with those of their customers. (And of course, companies aren't monoliths; the various employees have interests of their own). I'd say that's capitalism, but more fundamentally I think that's life.
So what is to be done? I don't think there is much to be done other than mitigate the worst excesses of corporatism with judicious regulation and socialism, as indeed has already been done.
And I was hasty in calling the CEOs and shills psychopaths. I see the corporate system as rewarding certain types of psychopathic behaviour, but given the right environment quite decent people can be induced to act in quite amoral (and immoral) ways. I think it wise to assume CEOs and their shills will act like psychopaths; the state of their souls is not my interest.
Oh, absolutely. Were the same critical approach applied to CAM that I just applied to "mainstream" medicine the results would not be pretty. At the end of the day I'll be sticking to "mainstream" medicine for my health needs.
What's really annoying is that the Big Pharma Gambit is too often successful: I typically feel compelled to point out the stupidity of the bloated multi-national corporate conspiracy, instead of demanding that quacks raise their standards up to at least the strict standards we hold pharmaceuticals to.
Prof. Baum has just published a strongly-worded piece in a UK newspaper: Homeopathy is worse than witchcraft - and the NHS must stop paying for it. He discusses the absurdity of spending money on a homeopathy hospital in his area when they can not afford some of the newer cancer drugs that he would like to offer patients. However, some of his solution is as follows:
Possibly, Dr. Novella would regard Prof. Baum suggestion as supportive of "anti-scientific ideology, new age nonsense, bad science, and discarded notions"? It would have been useful if the article had linked to the critical evaluations mentioned by Baum.