On moderation

Reluctant as I am to endorse anything on America's Shittiest Website, this article should be required reading for any politically active atheist. It's written as advice for social conservatives/political evangelicals, but for reasons which have implications I won't get into, it applies equally well to the New Atheists or whatever their favored term is these days.

Maggie Gallagher, a loon associated with various fringe evangelical projects like limiting access to marriage and complaining loudly about how much sex everyone else is having, observes:

Social conservatives simply have not been in politics. We lack institutions that can defeat our enemies and directly assist our friends.

After a while, threatening to leave the coalition unless the coalition does what you want gets old. And tiring. And ineffective. It makes your allies not like you very much. Social conservatives talk like that because it's our one lever of power.

I happen to think that you could pipe that through sed 's/Social conservative/Atheist/' and have it still work. Note also her observation that political action groups (broadly construed) "job [is] to make it easy for politicians to do what they ask, not the other way around."

I wouldn't bother raising the point, except that PZ Myers said something stupid, false, and categorically unhelpful to anyone and everyone who might want to help him. Reacting to cases where people refuse their children medical care on religious grounds, PZ writes:

These are cases of religion gone pathological, of belief so absurd and so deep that it denies truth and has overt negative consequences. Moderate Christian believers will read about this and dismiss it as irrelevant to their faith; sure, they'd pray, but they'd also get their children in to legitimate doctors who would give them effective treatment.

I have to say something that is heartfelt, and is also meant to offend. I do not absolve you mealy-mouthed moderates, I do not regard your beliefs as harmless. If Colleen Hauser or Leilani Neumann were in your church, you'd tell them to get medical care, but you'd also validate their belief in prayers. You would provide the soothing background muzak that says prayer is good, prayer is virtuous, prayer will connect you to the great lord who can do anything, prayer will give you solace in your time of worry. You would not raise your voice to say that prayer is useless, prayer is self-defeating, that while prayer might make you feel better while your child is suffering, that is no virtue. You pray yourselves. You think it is a noble and generous act for your representatives to prowl the corridors of hospitals, preying on the desperation of the sick. You abase yourselves before false hopes, and sacrifice human dignity on an altar built from the bones of the dead. You would spread the poison, piously excusing yourselves because you only want to administer sub-lethal doses.

I like PZ, he's a great science writer, and he's done great things to build a real community of atheists, skeptics, and allies. But the power he's gotten as an opinionmaker carries some responsibility, and I find this line of argument not just wrong, but irresponsible.

Prayer and religion more broadly certainly lead people away from proper medical care, but it also helps people choose to get the treatment they need. When my grandmother, a devout Lutheran, was thinking about getting a pacemaker, she was understandably nervous. As she did whenever she had a tough choice to make, she prayed over it. On one hand, she felt that her situation may have been God's will, and getting a pacemaker might be interfering with that plan. On the other hand, she noted that God had also given her access to modern medicine, and a doctor who discovered a treatable condition in time to get a pacemaker that would avert trouble. After much prayer and consideration, she got the pacemaker.

To say that she is responsible for the deaths of people who reach the opposite conclusion is stupid and offensive. PZ has described his own mother as a believing Lutheran, and I bet she's done the same thing. To the extent that people take PZ's message to heart, it leads away from any productive dialog, demonizing people for their private behavior, even if their substantive public behavior is no different than PZ's. They get sick, they go to the doctor, and they get better. Whether or not they pray at home, who really cares?

Furthermore, the suggestion that prayer is irrelevant to medical outcomes is unsupported by facts. It's true that intercessory prayer (where one person prays for someone else) is useless, but studies do tend to show that patients who pray have better outcomes than those who don't (or at least are no worse off). This is obviously an example of the placebo effect, but when someone's ill, every little bit helps, and there's no reason to rail against someone who avails him or herself of an effective adjunct to medical intervention if it has no ill effects and possible positive ones.

The problem comes when someone substitutes supernatural intervention for medical intervention. That's what PZ is highlighting in the cases of Colleen Hauser and Leilani Neumann. PZ tries to make anyone who prays equivalent to those few parents whose religious beliefs lead them to negligent, if not homicidal, acts. Why? Because they validate belief that "prayer will give you solace in your time of worry." Sure, PZ acknowledges that "prayer might make you feel better while your child is suffering," which looks a lot like "giv[ing] solace in your time of worry." But he also thinks "that is no virtue." Why giving comfort in a time of need is virtueless is never explained, and doesn't really seem to follow. It may not cure what ails you physically, but having a sick family member is only moderately less stressful than being fired. Anything that helps reduce that stress is unquestionably virtuous.

PZ's commission of the generic fallacy here is unfortunate, and it has the danger of backfiring, since the style of argument could be coopted and thrown back at him. Religious wingnuts periodically insist that atheism leads to genocide, citing as "evidence" the claim that Pol Pot, Stalin, and the architects of the French Revolution's Terror were atheists. This argument is obviously wrong. It's stupid, it's insulting, and it mischaracterizes both history and atheism. Atheists and their allies are consistent in slapping this silly argument down, and doing so forcefully. That said, it seems fair to argue that the atheism of the French Revolutionaries was a major factor in their homicidal rampage. Their aim was to eradicate the irrational, and they did so through notably violent means.

Christopher Orlet, writing against this fallacious argument at Butterflies and Wheels, presents the standard counterargument, pointing out that this is a fallacious style of argument, and in any event, it gets the details wrong:

The atrocities of the French revolutionaries were caused not by their new-found atheism, so much as by their hatred of the ancien regime and its close alliance with the Church, coupled with their desire for liberty and justice and a desire to access the wealth of church property and to minimize the power of the clergy.

To summarize, they weren't really reacting against religion per se, but against the particular cultural influence that Catholicism exerted over 18th century France. And that's fair. I'll note, though, that PZ himself identifies his general strategy as, "show what a botch [American Christian] theists have made of the country, and how hypocritical they are, and how absurd their beliefs are," an agenda that isn't so far removed from Orlet's description of the French Revolutionaries'. Not identical, and not leading to the same place, I'll emphasize. But if we're to distinguish late 18th century French atheism from modern forms of atheism, and if we're to distinguish reactions focused on one form of religion from reactions against religion in general, it would also be wise to ensure that we do not erroneously generalize attacks on one form of religion to attacks on all religion. Or generalize attacks on some ways of understanding prayer to attacks on all acts of prayer. If details matter, then details matter.

Some religions do lead practitioners to reject needed medical care for themselves or for their children.

Some religions do lead practitioners to reject science education in general or in some particular.

But other religions encourage medical care, and encourage scientific research. Lumping them all together is false.

Over 11,000 clergy have signed onto a statement declaring "To argue that God’s loving plan of salvation for humanity precludes the full employment of the God-given faculty of reason is to attempt to limit God, an act of hubris." That's a theology incompatible with forcing creationism into schools (or evolution out), and incompatible with substituting prayer for medical interventions. To lump them in with parents who let their children die without care is simply false, and it's a slander. These clergy and their flocks are PZ's allies on 99% of his public policy concerns. In their private lives, they do things that he doesn't do, things he finds useless and they find helpful. I don't know why he cares what they do behind closed doors, but he does, and he's free to try to change their minds, but this won't help.

PZ's point about chaplains in hospitals is well-taken. If I'm ever laid up in a hospital, I don't want someone bothering me with religious hokum. If they want to pray for me, and they do it without bothering me about it, I honestly don't care. Everyone needs a hobby. When I'm going through hard times and someone tells me they're praying for me, I thank them for their concern and move on. I don't give them a lecture alleging that they are complicit in the negligent homicides of sick children. Doing so would not just be rude, it would contradict any effort I might want to make to convince them that there are more effective uses of their time.

To a degree, this reflects the different goals that PZ and I have. I want to protect the public sphere (and especially the science classroom), from sectarian religious incursions. PZ wants atheism to triumph over religion. But I would humbly suggest that our difference also reflects my greater experience in politics.

Setting aside Maggie Gallagher's advice (which, however sage, comes from a dubious source), my thoughts on this are based partly on Freedom Singer and civil rights activist Bernice Johnson Reagon's advice, "If you're in a coalition and you're comfortable, you know it's not a broad enough coalition." Political change is about building successful coalitions. PZ's rhetoric here, blaming anyone who ever said a prayer for the deaths of other people's children, makes it impossible to build a broader coalition for any sort of change that he might favor. If I were PZ, with the megaphone and the influence he has, I'd be looking for ways to draw in allies and to broaden my coalition. That wouldn't mean moderating my views; he should always be forthrightly and openly opposed to religion if that's what he thinks is important. If I were him, though, I would moderate my rhetoric (not my message), in hopes that I could find more allies, and make it easy for other people to enact policies I favor.

I suppose it's fun to offend people and to stir up your base. But you don't win battles over the long run just by agitating your base. You win battles by growing your base, attracting new supporters. Pissing off (and pissing on) potential supporters doesn't do that. Whether he wants it or not, he has a lot of influence over how people perceive him, Scienceblogs, scientists, and even science in general. People judge me based on his actions, and statements like this don't help either of us achieve any of the results that we want. It doesn't help get atheists elected, it doesn't help keep creationism out of schools, it doesn't help keep chaplains from harassing sick people, and it doesn't keep parents from denying their children needed medical care.

My approach to politics (and I take politics here very broadly; any time two people get together and chat about just about anything, that's politics) centers on empathy. What you say to people should be premised on some notion of how that statement will be taken by your audience, including unexpected audiences. PZ has a sense of how his statement will be taken, but it lacks the empathetic feeling. Here's the relevant sentence: "I have to say something that is heartfelt, and is also meant to offend." That it is heartfelt is an expression of how he feels when he says, and his statement that it is meant to offend acknowledges the audience's feeling only in the context of how PZ feels about saying it. He knows it offends, but it feels good, so who cares how his audience feels.

Imagine you are a parent, and you wonder whether you should subject your child to painful, scary, and potentially dangerous medical interventions, or simply to trust entirely in prayer. Imagine the mental anguish for a moment, hard though it may be. Then imagine someone calling you on the phone and saying that even if you do go with medical treatment, the fact that you will also be praying makes you a moral monster. Does that leave you more or less likely to seek medical assistance? Does it make you trust medical science more or less? Does the comforting bosom of religion look better or worse? In short, would PZ's rant make people more or less likely to do what he wants them to do?

Or imagine that you are a hospital administrator. You have chaplains, and you allow religious groups to visit patients and pray with them. You get a letter from someone who wants those groups blocked. If the letter echoes PZ's venom, saying things "meant to offend," saying you and your hospital and the people you and your staff have gotten to know are just like murderers, are you likely to give them a careful hearing? Or are you likely to toss the letter in your crank folder?

PZ and others have express a laudable desire to see more atheists in public office, and to improve the very negative view many voters have toward atheists on spec. Imagine you are a voter who, like most voters, believes in some god and prays at least occasionally. If your atheist candidate tells you that you are complicit in every evil thing than any religious person ever does, and that anyone who ever prays is equivalent to a parent who murders her child by denying medical care, will that make it more or less likely that you will vote for that person?

Politics matters. When PZ uses his blog to try to influence public perception of religion, or to influence public policy, or to advance any sort of agenda on behalf of atheism, he is engaging in politics. Most of the policy goals he advocates are goals I share: honest science in science classes, evidence-based governance, equality without regard to one's theistic views. And he has a louder megaphone than I do, so I want to see him be as effective as he can be in advancing those shared goals. It hurts to see him mess it up.

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PZ's wrong in another way. I'm not convinced anymore that religion was truly the driving force behind the Hausers' rejection of chemotherapy for Daniel. It turns out that the Hausers have a deep distrust of conventional medicine because of birth trauma suffered by Daniel. It also turns out that Daniel's aunt died while undergoing chemotherapy when he was five, and that has left a lasting scar:

http://scienceblogs.com/insolence/2009/05/daniel_hauser_and_the_rejecti…

My take: Daniel and Colleen freaked out when they saw how sick the first round of chemotherapy made him, the memory of his aunt haunting them, and religion was a convenient excuse to latch onto to do what they wanted to do anyway. If it hadn't been the religion, it likely would have been something else.

But, hey, why try to understand the complexities of human behavior when going postal on religion is so much easier and more fun, right?

"Prayer and religion more broadly certainly lead people away from proper medical care, but it also helps people choose to get the treatment they need." Ah, but reason helps people choose to get the treatment they need with maximum effectiveness. Anything that reduces the chance of someone choosing to get the treatment they need (like belief in the supernatural) increases the chance of harm. There is no moral reason to choose the path of superstition over that of reason; quite the opposite is true.
In over 40 states, parents may legally withhold medical care from children for religious reasons, without fear of prosecution -- even if the child DIES. We atheists have the sense to be appalled by these hateful laws; believers apparently just don't care, and are completely unwilling to change them.

By Pluto Animus (not verified) on 22 May 2009 #permalink

"Prayer and religion more broadly certainly lead people away from proper medical care, but it also helps people choose to get the treatment they need. When my grandmother, a devout Lutheran, was thinking about getting a pacemaker, she was understandably nervous. As she did whenever she had a tough choice to make, she prayed over it. On one hand, she felt that her situation may have been God's will, and getting a pacemaker might be interfering with that plan. On the other hand, she noted that God had also given her access to modern medicine, and a doctor who discovered a treatable condition in time to get a pacemaker that would avert trouble. After much prayer and consideration, she got the pacemaker."

it seems like you are saying that you agree that prayer is in effect useless, but good when it helps the prayer come to the conclusion that you have reached through reason and science.

"Sure, PZ acknowledges that "prayer might make you feel better while your child is suffering," which looks a lot like "giv[ing] solace in your time of worry." But he also thinks "that is no virtue." Why giving comfort in a time of need is virtueless is never explained, and doesn't really seem to follow."

it absolutely follows that there is no virtue in substituting prayer for real medical treatment for a child if the only person who gains from it is the parent. and i'm sure you saw the study a couple of months ago that found that patients who know that someone was praying for them to recover actually did worse than the control group,

Amar, you're missing the point. There's a difference between replacing medical treatment with prayer, and supplementing medical treatment with prayer. There's also a difference between intercessory prayer and praying for oneself. Intercessory prayer doesn't work, as I note in the post itself, but praying for oneself does seem to have some positive effects.

And when I say "Why giving comfort in a time of need is virtueless is never explained, and doesn't really seem to follow," it is a non sequitur to reply "it absolutely follows that there is no virtue in substituting prayer for real medical treatment." I don't disagree with your statement, it just bears no relationship to what I said. I wasn't talking about substituting prayer for medical care.

"it seems like you are saying that you agree that prayer is in effect useless, but good when it helps the prayer come to the conclusion that you have reached through reason and science."

Praying for others has no measurable positive effect (and due to statistical flukes, has even been found to have negative effects in one study, as you note). Praying for oneself, or other meditative prayer, can be shown to have some positive effects. It is, as I say in the post, a potentially useful adjunct to medical treatment. And if people accept medical care, I really don't care about how they mentally justify that outcome.

Social conservatives simply have not been in politics. We lack institutions that can defeat our enemies and directly assist our friends.
After a while, threatening to leave the coalition unless the coalition does what you want gets old. And tiring. And ineffective. It makes your allies not like you very much. Social conservatives talk like that because it's our one lever of power.

I happen to think that you could pipe that through sed 's/Social conservative/Atheist/' and have it still work. Note also her observation that political action groups (broadly construed) "job [is] to make it easy for politicians to do what they ask, not the other way around."

Except of course that power is not the motivation for one side as it is for the other. If professing faith weren't one effective way to garner power in your society, I know the 'faithful' would look elsewhere.

Josh,
Thanks for your response.
My memory of the study on the effects of intercessory prayer were that the results were not merely a statistical fluke but also the added pressure of feeling like recovery was owed to the prayer. I think this points to the strange and as yet unexplained mind body conundrum that is the cutting edge of neuroscience. Far be it from me to deny that there could be some actual effects of positive thinking on the body of the thinker. I am not familiar with any of the research regarding praying for oneself. If you have a link handy, I would appreciate it (I am just a layperson and don't have access to any of the pay sites).
And just one last thing. I have been reading your blog for almost 2 years now and I am very grateful for the work that you do on the evolution / creation front line. That is why I was surprised to read you write "if people accept medical care, I really don't care about how they mentally justify that outcome". This seems to me to somehow contradict all of the work that you do to insure that our nation's schoolchildren are taught proper science. For what, in the grand scheme of things, is the point of teaching children good science but the process of teaching children to correctly reason and justify their actions?

The study's authors found:

We have no clear explanation for the observed excess of complications in patients who were certain that intercessors would pray for them (group 3). Although postoperative atrial fibrillation/flutter was responsible for much of the excess of complications in the group 3 patients, this outcome is only one of the complications that contributed to the composite outcome, and the excess may be a chance finding. Although there was a borderline excess of major complications (secondary outcome) in patients in group 1, this excess may also be well because of chance.

This file is older, but shows some other research which suggests the possibility of positive effects from praying for oneself: http://nccam.nih.gov/news/newsletter/2005_winter/prayer.htm

As a general matter, I accept that lots of people do things that aren't grounded in science, and that's fine by me. I don't like them forcing their beliefs on other people, and I want people to know what the science says. If they want to ignore that in their private lives, I'm not sure it's my business.

You need to read Myers again. He was not talking about meditation and contemplation, which is what your grandmother was doing, he is talking about intercessory prayer in which someone is asking a non-existent being to do as it is told.

Asking something that does not exist to do something for you is a complete waste of time and does not bring comfort. Meditating and contemplating the situation can be quite comforting and can be a way to achieve useful insights, but telling someone that 'I will be praying for God to heal your child' only encourages people to believe that non-existent beings can be made to do our bidding, something in which, as PZ notes, "is no virtue".

By anonymous pseudonym (not verified) on 26 May 2009 #permalink