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Sceptics, skeptics, Homeopathy and ‘soft targets’

An article in the latest edition of that very non-treehugging journal Scientfic American by a self-confessed skeptic (spelled with a ‘k’ because he’s American and with an ‘s’ very deliberately in lower case for reasons he makes clear), John Horgan, shows how self-styled ‘sceptics’ specifically attack ‘soft targets’ such as homeopathy (which he mentions specifically) while seeing fit to ignore much more pressing ‘hard targets’ such as:

PHYSICS: String theory and multiverses cannot be experimentally detected and therefore lack Popper’s sine qua non of a scientific theory: falsifiability. Nevertheless proponents of these hypotheses gain Nobel prizes etc. What say you astrophysicist and specialist attacker of the soft target of homeopathy, Simon Singh of the Good Thinking Society?  What would the Ministry of Truth say to this?

MEDICAL DIAGNOSIS: Overdiagnosed “Making People Sick in Pursuit of Health.by Gilbert Welch”, ‘a courageous health-care analyst at Dartmouth’ who makes the case that in the USA at least, many patients are actually harmed by being over-investigated. Another hard target conveniently ignored by the ‘good thinkers’.

MENTAL HEALTH and MEDICATION: Readers of this blog know that I’ve been talking about this for some time and asking how attackers of the soft targets homeopathy and CAM do not have the time to deal sufficiently with this outrageous issue. Just for starters here is the meta-analysis that really embarrasses prescribers of SSRI antidepressants – Kirsch et al. As I’ve pointed out this pretty much ignored hard target (the amount spent on these largely unproven meds for depression) costs the NHS 20x the amount of money that all homeopathic prescriptions for all conditions combined.

SPURIOUS ‘GENETIC’ REASONS FOR HUMAN BEHAVIOUR: Horgan is horrified by the public being misled into believing that there is any evidence to suggest single genes can explain particular types of behaviour in people eg ‘the infidelity gene’ Where are the sceptics and ‘good thinkers’ on this nonsense misinformation given to the public – something they constantly accuse the soft targets of homeopaths and CAM practitioners with?

BIOLOGICAL ‘REASONS’ FOR WAR: Horgan detests the idea that war is inbuilt to humans – even genetically so. In my opinion, while being unnecessarily and unfairly harsh on the USA in this regard (I guess he is American and thus has the right to do so), he is correct to assert that it is unscientific to claim that we are genetically programmed to fight wars. He claims it has been proven that war is a cultural innovation in the same way that religion and agriculture are.

Horgan ends strongly: ‘I’m asking you skeptics to spend less time bashing soft targets like homeopathy and Bigfoot and more time bashing hard targets like multiverses, cancer tests, psychiatric drugs and war, the hardest target of all.’ Somehow I doubt that sceptics/skeptics on either side of the Atlantic will take the slightest notice. After all it’s much easier and much more fun to attack soft targets than hard ones.

 

 

 

 

 

By | 2016-05-18T14:36:33+00:00 May 18th, 2016|Current Affairs, Homeopathy|11 Comments

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11 Comments

  1. paul May 23, 2016 at 7:34 pm - Reply

    I wonder how many comments from “skeptics” you’ll get?

    • Adzcliff May 26, 2016 at 9:56 pm - Reply

      Hi Paul.

      I’m a ‘skeptic’, and read Joe Horgon’s essay with interest. I especially indentified with this point:

      “When people like this [i.e. ‘skeptics’] get together, they become tribal. They pat each other on the back and tell each other how smart they are compared to those outside the tribe.”

      Having attended many sceptical events up and down the country, I recognise this phenomenon, and criticise it. I wish the experience of ‘non-skeptics’ at skeptical events was more positive, and that greater numbers of ‘skeptics’ recognised how tribal scoffing keeps ‘silly’ questions locked in minds, unanswered; or worse, sound answers packaged unpleasantly, risk inflicting the “backfire effect”, doing more intellectual harm than good.

      However, I’m not sure Horgon occupies any special position in this. For one, ‘skeptics’ do obsess over many of his ‘hard targets’. Take for example the pros and cons of medical screening and diagnostics. Dr Margaret McCartney (GP and author of the Patient Paradox) has brought this issue to skeptical audiences more than once – and more often, I’m willing to bet, than her criticism of homeopathy. CAM critic and pharmacologist Prof. Colquhoun has also blogged on this issue (http://www.dcscience.net/?s=screening). There may be others, I don’t know, but I’m willing to bet Horgon doesn’t know either.

      Then we have mental health and medication. Not only do we have Prof. Irving Kirsch banging this drum (as Dr Kaplan points out), but there is now a growing army of critical psychiatrists, psychologists, journalists and survivors (etc.) publishing and campaigning in this area, including the arch-critic of homeopathy, Dr Ben Goldacre. You may or may not be aware that the All Party Parliamentary Group for Prescribed Drug Dependence met in Westminster just a couple of weeks ago to discuss this very issue: (http://cepuk.org/2016/05/17/2498/). I’m willing to bet that all the leading voices in the critical psychiatry movement would consider themselves ‘skeptics’, given their insistence on robust scientific arguments in their criticism of traditional psychiatry. In psychiatry’s defence, I have never heard a practitioner point to the problems of CAM as an argument to be left alone.

      And assuming this argument goes all ways, are we really insisting that critical psychiatrists obsess equally over Big Foot and climate change, and String theorists find equal time for screening paradoxes and epigenetics, and CAM practitioners reserve every other criticism of Big Pharma for an anecdote on the biological reasons for war? Or is it enough that everyone pursues their personal interests and professional specialisms, and if our beliefs and livelihoods happen to be the butt of those focuses, then our arguments need to stand on their own footing; not grassing up the bad behaviours or unknowns of other fields to deflect criticism?

      How was that?

      • Dr. Kaplan May 27, 2016 at 10:07 am - Reply

        Fair enough Adzcliff. I certainly don’t expect psychiatrists to draw attention to their lack of evidence for their treatments. They want to be seen as ‘real doctors’. It just seems to me that there is a lot of careful selection of targets by these ‘skeptics’. Homeopathy (and it’s place on the NHS as a result of being invited to be part of the NHS having built 5 hospitals with the help of homeopathic benefactors) is a soft target for these ‘skeptics’. Nobody is telling the psychiatrists that they practise ‘witchcraft’ – even though there has been a robust anti-psychiatry movement for quite a few decades now – going back to R. D. Laing, David Cooper and others. I agree that the ‘skeptics’ have other targets but nothing can be compared to their trashing of homeopathy.

  2. Adzcliff May 27, 2016 at 3:57 pm - Reply

    Thanks for this Dr Kaplan.

    Many key players in the Critical Psychiatry movement are psychiatrists, and are indeed focussing on the lack of evidence for their treatments, as well as evidence of harms. Given the vociferousness of the debate, I wouldn’t put it past any of them to have called many psychiatric beliefs and practices “witchcraft”, and have certainly read comparisons between psychiatry and astrology (http://www.theguardian.com/commentisfree/2009/aug/31/psychiatry-psychosis-schizophrenia-drug-treatments). In fact, the debate is so heated, that there has even been talk of ‘safe spaces’ for psychiatrists to come and learn about critical psychiatry without the risk of hostility.

    On the wider point about the disproportionate ‘trashing’ of homeopathy, here’s a quick scan of upcoming talks at UK Skeptics In The Pub events, as a rough guide to what’s being chatted about in June 2016:

    Bedford: “Modern Families: Myths and Realities”
    Birmingham: Robots and AI
    Bournemouth: Psychics*
    Bristol: Conspiracy Theories
    Cambridge: North Korea
    Cheltenham: “The Importance of asking for evidence”
    Coventry: EU Referendum
    Eastbourne: Psychics*
    Gravesend: Psychics*
    Greenwich: Prediction models
    Lancaster: “Scientific method: uses and abuses”
    Leicester: Genetics
    Lewes: Agnosticism
    Liverpool: Risks and harms of recreational drugs
    London: Skepticism and pedagogy
    Maidenhead: Cannabis
    Maidstone: Superforecasting and geopolitics
    Milton Keynes: “Ask for evidence”
    Newcastle: CAM
    Nottingham: Psychics*
    Oxford: Forensic science
    Portsmouth: Psychics*
    Reading: Antibiotics
    Sheffield: Psychology of kinship
    Stoke: North Korea
    Teeside: Bondage, dominance & sadomasochism
    Tunbridge Wells: Psychics*
    Winchester: Radiophobia
    Worthing: EU Referendum
    York: Prediction models

    * “Psychics” is all Ash Pryce touring his “How to be a psychic conman” talk. If we were to replace them with the next scheduled talk (where they exist), we have: Superforecasting and geopolitics (again), lobbying and democracy, and “adventures in pseudoscience”.

    I suggest this makes Horgon’s list of hard and soft targets seem mightily narrow. Hopefully though it helps homeopathy feel a little less targeted, and portrays ‘skeptics’ as considerably more varied in their interests than previously assumed.

    Regards.

    • Dr. Kaplan May 27, 2016 at 4:52 pm - Reply

      Yes, this is very reasonable Adzcliff. Nevertheless I maintain that homeopathy is a particularly soft target.

      The rationale of the more reasonable’skeptic’ goes as follows: ‘If you want to believe in and use this rubbish then pay for it yourself!’ (Unreasonable skeptics would support a ban on it)

      The rationale of the NHS homeopathic doctor goes: ‘These hospitals were built by benefactors of homeopathy and invited to be part of the NHS (at a time when homeopathy was controversial) so as long as people want homeopathy (no matter HOW it works!) it should be available to them if doctors are ready to supply it.

      Various organisations of ‘Good Thinkers’, ‘Nightingales’ and other ‘Ministers of Truth’ have pressure-marketed the former and bullied and pilloried anyone daring to write in support of the latter. A clear instance of the insult to democracy of a majority hammering a significant minority.

      • Adzcliff May 27, 2016 at 8:05 pm - Reply

        Fair enough Dr Kaplan.

        This chat has got me thinking though: is there a homeopathy or CAM equivalent of the critical psychiatry movement (i.e. critics from within, holding their field to the highest scientific and ethical standards)? I suppose Prof. Edzard Ernst was this (not that he was ever that well received by the CAM community), but can’t think of any others?

        Thanks.

        • Dr. Kaplan May 28, 2016 at 11:22 am - Reply

          Yes good question. The problem is that no psychiatrist would want to put their profession and Royal College into disrepute. Nevertheless I’ve heard psychiatrists express disappointment with treatment
          and focus instead on ‘psychiatric services’. There is clearly a reason why there has been an Anti-Psychiatry Movement (eg Laing, Cooper et al) but never an Anti-Opthalmology or Anti-Surgery movements ;=)

          Re: Edzard Ernst: His ‘qualifications’ in any form of CAM are highly controversial. Most CAM professionals would not see him as one of their own or ‘within’ in any way.
          There has always been a movement in medical homeopathy that supported its use only by doctors capable of making full medical diagnoses but less so today.

          • Adzcliff May 28, 2016 at 12:04 pm

            Just on a point of pedantry: it’s my understanding that the anti-psychiatry movement is almost certainly a forerunner to the critical psychiatry movement, but they are not synonymous of one another. Anti-psychiatry grew out of the civil rights era, and described a broad range of beliefs, ideologies and philosophies united only by their dissatisfaction with traditional psychiatry. I don’t think there was any imperative to be scientific (although some were), with many of the defining mavericks refusing to be associated with the anti-psychiatry label and/or each other. Modern critical psychiatry on the other hand is much more organised, and applies the highest ideals of scientific and ethical scrutiny to the politics and practice of mental health care. I expect many anti-psychiatrists would infuriate their critical psychiatric descendants with truth claims that are just as wild as the ones they are trying to challenge.

            Cheers.

          • Dr. Kaplan May 28, 2016 at 12:28 pm

            Yes, good point. They are different. The very ’60s’ anti-psychiatry movement was as you say about much more than just psychiatry as anyone reading the works of R. D. Laing can easily see. When you say ‘critical psychiatry movement’ do you mean these people?
            https://en.wikipedia.org/wiki/Critical_Psychiatry_Network Now look the wiki entrance on Anti-psychiatry movement and you will see that the former cannot be compared to the latter in magnitude and academic and popular support. Still, the network sounds sensible – if wikipedia
            is anything to go on.

          • Adzcliff May 28, 2016 at 1:19 pm

            Yes, that’s them, but would be interested to know when the Wiki entry was last updated.

            If I understand you correctly, I think you might be right that popular support for critical psychiatry outside of the mental health field is probably much smaller than anti-psychiatry’s in its day. I think anti-psychiatry was aided by its affiliation to other important civil-rights causes, and helped by an emancipatory and anti-establishment message that was very popular with the youth culture of the day. As a more professional and academically-focused organisation, critical psychiatry is unlikely to ever emulate this external appeal, but it does appear to be making great strides within mental health care that perhaps anti-psychiatry never did. The Council for Evidence-Based Psychiatry seems to be underpinned by critical principles; and it is they that recently earned the ear of Parliament to share their evidence-based concerns and recommendations for the prescribing epidemic in mental health (available on video from today: http://cepuk.org/2016/05/27/video-now-available-appg-event-link-rising-prescribing-disability/). Notice many of the speakers are members of the professions under criticism, and occupy NHS or other publicly-funded positions. This feels like progress.

            P.S. On your point about Prof. Edzard Ernst’s CAM credentials; I take it you also appreciate that Prof. Irving Kirsch is unlikely to have ever prescribed an SSRI in his life?

          • Dr. Kaplan May 28, 2016 at 2:04 pm

            Yes that’s reasonable.

            Re: Ernst and Kirsch. Kirsch has a phD in psychology and is an acclaimed academic with a special interest in depression and placebo responses. Ernst’s qualifications to be a professor of CAM have rightly
            been challenged imo and I remain somewhat amazed that he can get into the press as often as he does. I guess the explanation is that when the populist ‘wisdom’ of the time bleats and jeers: ‘Homeopathy is placebo. Nya, nya’ without even understanding
            the difference between an outcome study and an RCT, then the zeitgeist is right for people like Edzard Ernst to be a commentator. But when Kirsch shows evidence that SSRIs mainly placebo (and I point out that the NHS budget for SSRIs is 20x that for homeopathic
            medicine) nobody is jeering and bleating the same about psychiatry. The answer to this ‘enigma’ can be found in the useful maxim: Follow the money.

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