From August till the end of the year is the season for science awards. Eureka Prizes, Prime Minister’s Prizes, State Awards for Science Excellence, The Unsung Hero of Science Award, The State Scientists of the Year, Nobel Prizes … on it goes; the glittering array of rewards for those who have truly advanced knowledge and improved the lot of mankind.
Predictably, most of the speeches that laud the winners will mention something like the growing number of Australia’s Nobel laureates in science, how this is a time when science is paramount, how our lives are dependent on science and technology and how virtually every benefit we now enjoy - from better health and longer lives to the internet and safer cars - is the product of scientific processes, improved technology and their application.
Why, then, is this era in which we live apparently the most superstitious and anti-science period since the Middle Ages? Pseudoscience and non-science not only abound, they are actively embraced by thousands who subject themselves and (worse) their children to a variety of nonsensical alternative “treatments” that at their best cause no harm, but at their worst cause serious disease, disability or even death.
Reflexology, iridology, homeopathy, naturopathy, anti-vaccination, crystal healing… the list is huge and growing.
Explanations are many. The huge dropout rate from science in schools means that there are fewer people who actually understand how science works. Maybe this lack of understanding induces fear of the unknown, so that non-science is seen as somehow safer than science.
Perhaps the complexity of science means that people happily opt for simplistic alternatives, however wrong, just as people flooded with too much information when they search for a house ultimately choose one simply because they like the door handle. There is probably a clue in the way that most alternative treatments are said to involve “energy,” “vibrations,” “purifying the blood,” or a host of other impressive but vague terms which sound vaguely scientific but hold absolutely no meaning at all.
Take, for example, the claim of The Chiropractor’s Association of Australia that “innate intelligence” determines body-wide health, that changes to spinal anatomy they call “subluxation” interfere with the “guiding energy” of innate intelligence and that adjustments can “cure 95 per cent of what ails man”.
Perhaps claims like that are so sweeping and all-embracing that they overwhelm, like the chiropractic paediatric websites which claim that this “adjustment” can help many potentially serious childhood conditions including “fever, colic, croup, allergies, wheezing, poor posture, stomach-ache, hearing loss, headaches, asthma, bed-wetting, bronchitis learning disorders, arthritis, poor concentration…“ and many other problems.
That is such a large net that catching only a few vulnerable converts - and most people with children are pretty vulnerable - will earn a tidy bit of income.
Undoubtedly some alternative treatments, dressed up as they are as “ancient wisdom,” “mysteries of the East” and “secrets of the ages” are cosmetically more exciting than an hour’s wait for a prescription in a conventional doctor’s waiting room with nothing to read but old copies of New Idea; almost anything beats that. It is also true that some alternative pursuits, unhampered by any ethical or advertising restraints, can claim what they like and spend a great deal on self-promotion.
Real doctors can’t do that, and most don’t want to.
Paradoxically, while spouting this nonsense about the wisdom of centuries-old pursuits (remember those times when the life span was 30 if you were lucky, and one third of Europe died of the plague, which they thought was caused by ‘miasmas’ in the air?), the practitioners of these pseudosciences get to parasitise not only the terminology of science but also the trappings of its conventionality.
You find the same thing with anti-evolutionary creationists who, while denying the real and demonstrable discoveries of science, are nonetheless content to adopt its terminology with meaningless terms like “Creation Science,” to lend their faith-based absurdities a bit of pilfered respectability. The alternative health brigade demand to assume the role of primary health carer, and are routinely photographed in white coats while calling themselves “Doctor.”
Think I am exaggerating? The 2011 annual report of the Chiropractors Association of Australia claims “We are in a unique position to be in the forefront of primary care and the natural leaders in prevention and wellness for Australia. Our intellectual property over the power of subluxation and its impact on health is well understood by the CAA.”
In 2010 they reported that “after ten years of hard slog by the CAA every chiropractor in the country will be permitted under legislation to use the title doctor.”
Medical doctors and those who have a doctorate in a scientific discipline have earned that title, not by 10 years of hard political slog to insist on being called it, but by 10 years of scientific study; evaluated not by themselves but by independent examiners well versed in evidence-based practice who are equipped to assess the scientific validity of knowledge and research.
You can find many people who will swear by their alternative treatments. Why, then, would you consider them to be inferior to evidence-based treatments? That phenomenon has, itself, been well researched.
First there is the placebo effect. Very powerful, it means that people given a sugar pill that they think will help, actually do feel better. It is not the treatment that works but the expectation of it. It even works when they know it is a sugar pill, but they don’t conclude that the placebo did the job; they assume that the treatment is effective.
Second, there is regression to the mean. People who get a cold feel terrible, but usually improve after about three days. They also feel bad enough on the third day to go to the doctor.
Irrespective of what treatment they get there, they feel better on the fourth day, but put it down to the doctor’s ministrations, not to natural recovery. The same is true if they consult a charlatan.
What practices can truly claim to be scientific or evidence-based? In short, they have to assume natural laws are involved, not mystical influences. They have to lend themselves to hypothesis, which means that you stick your neck out and say what you think will happen under certain circumstances. Some alternative practices get as far as that but most stop there.
The scientific bit comes when you set up a well-designed experiment or trial to test your hunch, introduce a control condition for comparison, get unbiased judges to vet your results (all of them), deal with their queries to the satisfaction of other independent witnesses and finally publish your study if it meets the approval of well-credentialled assessors who will try to fault your experimental design, methodology and conclusions.
Other people then repeat your experiment and, if they get different results, they say so, helping to weed out inaccuracies from science’s long list of evidence-based discoveries. You don’t get there by self-assessment among your disciples or by loosely claiming achievements, pointing to what you claim as successes while hiding your failures, relying on those who support you while ignoring critics, and dressing the whole thing up in vague descriptions, mystical references and invented terminology that sounds impressive but defies analysis, let alone experimental verification.
Why has all of this surfaced now? A group of doctors and scientists has just gone public to protest at the growing numbers of universities offering pseudoscience and alternative courses as though they are evidence-based and scientifically valid. It is easy to see why some universities do this; there is a quid in it, but in doing so they put at risk their credibility and that of their staff and their other science and health degrees, some of which are first class.
The number of universities involved is surprisingly large and growing. At least 14 universities across five states and territories now offer courses from homeopathy and chiropractic to aromatherapy and reflexology. Many courses lurk under general terms such as “Complementary Medicine” and “Alternative Therapies”. When in doubt, be vague; it is harder to discredit.
The trigger for this group of scientists has been the plan by Central Queensland University (CQU) to offer a degree in chiropractic, starting in 2012, but they have broadened their criticism to include pseudoscience in general and quackery in the name of science in particular.
This is not a territorial grab by medicos. Some of the group are pure scientists, but all of them understand and support the crucial role that science plays in sorting out truth from assertion in the health arena. They stress that they are not trying to stop the public accessing alternative therapists or unproven therapies, but they do want false claims about them to be policed effectively, and they want the public made aware about their lack of scientific evidence base.
They would also like to save you a lot of money. At present, partly because the pseudoscience practitioners are strident lobbyists, taxpayers’ money goes to funding their courses and even to reimbursing people who undertake their invalid procedures. The group of scientists advocates the stopping of federal funding to courses on unproven anti-science alternative medical therapies, and they urge that science–based universities stop endorsing dubious health practices.
They also urge that health funds offer insurance plans that allow the public to opt out of paying for alternative therapies that are not evidence-based.
When Prime Minister Gillard assumed that position, much was made of the government being guided in its future decisions by evidence-based information. Right! Good idea! Let’s follow through! As the group of scientists says, there should be greater government regulation of unproven claims for alternative therapies, both by therapists and for alternative medicines. They should also revisit who, in the supposed health arena, is entitled to call themselves “doctor.”
It is a paradox, and more than alarming, that if I want to set myself up as a medical practitioner, I will have to earn the right to do it, or if I want to foist a new drug onto the populace, I will need to subject it to serious scientific analysis by independent and highly qualified people.
Yet I can create a new ‘treatment,” attribute its power to the wisdom of anonymous ancients, describe it in mysterious but meaningless pseudoscientific terminology, declare some toxic plant a ‘beneficial herb,” label myself a doctor and proceed virtually unhindered to damage the gullible or, at best, keep them and their possibly dangerous illnesses from real treatments of proven value.
Back in the “ancient times” so beloved of some of this alternative brigade, surgeons were actually barbers, well equipped with razors to open the veins of their patients for a bit of blood-letting; the fashionable treatment of the time. The “doctors” of America’s wild west were self-proclaimed therapists, peddling worthless and sometimes dangerous patent medicines to people who knew no better than to trust them.
It is extraordinary that, in this most scientific and technologically advanced age of any time, when accurate information about disease and its effective treatment is available as never before, we should be reverting to pseudoscientific nonsense when it comes to the health and safety of ourselves and the people that we love, and paying dearly for it in the process.
When that is encouraged by institutions that should be among our most trusted advocates of evidence-based heath science, and the governments that fund them, it must be time for some serious evaluation of what has gone wrong.
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