Jordan Peterson is wrong: medical error is absolutely not the ‘third leading cause of death’

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Michael Marshallhttp://goodthinkingsociety.org/
Michael Marshall is the project director of the Good Thinking Society and president of the Merseyside Skeptics Society. He is the co-host of the long-running Skeptics with a K podcast, interviews proponents of pseudoscience on the Be Reasonable podcast, has given skeptical talks all around the world, and has lectured at several universities on the role of PR in the media. He has been the Editor of The Skeptic since August 2020.

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“If you did the statistics properly, I suspect that medicine – independent of public health – kills more people than it saves. I suspect if you if you factor in phenomena like the development of superbugs in hospitals, for example, that overall the net consequence of hospitals is negative.

“Now, that’s just a guess, and it could easily be wrong, but it also could not be wrong, and that is a good example of where my thinking about what we don’t know has taken me with regards to the critique of what we do

“You know, medical error is the third leading cause of death, and that doesn’t take into account the generation of superbugs for example”

It might surprise you to hear that these are the words of a man described by the New York Times as “the most influential public intellectual in the Western world” – Canadian Professor and self-help guru Jordan B Peterson. Peterson made these bold assertions in a recent YouTube conversation with Bret Weinstein, the former college professor and member of the Intellectual Dark Web, who responded to Peterson’s medical error claim by explaining that COVID-19 was created in a lab in Wuhan.

Neither of Peterson’s claims – that medicine has killed more people than it has saved, and that medical error is the third leading cause of death – hold up to even the most basic scrutiny. The impact of medicine, for example, has been overwhelmingly positive, even accepting Peterson’s stipulation that we discount public health interventions. Public health would include measures such as hygiene, fluoridation (which, incidentally, Weinstein believes is harmful), and arguably vaccination – the latter could fall into the ‘medicine’ category, but to steelman Peterson’s argument as much as possible we’ll consider them specifically ‘public health’ and leave them out of our reckoning.

Let’s first examine the impact of medical intervention on childbirth. According to the 2006 paper “British maternal mortality in the 19th and early 20th centuries”, for every 1000 births in the UK in 1870, around 50 mothers would be expected to die – giving a maternal mortality rate of 5%. Factoring in the trend at the time for families to have six or seven children – primarily due to high infant mortality – mothers might be rolling that 5% mortality dice more than half a dozen times during their life.

By 1970, in the UK, that number had dropped to below 1 in 1000 – a 0.1% maternal mortality rate, and the last 50 years has seen the trend continue further. According to figures at Our World in Data, the maternal mortality rate in the UK is now around 9 per 100,000. Even if we widen what counts as maternal mortality, according to the BMJ, in the three-year period between 2016 and 2018, 547 women died during or up to a year after pregnancy from causes associated with their pregnancy, among 2.2million women who gave birth in the UK.

The impact of modern healthcare on the natural act of giving birth has been unquestionably transformative. Some of that improvement is in hygiene, simply ensuring doctors wash their hands between handling corpses and birthing babies had a dramatic effect, which we can attribute to the public health column. But how much of the rest of the dramatic transformation is in managing pregnancy complications which would have been deadly before we had ultrasounds, medication, and the ability to safely induce labour if needed? Intensive care units and incubators save the lives of countless premature babies every year, and those babies go on to be kids who typically survive through to adulthood – unlike the high rates of child mortality before medicine. In the 1800s, more than a third of children didn’t make it to their fifth birthday. Medicine has had a huge role in lowering that to a child mortality rate of under 0.5%.

A newborn baby holding its mother's finger

It’s arguable that the impact on maternal and infant mortality alone has been enough to put modern medicine firmly in the plus column, but those numbers are further bolstered by, non-exhaustively: blood transfusions to keep patients alive during operations and after accidents; insulin keeping diabetic people alive; heart medication preventing heart attacks; CPR and defibrillators keeping heart attack patients alive long enough to be cared for; heart surgery preventing people from dying of heart disease; antibiotics and their effects on treating infections; chemotherapy, radiotherapy and the other huge strides we’ve made in cancer care.

That list barely scratches the surface, but for medicine to be a net negative, it would have to cause deaths in the kind of magnitude as to tip the scales on all of that. Peterson stipulated that medicine is negative before you even include the rise of superbugs – even if we steelman his argument further by adding superbug deaths to minus column, according to the CDC, that would account for 35,000 people per year in the US, less than the 36,000 Americans per year whose lives are saved by organ donations.

Hopefully the point is clear: Peterson’s first claim is patently absurd, delivered with intense confidence from someone still viewed by his ardent fans as valuable intellectual. His second claim, that medical error is the third leading cause of death, fares no better.

Medical error

Sticking with the US, according to the CDC during 2019 (the last non-COVID year), heart disease killed 659,041 people, follower by cancer at 599,601 people. ‘Accidents’ came in third, at 173,040 people – that’s all accidents, not just the medical accidents. That’s car accidents, accidental shootings (America), falls, drownings, everything… plus medical error. By the CDC stats, the number of medical accidents would need to be higher than the number of all accidents for Peterson to be right.

David Gorski wrote about the false “third leading cause of death” statistic for Science Based Medicine in 2019, long before Peterson repeated it. The original source for this falsehood seems to be a study out of Johns Hopkins which estimated that 250,000 to 400,000 deaths per year are due to medical errors, but as Gorski pointed out:

these figures are vastly inflated and don’t even make any sense on the surface. For one thing, there are only 2.7 million total deaths per year in the US, which would mean that these estimates, if accurate, would translate into 9% to 15% of all deaths being due to medical errors.

In fact, it’s worse: the study only looked at hospital-based deaths. As there are only around 715,000 hospital-based deaths per year, for the figures to be true medical error must account for between 35% and 56% of all in-hospital deaths. Half of all people who die while in a hospital would need to be victims of medical error. This obviously is not the case.

The study came to this absurd conclusion due to its methodological flaws, which Gorski highlights, including that the authors conflated unavoidable complications with medical errors, failed to take into account whether the deaths were preventable or not, and extrapolated from very small numbers. According to a more recent paper, a number of around 5,200 deaths per year in the US due to medical error is more likely.

Concerning confidence

The confidence with which Peterson states facts which were so demonstrably untrue is staggering and deeply worrying, given that this is not the first time Peterson has been so far wide of the mark – yet his reputation among his fans and followers as a deep thinker remains intact. In my opinion, Peterson’s intense certainty is a significant part of his appeal to his fanbase – in a complicated world, an authority figure who speaks with certitude can be comforting.

Peterson is not the first person to authoritatively state the “third leading cause of death” canard in order to denigrate conventional medicine – I’ve heard it from countless homeopaths, alternative healers, anti-vaxxers, chiropractors, flat earthers and even David Icke. Peterson’s fans may write this off as a guilt by association fallacy: just because you share an attribute with someone or something bad, that doesn’t make you bad (after all, if Hitler was a vegetarian, that doesn’t make all vegetarians Nazis). While it’s obviously true that we can’t write a view off merely by looking at the people who agree with it, it is not the case that such associations tell us nothing at all. It is valid to look at what epistemological or ideological company your beliefs are keeping, and if you find that the vast majority of people who hold your position are conspiracy theorists and pseudoscientists, it is a sign that you may need to give your beliefs some examination.

Peterson may well be the epitome of this maxim, and his rise to prominence in parts of the skeptical and atheist worlds is something there needs to be some self-examination over. That isn’t to say his ideas were broadly embraced – the vast majority of skeptics and atheists who came across his work recognised early on that what he was peddling sounded like conservative Christianity coyly masked behind rhetoric and sophistry. Nevertheless, there were parts of our communities that failed to see it, even after he set off a number of red lights.

Some of Peterson’s most famous claims would have been dismissed out of hand were it not for the charismatic pull of his personality. His advice on how to live life and the values to hold seem strikingly similar to the conservative Christian worldview his atheist followers would normally critique, even as he equivocates over his answer as to whether he believes in there being a literal god. The very atheists who parroted his explanation that we can understand human societies by observing the behaviour of lobsters would have greeted a similar claim from Deepak Chopra with ridicule, and would have swiftly pointed out that humans have no more in common socially with lobsters than they have with ants, so why should draw social conclusions from one not the other?

Dietary advice and mental health

Over the last couple of years, Peterson has been increasingly emboldened in sharing his wisdom on health and mental health. His views around dealing with mental health – including “sit up straight and tidy your room” – bordered on the kind of ‘think yourself better’ rhetoric we hear from self-help gurus and The Secret, despite Peterson himself suffering from severe depression. Peterson has attributed his depression to an allergic reaction to a glass of apple cider, which he claims gave him a sense of impending doom and prevented him sleeping for 25 days straight – claims which wouldn’t have seemed out of place in pseudoscientific allergy and food intolerance lectures given at Mind Body Spirit festivals.

Beef, in a saucepan, with some rosemary.

Peterson’s solution to his depression was to follow his daughter’s advice to go on “The Lion Diet” – consisting of nothing but beef, salt and water. If this depression cure had been posited by anyone else, those same skeptics who followed him would have torn it to pieces. His daughter was at the time charging people up to $600 per year for membership to her diet and nutrition website which she claimed offered advice on how to follow her revolutionary diet, but mostly seemed to consist of testimonials from users. All of this would normally be extreme red flags to the fans of his who see themselves as followers of logic and reason.

It gets worse. Peterson had become physically addicted to benzodiazepines, but refused conventional medical addiction treatment, because he and his daughter wanted him to have ‘alternative treatments’ that weren’t available in the US. Instead they headed to Russia for an unnamed alternative treatment… which led to him being comatosed.

Soon after his coma, Peterson contracted COVID-19, and was hospitalised again, with a CT scan showing his lungs were heavily affected. Despite this, his daughter maintained her stance underplaying the severity of Covid, claiming at the time:

“the meds dad was put on to treat it seemed to be harsher than the actual virus…

“I’m sorry to anyone who has experienced a worse case of the virus or who has lost anyone to it. That’s miserable. So is suicide from lockdown anxiety and lifelong neuroticism from children growing up in a lockdown though.

“Perhaps if we focused on making people healthier the world wouldn’t be so screwed up by a virus that doesn’t really kill healthy people… yikes, I went there.”

It is hard to see much difference between the claims of the Petersons and those of the various pseudoscience proponents who have told us that the real problem is that our lifestyles and our diets are unhealthy, and if we just eat right our bodies will heal themselves, without the kind of conventional medicine that “kills more people than it saves”.

Undeterred fanbase

Despite this litany of questionable assertions and pseudoscientific health claims, Jordan Peterson continues to enjoy a dedicated fanbase who praise him for his clear thinking, his logic and his reason. The podcast in which Peterson interviewed Bret Weinstein was viewed more than 1.1m times in just over a month, with comments that expressed universal and effusive praise. Commenters highlighted the exemplary humbleness of both men, explaining how much they “respect Jordan’s ability to honestly convey emotion in a honest way yet still stay true to a logic string of thoughts that deliver a profound truth”. This, we must bear in mind, is a conversation in which Peterson casually hypothesised that hospitals kill more people than they save, caveated with an unconvincing “I could be wrong, but I also could be right”, to which Bret Weinstein responded: “the fact that it’s even plausible is stunning”, before confidently explaining that Covid was developed in a lab in Wuhan and leaked.

This, I think, exemplifies the appeal of figures like Peterson and Weinstein – they are praised not for their insight, but for the well-packaged illusion of insight; the confident, self-assured tone in delivering ideas that would be rejected if they weren’t masked by charisma and intellectual theatre. Many of Peterson’s positions – at least the ones that don’t promote outright pseudoscience – essentially act as delivery mechanisms for a conservative Christian worldview to an audience who would normally reject those views.

There will be fans of Peterson who, upon reading this, will say these criticisms are unfair, because the Professor addresses exactly these concerns in a four-hour interview here or an eight-part lecture series there, and if only I would have listened to all of those my criticisms would fall away. Unsurprisingly, such a standard is rarely set for assessing Peterson’s claims – indeed, his initial rise to prominence came on the back of his insistence that he would willingly go to prison rather than abide by a Canadian equality law. As many lawyers pointed out at the time, this was nothing but a strawman: even a cursory glance at the law in question showed Peterson was misrepresenting its implications, and exaggerating its threat. There is a deep irony in the fact that Peterson’s rise to fame was powered by his – and his fans’ – refusal to put an idea they disagreed with into honest context.

Evaluating claims in their proper context is a crucial part of reasonable skepticism, and an integral part of avoiding strawman arguments; however, even this principle has its limits, as demanding an unreasonable level of context can be a tactic to deflect fair criticism. You don’t need to have read every one of David Icke’s books to know the world is not run by lizards, and you don’t have to have read the Koran to know that Muhammad didn’t really ascend into heaven on a winged horse, and you don’t have to have studied with homeopaths before you can say that diluting substances makes them weaker not stronger. The burden of proof lies with those making the claim, and when it’s people other than Jordan Peterson making the claims, his fans are usually able to recognise that.

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