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Conspiracy theorists, anti-vaxxers and alt-med quackery put our pets in harm’s way

Every day, in real life and on social media, we encounter a vocal antivaxxer brigade, evangelical proponents of grain free and raw meat diets, online stores selling magnetic therapy, and chiropractors, homeopaths and reiki healers promoting their businesses. This may sound pretty familiar to those involved in Skeptic societies. But I’m not a doctor. I’m a vet. 

It comes as a surprise, even to those who have been discussing pseudoscience for years, that the use of alternative medicine and implausible products is as common in veterinary medicine as in human healthcare. 

Over recent years, the aggressive promotion of alternative therapies to prevent and treat animal diseases has become widespread.  

Conventional veterinary medicine is a victim of its own success. The fact that vaccination campaigns have been so effective means people are less aware of the dangers of diseases, and more concerned about the potential side effects of vaccines.

As with human medicine, conventional veterinary medicine is also a victim of its own success. The fact that national vaccination campaigns have been so effective against previously common dog diseases such as distemper and parvovirus means that people are less aware of the dangers of the diseases and more concerned about the potential side effects of the vaccines. 

There is a widespread and very pervasive conspiracy theory that vets and pharmaceutical companies are promoting dangerous conventional medicines in order to make additional profit when pets become sick. In order to protect their profits, many of these groups believe vets and pharmaceutical companies are trying to suppress knowledge about effective and safe alternative medicines.  

Such is the level of suspicion that the British Veterinary Association felt it necessary to issue a public statement to dispel the myth that vaccines are linked to autism in dogs.  

Social media has undoubtedly played a role. Facebook groups act as echo chambers where medically implausible claims go unchallenged, and those who express different viewpoints are removed. Facebook groups containing thousands of UK pet owners discuss their mistrust of vets and the pharmaceutical industry. A common discussion point is that vaccines and many commercially available pet foods contain dangerous “chemicals” that make animals sick or cause illnesses such as cancer. 

Raw meat on a chopping board

Members of these groups urge the use of “safer” alternative therapies such as homeopathy, reiki, Chinese medicine and chiropractic interventions. Anti-vaxxers recommend orally administered “like cures like” nosodes which they claim are a safe and effective alternative to conventional vaccines, and in some groups animal psychics even offer therapy via Facebook Messenger or phone. There are dog and cat groups containing thousands of members purely discussing what they believe to be ‘natural’ diets for animals, motivated by the supposedly dangerous content of commercially available dog and cat foods. Members of these groups champion unproven health benefits of feeding their pets on raw meat-based, grain-free, organic, or even vegan diets. Some of these raw diets have been shown to be a public health risk

To add weight to the opinions of those who distrust conventional medicine, a small number of vets are very vocal advocates of alternative medicines, and have huge social media followings. Their clinics offer therapies including homeopathy and bioresonance, and the British Association of Homeopathic Veterinary Surgeons has multiple case reports of cancer cured by homeopathic treatments on their website. These vets have a dedicated following of animal owners who believe that they are whistleblowers speaking out against a corrupt profession who are in the pocket of ‘Big Pharma’, just as discredited ex-doctor Andrew Wakefield purported to do in human healthcare. 

To address potential animal welfare harm caused by a small number of vets promoting anti-vaccination advice, homeopathy and other treatments with no scientific plausibility, the Royal College of Veterinary Surgeons (RCVS) published a position statement in November 2017. That statement advised that vets should only use complementary and alternative medicines in conjunction with appropriate treatment, so as not to cause animal suffering by replacing or delaying treatment. The statement went on to explain that homeopathy exists without a recognised body of evidence for its use and that it is not based on sound scientific principles. Such was the strength of opposition that protestors, led by an MP, marched outside the RCVS Headquarters and submitted a petition signed by over 11,000 members of the public, urging them to retract the statement.

Former MP David Tredinnick addresses a crowd as part of a protest against the RCVS.
Former MP David Tredinnick addresses a crowd as part of a protest against the RCVS.

Delaying or withholding effective treatments can cause animals to become more ill as a disease progresses. In humans, people argue (rightly or wrongly) that the placebo effect can very real and dramatic. However, there is no evidence that animals experience a psychological placebo effect when given ineffective remedies, most probably because they are unaware that they are receiving any treatment. Fascinatingly, as with parents of young children, owners may experience a ‘caregiver placebo effect’ whereby any improvement in the pet’s demeanour is attributed to the effectiveness of the treatment – rather than recognising that many animals with long term heath conditions such as arthritis have ‘good weeks’ and ‘bad weeks’ which are affected by a huge variety of factors.  

In conditions such as osteoarthritis, substituting actual painkillers with implausible alternative therapies would lead to an animal experiencing avoidable pain. In cases of severe bacterial infection, death is a real risk if appropriate antibiotics are not administered in a timely manner.  

Pet owners often fail to understand that delaying or withholding effective treatments can cause animals to become very ill, and that they could even be prosecuted if their animal suffers because they did not seek veterinary advice. 

It is difficult to engage in constructive dialogue with people who believe that anyone with a different opinion is part of a conspiracy. Focussing purely on educational interventions and explaining statistics to anti-vaxxers seems to have little effect. Understanding how these beliefs form in the first place is key. Anti-science attitudes are often more closely tied to an individual’s personal values, and even their politics, than to their level of education. This means that epidemiologists and advocates of evidence based medicine will probably have to rely on the expertise and research of political science and social psychology to develop successful techniques or campaigns to influence animal owners and their decision making. 

A vet with a stethoscope around her neck leans over a small white kitten with dark ears and blue eyes.

Adult humans can choose to ignore medical advice and elect to use unproven or dangerous alternatives to genuine medical treatment. However, animals are entirely dependent on their carers to make medical decisions for them. It is therefore unethical to force them to receive treatments that are implausible in place of proven treatments. They have no choice. 

Over the coming weeks and months we will be discussing further the various alternative therapies and medicines commonly used in animals, and, importantly, we’ll look at how to engage with animal owners in a compassionate and constructive way to ensure animal welfare is not compromised.

After all, we must remember that we have a lot in common, as those who champion alternative medicine want the same outcome that we vets are striving for: happy, healthy pets. 

The Skeptic would like to thank Zoe Belshaw for her contributions to this article.

Behind the Bastards, with Robert Evans: an infectiously enthusiastic dive into the darkness

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This twice-weekly podcast, running since 2018, looks at some of the worst people in history. As you might imagine from the title, the Behind the Bastards takes in a lot of obvious targets, from the Ku Klux Klan to Jeffrey Epstein, via Saddam Hussein’s erotic fiction and Joseph Stalin’s childhood. 

While almost everyone can get on board with hating the above-mentioned bastards, the show also covers a lot of targets that skeptics in particular may consider worthy of vitriol and discussion. Episodes have focused on everyone from Samuel Hahnemann, founder of homeopathy, to discredited ex-physician Andrew Wakefield, the man behind the MMR anti-vaccine scare that lingers to this day. 

The podcast is hosted by former Cracked.com editor and Bellingcat journalist Robert Evans. Evans is fairly open and vocal about his opinions, and this makes the podcasts very entertaining, and also leads to fun political connections, from the links between Nazis and Flat Earth to the racist origins of phrenology

There are also plenty of episodes that turn up less-obvious curiosities, from the influence of astrology on Ronald Reagan’s presidency, to the surprisingly lurid links between Aleister Crowley and Jack Parsons, of the Jet Propulsion Laboratory. 

Evans is always joined by a guest – either a writer, actor, podcaster or comedian, including David X Cohen, Edgar Momplaisir and Sofiya Alexandra – with whom he has excellent chemistry. The style is fairly irreverent and despite the often extremely dark subject matter remains an upbeat and funny listen. This is primarily down to Robert Evans’ infectious enthusiasm, and his endless jokes about starting a cult, podcasting machetes, and the super-awkward cuts to adverts, during which he typically damns the upcoming products and services with extremely faint praise that relate to the podcast topic at hand, promising that they defintely won’t murder your children or are highly unlikely to commit genocide. 

Finally, for a skeptic it’s reassuring to note that all of the episodes are well-referenced, in case you want to go behind-Behind the Bastards and check Evans’ sources.

‘Mask Mouth’: a real dental phenomenon, or merely a confection?

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With over 40,000 deaths in the UK and over 800,000 worldwide related to COVID-19 at the time of writing, you’d be forgiven for not having dental issues at the forefront of your mind at the moment. Unless that is, you’re one of the many people who have read about the new dental phenomenon known as ‘mask mouth’.

I hadn’t heard about mask mouth until a dentist friend of mine pointed me in the direction of an article on David Icke’s website. Icke’s site links to an original piece in the Daily Mail, and the story also made it into The Sun and Glamour magazine (now removed but available via archive), among others. You might think that these aren’t the most reliable of sources, and you’d probably be right, so it’s worthwhile looking at these claims to see if they stand up to scrutiny.

Woman wearing a face mask

As the story goes, the wearing of facemasks during the pandemic is causing an ‘explosion’ in the number of patients suffering from both cavities in their teeth and gum disease. People who have had no previous history of dental problems are starting to have issues with their teeth, and according to the dentists interviewed for the articles, it’s affecting up to half of their patients.

But are these claims realistic, or are they simply a confection? Let’s start with the claims that wearing a mask leads to tooth decay.

Decay, or ‘dental caries’ as dentists like to call it, is one of the most common diseases worldwide.  To experience decay, you need four things: teeth (obviously), bacteria, a fermentable substrate (for this; read sugar) and time. Remove any of these, and you remove the chance of decay.

Of course, it’s a little bit more complicated than that. The decay process occurs when the bacteria in the mouth break down the sugars you ingest into acids. If these acids demineralise the surface of the tooth faster than your saliva (or artificial alternative) remineralises it, your tooth begins to decay. The bacteria in the mouth live in a complex colony called a biofilm, which is removed for a short period when you brush your teeth.

It’s worth a brief interlude here to discuss the anatomy of the tooth Teeth consist of three types of hard tissue: enamel, dentine and cementum. These protect the pulp, which is where the tooth receives its nerve and blood supply. If decay reaches the pulp, you tend to end up with toothache of the agonising kind.

Enamel is the hard-outer layer; the first line of defence for the tooth against the outside world. You probably help strengthen this layer by using a fluoride-containing toothpaste. And if you don’t, you should.

The dentine layer of the tooth lies just below the enamel and consists of microscopic canal-like tubules. These tubules contain projections of the pulp and it’s these pulpal projections that cause the sensitivity you may experience when you have something particularly cold. Sensitive toothpastes work by either blocking the tubules or reducing the responsiveness of the pulp

Cementum covers the root surfaces of the teeth and helps attach to the bone of the jaw via the periodontal ligament. You’re only likely to experience decay of the cementum if you’ve had a significant amount of recession of the gums due to long-standing gum disease or trauma.

Dentine and cementum have lower mineral content than enamel. If the decay reaches these deeper layers, it’s likely to spread more quickly, so what we characteristically see is decay breaching the enamel and blooming at the junction between the enamel and dentine. It’s not unusual for what appears to be an insignificant cavity on the surface to be much more sizeable when you get into it.

With that short dental biology lesson complete, we can return to ‘mask mouth’, and ask: is the wearing of masks likely to be a factor in the decay process?  In short, the answer is no. Wearing a face covering doesn’t affect the bacteria in the mouth, and it doesn’t increase the amount of sugar you take in. For the short amount of time that most of us will be wearing masks in our everyday lives, the effect on the oral environment is likely to be negligible.

But what about gum disease? Perhaps unsurprisingly this looks unlikely too.

Gum disease is an inflammatory disease of the tissues that surround the teeth. We generally divide this into two types, gingivitis and periodontitis.

Gingivitis is the gum’s inflammatory response to plaque. Importantly, gingivitis doesn’t cause loss of the bone that supports the teeth – that bone loss is a sign of the less common, but more severe, periodontitis. Again, we know that gum disease can be controlled, for most people, by efficient biofilm disruption. And by that, I mean brushing your teeth well. Make sure to concentrate on the gum line, where the biofilm starts to grow; and use interdental brushes or floss to clean in between your teeth regularly.

For most people, the bone loss associated with periodontitis may take years to become apparent. By the time patients have noticed symptoms, which usually involve loose or drifting teeth, the disease can be at an advanced stage. Wearing a mask for the last few months, even if you were doing it for hours every day, is not going to accelerate that process.

A dentist, in full PPE, examines a patient

Speaking of which, do you know who is wearing masks for many hours a day, every single day at the moment? Dentists. Sure, we are probably a bit better than most at keeping our teeth clean, but there simply haven’t been any reports of dentists developing ‘mask mouth’. And, come to think of it, other than the one or two dentists cited in the mask mouth articles, I can’t think of a single dentist who has even heard of it.

What is ‘mask mouth’ then? One answer might be that it is a cynical ploy to drum up trade by a handful of dentists who haven’t been able to work during the coronavirus pandemic. And that’s what really leaves a bad taste in the mouth.

The Ockham Awards 2020: recognising the best in skepticism, and the worst in pseudoscience

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Since 2012, The Skeptic has had the pleasure of awarding the Ockham Awards our annual awards celebrating the very best work from within the skeptical community. The awards were founded because we wanted to draw attention to those people who work hard to get a great message out. The Ockhams recognise the effort and time that have gone into the community’s favourite campaigns, activism, blogs, podcasts, and outstanding contributors to the skeptical cause.

I am pleased to announce that nominations for the 2020 Ockham Awards are now open! 

The Ockham's Award logo

Past Ockham winners have have included current contributors to The Skeptic, Professor Edzard Ernst and Hayley Stevens, the European Skeptics Podcast and Say WHY To Drugs podcast, ex-naturopath Britt Hermes for her blog exposing quackery in her former career, the Edinburgh Skeptics for their annual Skeptics on the Fringe event, and Mark Tilbrook for spreading critical thinking about so-called psychics in the face of verbal and physical abuse from ‘Psychic’ Sally Morgan’s management team and family. 

In fact, prior to becoming editor of The Skeptic, I was honoured to receive the 2018 Ockham for Skeptical Activism and the 2016 Ockham for Best Skeptical Campaign for my work in stopping NHS homeopathy, as part of the Good Thinking Society. Needless to say, I won’t be eligible for nomination this year! 

The Rusty Razor award

While we recognise the best in skepticism, our awards are also an opportunity to highlight the danger posed by promoters of pseudoscience with our Rusty Razor award. The Rusty Razor is designed to spotlight individuals or organisations who have been prominent promoters of unscientific ideas within the last year.

Previous Rusty Razor winners have included Andrew Wakefield for his ongoing promotion of anti-vaxx misinformation, and Gwyneth Paltrow for her pseudoscience-peddling wellness empire, Goop

One of the most important elements of our awards are that the nominations come from you – the skeptical community. We’d like you to tell us who you think deserves to receive the Skeptic of the Year award, and who deserves to receive the Rusty Razor. 

Submit your nominations now!

Nominations are open now and will close on October 31st. Winners will be chosen by our editorial board from the nominations we receive, and they will be announced at Skeptics in the Pub Online on November 19th, at 7pm.

Featured image taken by Rob McDermott at QED 2018

Don’t believe what you think! Examining misinformation about so-called alternative medicine

What follows is a slightly modified and abbreviated version of the introduction to Professor Edzard Ernst’s recently published book, Don’t Believe What You Think.

Why do even intelligent, well-educated people so often draw wrong conclusions about so-called alternative medicine (SCAM)? The main reasons, I submit, are misinformation, motivated ignorance, motivated reasoning, confirmation bias, and denialism.

Misinformation overload

The popular press has an insatiable appetite for SCAM. There are currently some 50 million websites on the topic. This amount is extraordinary; no other medical subject comes even remotely close. Amazon UK lists currently over 50,000 books of SCAM. This figure dwarfs the numbers of books on most other medical subjects – gynaecology: 10,000, orthopaedics: 10,000, rheumatology: 4,000, for instance. These numbers become even more impressive, once we realise that the vast majority of all SCAM books are written for a lay readership, while most of the books on other medical topics are for healthcare professionals. It is clear from these data: consumers are currently bombarded with information about SCAM.

news paper with the word truth in large writing

But such an abundance of material is not necessarily a bad thing. What makes this plethora of information worrying is the fact that the information includes an opulence of falsehoods. SCAM has been an industry of ‘fake news’ and ‘post truths’ long before these terms even entered our vocabulary. Crucially, most SCAM proponents seem to be unwilling or unable to differentiate between reliable and unreliable sources of information; those that agree with their preconceived ideas tend to be viewed as reliable, and those that don’t are dismissed as unreliable.

Some 15 years ago, my team systematically investigated this ‘industry of untruths’ by extracting from 7 best-selling SCAM books the number of treatments being recommended for given diseases. The results were staggering; every SCAM seemed to be recommended for every condition regardless of any common sense or scientific evidence. In fact, for most of the recommendations, the evidence was either non-existent or outright negative. Even worse, there was no agreement between the 7 books indicating that the recommendations were entirely random. Here are a few examples (the numbers in brackets refer to the number of different SCAMs recommended for that condition):

  • Addictions (120)
  • Arthritis (131)
  • Asthma (119)
  • Cancer (133)
  • Depression (87)
  • Diabetes (89)
  • Hypertension (95)

When we evaluated the content of SCAM websites for certain diseases, such as cancer, our findings revealed that most sites recommended for an abundance of treatments not supported by sound evidence. The potential for patients to get harmed by these books was undeniable. We concluded that “the most popular websites on SCAM for cancer offer information of extremely variable quality. Many endorse unproven therapies, and some are outright dangerous.

We also assessed the content of the websites of 200 chiropractors. Our findings showed that 95% of these sites made unsubstantiated claims. We concluded that “the majority of chiropractors and their associations in the English-speaking world seem to make therapeutic claims that are not supported by sound evidence”.

But this bombardment of consumers with misinformation is not just confined to the written word. When the falsehoods come directly from the mouth of a SCAM enthusiast, they get even more dangerous. SCAM practitioners issue wrong advice to their patients all the time, and the same sadly applies to many pharmacists. Another of our investigations determined what advice health food store employees present to individuals seeking treatment options for breast cancer. Eight researchers asked employees of all health food stores in a major Canadian city what they would recommend for a patient with breast cancer. Thirty-four stores were examined, and a total of 33 different products were recommended. Crucially, none of these products were supported by good evidence of efficacy.

Many consumers will readily accept the false information as true. Others might initially have some doubts but will eventually yield to the constant onslaught. The plenitude of cleverly marketed untruths acts like a brainwash and is unquestionably a prime reason for consumers’ erroneous beliefs about SCAM.

Motivated ignorance

A stethoscope on a table

Motivated ignorance is a lack of knowledge due to a conscious decision to ignore information that, for some reason or other, is inconvenient, disturbing or unwelcome. The phenomenon is very common and affects us all. A classic example of motivated ignorance is the person who feels unwell but does not consult a doctor because she is afraid of a serious diagnosis; she thus makes the conscious decision to remain ignorant about her health.

Motivated ignorance has been studied extensively. In one investigation, for instance, volunteers were given the choice of reading either a pro or a contra article on the topic of gay marriage. Those who chose to read the opinion they agreed with would be given a chance to win $7, while those who chose to read the opinion they disagree with would have the chance to win $10. The results showed that 63% of the volunteers opted for motivated ignorance and chose not to read the opinion they disagreed with thus preferring to forfeit the chance to win more money.

We all regularly succumb to motivated ignorance, if we want to avoid disconcerting information. Such avoidance of knowledge occurs particularly in the area of healthcare. In SCAM, it is an important reason for people to shut their eyes and ears to the uncomfortable reality that their favourite SCAM might be not as fabulous as they think. The phenomenon is especially powerful when someone has acquired a quasi-religious belief in SCAM. On my blog, I often receive comments from such believers. Whenever they are confronted with the evidence that their SCAM might not be as beneficial as they had assumed, they deny the validity of this information. They might state, for instance, that they reject the evidence because they assume:

  • the evidence is fabricated,
  • the research is paid for by ‘Big Pharma’,
  • the study is fatally flawed.

It is hard to convince a religious person that her god does not exist. In my experience, it is equally difficult to convince SCAM-believers that their SCAM is bogus, and even harder perhaps that their guru is a charlatan. In fact, in many instances, this proves to be impossible. For people who are bent on rejecting science, even the most persuasive evidence will have little impact. In the extreme, motivated ignorance can kill the person who is afflicted by it; think, for instance, of patients refusing life-saving therapy and preferring to opt for an ineffective SCAM despite overwhelming evidence that the conventional treatment would save their lives.

Motivated reasoning

Motivated reasoning goes one crucial step further than motivated ignorance by consciously defending a treasured belief regardless of even the most compelling evidence against it. The two phenomena are paired like twins and usually affect us simultaneously. Motivated reasoning uses a range of techniques aimed at defending indefensible positions, e.g :

  • inventing untruths,
  • abandoning logic,
  • cherry-picking the evidence,
  • discrediting opponents.

Motivated reasoning can be seen as an attempt to avoid cognitive dissonance – the mental discomfort we experience when faced with contradictory beliefs – frequently at the expense of integrity and sometimes even honesty. Yet, motivated reasoning is common and few of us are immune to it. In SCAM, it is applied abundantly both by individuals as well as organisations, and there are countless examples to demonstrate it.Motivated reasoning is not merely distorting the views of SCAM providers and their patients, it also has the potential to endanger public health.

Confirmation bias

Confirmation bias describes our preference for information that is in line with our prior beliefs. For explaining why consumers often believe in falsehoods about SCAM, it probably is, next to misinformation overload (see above), the most important phenomenon.

While motivated reasoning and motivated ignorance are largely based on our conscious decisions, confirmation bias occurs without us even noticing it. It functions like a filter that eliminates disagreeable information and selectively allows material to enter our mind that agrees with our views. Thus, we subconsciously focus on information that confirms our opinion, while rejecting data that contradict it.

The effects of confirmation bias can be profound and alarming: we might pride ourselves of having an open mind and to fairly consider all the available evidence, while our preconceived beliefs continuously eliminate much of the information that would otherwise contradict them. In the end, we might feel entirely confident to be well-informed and correct, while we might, in fact, be totally misinformed and wrong.

An open book with glasses resting on the page

The best protection from falling victim to confirmation bias is to systematically follow where robust science leads us. The criterion must be the reliability of the science, not the direction of its results. Avoiding being influenced by confirmation bias can be a big ask indeed. It often requires not merely accessing the scientific literature but also differentiating between rigorous science, poor science, pseudoscience and fake science.

Patients, particularly those suffering from serious conditions, want the benefit of their pet therapy to be true, and thus it becomes true. They filter out unwelcome information and what remains is a positive impression.

Denialism

In extreme cases, confirmation bias can degenerate into a complete denial of the truth. An apt example of science denial is SCAM providers’ prevalent negation of the benefit of immunisations. The evidence that vaccinations generate much more good than harm is truly overwhelming. Yet, in the realm of SCAM, many enthusiasts deny this well-documented, undeniable fact.

Science denial is defined as dismissal of established scientific evidence for irrational reasons. Even though they sometimes get confused, denialism is fundamentally different from scepticism. In some ways, it is even the exact opposite. Scepticism is based on rational analysis, scientific information, theoretical predictions and empirical evidence. By contrast, science denial is irrational and disregards scientific information and evidence, even in the face of overwhelming data.  

Science denial can be naively innocent and inconsequential, for example, in the case of members of the flat earth society. However, in many instances, it causes considerable harm. The denial of the benefits of immunisations, for instance, has brought back measles epidemics and caused the death of hundreds of children. The South African AIDS denialists claimed that AIDS was caused not by the HIV-virus but by poverty-induced malnutrition, recommended nutritional treatments for AIDS and banned the use of antiretroviral drugs. This prompted around 171,000 HIV infections which caused ~343,000 deaths between 1999 and 2007.

Science denial is often paired with conspiratorial thinking which can be viewed as critical thinking gone badly wrong. Conspiration theorists tend to explain certain events as a result of secret machinations of powerful, dark forces. Thus, anti-vacationists as well as AIDS denialists tend to believe that the pharmaceutical industry is conspiring against the public in order to make money at the cost of our health.

The words "fake news" typed on a typewriter

In a similar vein, some SCAM proponents believe that their SCAM is suppressed by the powerful interests of the establishment. A study from the US, for example, found that belief in conspiracy theories is rife in the realm of SCAM. The investigators presented people with 6 different conspiracy theories, and the one that was most widely believed was the following: THE FOOD AND DRUG ADMINISTRATION IS DELIBERATELY PREVENTING THE PUBLIC FROM GETTING NATURAL CURES FOR CANCER AND OTHER DISEASES BECAUSE OF PRESSURE FROM DRUG COMPANIES. A total of 37% agreed with this statement, 31% had no opinion on the matter, and 32% disagreed. What is more, the belief in this particular conspiracy correlated positively with the usage of SCAM. Such findings imply that the current popularity of SCAM is at least partly driven by the conviction that there is a sinister plot by ‘the establishment’ that prevents people from benefiting from SCAM.

Perhaps the most tragic examples of the damage caused by confirmation bias combined with science denial and conspiratorial thinking are those of parents preventing their own children from receiving life-saving treatments.

The three-year old Noah was diagnosed with acute lymphoblastic leukaemia, a blood cancer with a very good prognosis when treated (~85% of all children affected can be completely cured and expect to live a normal life). The child was admitted to hospital and, initially, chemotherapy was started. But the treatment was not finished, because the parents took their child home prematurely. The mother, a 22-year-old ‘holistic birth attendant’, had been against conventional treatments from the start. She nevertheless agreed to the first two rounds of chemotherapy “because they can get a medical court order to force you to do it anyways for a child with his diagnosis”. Then she absconded and treated her son with several forms of SCAM: rosemary, colloidal silver, reishi mushroom tea, and apricot seeds.

In a matter of hours, they were found by the police. Noah was then taken from his parents to be medically treated. The parents, meanwhile, were being investigated on suspicion of child neglect. They insisted that they were merely trying to give their son alternative medical care, accusing the police and medical officials of stripping them of the right to choose their own treatment plan for their son. Their supporters called the state’s decision to take custody of Noah a “medical kidnapping”. 

Another article reported an even more dramatic case:

The parents of a seven-year-old boy who died after they decided to treat his otitis with homeopathy were convicted of manslaughter. Francesco, from Cagli near Pesaro, died on May 27, 2017 from bilateral bacterial otitis. His parents were found guilty of complicity in aggravated culpable manslaughter. They were given a suspended sentence of three months in jail. The parents had entrusted their son’s care to Pesaro homeopathic doctor Massimiliano Mecozzi, who is set to go on trial on September 24. The homeopath advised treatment with homeopathic products instead of the antibiotics which would have saved him, the court found. Francesco died after the otitis degenerated into encephalitis.

Such cases exemplify how misinformation overload, motivated ignorance, motivated reasoning, confirmation bias and science denial can generate the wishful thinking that misleads many of us into believing things that are not true. I therefore feel that it is wise and timely to caution: do not believe what you think!

Ethics for skeptics: why compassion and reason go hand in hand

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When I was first invited to contribute to The Skeptic, I jumped at the chance. I have nothing but respect for everyone involved in the Merseyside Skeptics Society, and I hoped this column could be a space to discuss two things I care deeply about: skepticism and ethics. When I saw the mag’s new tag line, “reason with compassion”, I knew I was in the right place.

I believe that ethics and skepticism need each other. A good life is one that contains both in healthy balance. Thinking about how we ought to act, what we owe to others and ourselves, is crucial to our flourishing. Yet Ethics is amongst the most difficult areas of human exploration. Our ethical thinking is often hampered by cultural assumptions and unexamined heuristics, leading many to wonder if ethics is even real, or just something we made up to keep people in line. While I believe there are some objective ethical truths out there that humans can understand, I’m sympathetic to the concern that our knowledge of them is always mediated through our limited understanding, which is why it’s so critical to maintain a healthy skepticism towards our currently held ethical belief, just as we do with our currently held empirical beliefs. Anyone who doesn’t abide by fundamentalist ethics will see the value in approaching ethical claims with a skeptical eye, so it’s clear why ethics needs skepticism. It may be less clear why skepticism also needed ethics. Or, more precisely, why the skeptical mindset is fundamentally an ethical proposition.

Sextus Empiricus

Historically, skepticism has always been driven by ethical concerns. Ancient skeptics like Sextus Empiricus saw skepticism as the best way to maintain mental health and stability, what they called “ataraxia.” These ancient skeptics argued that humans should cultivate the ability to suspend judgment when they lacked sufficient evidence, rather than succumb to the human inclination to form a bunch of unjustified beliefs. Sextus’s skepticism was a form of virtue ethics, the view that humans should cultivate the ability to act well through practice in order to live a life of flourishing. The resulting virtue epistemology claims that we ought to get in the habit of believing in the right ways and for the right reasons, otherwise we will slip into vicious and harmful modes of believing. Holding only justified beliefs contributes substantially to a life of flourishing. Credulity, on the other hand, leads to false beliefs, and acting on false beliefs often causes suffering. Even if we don’t act on the false beliefs, the cognitive dissonance caused by the repeated collision of truth with error can produce unnecessary suffering when we are strongly invested in false beliefs. To avoid contributing to that suffering, we ought to remain skeptical and circumspect in our belief formation. Of course, skeptics throughout history have debated what counts as sufficient evidence, but that’s the hard work of epistemology. The key insight is that skepticism is an intellectual virtue.

Like Sextus before him, William Clifford defended a particularly extreme form of virtue epistemology that I find valuable for understanding the ethical foundation of skepticism. In his 1877 essay “The Ethics of Belief”, Clifford argues that “it is wrong always, everywhere, and for anyone to believe anything on insufficient evidence”. Clifford argues that it is even wrong to believe harmless beliefs based on insufficient evidence, because it can get one in the habit of credulity, which will lead to believing harmful beliefs down the line. Clifford presents the chilling example of a shady shipowner who convinces himself, based on little more than wishful thinking, that his aging vessel will safely make another trip across the ocean. When it fails to do so, the shipowner pockets his insurance money with no shred of guilt, fully-convinced that it was just unforeseeable bad luck. When we take seriously the potential harms of credulity, it gives us a strong justification for setting the standard for belief formation deep in skeptical territory. While Clifford’s view is criticized as far too epistemically demanding, it fully exposes skepticism’s ethical foundation. Belief impacts behavior, and false beliefs can cost people dearly.

William K Clifford

Some have argued that skepticism is completely separable from any particular ethical commitments. They point out that skepticism only tells us how to act with regard to beliefs, it doesn’t mean that we have to adopt any particular ethical view, as long as our ethical beliefs are based on sufficient evidence. This thin account of skepticism, combined with some questionable metaethics, leads many skeptics to adopt either ethical nihilism or ethical subjectivism. Ethical nihilism is the view that there are no ethical truths and it doesn’t matter if we try to act ethically or not. You see this view most prevalently in the spaces where skepticism and internet troll communities overlap. Much of the rest of skepticism is dominated by subjectivism, the view that ethics is entirely determined by our beliefs about ethics. On this view, there are no objective ethical truths, but rather, we construct ethical theories that serve our needs. Subjectivism fits comfortably into the scientific materialist worldview that many skeptics understandably adopt, and provides some ground for defending claims about ethics. I plan to devote future columns to raising concerns about both of these views, while offering a robust, secular moral realism as an alternative. For now, let me say that I think there is insufficient justification for adopting either nihilism or subjectivism about ethics.

Other folks may challenge my lashing of skepticism to ethics on the grounds that skepticism is not, essentially, a means to any other end beyond the seeking of truth and the shunning of error. They claim that a skeptic’s motivation should rest entirely on the value of truth itself, separate from any further goods it can produce. I am sympathetic to the view that truth has some non-instrumental value. It does seem better to have a true belief than a false belief, even if no further good follows from having that true belief. However, it seems to me that the bulk of what makes the truth valuable is not intrinsic to the truth itself; it’s the power it gives us to reshape the world in a way that reduces suffering and promotes flourishing. Given the choice between knowing an infinite number of instrumentally-useless truths and knowing just one truth that could really help people, I think we ought to always choose the latter.

I’ve spent the bulk of this first article unpacking my understanding of skepticism, but I should also say a little about what I mean by ‘ethics’. First, I use ‘ethics’ and ‘morality’ interchangeably, as is the fashion in ethics these days. I define ethics as a broad field that includes considerations about good and bad, right and wrong, and what it means to live a life of flourishing. Those might seem like synonymous concepts, but I believe that the way they connect and come apart is surprisingly complex. Much good can come from understanding the peculiar relationships between these different ethical concepts, and the only way we get there is through skeptical interrogation of the universe, society, and our own ethical intuitions.

Image of the earth

Skepticism has the power to bring about profound change in the world. Skepticism allows us to raise doubts about prevailing social norms, leading to the reform of unjust laws. Skepticism gives us a powerful tool for pushing back on harmful pseudoscientific claims that are being commodified at a frightening rate. Skepticism allows us to turn our compassionate reasoning into substantive social progress. We are the benefactors of a rich tradition of mitigating the suffering caused by natural human credulity, and when the time comes, we ought to hand that tradition off to our successors with the ethical foundations intact.

Aaron Rabinowitz is a lecturer in philosophy at Rutgers University, and host of the Embrace The Void podcast.

NHS Lincolnshire Reiki-d over the coals for ‘Spiritual Healer’ job ad

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So, let’s be very clear about this to start out with; Reiki is nonsense. It’s nonsense of the highest order. For the uninitiated, Reiki is a form of alternative medicine based on the concept of a universal life force known as qi (or, chi). Practitioners claim to be able to manipulate this energy, usually through their palms, to promote wellbeing and healing. There is no reliable evidence that they can do so, or that qi even exists. It was even debunked by an eleven year old. Imagine therefore the outrage when this job posting from the NHS reared its ugly aura:

Spiritual Healer / Reiki Therapist – Band 4 – 15 hours

Cue immediate criticism on social media from Skeptics, Humanists, and, not surprisingly, from a number of Band 3 NHS employees. Those of us who applauded the NHS in the hell-cyon days of early Covid-19 lockdown were decrying the chronic underfunding and perceived dismantling of our nation’s pride. Surely our beloved NHS weren’t then wasting their limited resources on bogus treatments like this?

Well, thankfully not. Shortly afterwards the job description was conspicuously changed:

Charity Funded Reiki Therapist job reference - Band 4 - 15 Hours - note that the words charity funded have been added and the words spiritual healer have been removed from the first iteration of the job listing

However, the fact that the NHS isn’t directly funding this position only partially dowses the flames of discontent.

Interestingly it appears that there was also some kind of assumption from the administrators that the eye of the tweetstorm was focused on the “Spiritual Healer” part of the job description, and that somehow Reiki would get a pass. It certainly doesn’t, and there’s still plenty to be concerned about: there’s the perceived legitimacy that alternative medicine gets from being an indirect part of the NHS care package; the administrative and logistical costs of incorporating those externally funded staff members into the overall running of the hospital; the disturbing fact that these so-called ‘Healers’ are permitted to take part in multidisciplinary team meetings to discuss treatment plans for patients; and the even more disturbing fact that highly qualified medical professionals have given the hand-wavers a waiver on this. On top of all that there’s also the time and effort of whoever was unfortunate enough to be managing the social media accounts of United Lincolnshire Hospitals NHS Trust when the news broke. You’re doing a fine job whoever you are!

Keyboard and mouse with headphones and coffee cup behind. A hand is on the mouse.

All of these perfectly valid concerns might give reason to mount a robust campaign to oust them from the wards, but arguably it may not be quite as simple as that. There’s another, bigger problem out there, and while the pseudoscientists are attempting to address it in their own misguided way, we Skeptics can sometimes be too busy behind our keyboards to notice it.

The job in question is at the Waddington Unit in Lincoln County Hospital, a haematology and oncology unit caring for patients receiving chemotherapy/radiotherapy and end of life care. Cancer treatment isn’t fun. We don’t recommend you put it on your bucket list… unless have cancer, in which case we recommend you put it at the very top of your bucket list. The treatment can be incredibly punishing on the body, but it also takes a considerable toll on the mind. Aside from what is most probably some excellent bedside manner from the (genuine) healthcare professionals who work there, it’s likely that they have limited extra time to spend with those patients. If they had more time and resources, perhaps they might not be so open to inviting practitioners of complementary medicine onto their premises.

Pain is real, but it’s subjective. So is nausea. Ever been ill and been lucky enough to have someone who cared about you enough to give you some care and attention? Did it make you feel better? Even for a short while? Facts don’t care about your feelings, but your feelings matter. The feelings of cancer patients certainly matter. It seems therefore that one could fairly argue that those Reiki practitioners are meeting a requirement that might otherwise remain unfulfilled. It’s just a pity, and even a legitimate concern, about the unpleasant baggage they bring with them.

A woman lays on a therapy bed with a reiki practitioner behind her holding his palms either side of her head.

So, how did such a discredited treatment make its way into some of our hospitals in the first place? Enter Angie Buxton-King, founding member and driving force behind the Sam Buxton Sunflower Healing Trust. She’s the author of the disturbingly titled book ‘The NHS Healer’, and its disappointingly named follow-up ‘The NHS Healer – Onwards and Upwards’. These books chronicle the ‘integration of Healing within the NHS’. The capital H in Healing seems to be used more like a brand name than an actual solid claim of curing anything. The implications are there nonetheless; even their website address of cancertherapies.org.uk has a disturbingly over-promising sound to it. The website appears somewhat primitive looking, but very carefully worded as they under-promise just enough to stop them falling foul of the Cancer Act.

Angie appears to have been working for the NHS as a ‘healer’ since 1999. Disappointingly, it seems that University College London Hospitals have had somewhat similar complementary therapies funded by various different charities for quite some time. The inception of Angie’s charity came a few years later when Angie’s son Sam tragically passed away from Leukemia at the age of ten. So we’ve got a grieving mother with some unusual beliefs who saw first-hand the toll that cancer treatment, and the cancer itself, can take on someone. In such a situation it’s natural to try anything and everything to help make things better, even if actual healing-with-a-lower-case-h isn’t possible. It’s all too common for grieving relatives to turn the death of a loved one into some form of campaign. It’s a coping mechanism of sorts.

The service provided by this somewhat misguided charity may appear to be giving comfort. There’s a fair amount of patient testimony to that effect, and glowing compliments from other staff members in the unit. Anecdotes aren’t always indicative mind you, and it’s hard to find any meaningful comparative data when it comes to patient satisfaction or survival/recovery rates.

Angie is clearly an intelligent and driven individual, and her insider knowledge of how the NHS works clearly allows her to move carefully within the system without overselling the potential benefits of the services her charity provides. She’s also aware of some of the baggage that’s carried by complementary medicine. From an online interview:

“Spiritual Healing and Reiki are one and the same thing. If you use the term Spiritual Healing then it will close the doors of the hospice.”

It’s far from ideal, and given that Reiki often comes with implied or explicit claims to be able to actively heal illness, there is an argument as to whether the pros outweigh the cons in this case. But we can’t deny there appears to be a patient need which should be addressed. By understanding what that need is we can look to find less problematic, pseudoscientific solutions. Even some of the little things could make a difference. For instance;

a man undergoing shoulder massage
  • Massage.
  • Talking through your situation with someone who is an active, empathetic listener.
  • A relaxing bath.
  • Gentle hugs from a loved one.

So, until such time as someone starts up a charity providing one of the above options that can ramp up to the levels of funding multiple dedicated staff members across a number of hospitals, and push it with the same drive as a bereaved parent, we should perhaps leave the pitchforks at home for now.

The Atacama mummy: putting together the pieces of an “Archaeology bombshell”

An absolute tyre fire. Several storeys high and visible from space.

That’s my search history every time I’m asked to do something ‘fun’ by a member of the skeptics community. A recent appearance on a podcast, for example, required ‘just a bit of research’. Now Youtube is trying desperately to show me nought but QAnon videos!

You’d think I’d learn my lesson, but here we are again. When I was asked to write this article the brief looked promising; a topic of my choice investigated using the critical eye of an archaeologist. All I had to do was pick a topic that couldn’t possibly be sad/infuriating/convoluted.

A Player Playing PUBG Mobile

Inspiration came quickly, but from an unexpected angle. During the lockdown I’ve found a fun way to keep in touch with my friends is to play the online video game PUBG (although most of the voice chat included some variation on, “it’s actually been really nice to have to time to reconnect with… FOOTSTEPS, THERE ON YOUR LEFT, GET HIM, GET HIM!”).

To keep things fresh, the developers add themed events and as fate would have it the latest update landed just when I needed it. I logged on, there it was: a great big Egyptian pyramid shaped spaceship. That’s right, we’re doing ancient aliens!

The idea that aliens, and not humans, are responsible for many ancient monuments is a surprisingly tenacious one. It’s also an idea which appeals to tabloids as an easy way to fill column inches and Google brought up several promising articles. I decided to look at the most recent, published 30th July 2020 in the Express, with the headline “Archaeology bombshell: Strange discovery of mysterious ‘alien’ figure“.

Leaving aside any discussion of what an ‘archaeology bombshell’ might entail (does it blow everything up, but leave the pieces meticulously recorded?) this article covered the 2007 discovery of a 15cm long mummy in the Atacama Desert. Despite the headline, the article gave little time to the idea that the specimen was an actual ‘alien’.

Piedras Rojas, Atacama Desert, Chile
Piedras Rojas, Atacama Desert, Chile

Instead, it covered an ancient DNA analysis (Bhattacharya et al 2018) which suggested that the reason for the appearance of the mummy, identified as a premature human infant, was that the individual had multiple physical malformations including an ‘unusually’ elongated skull, skeletal malformation and ‘missing’ 11th and 12th ribs, all identified by mutations in the genes.

That’s the end of that right? An alien myth debunked using DNA evidence. Well it would have been if I hadn’t decided to read the original study the article was based on, just to see if anything had been lost in translation from boffin to hack.

Off to google again. The original piece was there, but that wasn’t what caught my eye. I’m drawn to two other links. The first is a rebuttal and the second is an editorial response to the rebuttal. Academic fight! Get everyone around and chant ‘peer review’ until someone cries!

The rebuttal (Sian E Halcrow et al, 2018) made for interesting reading. Written by an interdisciplinary team of archaeologists, anthropologists, gynaecologists and anatomists, their issues with the original paper could be summed up as: “What the hell are you talking about?”. It reviewed each of the supposed mutations and pointed out how they are completely normal features of a foetus at 15 weeks gestational age. The elongated skull? Moulding of the cranium as it passed the cervix. The missing ribs? What little data we have on the formation of the 11th and 12th ribs suggest they don’t appear until later in gestation. Other skeletal malformations? Nope, everything looks normal thank you.

A very smart geneticist (my brother) said, “People have a fuckton of variation…mutations can be very unpredictable”. In other words, it’s more about probabilities than certainties, but the temptation remains to treat it like it’s the other way around. Ancient DNA is becoming more popular in the field of archaeology. The appeal is understandable, to look beyond bones to physical attributes which might not be preserved. These areas were generally a closed book and ancient DNA analysis appeared to be a way to start turning the pages, but it’s important not to get carried away.

Theatrical poster for "Sirius". The poster art copyright is believed to belong to Neverending Light Productions.

By Source, Fair use, https://en.wikipedia.org/w/index.php?curid=39365418

Another issue raised was the ethics of how these remains were treated. Firstly, it is important to note that the mummy is currently held in a private collection in Spain. Secondly, the instigating factor for the study is rather dubious: it was commissioned as part of a documentary called Sirus, which claimed the mummy was proof of ancient aliens. The authors approached the film-makers in order to offer their services to help define the true nature of the specimen. In their editorial response (Nolan and Butte, Genome, May, 2018), the authors claimed that their findings “provided a definitive scientific basis to put a stop to unscientific accounts”. A claim that would hold more water if the documentary team hadn’t ignored the findings and gone with the alien line anyway.

The information they were able to recover gave a clue to another troubling aspect of this story; the possible period from which the skeleton originated. In Sirus, the claim was made that it was thousands of years old; however, given the preservation of the material the geneticists posited it was 500 years old or younger. Personally, I think it might be a bit more on the recent end of that estimate.

The original paper included a theory the mutations were the result of nitrate poisoning. While this idea wasn’t expanded on, it isn’t entirely pulled out of their collective bums, either. The mummy was possibly found by a ‘treasure hunter’ (eye rolls for infinity) and, though the specific providence is unknown, it is believed to have come from around La Noira, once a thriving town in the heart of the Chilean nitrate mines. Founded in 1826, it was occupied until WWI when the Chilean nitrate industry collapsed.

The keen-eyed among you may have already noticed that 1826 isn’t 500 years ago, and as such if the mummy is from La Noira it is likely to be either C19th or even C20th in origin.

So, lets recap: instead of an ancient alien, what we have instead is the mummy of a premature baby – which may have died recently enough to have still living relatives – being stolen by a treasure hunter, sold out of country to a private collection in Spain, after which it is held up as proof of aliens in a documentary, and cut up to find out if it’s human. And then a paper was written about how horribly mutated it was, even though it wasn’t… you see what I mean about researching things for the skeptics?!

At the core of this story is a very human tragedy: a family losing a child. It raises many questions around exploitation, the treatment of human remains, and the colonial mindset that sees a mummified foetus privately owned by someone on the other side of the world.

Those are questions for another day and for another article. Because, as much as it leaves my internet browser looking like a Nazi who picked the wrong grail to drink from, if I’m being honest, I always enjoy when the skeptics come calling. At the very least I know it won’t be dull.