This is an old post, but I wanted to bump it up given the current homeopathic shenanigans
originally posted: Monday, July 17, 2006
In looking at countless quack web sites and having discussions with various quacks on message boards, the inevitable question that I ask myself is “What sort of quack am I dealing with – deluded or fraudulent?” The fraudulent quack knows they are promoting cures and remedies that do not work (above the placebo) but make money out of it anyway. The deluded quack believes they are promoting something genuinely wonderful, but misunderstood by ‘science’.
The more I delve into quackery, the more I believe that we are mostly dealing with the deluded. Frauds can be dealt with by legislation and prosecution. The deluded appear to be a tougher nut to crack – minds have to be changed. However, the belief systems around alternative medicine appear to be impervious to criticism and rational enquiry. The defensive walls are high.
This situation appears to be very similar to arguments surrounding religious beliefs. Religion is largely immune to rational enquiry with people who hold such beliefs as they have many defenses against such enquiry.
Richard Dawkins coined the term ‘meme’ to represent a ‘replicator of cultural information that one mind transmits (verbally or by demonstration) to another mind’. The God meme is usually at the foundation of religious beliefs. If you are unfamiliar with the concept of the meme then best start here. The point I want to make is that memes rarely appear on their own, but usually cluster together to form cooperating meme-plexes that help each other to survive. A God meme on its own may not last in a culture for long. Gods are notorious in their reluctance to offer direct evidence of their existence and so a God meme may soon be subject to attack from a sceptical mind. However, if you couple a God meme with a ‘faith is good’ meme and a ‘doubt is bad’ meme then together, these memes may form a more stable meme-plex. Any sceptic can be brushed aside as a ‘doubter’ and any self-doubt can be parried with a renewed sense of the need for faith.
I would suggest that Alternative Medicine advocates must surely also carry around similar meme-plexes of symbiotic ideas that prevent logic, reason, intelligence, science and experimental evidence from demolishing the core ideas of the practice.
However, a customer of alternative medicine need not carry around huge meme-plexes in order to take their medicine. A person need only believe a few things about homeopathy in order to try it – gentler than ‘western’ medicine, ancient principles, no side-effects, and so on.
However, the meme theory would predict that the stronger the advocate of homeopathy, the more memes need to be believed to fend off scepticism and evidence. This contrasts with a scientist; the closer you are to the science, the more facts and theory you will know – there is no need to hold beliefs that prevent rational enquiry about the science – their defense is the strength of the evidence. The homeopathists on the other hand needs more and more defensive walls around a small core of unchanging beliefs. So here is my hypothesis of the memetics of quackery and pseudoscience:
The greater advocate a person is for quackery, the more that defensive memes need to be held that can stall rational enquiry, whilst the core memes regarding the theory of the quack subject remain fairly constant with the degree of advocacy.
So we need to test this now. Maybe I can even build tests into the quackometer to spot pseudoscience and quackery!
Looking at the homeopathist example a bit further. The BBC’s Newsnight programme this week carried a report into how high street homeopathists are giving dangerous advice regarding the prevention of malaria. Of ten surveyed, all offered a homeopathic sugar pill to act as prophylactic and gave no other advice about bite prevention and the need to see your GP. This is appallingly dangerous as malaria kills. Melanie Oxley of the Society of Homeopaths appeared on the programme to answer these allegations. Her response was breath-taking in her inability to grasp the nature of what the accusations were and was a classic example of complete internal denial. Is Ms Oxley stuffed full of quack memes to prevent critical analysis?
The Society of Homeopaths has a list of press releases, the most recent one about the above BBC report. These press releases appear to contain lots of ‘official’ responses to complaints or criticism and so, according to my hypothesis above, be rich with memes for preventing rational enquiry into homeopathy.
Let’s dig out some of those memes…
1. In the response to the BBC report, the society is adamant still that homeopathy can act as an alternative to malarial prophylactics. (An utter outrage.) The society states the truth at one point:
At present, there is no large scale research evidence to support the use of homeopathy in preventing malaria.
but then goes to on to offer a list of memes to get out of this…
Consequently, there is substantial anecdotal evidence from around the world to suggest that homeopathy may offer a gentle, yet effective, complementary or alternative approach.
Clearly, this needs more research. Nevertheless, absence of evidence is not the same as evidence of inefficacy”.
So, we see several memes to ward of the uncomfortable nature of the truth – anecdotal evidence says is works and the (brilliant) “absence of evidence is not the same as evidence of inefficacy”. We would love to point out to them that anecdotal evidence is not sufficient to prove efficacy and of course, that absence of evidence is not evidence of efficacy.
2. The next press release is about Professor Michael Baum’s report that homeopathy is an implausible treatment for which over a dozen systematic reviews have failed to produce convincing evidence of effectiveness. The press release quotes a number of flawed studies to suggest that Prof. Baum is wrong, but also comes up with the exceptional defensive meme that
Access to [homeopathy] should be a matter of choice for individuals and The
Society of Homeopaths firmly supports the Government’s agenda of patient choice.
In other words, freedom of choice is more important than evidence of efficacy.
3. The next defensive press release concerns an article in the Guardian, by our friend Ben Goldacre, regarding recent meta-analysis of trials showing homeopathy as being just placebo. The Society naturally brush this off and use another well crafted meme to dismiss this criticism:
It has been established beyond doubt and accepted by many researchers, that the placebo-controlled randomised trial (RCT) is not a fitting research tool with which to test homeopathy.
So, the cornerstone of modern evidence-based medicine cannot be used to test homeopathy – a very useful quack meme. Homeopaths complain that the ‘individualised treatments’ involved in ‘real’ homeopathy cannot be subject to placebo controlled trials. An obvious canard. Even more bizarrely, the claim here is that what is important is not what is in the pills, but the very experience of the consultation and dispensing of the pills. I would appreciate their sincerity in this belief, but I do not see the Society condemning Boots for offering off-the-shelf homeopathic pills.
I am sure there are more in there, but this blog entry has gone on long enough.
What does this mean for our fight against quackery? If it is true that most participants in quackery (both practitioners and customers) are more likely to be deluded and protected by defensive memes, rather than outright frauds, then legislation and prosecution may not do so much good. Rather we need ways to prevent these sort of memes and canards from being implanted in the first place. Better science education and science reporting in the press would go a very long way here.