Edzard Ernst has accused practitioners of alternative medicine of lying to their patients. In last week’s New Scientist he gave an interview where he described his childhood experiences with homeopathy, and his subsequent medical and homeopathic training, and his work in the only German homeopathic hospital. His conversion to doubt has been slow and guided by the evidence. He now believes that homeopathy is nothing more than a placebo therapy. That is what the science says. According to Ernst, the continued popularity of homeopathy is essentially due to homeopaths lying to their patients about the state of research into the subject. If they told the truth, their businesses may collapse.
Now, Dr Brian Kaplan, a medically qualified homeopath, has taken exception to Ernst remarks and thrown down the gauntlet – pistols at dawn. Kaplan says,
I have met hundreds if not thousands of homeopaths in my career. Some have indeed believed in some strange things, some have been very naive indeed in my opinion, but I have never met a homeopath whom I thought was lying to his/her patients. They may have said things to patients that Ernst thinks is untrue but that is very different from lying which is the deliberately not telling the truth.
Now, for once, I would pretty much like to agree with Kaplan. I think few homeopaths are out-and-out liars. Lying is not the word for what homeopaths do. The actual word that is most commonly appropriate is ‘bullshitters’.
To explore this issue, I would like to draw on the work of renowned moral philosopher and Professor Emeritus of Philosophy at Princeton University, Harry G. Frankfurt. In 2005, Frankfurt published an essay entitled On Bullshit. This groundbreaking work explores the philosophical meanings of bullshit, why there is so much around and how it differs from other sorts of untruths.
Frankfurt argues that bullshitting is not the same thing as lying, but both are an abuse of the truth. In his words,
It is impossible for someone to lie unless he thinks he knows the truth. Producing bullshit requires no such conviction. A person who lies is thereby responding to the truth, and he is to that extent respectful of it. When an honest man speaks, he says only what he believes to be true; and for the liar, it is correspondingly indispensable that he considers his statements to be false. For the bullshitter, however, all these bets are off: he is neither on the side of the true nor on the side of the false. His eye is not on the facts at all, as the eyes of the honest man and of the liar are, except insofar as they may be pertinent to his interest in getting away with what he says. He does not care whether the things he says describe reality correctly. He just picks them out, or makes them up, to suit his purpose.
Homeopaths are renowned bullshitters. They do not care about the truth. They are extremely reluctant to say anything definitive that can be proven wrong. They do not test their ideas themselves in any meaningful way. They will say anything to make themselves look plausible in the face of sincere criticism. Instead of addressing the concerns raised by Ernst, they bullshit about conspiracy theories about how pharmaceutical companies are funding people like him to discredit them. There is not a shred of evidence for this – but that does not matter – they just bullshit away.
We saw Neal’s Yard Remedies this week after they were caught dishing out useless sugar pills to prevent malaria bullshitting for England. Their PR department will undoubtedly be winning PR bullshit awards over that attempt to get-out of-gaol-free.
We have seen The Society of Homeopaths trying to bullshit their way out of similar accusations, issuing press releases that really did not appear to care if what they were saying was the truth. They claim to be consulting with the Department of Health over self-regulation. A freedom of information act request suggest otherwise.
We see their ‘intellectuals‘ publishing papers on quantum mechanical explanations for homeopathy. It is utter bullshit of the highest order, but that does not matter, because the homeopaths lap it up.
When homeopaths, like Kaplan, only partially review the evidence for homeopathy, cherry picking the positive studies and ignoring the overwhelmingly disappointing, they are bullshitting. By continuously saying that meta-analyses are ‘discredited’ when they are not is just pure bullshit.
Bullshit may not cover all homeopaths abuses of the truth though. Some have seen Frankfurt’s analysis of truth abuses as incomplete and in need of further revision and extension. It was therefore necessary for former Oxford Wilde Reader in Mental Philosophy and current Professor of Philosophy at the University of Miami to publish an essay entitled mindfucking.
McGinn’s 2008 analysis notes that not everyone who engages in speaking without regard to the truth is a bullshitter. They may well be just telling stories, or singing a song, and is not making any claims to be either telling the truth or a lie. Defining a bullshitter cannot be done by just noticing a disregard for truth.
In examining the true nature of bullshit, we discover that in order to be a bullshitter you must intentionally represent yourself as competent and sincere and be trying to place this false belief in the listeners head that you are telling the truth. As such, a bullshitter is not completely indifferent to truth and falsehood as Frankfurt has suggested. We can see how homeopaths publishing papers on quantum mechanics gives the impression that they know what they are talking about in this area. There is the intention to come across as an authority. The fact that these papers are not published in quantum physics journals should set off loud alarm bells. There is no one in an alternative medicine journal capable of telling the authors that the paper is bullshit and so rejecting it.
But deeper into this new analysis of truth abuse comes the concept of mindfucking. Both liars and bullshitters are concerned with beliefs – that of what their listeners think. There are always two untruths for the liar and the bullshitter – the (possible) untruth of what is being said and the untruth of the belief in the listeners head that what is being said is sincere. The mindfucker, on the other hand, does not just care about their listeners beliefs and what the listener thinks of them, but about manipulating their emotions too. The intention is to disturb and abuse. The mindfucker seeks to raise emotions of alarm, confusion, insecurity, fear and hatred. At the very least, mindfucking is using emotion to manipulate thought.
And this is where we can see that homeopaths are most definitely mindfuckers. It is just not good enough to lie to you patients about the power of the pills. It is also not good enough to bullshit about evidence. Homeopaths find it necessary to fuck with people’s minds. They tell them that the real enemy is their doctor. They scare them in one-sided stories about the harm that drugs and immunisations do. They tell them their medication will do them more harm than good. They talk incessantly about side-effects of drugs as if the actual effects of the drugs and the illness itself were secondary issues.
Is Kaplan guilty of a mindfuck in his criticism of Ernst? Instead of addressing Ernst’s evidence of the ineffectiveness of the majority of complementary medicine, Kaplan accuses Ernst of ignoring the supposed lack of evidence behind conventional medicine. It is a mindfuck because it plays to the usual emotion of distrust in Big Pharma, it deflects from the issue and seeks to cause alarm about Ernst’s motives. But of course, Ernst is Britain’s only Professor of Complementary Medicine and it is a complete red herring to accuse him of ignoring a subject that he never intended to study. There are thousands of researchers in Britain studying and improving the evidence base of medicine and yet Kaplan wants to attack Ernst over it. The irony is of course is that Ernst is improving the evidence base of CAM – people like Kaplan do not like the answers coming out of his department. Let’s fuck with people’s minds instead.
So, I am not sure if Ernst is going to take up Kaplan’s offer of a duel. My bets would be on the canny German. They still train people to duel there, you know. Kaplan has not made a case that a duel is necessary. Rather, it is up to Kaplan to state that homeopaths do not misrepresent the truth about the evidence base for homeopathy. If he is sincere about the truth, why is he not as concerned about his own profession as Ernst appears to be? Where is the condemnation of homeopaths running high street shops with dangerous beliefs about immunisations? Where is the concern that homeopaths do not practice within the knowledge of a sound evidence base?
I think Ernst was actually being rather kind in calling homeopaths liars. He should have called them all bullshitters and mindfuckers.