Apr 17 2012

Alternative Medicine’s Attack on Science

If you have been paying attention it is quite clear that at the core of the CAM (Complementary and Alternative Medicine) movement is a deliberate and calculated attack against science as the basis for medicine and health care. The original brand of “alternative” medicine was the most accurate – it is an alternative to science and evidence-based medicine. The later terms, “complementary” and “integrative,” are deceptions meant to distract from the fact the CAM (as much as general statements can be made about such a loose category) is anti-science, and therefore cannot be integrated into science.

Fortunately for those of us who are trying to increase public awareness about the anti-science agenda of CAM, CAM proponents frequently show their hand. They advocate for changing the rules of evidence to suit their needs. They talk about integrating their therapies with science-based medicine, but then pull a bait and switch and push pure pseudoscience as first line treatment. They dismiss and denigrate legitimate science as if it were all a big corporate conspiracy. They advocate for (and are slowing getting) laws to weaken the science-based standard of care for medicine. And of course, they distort and misrepresent real science and promote abject pseudoscience.

Perhaps none are worse in their broad-based attack on science than the homeopaths. Really, if they are going to promote homeopathy, they have no choice. Homeopathy is pure magical pseudoscience, and it doesn’t work. A thorough review by the British government recently concluded that homeopathy is “witchcraft.” Science, therefore, is the homeopath’s worst enemy (as homeopath Werner aptly demonstrates in this hilarious YouTube video). To the homeopath there is no more frightening phrase than, “Science-Based Medicine.” To survive they must either destroy science or break it to their will (which would destroy science).

Orac brought my attention to the latest attack against science by a homeopath, Heidi Stevenson. He does a fine job of deconstructing the nonsense, but I feel the need to add my own comments. Stripped down the article has two points to make: anecdotal evidence is not only legitimate, it’s the best form of evidence; and science-based doctors use mostly anecdotal evidence too. Both points are wrong.

I have written extensively already about the role of anecdotes in science. In short, they are the weakest form of evidence. They are not without any value, but their use is primarily as a preliminary form of evidence useful for forming hypotheses. They are too weak a form of evidence, however, to use as a way of testing hypotheses or on which to base conclusions. Anecdotal evidence tends to be overwhelmed by confirmation bias, perception bias, and a host of other cognitive biases so that they will appear to support whatever we already believe or wish to believe. They are not a tool for leading to the truth, however.

Stevenson offers the following as evidence for her claim that real doctors use anecdotes all the time:

If you tell your doctor that a drug he’s just given you is causing a terrible headache, the chances are that you’ll be believed, and your treatment will be changed. He’s basing that decision on the anecdotal evidence you’ve just given.

This is a hopelessly naive statement, on many levels. This is not, in fact, legitimate clinical decision-making. If a patient tells me that they got a headache after taking a new prescription that I have given them, I do not automatically conclude, based upon this anecdote, that the medication gave them a headache. This would be post hoc ergo propter hoc (after this therefore because of this) reasoning, a logical fallacy. Rather, I would consult the scientific evidence – what percentage of patients in the clinical trials taking this drug reported headache, vs those taking the placebo? If three percent of people taking the drug and three percent of those taking the placebo reported headache, then it is reasonable to conclude that the drug does not cause headache. The certainty of this conclusion will be based upon the number of people in the study. If there were a thousand people in the study, it’s still possible that 1 in 10,000 people will get a headache from the drug. But at least I can conclude that headache as a side effect is very unlikely. If, on the other hand, 20% of people taking the drug reported headache, then it is much more likely that the patient is correct and the drug did indeed cause their headache.

I would also gather more information from the patient. Did they get headaches before taking the drug? Was their new headache similar to or different from their prior headaches? Was there anything else going on that could possibly have caused the headaches? This is all part of taking a thorough history, which is a way of testing hypotheses by looking for additional information that would support or refute the hypothesis (in this case, that the medication caused the headache).

I then take other factors into consideration. What is the patient’s attitude toward the medication? Even if it did not cause their headache they may be unwilling to keep taking it because they believed it caused their headache. There is no point in prescribing a medication that a patient is not going to take. Also, how many other options are available? If there are many other options, then it might just be easier to try something else. If there are few other options then it may be better not to give up on this one medication too quickly, just because of a side effect that may have actually been a coincidence. We have the option, if the patient is willing and it is medically appropriate, in some cases to gather some additional data. I may have the patient stop the medication for two weeks and monitor their headaches, and if they are gone then restart the medication to see if the headaches recur. If they do, then that greatly increases the probability that the medication is actually causing the headache and it wasn’t just a coincidence.

Compare my actual practice to the simplistic characterization by Stevenson.

I need to further point out, as Orac does, that the individualization of treatments that have been proven to be safe and effective by scientific studies is not the same as relying on anecdotes. It is the application of scientific data to the individual. On this point Stevenson writes:

Unfortunately, those who promote science in medicine to the exclusion of all other means of learning miss the most significant fact of all: Humans are individuals, complex beyond comprehension. Life itself is something more than the interaction of chemicals and the laws of Newtonian physics.

This is a massive straw man. Science-based medicine does not ignore the complexity of human biology – that is actually core to the SBM approach. That is precisely why we need the best information in order to make effective decisions. Scientific studies do give us information about average responses of groups – but that information can be statistically applied to individuals. There is no way to predict exactly how an individual will respond to a treatment, but we can say how they are statistically likely to respond, and make rational clinical decisions based upon that information. Those treatment decisions can then be individualized based upon the patient’s actual response – as best as we can determine. It is not perfect, and no one has claimed that it is, but it’s the best we have. It is not the same as pure anecdotal evidence, as Stevenson suggests.

She goes on to write:

We learned that certain herbs had beneficial effects by trying them and passing on the information of what resulted: pure anecdotal evidence. But that’s how we know, for example, that milk thistle is good for the liver and hawthorn is good for the heart. No studies needed to be done. We learned through experience and anecdote.

This is nothing but circular reasoning. How do we know that milk thistle is good for the liver? Is she using anecdote to confirm anecdote? What does the scientific evidence say? Well, recent reviews conclude that there haven’t yet been good studies, so we don’t know. There is concern about possible contamination and toxicity. It would also be nice to have data on active ingredients, dosing, pharmacokinetics, and drug-drug interactions. Try to get that with anecdotes.

What about hawthorn for the heart? The evidence is mixed. In preliminary studies it appears to have benefit for heart failure, but not other measures of heart function. While generally well tolerated, there are some safety concerns. Stevenson’s summary is that “hawthorn is good for the heart.” That is what anecdotal evidence tells us, she argues. But that is useless clinical information. We need careful scientific studies to tell us – how much, with what side effects, and for what conditions specifically? In order to make rational risk vs benefit decisions and engage in practical clinical decision making, you need scientific evidence, not just anecdotes. If Stevenson is arguing that scientific studies support the anecdotes, then ironically she is acknowledging that scientific studies are the gold standard.

Her examples are also cherry picked. Anecdotes also lead people to believe that gingko was good for memory (it isn’t), that echinacea can treat cold symptoms (it doesn’t) and that aristolochia is safe (it isn’t). Anecdotal evidence failed in these and countless other beliefs. The history of anecdotal evidence is a mountain of failure with a few successes – and it is rigorous scientific evidence that has enabled us to separate out the successes from the failures. To argue that all we need are anecdotes is to be willfully blind of history (even very recent history).

Conclusion

Anecdotes have a real but minor and preliminary role to play in scientific evidence. They are at best exploratory evidence that guides later rigorous study. Homeopaths (and CAM proponents in general) want to rely on weak evidence, because rigorous evidence does not support their fairy tales. Stevenson’s arguments are confused, factually incorrect, biased, and fallacious – also par for the course for CAM proponents. She wants you to think that science is all a big conspiracy of corporations and corrupt government. She would rather have you listen to her anecdotes, because they can be used to back any claim you wish to make.

This is the position of the guru, not the rational or science-based practitioner. “Ignore and distrust science – listen to my stories.”

It is also a clear example of the pernicious nature of CAM. Often people ask – what’s the harm. There is much harm from believing in and relying on nonsense. Stevenson’s article highlights just one form of such harm – fostering an overall distrust in science, the harm of which is hard to measure but should not be underestimated.

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32 responses so far

32 Responses to “Alternative Medicine’s Attack on Science”

  1. locutusbrgon 17 Apr 2012 at 11:00 am

    In the office I get common anecdote descriptions of how someone’s cholesterol medicine is giving them aches and pains. In my specialty I do not prescribe these medicines but people bring to my attention asking if I agree with the decision. Although, that medicine can cause those problems, only a small fraction actually have representative symptoms of statin related complications. I recommend that they need to contact the prescriber. That aches and pains are common and you should not stop drugs such as this with exploring the problem more completely.
    Obviously Ms. Tyler would say that my statement is only an anecdote, of course she believes in the truth of anecdote, that makes it true. Yet it makes her belief in physician directed treatment based on anecdote untrue. Which of course would make anecdotes unreliable, but she believes in anecdotes so it must be true.
    Well she is not a robot and her head would not explode with the logical conundrum. Still would be nice if it worked that way. Not that I am advocating violence just saying.

  2. locutusbrgon 17 Apr 2012 at 11:05 am

    “That aches and pains are common and you should not stop drugs such as this with exploring the problem more completely.” Should read..
    That aches and pains are common and you should not stop drugs such as this without exploring the problem more completely.

    Also for the nit pickers
    “Bot point are wrong.” Steve meant to type Both.

  3. drsteverxon 17 Apr 2012 at 12:42 pm

    Anecdotes have powerful suggestive effects on people. Often in the pharmacy when a patient asks for my suggestion on an over the counter product, they seem to looking for confirmation on a product already recommended by a neighbor, relative or whomever. When I have a dissenting opinion they say “well I will just give this one a try anyway” even if I tell them that what they want is 12 dollar water in fancy packaging. In the prescription end of things, I often hear anecdotes about how this prescription or that prescription caused this or that problem in a person they know so it is going to happen to them as well. Positive anecdotes seem to hard to come by despite all of the benefits patients actually experience. Are all of the negative campaigns against SBM having the desired effects for woo-meisters? Anecdotally, yes.

  4. Karl Withakayon 17 Apr 2012 at 2:25 pm

    “If you tell your doctor that a drug he’s just given you is causing a terrible headache, the chances are that you’ll be believed, and your treatment will be changed.”

    I can provide numerous anecdotes to refute this. Oh wait, anecdotes as evidence to refute the value of anecdotes as evidence….divide by zero… …error…error…analyze…analyze…faulty…faulty…Norman, help me…..beep, beep, beep, beeeeeeeeep.

    “We learned that certain herbs had beneficial effects by trying them and passing on the information of what resulted: pure anecdotal evidence.”

    Actually a lot of herbal medicine is based on superstition and sympathetic magic rather than actual effectiveness. For instance, things that superficially resemble a phallus are often used to promote male virility and fertility.

  5. eyeconoclaston 17 Apr 2012 at 5:54 pm

    Dismissing these anecdotes and post hoc ergo propter hoc logical fallacies is relatively low-hanging fruit. What’s tougher is PubMed CAM articles with the appearance of rigorous science. Consider, for instance, this article claiming Pan-Asian medicine + vitamins reduced 10-year lung cancer mortality by as much as 83%(?!):

    http://www.ncbi.nlm.nih.gov/pubmed?term=%2021824893

    Any thoughts on how one would approach debunking these published studies masquerading as science-based medicine?

  6. Dirk Steeleon 18 Apr 2012 at 7:13 am

    But even you, Dr. Novella, as a scientist and skeptic still subscribe to the belief in ‘diseases of the mind’, which Thomas Szasz pointed out, over 50 years ago, was a metaphorical statement and had no scientific basis. How can you , quite correctly, berate those that believe in the efficacy of homeopathy and crystal healing yet still hold your views on psychiatry as being scientifically based. Indeed, to even insult those who can see through the vacuous nature of psychiatry by calling them ‘deniers’. The fact that you can hold this paradoxical view is a mystery to me. What hope is there for the lay person?

  7. banyanon 18 Apr 2012 at 9:56 am

    @Dirk Steele: First of, I hope that’s your real name. Second, Steve wrote a three part post on Mental Illness Denial back in 2007, so you’ll find the answers to your questions there:
    Part I: http://theness.com/neurologicablog/index.php/mental-illness-denial-part-i/
    Part II: http://theness.com/neurologicablog/index.php/mental-illness-denial-part-ii/
    Part III: http://theness.com/neurologicablog/index.php/mental-illness-denial-part-iii/

  8. jwadamsonon 18 Apr 2012 at 11:24 am

    @Dirk Steele: I must be missing the connection, because it would seem that you could copy and paste that comment on almost any post on this blog. You have already commented *very* extensively on the “mental-illness-denial” articles pointed to by banyan, which is the appropriate place for these observations. I can also assume therefor you are familiar with Steve’s position and his rational behind his position about modern psychology which leaves very little room for you to have a reasonable exception of new information or discourse in response to your post.
    Thus your comment comes across as an off-topic ad-hominem attack.

  9. robmon 18 Apr 2012 at 11:35 am

    @banyan and jwadamson: Dirk has already commented on those threads, and failed to find an audience since they’re 5 years old. As a result Dirk has tried to derail other threads, like this one.

  10. caryatison 18 Apr 2012 at 12:18 pm

    I see only one reference to “witchcraft” in the British government report; witchcraft is used as an example of an absurd thing. Isn’t it deceptive to imply that the study “concluded that homeopathy is “witchcraft.” ?”

  11. Dirk Steeleon 18 Apr 2012 at 12:20 pm

    ‘As a result Dirk has tried to derail other threads, like this one.’

    Yes I have completely failed to find an audience. My reason for commenting on a 5 year old thread was that I was recently referred to this on the JREF forums as an answer to my skepticism and my support of Szasz. I was unconvinced by Dr. Novella and have therefore left comments that have been ignored. I was not attempting to derail this thread, only making a point that the science behind certain medical ideas can be completely lacking yet still having a considerable hold on society’s viewpoint. I am happy to be proved wrong but in the right way.

    ‘@Dirk Steele: First of, I hope that’s your real name.’

    If you are asking whether I have a legal claim to this nomination then my answer is affirmative.

  12. robmon 18 Apr 2012 at 1:45 pm

    @Dirk Steele your post provided a convenient segue from anything related to the post to the topic you wanted to discuss. A response to your questions would lead to you responding with arguments in favor of your position that would lead to more responses, none of which would have anything to due with the topic or points raised in the original post. Thats what derailing a thread is.

  13. Dirk Steeleon 18 Apr 2012 at 2:08 pm

    @robm

    ‘Dirk Steele your post provided a convenient segue from anything related to the post to the topic you wanted to discuss. A response to your questions would lead to you responding with arguments in favor of your position that would lead to more responses, none of which would have anything to due with the topic or points raised in the original post. Thats what derailing a thread is.’

    Are you drunk?

  14. daedalus2uon 18 Apr 2012 at 2:31 pm

    Not knowing who Szasz is, I looked him up and I understand why no one is engaging you. Szasz is a denialist. He has a political position through which he filters his understanding of mental processes. He is allied with Scientology in their attacks on psychiatry. I appreciate that there is great potential for the misuse of science for political purposes. Fortunately science is self-correcting. The alternatives he proposes (free markets) are much more problematic and have no self-contained corrective mechanism.

    There was a great deal of deinstitutionalization in the 1970′s, with number of resident patients in 1966 being 452,089; in 1976 being 170,619; and in 1986 being 111,135; and in 1996 being 61,722.

    http://ps.psychiatryonline.org/data/Journals/PSS/3533/41.pdf

    Of course, accompanying the great reduction in institutionalized patients there was an increase in incarceration rates.

    https://en.wikipedia.org/wiki/File:U.S._incarceration_rates_1925_onwards.png

    from 0.1% in 1966 to 0.13% in 1976, to 0.4% in 1986, to 0.8% in 1996.

    Converting these to numbers of inmates using average populations, we have

    in 1966 there were 215,00; in 1976 there were 283,000; in 1986 there were 961,000; and in 1996 there were 2,155,000.

    Szasz objected to the pathologizing of homosexuality by the medical community, but the medical community has self-corrected itself (through application of science) and sexual activities between consenting adults are no longer considered to be mental disorders.

    What is ironic is that the conservative mindset that drove the emptying of the mental institutions and filled the prisons have not accepted the framing of homosexual activity as non-pathological. Some of those conservative politicians are supporting criminalizing homosexual activity in Uganda with the “kill the gays” bill.

    https://en.wikipedia.org/wiki/Kill_the_gays_bill

    Szasz’s arguments are political, not scientific. Scientiology arguments are motivated reasoning to control its members and enrich its leaders. The problem is motivated reasoning, not science. Szasz’s arguments are fundamentally not scientific. He objects to science because it doesn’t produce the results that he wants.

    You can’t blame science when non-scientists misuse science to justify their motivated reasoning. This is exactly what Dr Novella is talking about with CAM.

  15. Dirk Steeleon 18 Apr 2012 at 3:07 pm

    ‘Szasz’s arguments are fundamentally not scientific.’

    Szasz would point out the very concept of a ‘mind disease’ or mental ‘health’ or ‘hygiene’ of the mind is not a scientific concept. It is a metaphor. Szasz points out that psychiatry is a political ideology. I agree with the views of Dr. Novella when he discusses homeopathy, chiropractic techniques, or even crystal healing. Psychiatry has made great claims in the past. Without foundation. Neurology is a scientific discipline that deals with and attempts to resolve empirical objective events. Psychiatry is a pseudoscience. 100 years ago Emil Kraepelin identified 3 mental diseases in hospitals that were full of those suffering from neurosyphilis and encephalitis. Today the DSM describes over 350 distinct mental disorders. You show me the science behind this please. There is none. Zilch. I challenge you and Dr. Novella to demonstrate the science that underpins psychiatry.

  16. daedalus2uon 18 Apr 2012 at 3:57 pm

    Psychiatry is difficult because it deals with the evanescent and emergent properties of the most complicated thing that we know of in the universe, the human brain. Because those human brains are owned by and actually comprise human persons, they cannot be experimented on without taking into account the rights and sensibilities of those human persons.

    The human genome evolved to produce a human brain via neurodevelopment, so that the final human brain would instantiate properties that aided the survival and reproduction of that genome. Humans are social beings, social behaviors are among the most important and most complicated behaviors that exist, social behaviors only occur via social interactions.

    Social interactions cannot be looked at in isolation because all social interactions involve both participants and all social interactions modify the neuroanatomy of the participants.

    Anything and everything can be studied using science. Is every psychiatrist a scientist of the caliber of Richard Feynman? No, but neither is every single one a pseudoscience charlatan like homeopaths are, or a pseudoscience huckster like Hubbard.

    Extremely complicated things are always difficult to study. There is abundant evidence for things like depression and psychosis. Defining them to be “normal” does not help the people who are suffering from their effects, individual patients and their families.

    I don’t consider myself an expert in psychiatry, but I know enough about it to know that it can be studied scientifically and that psychiatry does have positive effects with some patients. The reason that psychiatry is such a target is that usually the people casting stones have even less science to back up what they are doing. For a good example look a Scientology.

    I don’t really like a “disease” model of mental health that much. I appreciate that much of it is metaphor and is used to vaguely describe something that is too complex to put into words, and for which humans mostly don’t have words to describe because the things are happening at levels that cannot be communicated. The point is that people are suffering from adverse effects and we should try to ameliorate those adverse effects.

    I came across a quote from the Dalai Lama the other day which reflects how I think about mental health disorders and their treatments:

    “If you can, help others; if you cannot do that, at least do not harm them.”

    Psychiatry can be used to harm as can every other field. As far as I can tell, most of the anti-psychiatrists cause more harm and more exploitation than psychiatrists do. Their goal of eliminating the idea of mental illness as something that can adversely affect people is something I see as selfish and misguided and has the potential to cause great harm to individuals and to society.

    I appreciate that nothing I can say here will make you feel that psychiatry can be studied scientifically. That is a feeling you are having, not a conclusion you arrived at based on a logical examination of the facts.

  17. Dirk Steeleon 18 Apr 2012 at 4:18 pm

    ‘“If you can, help others; if you cannot do that, at least do not harm them.”

    We agree.

    ‘I appreciate that nothing I can say here will make you feel that psychiatry can be studied scientifically. That is a feeling you are having, not a conclusion you arrived at based on a logical examination of the facts.’

    Not true. I have no axe to grind. What I desire is a scientific examination of the ‘facts’. If we are to help those that suffer we must first agree on the cause. Based on science not feelings.

  18. Dirk Steeleon 18 Apr 2012 at 4:26 pm

    ‘As far as I can tell, most of the anti-psychiatrists cause more harm and more exploitation than psychiatrists do.’

    I know of no other scientific speciality that has resulted in the term similar to ‘psychiatric survivor’. Even those medical procedures such as chemotherapy that can cause great distress. You dismiss these views with a wave of your hand. And I do know the claims of homeopaths are a total crock. But do sugar pills do less harm than lobotomies? No?

  19. Dirk Steeleon 18 Apr 2012 at 4:36 pm

    ‘Social interactions cannot be looked at in isolation because all social interactions involve both participants and all social interactions modify the neuroanatomy of the participants. ‘

    I agree with this statement also. But you make the claim that the ‘abnormal’ neuroanatomy is caused by a disease. Does Anders Breivik suffer from an ‘illness’ or an ideological thought abnormality. Show me the science and I will acceed. Otherwise you only demonstrate that you accept magic and superstition as a truth.

  20. Dirk Steeleon 18 Apr 2012 at 4:46 pm

    ‘Because those human brains are owned by and actually comprise human persons, they cannot be experimented on without taking into account the rights and sensibilities of those human persons. ‘

    History shows that psychiatry appears to have totally ignored this principle. By the way, at this point, as usual, I have to state again that I am not a bleeding scientologist. I follow no dogma apart from that defined by the scientific methodology.

  21. Dirk Steeleon 18 Apr 2012 at 5:01 pm

    i am a penguin

  22. Dirk Steeleon 18 Apr 2012 at 6:00 pm

    to catch me in action:

    http://dsc.discovery.com/tv/frozen-planet/penguin-cam/

  23. Dirk Steeleon 18 Apr 2012 at 6:58 pm

    Just show me the science behind one of the 350 mental diseases described by the DSM. Just one. ADHD for example. Running or climbing trees inappropriately? You are having a laugh! Science? I don’t think so. But it is up to you, the great scientists, to prove your claims. All I hear is a profound silence.

  24. Dirk Steeleon 18 Apr 2012 at 7:03 pm

    I am still listening.

  25. daedalus2uon 18 Apr 2012 at 10:04 pm

    If you want people to accept the idea that psychiatry is insufficiently-scientific, you need to provide a system with better explanatory and treatment power that is more scientific. That is how science works.

  26. Dirk Steeleon 19 Apr 2012 at 4:38 am

    @daedalus2u

    ‘If you want people to accept the idea that astrology is insufficiently-scientific, you need to provide a system with better explanatory and treatment power that is more scientific. That is how science works.’

    I changed your quote for emphasis. Others with a greater intellect than I have already done this. Thomas Szasz, Erving Goffman, Richard P Bentall, Allen Francis, Karl Popper, and even Richard P Feynman etc etc have already ridiculed the unscientific nature of psychiatry. I will call upon Ocamm’s razor. To believe that MDD or even ADHD is the result of a ‘disease’ of the ‘mind’ that can be ‘cured’ by a hefty dose of ECT is preposterous. It is only when this unscientific nonsense is abandoned that some true progress may be made.

  27. daedalus2uon 19 Apr 2012 at 7:40 am

    You are confusing how science works with how humans work. Humans have a difficult time being scientists. The default mode in human thinking isn’t to “think”, it is to feel, and to use cognition to justify those feelings.

    As Box said, “all models are wrong, some are useful”. Yes, the “disease model” of neuropsychiatric disorders is wrong, as is every other model of every other thing. Is a disease model of neuropsychiatric disorders useful? That is not a scientific question. Useful for what? Useful for suppressing political dissidents? Useful for preventing suicide? Useful for helping people to live happier and more productive lives?

    There was a recent post about ECT. No one suggested that MDD is caused by a deficiency of ECT. I think that MDD is a “feature”, the normal and necessary aversive state between “at rest” and the euphoria of near death metabolic stress. It is not a “disease” per se, but the metabolic state that leads to MDD at rest is an adverse metabolic state and that metabolic state can be corrected which resolves MDD. This is difficult to do.

    I have only read the wikipedia page on Ssasz, but if he allies himself with Scientologists, he is no scientist. If his agenda is not to understand neuropsychiatric disorders, then what is it? Whatever his agenda is, if it is compatible with Scientology, then it is not compatible with being scientific.

  28. superdaveon 19 Apr 2012 at 9:17 am

    I’m a little late to this party but Dirk, let’s use Occam’s razor.
    If you agree with Dr. Novella that homeopathy is crap then you agree he has at least some skill in interpreting science and evidence to come to a conclusion about a treatment. But you claim he fails to use those skills correctly when evaluating one particular branch of medicine. Why would he do this? How could he? If we agree that Dr. Novella knows how to apply his knowledge to interpreting efficacy of medicines, isn’t it a simpler possibility that he is likewise correctly applying his knowledge to the case of psychiatric medicine and you are simply mistaken? Doesn’t this more neatly solve the discrepancy than the supposition that Dr. Novella is right about everything but this?

  29. superdaveon 19 Apr 2012 at 9:20 am

    I should add that I am not implying that Dr. Novella is always right, or that his logic should be unquestioned. But an extraordinary claim like psychiatric medicine being entirely crap requires extraordinary proof and it makes more sense to go with the status quo in the absence of this proof.

  30. ccbowerson 19 Apr 2012 at 9:23 am

    “If we are to help those that suffer we must first agree on the cause.”

    Completely untrue.

  31. Steven Novellaon 19 Apr 2012 at 9:24 am

    FYI – you might want to move this discussion to my post for today.

  32. Ufoon 20 Apr 2012 at 3:34 am

    A few typos to correct:

    They advocate for (and are slowing getting)

    from the fact the CAM (as much as general statements can be made about such a loose category) is anti-science

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