As I continue my efforts to fight against pseudoscience in medicine, I often ask myself – how bad can it theoretically get? I have had this discussion with others as well, some of whom argue that we should not worry because science will win out in the long run. Science is self-corrective, and pseudoscience will become marginalized over time. I hope this optimistic view is correct, but I am not reassured by the evidence.

Let’s consider a recent article in the Hindustan Times, written completely without skepticism or irony, which details how the government of India has opened a state-of-the art laboratory to study homeopathy.

Howrah-based Centre of Excellence in Fundamental Research in Homoeopathy will also undertake fundamental research studies in homoeopathy with an interdisciplinary approach.

“This institute has undertaken several clinical research studies such as autism, psoriasis, vitiligo, breast cancer, hypertension, migraine etc. along with proving of new drugs in homoeopathy with their clinical validations,” said Naik.

The lab will support PhD students in homeopathy and focus on research into viral and other infectious diseases. This is all part of the Ministry of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH). In India, pseudoscience in medicine, including homeopathy, have been fully institutionalized and are explicitly endorsed by the government.

This is how bad it can get.

For those who may not be aware, homeopathy is 100% pure nonsense. It is not herbal medicine as many falsely believe. It is based on a 200 year old pre-scientific belief that you can take a substance that causes a symptom, dilute it out of existence, and its magical essence will remain behind and somehow treat the illness which causes the same symptom. It’s witchcraft.

Further, multiple independent systematic reviews of the clinical evidence have concluded that homeopathy does not work for anything.

Science is Fragile

The historical experience of homeopathy has an importance lesson to teach us – science can be fragile. In fact, one hard truth we have been forced to confront recently is that many of the institutions we have taken for granted are more fragile than we had suspected.

Many professions such as journalism, medicine, and science depend on a shared culture and dedication to a set of standards and principles. However, it is possible to turn those standards on their head, to create pseudojournalism, bad medicine, or fake science. News outlets dedicated to an ideology or a tribe rather than to journalistic standards can easily displace real journalism.

The fact is that institutions and professions are based on a shared set of rules. Members have to agree what those rules should be and abide by them. This takes a certain amount of understanding and courage. Perhaps it is just too easy to become complacent, to collectively forget why we have the rules in the first place.

Science also has rules, and requires a true dedication to fairness, openness, and to methodology over conclusions. It requires judgement, and the willingness to challenge core assumptions. Science works when scientists are willing and able to ask – is this really true? How do we know?

The institutions of science are fragile because the only thing standing between them and descent into rank pseudoscience is the collective understanding and dedication of its members to high standards. This is a high energy state, however, and will tend to degrade to lower energy states in which cutting corners is progressively acceptable.

If you don’t think this can happen, it already has. Over the last few decades absolute pseudoscience has worked its way into mainstream medicine. It was frighteningly easy for this to happen – all it really took was a lack of concern and outrage on the part of the majority of medical professionals and scientists. This is embedded in a more complex social context, such as the rise of postmodernism and political correctness within academia. These, in my opinion, eroded an unflinching dedication to the truth which is necessary for any legitimate scholarly activity.

I watched as it became acceptable to change the rules of science in order to promote nonsense. Promoters of magic and witchcraft were allowed to have their own peer-reviewed journals, set their own rigged standards, lobby for laws which eroded protections for consumers and created a literal double standard for their snake oil, and were progressively made the gatekeepers of their own claims.

When we look at India (and also China with respect to TCM and chi) we are seeing where this all leads, unless we collectively fight hard to stop it. I now think it is naive to believe that science will somehow work it all out. It won’t do it by itself, because there is no abstract science. Science is a human endeavor, it is only as good as the institutions and culture of science.

Science can easily, therefore, be subverted to other agendas, political and ideological. Homeopathy is fully institutionalized in India. You can get a “degree in baloney,” conduct research in a tricked-out lab, get published in journals – and it all means nothing. It will never self-correct, because the entire process is biased and subservient to a belief.

What all this shows is that the difference between real science and fake science is often razor thin. I also fear that we may have a limited time window to turn this around. The purveyors of snake oil and medical pseudoscience have so thoroughly infiltrated our institutions that they are now influencing the next generation of scientists and doctors. Once the next generation is fully indoctrinated, who will be around to ask the hard and important questions? They will be in the minority, on the fringe, impotent to effect any real change.

I have colleagues in China who have expressed that very reality. They understand that chi is magical pseudoscience, but they are working in a culture that accepts the reality of chi without question. They essentially have no opportunity, short of sacrificing their career, to stand up for reality.

This is how bad it can get.