The following quote from a recent address to graduating student resonated with me:

“What’s become clear is that social media can also be a tool to spread conflict, divisions, and falsehoods, to bully people and promote hate,” he said. “Too often, it shuts us off from each other instead of bringing us together, partly because it gives us the ability to select our own realities, independent of facts or science or logic or common sense. We start reading only news and opinions that reinforce our own biases. We start cancelling everything else out. We let opinion masquerade as fact, and we treat even the wildest conspiracy theories as worthy of consideration.”

The speaker advises students to, “Use all that critical thinking you’ve developed from your education to help promote the truth.” I agree, although honestly I think students need to learn much more critical thinking than is typically the case. These words could have been spoken by any skeptic or science communicator, and is a core message of the skeptical movement. We need scientific literacy, deep understanding of critical thinking and how to apply it every day, and media literacy. But these words were spoken recently by former president Barack Obama. Don’t leg your political opinion of him, if they are negative, color your perception of these words. Let them speak for themselves.

That is actually the point I want to make in this post. Humans are tribal by nature. We now know from years of psychological study that we tend to plant our flag with one group, one ideology, one narrative – and then defend it at all costs. The more we identify with a position, or see it as a marker of our group, and the more we do, the greater our motivated reasoning. For things we don’t care about, or do not identify with, we tend to revert to a fairly rational approach – listening to new evidence and incorporating into our view. So we have the capacity to be rational, when our identity does not get in the way.

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The safety and efficacy of hydroxychloroquine for the treatment of COVID-19 has quickly become an important medical question in managing this pandemic, although not by far the most important. There are many drugs under consideration, and some with promising early results. But hydroxychloroquine has garnered the majority of attention for purely political reasons. I most recently wrote about the scientific evidence for hydroxychloroquine on May 18th, referring to four studies all showing no benefit. Since then there have been more studies, including this one in NEJM showing no benefit from hydroxychloroquine in terms of preventing the contraction of COVID-19. Systematic reviews, which are being done in an ongoing manner, also conclude no benefit from this drug.

But at the end of my May 18th blog post, on May 22nd, I added a brief addendum because another study had just come out I thought was worth noting – a multinational study which compiled evidence from 120 different hospitals involving over 90,000 patients. This study found no benefit but significantly an increased risk of heart complications and death from hydroxychloroquine. If you follow this link now you will see a giant “retracted” posted over the study. The Lancet reports:

But in an open letter last week, a group of scientists raised “both methodological and data integrity concerns” about it.

These included a lack of information about the countries and hospitals that contributed to the data provided by Chicago-based healthcare data analytics firm Surgisphere.

One other hydroxychloroquine study used data from Surgisphere, this one published in the NEJM, and has also since been retracted. So what happened and what does all this mean?

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This is an important and sobering study, that I fear will not get a lot of press attention – especially in the context of current events. It is a bit wonky, but this is exactly the level of knowledge one needs in order to be able to have any chance of consuming and putting into context scientific research.

I have discussed fMRI previously – it stands for functional magnetic resonance imaging. It uses MRI technology to image blood flow to different parts of the brain, and from that infer brain activity. It is used more in research than clinically, but it does have some clinical application – if, for example, we want to see how active a lesion in the brain is. In research it is used to help map the brain, to image how different parts of the brain network and function together. It is also used to see which part of the brain lights up when subjects engage in specific tasks. It is this last application of fMRI that was studied.

Professor Ahmad Hariri from Duke University just published a reanalysis of the last 15 years of his own research, calling into question its validity. Any time someone points out that an entire field of research might have some fatal problems, it is reason for concern. But I do have to point out the obvious silver lining here – this is the power of science, self-correction. This is a dramatic example, with a researcher questioning his own research, and not afraid to publish a study which might wipe out the last 15 years of his own research.

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A recent interview published in Scientific American is a good case study in what can happen when you have journalism without skepticism.  By skepticism I mean a working knowledge of the discipline of scientific skepticism, which combines our current understanding of the philosophy of science, the nature of pseudoscience, critical thinking, mechanisms of self-deception, deliberate deception, and specific knowledge about individual pseudoscientific and paranormal topics.

The interview was conducted by John Horgan, who I have trashed in the past for criticizing skepticism while demonstrating an almost complete ignorance of it. The subject of the interview was Leslie Kean, a journalist who has written a book on UFOs and another on life after death. Doing a deep dive into these two issues is beyond this one article, and they have already been covered at length here and elsewhere. I want to focus on what the interview itself reveals.

Kean appears to take a solid journalistic approach to these issues, but there is a massive hole in her approach. She does not seem to be aware that there is already a thorough investigation into these questions, showing convincingly in my opinion that they are not genuine. She ignores it because she thinks she already understands it, when she doesn’t – so she is missing the skeptical take on these issues. She is dismissive of skeptics as deniers and as closed-minded. She then goes on to make rookie mistakes, that any well-informed skeptic could have pointed out to her. The result is a repetition of long debunked fallacious arguments, but with a patina of serious journalism.

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In the last 20 years I have been called to jury duty several times. Every time I was dismissed almost instantly, once I made it known that I am a professional skeptic. Apparently lawyers fear that kind of skepticism on their juries (at least one side always did). The same is true of many of my skeptical colleagues, so I am not an isolated case. Once my brother said during the process that he wrote an article on the fallibility of human memory and eyewitness testimony. His but barely hit the seat when he was dismissed.

It is unclear how best to interpret these anecdotes, but what is clear is that justice requires facts and needs to align optimally with reality. Falsehoods and pseudoscience do not generally lead to justice. It is for this reason that courtrooms have elaborate rules of evidence, and generally they work well. Even in our adversarial system, you need to use generally valid arguments, you need to back up your statements with evidence, and there are rules of admissibility. Each side provides a check on the other, as a neutral arbiter presides over the process. It is imperfect (because imperfect people are involved) but at least it has a process.

One area where this process has historically had significant problems, however, is in forensic science, and the admissibility of science itself. The main problem, as I see it, is that it is based largely on authority, in both a good and bad way. Each side is allowed to find their own experts, and they can cherry pick experts whose opinion aligns with their needs. Often a non-expert jury is then tasked with sorting it out. There are standards for which expert testimony is admissible, and this has been a controversy unto itself. Here is a good summary:

Prior to 1993, the Frye standard for admitting expert testimony was the prevailing standard for guiding federal and state courts in their consideration as to whether scientific expert testimony should be admitted at trial. Frye v. United States[1]. The Frye standard requires that the proponent of the evidence establish the general acceptance of the underlying scientific principle and the testing procedures. Notably, Frye only applies to new or novel scientific evidence. However, in 1993, following a revision to the Federal Evidence Code by Congress, the Supreme Court of the United States annunciated the new standard in Daubert v. Merrell Dow Pharmaceuticals, Inc.[2] The Daubert inquiry was meant to be flexible and focused on scientific principles and methodology, not conclusions. The Daubert opinion emphasized that the Federal Rules of Evidence governed admissibility and suggested a series of factors a court could consider, but did not establish a test per se. Under Daubert, the admissibility of expert evidence rests squarely within the discretion of the trial court judge. In contrast to Frye, Daubert applies to all expert witness testimony.

This article is about the fact that Florida has reverted to the Frye standard recently. This highlights the fact that legal precedent is largely how this is sorted out, and may differ for every state and at the federal level.

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