Archive for August 15th, 2008

One alternative reality, please…! No, make that several.

August 15, 2008

In which it is re-stated that an infinite number of forms of incompatible “my personal alternative reality” nonsense can co-exist. Its, like, that multiple worlds Quantum incoherence thingy, innit?

[An apology: due to my current intermittent lack of sleep and rather fractured thinking time, I am incapable of doing anything requiring research or serious thinking – at least that’s my excuse. Miscellaneous disjointed rambling, on the other hand… …Anyway, consider yourself pre-warned]

WikiWoo… Encyclopedia Deluderanda… Quackapedia…

Several people around the Bad Science blogosphere, including both Gimpy and Martin at The Lay Scientist, have noted the recent announcement that some of the CAM gang are setting up their own Wiki. Lay Scientist reproduces parts of the announcement, with Martin’s own running commentary, while Orac gives even more detail on the “Wiki4CAM” mission statement and purpose. Gimpy has already catchily re-named the Wiki ”Quackapedia”.

One key rationale is stated to be that nasty “skeptic” editors over at the real Wikipedia keep insisting on a balanced (or fairly balanced) treatment of CAM therapies, of which Orac gives several examples.

These Wikipedia entries are about what one would expect: they outline what has been claimed; they mention the major critiques, coming from whom, and based on what. They often distinguish between the views of “advocates” or “practitioners”, and those of “scientists”. To my eye they are studiedly neutral.

In particular, Orac quotes a lengthy chunk of the Wikipedia entry on homeopathy which he – as, I am pretty sure, would David Colquhoun – finds rather mealy-mouthed, since it uses several of the neutral language distortions that the homeopaths prefer – such as “highly dilute remedies” rather than “remedies diluted well past the point where no molecule can possibly be left”. Anyway, it is hardly the clear-cut debunking of homeopathy that you can find over on a “skeptic site” like Rationalwiki.

Seemingly, though, this is not nearly enough for the CAM gang. What they want is no less than an online CAM encyclopedia that is unstintingly positive about absolutely everything to do with CAM. Hence the drive to set up a CAM-only Wiki, where all entries will be written by CAM boosters, sorry, practitioners.

Now, as I have argued elsewhere in the Bad Science blogosphere (e.g.here), no CAM therapy ever really dies out. This is partly because CAM’s lack of basis in evidence means that a CAM therapy can never be “disproven” in a way that its advocates will accept – and partly, of course, because there’s one born every minute. And given that no CAM ever dies out, we can only presume this will mean that ultimately every kind of CAM ever tried, no matter how insane, will have a glowing entry on Quackapedia written by an enthusiast.

What an enticing prospect. I can’t wait to see the currently rather disappointing entry on Urine Therapy once it’s been really beefed up with some patient testimonials and practitioner insights. Remember also that CAM believes in a sort of “spirit of benign acceptance”, so that nothing can ever be dismissed for being wholly implausible or silly… no matter how wholly implausible and silly. And if you don’t believe me, look up Radionics.

I like to shorthand this kind of post-modern dippy-ness as:

“No childish nonsense left behind”

..of course, this benign acceptance only pertains if you are sincerely deluded, or at least pretending that you are. Con-artists get the benefit of the doubt – they might be sincere – but “skeptics” (otherwise known as “almost all scientists and doctors”) must be rigorously excluded.

I am sure this makes the con artists very happy indeed.

It is tough on the skeptics, though. I sometimes muse about ”doing a Sokal” by setting up my own utterly spurious “virtual” complementary therapy website, and then asking to be included on things like Quackapedia. But I’m not sure I have the energy.

[Stop press: it appears that some people not only have the energy but are already on the job. Orac has the story here].

Million-dollar brain-twister: Who is nuttier? Quackapedia or Conservapedia?

Over at The Lay Scientist, Martin has wittily christened the set-up-your-own-wiki-so-you-can-apply-your-own-version-of-reality approach the “Schlafly Gambit”. This name honours – I use the word ironically – publicity-hungry US-Christian-right Wing-nut lawyer Andrew Schlafly. Schlafly, son of legendary anti-feminist (and committed opponent of Equal Rights laws) Phyllis Schlafly, is one of the people behind the deranged Conservapedia Wiki. This is the place where extreme right wing conservative Christian homophobes write useful, like Young Earth creationist-acceptable histories of the world – for an audience of their equally frothingly mad friends.

Andrew Schlafly has recently been making an utter spectacle of himself trying to accuse bacterial evolutionary biologist (and recently elected member of the US National Academy of Sciences) Richard Lenski of being a bad / dishonest scientist and (by implication) a tool of Godless Dark Forces. Schlafly’s posturing was thoroughly de-trousered, notably by Lenski himself, as chronicled gleefully on numerous science blogs including both Bad Science and The Lay Scientist. The full story of “The Lenski Affair” can be found here.

Getting back to “childish nonsense”, Schlafly’s approach will be very familiar to anyone who has ever had a child, or who remembers their own childhood. That is, if the other nasty boys and girls won’t play the game the way you insist they should, then you just set up your own sand-box and invent your own rules.

Whether you can actually find anyone else apart from yourself to play according to your rules is another matter.

Which brings me to another familiar trait of CAM; the idea that you can disregard reality when it conflicts with your magic, and instead insist that a parallel set of physical laws should apply whereby your magic DOES work.

If it ducks like a quack…

An almost invariable corollary of this insisting on your own special reality is taking offence, and sticking your fingers in your ears, whenever anyone points out that your position is inconsistent with the facts.

Or, indeed, insisting that nasty “skeptics” should be excluded – see above.

But there is a catch.

Sometimes, what you write is far better at making you look idiotic than anything your opponents could come up with.

For instance, let’s see what the CAM people write about their new Wiki4CAM project:

“We need a place where the CAM community can build its own knowledge base without the undue interference of skeptics… a place where the CAM practitioners themselves write articles and create a true picture of its history, development, efficacy and positive research.

… We will try to ensure that this wiki gives the CAM community the most conducive atmosphere for creating its knowledge base. This wiki is open ONLY to CAM practitioners.We strongly discourage skeptics from registering here. Anybody found posting any anti-CAM data will be quickly removed.

Now perhaps, like me, you did a double-take when faced with this. Is it a put-on? After all, take the line a true picture of [CAM’s]…efficacy and positive research.”

Now, anyone who reads the Cochrane reviews on CAM therapies, or looks at the assessments in the NHS CAM Specialist Library, or who has read any of Edzard Ernst’s work, will know that there is precious little reliable evidence of efficacy for most CAM therapies. And also that most of the “positive research” comes from small, and methodologically poor studies, or even from customer surveys. And that, in almost every case where there is enough research to tell, the rule seems to be that “the better quality the study of a CAM therapy is, the less evidence there is for any effect beyond placebo”.

But… it seems clear that the folks at Quackapedia are not pulling our leg. We must conclude that no irony is intended, and they are completely serious.

Which brings me to a central point:

Isn’t it striking how practically every statement the Alt-Med crew make – and it is especially true when they are talking to each other, rather than reciting the neutral-language mantras about “integrative medicine” to sugar-coat it for the politicians – hammers home the central point that they do not understand how the scientific process (in its broadest sense) works?

Orac sums this up beautifully in his post about Quackapedia:

Of course, I find it most hilarious that the homeopaths setting up Wiki4CAM explicitly and openly state that they will censor any “anti-CAM” (read: actual scientific) data posted to their Wiki. A more explicit statement of what CAM is about when it comes to science I have never seen. In marked contrast, we in the business of scientific medicine don’t have the luxury of censoring criticism of our therapies, whether those criticisms come from within or without medicine. We have to deal with them, whether they are good science or spurious. That CAM practitioners are too afraid to deal with skepticism and science shows that they are neither skeptics or scientists.

Quite.

The overwhelming majority of CAM practitioners I have encountered and/or debated reject science, or meaningful testing. They are about belief, and the idea that believing in something fervently enough means that it must be true. “Your tests must be wrong”, they state, “because they contradict what I KNOW to be true.”

Though most CAM therapists are sincere in their delusions, this is one of the first principles of lying: say it often enough, and loud enough, and with a straight enough face, and never deviate from it, and eventually people will give up asking you the question. Even better, if you go on insisting black is white long enough and with sufficient conviction, then some people you are shouting at will waver and begin to concede that the black might actually be grey – or that what looks black might be white in an alternative reality.

My reality, your reality, his reality…

One of the things I will be most curious to keep an eye on over at Quackapedia is how they deal with Woo-therapies which are effectively mutually incompatible.

Perhaps the most obvious example of this is in the Woos’ obsession with oxygen and “oxidative stress”. In one part of the Woo pantheon, oxidative stress, and free radicals, are baddies, and the woo response is typically to tell you to chomp bucketloads of anti-oxidant supplements, typically starting with several grams a day of Vitamin C and adding selenium, Vitamin E and half a dozen or more other ”special antioxidant phytonutrients”

The crib version: Antioxidants GOOD. Oxidative stress mucho BAAAD.

Meanwhile, in a different part of the Woo-niverse, people are being “treated” (though, as usual, with zero evidence for efficacy) with 100% (pure) oxygen or even hyperbaric oxygen (oxygen at higher than atmospheric pressure). And even O3, ozone (trioxygen). And madder still, hydrogen peroxide (H2O2) – a truly quack-a-licious H2O2 therapy page can be found here. [And a Quackwatch round-up of idiotic “oxy-therapies” touted for cancer specifically is here.]

Now, you may say that I am being unfair here, and sometimes in conventional therapy what is good for you in one setting is bad for you in another. That is a fair point. But in those cases, there is an underlying rationale with a plausible basis in physiology. For instance, it is possible to explain why a lot of oxygen is useful for some specific things, and less oxygen for others – e.g. hyperbaric oxygen to remove (compete off) carbon monoxide tightly bound to your haemoglobin in carbon monoxide poisoning, or during hyperbaric treatment for decompression sickness (“the bends”), and hypobaric oxygen to try and induce ”Altitude Adaptation” (not a medical treatment, but widely used by rich athletes training for endurance events, often in so-called ”Live high, train low” regimes).

There will also be proper trials to assess how beneficial these interventions are, and what the unwanted effects are, when giving different amounts of oxygen for different conditions and in different groups of patients (brief intro on Wikipedia here). In fact, even though getting patients to breathe oxygen is a very common medical intervention for all kinds of things, there continues to be rigorous examination of whether it is useful, and of precisely how much O2 to give: should it be 100% or 40%? How many litres a minute? Should it be given by face mask or by nasal prongs? And so on, and so on.

In Woo, of course, none of this applies. Typically, vague symptoms of fatigue and malaise (or, as we people over 35 refer to it, “life”) are attributed to “stress” and you are told to take a ton of antioxidants.

Unless, of course, you have consulted a practitioner of hyper-oxygenation, ozone or H2O2 therapy, in which case your symptoms could well be attributed to “inadequate oxygenation”, and you will be told you need more oxygen, or possibly a “oxygenating flush” or “artery cleansing” with H2O2.

Basically, in this real-world Alt.Health.Reality scenario, the only determinant of what idiocy you end up with will be what sort of snake-oil that particular practitioner sells.

Homeopathy… Traditional Chinese herbs… Acupuncture… Reflexology… Ozone therapy… Colonic cleansing…

…etcetera etcetera.

Pick a Woo… Any Woo…

Rather weirdly, to my mind, all these people find all the others’ therapies equally valid.

Basically, it seems to be non-PC in Alt Reality to criticize someone else’s Alt Reality.

The only thing you have to be opposed to is those evil doctors and scientists with their “Big Pharma toxins” and “slash, burn and poison”.

(note that even this is not true when your special “natural” vitamin supplement, e.g. Coenzyme Q10, is in fact made by a big pharmaceutical company, as many supplements are- but I digress).

Yes, the Woo credo of Universal Acceptance of Woo means that, by a special kind of “Doublethink”, even Woo-beliefs which completely contradict one another can co-exist.

Which is completely inconsistent in a scientific sense – but completely consistent in a reality-free sense, which is where most Alt Therapies live.

The rationale is simple:

Once you have invented ONE parallel reality, why stop there?

Some readers may recall that in an earlier post I wrote my own advertising tag-line for homeopathy:

Don’t like the physical laws of this universe? Insist on being judged by the laws of a parallel one you thought up specially!”

And – to take this idea a bit further, if my Woo-niverse and your Woo-niverse are irreconcilable, don’t worry, because in the Woo Multiverse they can ALL co-exist!

How is this remarkably agreeable state of affairs achieved?

Easy. As all true Woos know, all you have to do to justify it is to wave your hands and invoke quantum theory.

Goodnight. And may your Personal Physical Reality go with you.

[BPSDB]