Rank… in more ways than one

In which Dr Aust considers his lack of promotion prospects, but does attain rank in the “Anti-CAM brigade”

Dr Aust is feeling very sheepish about his lack of blog activity, and even more so since the much-appreciated plug (combined with a bit of gentle chiding) from ace legal blogger Jack of Kent a couple of weeks back

Indeed, a bit earlier last month Jack had even appointed Dr Aust to a rank in the “anti-CAM brigade”:

Which is curious, in one way, since I started off being neutral or even vaguely sympathetic to the less loony bits of CAM. Honestly.

I was recently reminded of this as I came across an old letter I wrote to Prof David Colquhoun almost three years ago, when I first started commenting on the blogs. As a chemistry undergraduate many years ago I was fascinated by natural product chemistry, so I have always found natural product-based remedies intriguing. (Like most biological scientists, I use various natural products as reagents in my scientific work.) And over the years I have taken a number of herbal pills – valerian and hops for poor sleep being an example. I was also probably influenced by Mrs Dr Aust, who trained in medicine in a European country where complementary therapies are more widely used by doctors than in the UK, and are rather more stringently regulated.

So why would I now be pretty relaxed about being labelled “anti-CAM”?

The reason is that the more I have had to do with the CAM folk over the last 2-3 years, the less and less sympathetic I have become. The reasons for this, I think, lie in the behaviour and evasions of the pro-CAM people, neatly summed up in Edzard Ernst’s personal paper here.

If you wanted to boill it down to a brief statement, my objection would be twofold:

Why do people have to invent fanciful and frankly ludicrous explanations for stuff, when there are perfectly reasonable ones around that do not require you to conjure up a special personal reality?

Why do the same people then cry (variously) “Foul!” “Not Fair!” “Leave my reality alone!” or “Libe!!” when people point this out?

In the specific context of science and medicine, if the CAM lot want to play in the game, then they have to play by the evidentiary rules that apply, notably the ones in which good evidence trumps bad. Otherwise, as David Colquhoun often says, it is like throwing the last 50-60-odd years of medical and scientific advancement in the dustbin.

So how did Jack of Kent come to be handing out ranks in the anti-CAM brigade? The answer is that this arose as a result of a mildly surreal letter that noted CAM apologist Prof George Lewith (who seems to have become the go-to-guy when an academic medical defender of CAM is required) wrote to the New Scientist earlier last month. The letter was in turn prompted by an article Jack had written in the New Scientist – “Don’t Criticise Or We’ll Sue” – noting the enthusiasm of Alt.Reality folk for calling in M’Learned Friends.

Prof George concluded:

“It should be noted that the article you published on this matter is from a prominent member of the anti-CAM brigade.”

Which strikes me as rather a cheap shot coming from a “medically-qualified researcher of CAM”, as Professor George describes himself.

Jack of Kent tells the full story here, noting that his only interest in Alternative Medicine has been the use (or misuse, if you prefer) its practitioners make of the Threat of Legal Retribution to salve their wounded reputations.

Jack was rather amused at Lewith’s parting jab:

Gosh!

But I think this [that JoK is a member of the “anti-CAM brigade”] is incorrect.

Not that there is any shame being a member of such a “brigade”. If so, I would want to be Captain Jack serving below Brigadier Ernst, Colonels Colquhoun and Goldacre, and Majors Noir, Aust, and Gimpy.

Gentleman rankers?

Now, though I happily plead to membership, I’m not sure what rank I should be accorded in the “anti-CAM brigade”. “Major Aust” does, I admit, have a certain ring. And I have been variously described by several of my line managers as “a major something-or-other”. (The something might be “puzzle”, or sometimes “pain”.) However. I have to say that I’ve never really seen myself as officer material.

In fact, a certain aversion to the officer class seems to run in the Aust family. Dr Aust’s father, who was a national service conscript in the early 50s, was the only family member to be a commissioned officer, but he insists this was due to a combination of his technical aptitude for fixing things and his left-wing politics. It was, according to Dr Aust’s dad (or “Grandpa Aust” as he will henceforth be known on the blog, since this is approximately how Jr Aust and her cousins address him), viewed as a bit dangerous to have well-educated and articulate leftie types in the ranks, as they might foment discontent among the enlisted men. Therefore it was safer to make them junior officers and stick them variously in the Education, Intelligence, or Engineer Corps. As Grandpa Aust was both mechanically skilled and a keen teenage radio ham, he was sent to officer training school and then off to the Royal Engineers as a 2nd Lieutenant.

No other member of the Aust family, as far as we know, has ever achieved officer rank. Indeed, Dr Aust’s maternal grandfather, a career soldier who became a Regimental Sergeant Major, turned down a battlefield commission in World War 2.

Anyway, Dr Aust’s failure ever to get promoted in two decades in his current job seems to me to be more of a pedigree for a cynical old NCO than for an officer. And sergeants do feature among Dr Aust’s comic heroes, notably Sergeant Wilson from Dad’s Army, and the wonderful Sergeant Bilko.

So all in all, I think it will have to be Sergeant Aust of the anti-CAM brigade.

But what kind of a Sergeant?

Now, Dr Aust has always had a kind of unofficial job advising on scientific equipment, particularly for optical microscope-based imaging, plus rescuing and renovating older bits of scientific kit and re-distributing it to where it is needed around the Department.

So perhaps his brigade rank ought to be Quartermaster Sergeant.

Though come to think of it, an alternative job might be as a Sergeant Instructor. I do have plenty of teaching experience. And the anti-CAM brigade seems to be gathering fresh recruits by the day.

For which, I think, we must thank our old friends at the British Chiropractic Association.

Indeed, if I may allow myself a brief officer-style compliment:

Cracking work, chaps. Carry on.

Back crack quack attack – the song

Not got round to doing any extended chiropractic debunking as yet, though I am enjoying tremendously seeing what the rest of the posse have been up to. Anyway, as a small contribution, I thought that perhaps the counter-Chiropractic unreality movement needed a theme song. So here is my attempt.

For the tune I have chosen a late 60s classic of pained disaffection with the state of the world. It seemed appropriate somehow. For full versions of the song see below.

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Back Crack quack attack

Back crack quack attack

Lawyers’ fangs rip honest hack

Reality’s all out of whack

Nineteenth century Chiro sCAM

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Writs gag – rich man’s law

Chiropractors scream for more

Free discussion shown the door

Nineteenth century Chiro sCAM

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Back crack quack attack

Libel lawyers’ lips will smack

But beware! The nerds fight back

Nineteenth century Chiro-sCAM

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The little video above, which is actually just the last part of the song, comes from an early performance of the song 21st Century Schizoid Man when King Crimson supported the Rolling Stones at a famous free festival in Hyde Park in 1969. This was the festival a few days after ex-Stones guitarist Brian Jones’ death, and the performance at which Mick Jagger famously read Keats to the assembled fans in memory of Jones – a clip which turns up on many a TV documentary and indeed on Youtube.

And before you ask, of course I wasn’t there. I’m old, but I’m not that old.

The full audio of 21st Century Schizoid Man from the same performance (no visuals) is here, with the album version here. Finally, there is another version, apparently from a BBC session, here.

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PS In an earlier version I did have a slightly different verse:

Laws to keep the truth unsaid
Legal maze and robes of red
Keep the rich and powerful fed
Nineteenth Chiro sCAM

– which might have been better, but sadly it seems that English High Court Judges sitting on defamation cases no longer wear the old red robes.

Truly Much Bogosity – latest news

In which Dr Aust considers the plight of Simon Singh, the Alice in Wonderland world of defamation law English-style, and the implications of Mr Justice Eady’s ruling.

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Stop Press 18/05/09 9.30 pm: Simon Singh “hopes to appeal but cannot confirm yet” Simon says he hopes to make the final decision on whether to appeal Mr Justice Eady’s preliminary ruling by the end of next week. You can read more in a hot-off-the-press account of tonight’s meeting and announcement at the New Humanist blog here.

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**Apologies, this post still has  some of the links missing**

So where to go with blog commentary of the BCA vs. Simon Singh case?  After all, it has been said, really. Apart from Jack of Kent’s coverage, many other Badscience and sceptical bloggers have had a go. Most recently, Andy Lewis at the Quackometer has produced a brilliant post lamenting the surreal madness of a legal system which can put precise words on trial, without addressing in any way the substance of the issue of fact that was being referred to – a system, needless to say, whose prohibitive costs make it the preferred way for the rich and powerful to suppress examination of their conduct.

Plus, in just over 21 hours we will learn what Simon Singh is actually planning to do.

Bogo-metrics

For a time I thought of writing a short dissertation on the meanings, ancient and modern, and formal and more vernacular, of the much-debated word “bogus”. Hence, indeed, the title of the post.

However, the excellent – actually, in context that should be “truly most excellent!” – Language Lab has got there before me, so you can go and read theirs. Suffice it to say that the High Court judgment would strike Bill and Ted (video here – note the word 44 sec in) as “totally bogus”, strictly in one of its hacker / slacker vernacular senses of “really really bad”.

Language Lab will also introduce you, via the Jargon File, to the related concepts of bogosity, and the semi-mythical bogometer. There has even been some discussion of what to name the SI Unit of bogosity – in its hacker sense of  “wrong-ness” -, with some interesting suggestions coming in (one wag suggested the “micro-Eady”, which is kind of catchy).

I rather fancy getting hold of a bogometer, which seems to be a relative of the Bullshit Detector that my mates and I used to sing about back when we were playing Clash covers several decades ago. Anyway, if anyone knows where I can buy a, like, truly righteous bogometer, let me know.

What next?

Anyway, the real questions now for Simon Singh are self-evidently (i) what are his options, and (ii) what is he going to do? Jack of Kent has covered the first of these, and as I said above, we must wait until tomorrow (Monday) night to find out the second.

I actually posted my thoughts on these two issues a few days back to a comments thread over at Respectful Insolence, hence the silence here. But in case anyone’s not read them, I will repeat (slightly edited):

“The real problem with the ruling in the present case is that it restricts Singh’s defence to one that is untenable, first off since it would require him to prove the truth of something he never meant to say and pretty clearly does not believe. And this simply on Eady’s ruling that this meaning (to paraphrase, “you accuse them of deliberate deception”) is the only way that what Singh wrote could, and would, be interpreted by a typical citizen.

The defence [i.e. the defence Eady’s judgement said Singh would have to run] would also be asking Singh to prove something pretty much unprovable, even if it were true (which, again, no one is claiming it is). How do you prove someone, or a trade body, did something “with malice aforethought”? It is a non-starter, really, unless there is a “smoking gun” memo somewhere that you can find (like, to give an example, the Big Tobacco company reports about “let’s put more nicotine in cigarettes as we know it is addictive and makes people keep smoking”). Indeed, the impossibility of proving same is another reason why I would argue Singh self-evidently did not mean the article in this sense.

As Jack of Kent makes clear, the prospects of changing Eady’s bizarre ruling are poor unless it goes to the European Court, but that would require several London-based appeal stages. Of course, the legal fee-o-meter will be running (very expensively) on both Singh’s and the BCA’s legal tabs through any and all appeal stages. Worse, if Singh ultimately loses he would likely end up liable for ALL the costs of BOTH parties. The “smart” move, absent matters of principle, would be to cut and run now, issuing a public statement clarifying the meaning he ascribes to “bogus”.

I think, myself, that Singh will be tempted to appeal Eady’s ruling. The question is how he would be able to meet the running costs of the appeal and “insure” himself against the potential further costs of possibly losing. Personally I would like to see the newspaper in which he published the article, the Guardian, step up and fund his appeal against the ruling as a matter of clear public interest. The Guardian were expressly NOT sued by the BCA, which suggests they apologised for running Singh’s article (and Ben Goldacre has said as much on his blog). But the implications of Eady’s ruling for clear speaking on contentious issues in general are so chilling that I think the paper should strap their ‘nads on, get off the bench, and into the game.”

[Apologies to UK- based readers for the American vernacularisms at the end]

Now, we have no idea whether the Guardian are in any way involved, but at least some journalists, a well-known comedian, and even a politician or two are taking an interest. Private Eye ran, in the latest issue, a short column on Eady’s judgement which seemed to owe a debt to Jack of Kent’s reporting. Lib Dem MP Evan Harris has added his two penn’orth, and Observer columnist Nick Cohen is appearing with Simon Singh tomorrow when we will hear what Simon is going to do. If Singh does decide to appeal the ruling – and gossip on the internet suggests he is leaning this way – I would think he will need a legal expenses fighting fund. I would be more than happy to kick in a few quid myself, and I imagine many other sceptics will feel the same. And a few sceptical benefit evenings, or concerts, or other events, would help too. I’m sure Ben Goldacre would be available for benefit gigs, and I reckon we can also count on Dave Gorman. Wonder if Stephen Fry would like to do one too? Or Tim Minchin?

But all this must wait, of course, until tomorrow when we will know which way Simon Singh is going to jump.

Words…. don’t come easy…

One aspect of the case that has given the whole affair a surreal feel is the “libel trap-door” effect of particular words, and their imputed meanings. Hence the discussion of “bogus” above, as well as extended discussions on several blogs. Some commentators have pointed out that “bogus” seems to be a term which has especially strong and specific meaning for Mr Justice Eady when he has met it previously in the context of an allegedly defamatory statement. Others, including a libel expert commenting on Jack of Kent’s blog as “Richard Keen”, have noted that this is not clear-cut, and that other phrases Singh used may have contributed to the interpretation Eady chose to place upon his words.

Whichever it is, it still rather fries the brain cells to think that the outcome of this hearing could have hinged in large part on the use of one particular word like “bogus” – as opposed to any one of the numerous alternatives Singh might have used which are arguably harder to read as “implying deliberate deception” – such as “daft”, “unbelievable”, “discredited” “ridiculous” “wholly implausible” or “risible”, to name but a few.

Another point is the largely unfathomable – at least to the layman – nature of English defamation law. This is an issue which clearly has resonance for sceptical bloggers in general, as many commentators have made clear. There seem to be few reliable principles in defamation cases, and almost unlimited judicial discretion. An approach that works in defending one case seems not to work in defending another.

Take, for instance, an earlier defamation case familiar (at least in outline) to UK-based skeptical readers, the Matthias Rath vs. Ben Goldacre and Guardian newspapers case . This was heard by a different judge, Mr Justice Tugendhat (PDF of his ruling here). Ben G’s lawyers argued successfully at the preliminary hearing – again, as I read it, NB IANAL (disclaimer) so take with pinch of salt – that the whole of an article had to be used to give context to, and thus clarify the meaning of, contentious (i.e. argued to be defamatory) statements made within that particular article.

The judgement in the BCA vs. Singh case seems to be saying precisely the opposite. Curious. Perhaps a lawyer can explain it to me… Or are we to take it that certain “red flag” words are construed by the law of libel to have no contextual nuances whatsoever in their received meaning?  Or perhaps that, going back to Jack of Kent’s pseudonymous commenting libel ninja, if one or more phrases are used in a particular way (as in Singh’s first paragraph), the law will not allow you to clarify, or set out, the meaning you thought you were giving the phrases later – even in the next paragraph?

Which raises an interesting thought. What if Singh had put the paragraph where he sets out why he regards the treatments as “bogus” before the paragraph where he talks about the BCA “promoting” them? Would that have been construed as less libellous? Or at least, would that have made the meaning Singh wanted to try to impute to the offending phrases more arguable / allowable in the Judge’s view? Some of the legal and journalistic commenters on the case (see e.g. here) have noted that earlier rulings by Mr Justice Eady had made it easier for English newspapers to mount fair comment defences of defamation actions – provided the newspaper could argue that they had clearly distinguished the known facts from the interpretation subsequently put on them. Thus the adage – “first state the established, or establish-able, facts, then give the interpretation, but do not mix the two”.

Which in a weird way reminds me of an old line about how to write a scientific paper, one which to this day promotes heated, often inter-generational, arguments:

“Don’t put the interpretation in the Results Section! It belongs in the Discussion!”

So… did poor Simon Singh simply get the paragraphs the wrong way round?

Enough word-salad. Let’s talk turkey.

Now, all this discussion of nuances of phrase and the order of paragraphs may appeal to those academic professional wafflers (like Dr Aust) or amateur lawyers-manqué, (probably like Dr Aust again), who are intrigued by words and their use and meanings.

But we can all agree that it is all enough to make your head hurt.

Let alone potentially cost you the shirt off your back.

Turning to consequences, it does not take a genius – or even a libel silk – to work out that there are a number of things that are highly likely to follow, albeit indirectly, from Eady’s judgement.

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– It will make defamation and “reputation management” lawyers richer, since it remains clear that navigating the baroque and Byzantine English defamation laws is not a task for a layman.

– Sceptical commentators, on any issue, will be walking a tightrope in terms of the precise words of description they use, and even of the order of their paragraphs.

– There is likely to be even more recourse to law in the future by Alternative Medicine practitioners, and bodies like Alternative Therapy professional associations, seeking to “defend their reputation”, when people point out that their offered nostrums are unproven and sometimes known to be nonsensical.

– These lawsuits will NOT, it is clear, hinge upon the validity (or not) of the scientific statements made by the Alt.Therapy types. Not if they have smart lawyers, anyway.

– Consequent upon the last, there is likely to be less open debate of the validity (or not) of such practices – at least, I would suggest, in the mainstream media.

– The UK – more specifically England, and more specifically still London’s courts – will be ever more firmly tagged with the description “the place where there is no defence of free speech against defamation claims”. This is a common view in the US in particular, as you can infer from Pal MD’s comments here.

– And as a consequence of the last, “Libel tourism” to England will not be going away.

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All. Really. Rather. Tremendously. Depressing.

I don’t want to leave you on too depressing a note, though, so here is a more positive thought. A chiropractic professional association, like the BCA, can sue you. “Chiropractic” cannot. Nor, in fact, can a body established by English law like the General Chiropractic Council (GCC) which licences chiropractors in the UK.

This point was made by the libel expert commenting on Jack of Kent’s blog as “Richard Keen”:

“It is important to keep this all in perspective.

…it is perfectly possible to use the word “bogus” to describe chiropractic. Just be careful of mentioning an entity which is able to sue.”

Which reminded me of an exchange that we had back in January when I posted my update to the Singh case. In response to some interesting comments from reader Blue Wode, who is highly knowledgable about chiropractic, I wrote:

“As the General Chiropractic Council is a statutory body established by an Act of Parliament it would not, as I understand it, be able to sue someone for defamation. So I wonder what would have happened if Simon Singh had said “Chiropractic” (in general) supports treatments for which there is no evidence base, rather than saying “the BCA”. The GCC would not be able to sue, and it would probably be harder for the BCA to claim they had been libelled than with the form of words Singh actually used.”

To which Jack of Kent replied succinctly:

“Correct”.

So to finish, I will give you one of my favourite pithy cut-to-the-chase summaries of chiropractic (in general), from American doctor-blogger PalMD, in a post entitled “Why chiropractic is patently ridiculous”:

“I am often asked my opinion of chiropractic care. My usual answer (based on evidence) is that it can be somewhat helpful in the treatment of low back pain. That’s it. Any further claims are complete and utter [expletive] …”

Which sums it up nicely for me.

Now, I have been doing some browsing round on the websites of UK chiropractic practitioners, both in my own geographical area and further afield. Thus far, every single site I have looked at makes multiple “quasi-medical” claims about how chiropractic, and chiropractors, can help with things far beyond lower back care.

I think one might reasonably infer, from the prevalence of these claims, that they are practically “boilerplate” for practitioners of chiropractic.

You may draw your own conclusions.

But – and I must make this absolutely clear – don’t ask me anything – anything at all – about the BCA.

As Manuel from Fawlty Towers would say:

“I know nothing”.

[BPSDB]

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Edit 20/05/09 – Jack of Kent has reminded me that it is English defamation law, NOT “UK” – Scotland has separate laws. “Confused? You will be… “ Anyway, corrected accordingly.

You couldn’t make it up

A small round-up of what I have been reading.

The line “You couldn’t make it up” is a rather over-used one in the UK. Nonetheless, it often seem apposite when confronting enthusiasts for Alt.Reality.

Sometimes the line springs to mind when a particularly egregious example of Alt.Med abuse surfaces. One such of recent vintage comes from Gimpy’s brilliant coverage of the extraordinarily deluded Jeremy Sherr, the homeopathic guru who thinks that homeopathy can cure HIV/AIDS. More that that, Sherr is on a kind of Sacred Mission – I am oddly reminded of the Blues Brothers – to bring the joys of pure-water-plus-hocus-pocus to desperately unfortunate people in Tanzania who are both HIV-positive and in the grip of poverty.

Gimpy has done a tremendous job of exposing Sherr’s messianic delusions and ethical blind-spots – but the “You couldn’t make it up” moment does not stem just from Sherr himself. It also comes from the hordes of homeopaths who have lined up to defend – and heap praise on – Sherr, and from the homeopathic “trade bodies” which have been stunningly silent on what Sherr is up to. Behold the chorus of disciples on, for instance, Gimpy’s threads here and here.

AIDS is a deadly disease. It can be staved off with drug treatments. These antiretroviral drugs (ARVs), particularly the protease inhibitor cocktails, constitute one of the greatest recent achievements of the much maligned (often with considerable justification) ” Big Pharma”. Without ARV treatment, it is essentially inevitable that eventually your immune system will fail and an opportunistic infection will finish you off – as has sadly happened to most “It’s not HIV! ARVs are evil!” activists. With the triple cocktails, or similar ARV regimes, you have a good shot at living for many years. People with a grip on reality have campaigned tirelessly for HIV-positive people in the developing world to have access to ARV drugs at cost. These activists, like the Treatment Action Campaign in South Africa, are the real heroes.

But apparently, most lay homeopaths are quite convinced you should forego the anti-retrovirals and embrace their particular brand of “spiritual healing”.

You really, truly, couldn’t make it up.

And let’s not forget – Jeremy Sherr is widely regarded within homeopathy as a leader of the “discipline”, one of their key intellectuals and most revered teachers. Which says it all, really. You could hardly want for a more perfect demonstration of just what an extraordinary parallel reality homeopaths inhabit.

Did you call me a cult?

Also in the “You couldn’t make it up” category, but perhaps rather more predictable, the anti-vaccine cultists have resoundingly ignored the recent body-blows for the anti-vaccine cause. The first thing I am thinking of is the US Autism Omnibus decision, where the judges decisively rejected the idea that MMR vaccine could cause autism, and laid out in excruciating detail (excruciating for the anti-vaccine believers, that is) precisely how discredited, half-arsed, and nigh-on fraudulent is the so-called “research” and laughably useless “experts” on which the anti-vaxxers relie.

The second body-blow was the latest tranche of revelations from investigative journalist Brian Deer about Andrew Wakefield’s original work at the Royal Free that triggered the MMR scare. If even a fraction of what Deer alleges is true, then Wakefield stands revealed as a data-fabricator of the worst kind, and everything he has ever said turns irrevocably to dust.

However – none of this seems to have had the slightest effect on the True Believers. You can see this from a mammoth thread over at Kev Leitch’s Left Brain/Right Brain blog. A collection of the usual suspects from anti-vaccine group JABS – John Stone, Isabella Thomas, etc. – are clearly unshaken in their faith. They view the recent events, and the scientific revelations like Prof Steve Bustin’s devastating testimony on the stunning incompetence of Wakefield and O’Leary’s RT-PCR work, as a side issue. They are, predictably, more interested in trying to spread slurs and conspiracy theories about Brian Deer, and nitpicking over obscure legal decisions on what UK expert testimony was or wasn’t made available to the US courts.

If you can face the mega-thread, look particularly for the posts by “brian” (who identifies himself as a medical doctor and a molecular biologist), and see the responses they draw from John Stone and friends. The JABbies, as has been said before, are beyond reason. They are a cult.

Though they are a cult, sadly, that retains the odd friend in the media. Notably, the increasingly-out-of-touch-with-reality Melanie Phillips. Phillips  is still determined that Wakefield was right – though we don’t really know how she would know, given that she doesn’t understand the science – and that it is all a Dark Conspiracy.

Reading her latest post on this I was struck by the fact that there seemed to be almost no commenters apart from the hard-core Wakefield Groupies – John Stone, Clifford G Miller, Isabella Thomas, Seeonaid etc etc. Unsurprisingly, Melanie’s previous comment, a few days earlier, had echoed precisely the line taken by the JABS Mafia over at Left Brain/Right Brain by re-framing the whole thing as an attack on Brian Deer.

Among the dwindling band of normal people reading Melanie’s rant I was particularly struck by this comment from a poster styling himself “Valetinius” (7th comment on this thread):

“This is actually indicative of the new dogmatism that has deprived Melanie Phillips of the independence of mind that once made her a commentator of note. There is a lesson in discourse analysis on all of these recent pieces… …not that here is a journalist with an interesting, novel assessment of a controversial issue, but here is the definitive, conclusive, indisputable truth, sweeping away all contrary evidence and labelling opponents variously as knaves, liars or antisemites. Of all of the controversies [Phillips] has adopted as personal crusades, [MMR] is the most revealing. With infinitely more proof than global warming could ever hope to command, study after study has comprehensively refuted the Wakefield MMR-autism hypothesis, yet Melanie tastelessly maintains her contrarian position. She doesn’t seem to realise how revealing this is and how much damage it has inflicted on her defence of her other favourite causes. I agree with those who lament this personal and professional lapse of judgement. Instead of refreshingly adversarial, she now just looks silly.”

This summarised perfectly why it is that, for the last couple of years, I have been turning off BBC Radio 4’s The Moral Maze as soon as they announce that Melanie is on the panel. But perhaps it offers a clue as to the reasons for Phillips’ unwavering support of Wakefield, even as the scientific underpinnings of his ideas and his credibility have crumbled.

It is our old Alt.Reality friend the Galileo Gambit – an unshakeable belief that you must be right, precisely because everyone else is telling you that you are wrong.

Alternatively, of course, you could just be wrong.

How DARE you not take me seriously?

Something that comes across strongly in long argumentative threads on Alt.Medicine themes is a sense of just how seriously Alt.Reality folk take themselves. They also have thin skins. This is particularly marked, I have been finding recently, with Chiropractors.

Now, chiropractors are institutionally, as well as individually, thin-skinned – as the BCA vs. Simon Singh libel case, and recent events in New Zealand, show. They also seem to be rather humourless. I started to get this latter idea while reading a recent Economist thread on Alternative Medicine. Here you will find a Dr Robinson – a “Doctor of Chiropractic” (DC), to be precise – defending Alt.Reality and getting a bit huffy when anyone appears not to be taking her as seriously as she takes herself. Rather scarily – from my point of view – it turns out she works for this bit of the World Health Organisation (more about them here).

I casually (or possibly mischievously) posted a link to the Economist thread over at Respectful Insolence, thereby inadvertently triggering another “discussion” about Chiropractic and its relationship (or not) to reality.

The Respectful Insolence thread makes for an interesting demonstration of how many Alt.Reality types see their own professions, including those of their fellow “practitioners” who are at the wackier end of the spectrum:

Chiropractors who advise against vaccination? Just a few bad apples.

Chiropractors who push chiropractic for things that it is demonstrably useless for? Exercising their clinical judgement.

Chiropractors who wrench peoples necks around? There’s no stroke risk, the people who caution that there is, like Edzard Ernst, MUST be liars.

Chiropractors who call themselves “Doctor” and don’t make clear they are not conventional physicians? Well, why not, Chiropractors are fully trained clinicians, with all the expertise to resuscitate you if you keel over. (Seriously, some of them believe this).

Ben Goldacre once wrote somewhere that the most defining characteristic of CAM was its hard-wired inability to critique itself in any meaningful way. Threads like this show you exactly what he meant. And remember, a US “Doctor of Chiropractic” with the DC degree is the absolute top of the training tree in terms of a CAM practitioner, at least with regard to length of training. As Dr (of Chiropractic) Robinson pointed out to me, they do a postgraduate degree taking 4 years to become a DC, just like a conventional US medical degree which takes four postgraduate years.

Having said which, if I rocked up in an American ER with a chest pain, I would not want to see a DC. I would want an MD. And personally I would feel the same about a bad back. If I had back pain, and shooting pains down my leg, I would want a medical doctor to assess me. If I had uncomplicated lower back pain, and wanted spinal manipulation, I would go to a manipulative physiotherapist. A chiropractor might know slightly more background about spinal ailments than the latter, but I would have zero confidence in the clinical judgement of someone who believes that chiropractic spine-bashing is a useful way to treat a small child’s asthma.

[In the interests of balance, it should be said that there ARE some people in chiropractic who would like to make it evidence-based, and who campaign for chiropractic to remove the quasi-religious overtones, fact-free 19th century hocus-pocus, anti-vaccine propaganda, and general nuttiness. However, if recent surveys of what practising UK chiropractors actually believe are to be trusted, these reformers are going to have their work cut out. Needless to say, their ideas have not really caught on in the chiropractic community]

No logic please – we’re intuitively crazy

Last of all, and by far the best from a surrealist point of view, here is an example of Alt.Reality that provokes laughter and “you couldn’t make it up” in equal measure. Andrew Taylor of the “Apathy Sketchpad” blog tells us that he has been banned from the earnestly reality-free Homeopathy4Health blog.

The reason? He has been guilty of dangerous use of logic. Apparently logic is frowned upon when discussing homeopathy. Though I suppose one shouldn’t be surprised.

The blog owner, the homeopath who goes by “Homeopathy for health”, starts it off.  Another old friend of ours then chips in:

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Andrew’s comments are no longer allowed on this blog. This is because he has a tendency to write opinions based on logic and not from experience or facts. He is a programmer by profession.

Comment by homeopathy4health — 7 March 2009 @ 10:45 am

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h4h, that’s the funniest thing you’ve ever written. Am I to assume that only illogical arguments based on experience and facts are allowed?

I had a bad egg this morning, therefore it rained.

Comment by gimpy — 7 March 2009 @ 1:55 pm

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You can’t present opinion on logic alone.

Comment by homeopathy4health — 7 March 2009 @ 2:31 pm

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To which there is really no answer, apart from rolling on the floor helpless with despairing laughter.

Or – as they say – “You couldn’t make it up”

Which is, of course, where we came in.

Goodnight. And – as the late, great, Dave Allen might have put it –

“May your Personal Alternate Reality go with you.”

[BPSDB]