What is the medical version of the Courtier’s Reply?

We find a perfect example of this detestable apologetic accommodationist approach for ‘sophisticated’ thinking over at Sabio Lantz’s popular Triangulations, offered up on platter in his post Why do you reject Homeopathy? This is the medical version of the Courtier’s Reply that invokes the need for some level of sophistication to be exercised in order to reject the tenets of homeopathy properly… while making room for what starts out to be hypothetical efficacy derived from it and morphs into actual efficacy associated with it.

Sabio lists three main categories into which a reader’s rejection may fall: tribal doubt (no other ‘tribe member’ accepts it so, being part of this ‘tribe’, you don’t either) , mechanism doubt (the mechanistic explanation is inadequate), and smattering of science (you believe some studies you’ve heard in passing that claim no evidence of efficacy). A fourth classification is for those who have done in-depth research into the applicable science and waded through all the counter evidence of non-efficacy before arriving at an opinion of rejection (similar to the level of knowledge about the finery that is needed before one is allowed to comment of the nakedness of the Emperor).

He is following the tried and true method of the accommodationist so that he can ask with a straight face, Do you agree that something can work in spite of the explanation offered? Notice the words ‘CAN WORK’. That sounds like a reasonable question, doesn’t it? But then, Poof! ; suddenly we’re talking about homeopathy as if it DOES WORK – even if this explanation is absolute bunk – which is slowly revealed to be Sabio’s position all along… beginning with the comment that “I strongly agree that much is to be learned from alternative medicines which has nothing to do with the science behind their treatments.” Really? And what might that be? How gullible people are? How undermining healthy scepticism helps woo-peddlers? How faith-based belief can be accommodated with conflicting knowledge? Do tell, Sabio; do tell. In this post, of course, we never do find out.

What he means by has nothing to do with the science behind their treatments , of course, is the LACK of good science, plausible science, that informs these alternative, complimentary, integrated, holistic, natural treatments… treatments  that are somehow qualitatively different from what we call efficacious medicine but still cause effect, but once you start down the path to presenting the Emperor as if he could be clothed – that woo treatments CAN WORK even if the explanation is wrong  – it is difficult to regain one’s intellectual footing. But intellectual integrity is never the goal of accommodationism; it’s all about appearing to be non judgmental about woo and hyper-critical of justifiable scepticism. The real goal at the end of the day for the accommodationist is to present himself as both a supporter and defender as well as a reasonable sceptic of woo (unlike those ranters and hyper-rational people who dismiss woo claims out of hand because they have no good reasons to believe them in the first place).  It’s tricky ground for accommodationists when the two – woo and scepticism – are in conflict from the get go (see here for why the treatment should banned according the British Medical Association).

Well, what is the explanation of homeopathy that is being dismissed by some level of ‘sophisticated rejection’?

Orac explains:

Most skeptics are aware of the two main principles of homeopathy, neither of which is based on anything resembling good science. The first principle is known as the Law of Similars, which is commonly phrased as “like cures like.” The concept is that the way to choose a homeopathic remedy is to choose something that causes the symptoms the practitioner wants to alleviate. Of course, there’s no general scientific or biological principle to support the Law of Similars. In reality, it’s nothing more than a variant of ancient concepts of sympathetic magic. Yet it is the main basis of all of homeopathy.

The second big law of homeopathy is known as the Law of Infinitesimals. This is the most famous principle of homeopathy that states that the way to make a remedy stronger is to dilute it, a principle that laughs at chemistry, physics, and biology. Indeed, common dilutions of homeopathic remedies (for example, 30C, which is 30 serial 100-fold dilutions, or a dilution of 10⁶⁰) have been diluted so much that the odds that even a single molecule remains in the remedy are, well, infinitesimal. That’s why it’s not for nothing that skeptics frequently point out that homeopathy is nothing but water. It’s even loonier than that, though. The reason is that dilution is not enough. At each step, we are told by homeopaths in all seriousness that the succussion at each dilution step is critical to “potentize” the remedy. Samuel Hahnemann himself, the inventor of homeopathy, used to succuss his remedies by slapping them against a Bible. These days, in at least one case, a big company like Boiron have machines that do the succussion automatically for remedies like oscillococcinum up to 200C, which represents a 10⁴⁰⁰-fold dilution. Given that there are only around 10⁸⁰ atoms in the known universe, readers can easily see the ridiculousness.

So here’s the thing: what is it that is actually being rejected? I think it’s the central tenet of any woo claim about efficacy  – a faith-based belief that supernatural forces can cause through natural treatment natural effect. Sabio suggests that there really, really, really is evidence of efficacy in some of these woo treatments (“I have demonstrated acupuncture to many folks (not just patients). What is real fun is to get a hyper-rational person to experience things they don’t believe exist”) and that this evidence is available (“But I wager you have not read the studies published by homeopaths showing effectiveness. I worked with an MD homeopath who published in Pediatrics about her research in Guatemala with homeopathic remedies used to treat diarrhea and showed an effect”). See? Homeopathy, says Sabio,  DOES produce evidence of efficacy, and there it is: the switch in language from the reasonable CAN WORK to DOES. But he doesn’t really mean supernaturalism at work, does he?

Let’s look.

Sabio actually means efficacy of placebo when he talk about efficacy: “It is funny how people can allow various placebos (to) work for them and yet now (sic) allow others.” Now think about that comment for a moment because it reveals the sneaky way accommodationists forgive promoters of woo for their lack of specificity… through the subtlety of language.

Sabio is suggesting that placebo is more than what it actually is:  self-reporting of feeling better. He present it as a thing, something you can allow or reject, something that works for you. But that’s not what placebo is, not what placebo means. What placebo means is that mood and belief can have a significant effect on the subjective perception of a treatment’s efficacy. Placebo is not any kind of additional ‘thing’ brought to bear by health care practitioners. Placebo comes only from the patient and its ‘efficacy’ is not directly physiological (although to be clear there are biological mechanisms by which mental processes can affect pain). That’s why placebo is often – and confusingly – referred to as an ‘effect’. But to be equally clear, the more concrete and physiological the outcome, the smaller the placebo effect. At its explanatory extreme, that’s why amputees don’t grow back new limbs no matter how much they may wish it to be.

Notice how Sabio slips in the notion that placebo works ‘for’ someone…as if to say if we build it they will come, that putting efficacy of placebo into the patient’s domain means the same thing as putting efficacy of woo treatments under the control of the patient.  This subtle change in language is insidious because it alters what placebo is – self reporting perception – into something it is not – an efficacious deliverable element of treatment with the patient’s permission. This confusion is rampant in the public domain and, in a nutshell, is the main driver of woo in health care: confusion about causal effect.

From wi-fi fears to chlorination of water, from acupuncture to reiki, from faith healing to anti-vaxers, the confusion about the need to link causal effect is neither clarified nor confirmed by accommodationists who pretend we can put aside causation to better respect faith-based beliefs while maintaining intellectual integrity. We can’t. It’s sneaky, dishonest, and cowardly, and comes at a high cost to respecting knowledge . And here’s why:

I think the notion of what’s true in fact (information that is reliable, consistent, and practical in reality) is knowable and dependable. This is what science is built on and we use practical applications based on exactly this everyday in every way of our lives. Accommodationists and apologists for woo take all this and assume it’s equivalent to some democratic vote. (Sabio: I hope to help interested readers to understand why people practice homeopathy and why millions of patients swear to its effectiveness.  So I am talking to those who are willing to consider not dismissing homeopathy out-of-hand, and instead make an effort to understand why others value it so strongly.) That’s not how reality works. You can’t vote against gravity and expect efficacy because millions want to lift its effects to make room for their anti-gravity beliefs any more than you can vote against evolution to make room for the oogity boogity of creationism or vote against science-based efficacious medicine to make room for homeopathy and expect me to sit by and nod and say how wise that is. It’s not. It’s a denial of what’s true in reality (see above description of what that means)… not a philosophical difference, nor a lack of rejection sophistication, nor any other mitigating term accommodationists would prefer to call it. Belief in woo is a denial of what’s true in reality (remember, see above description of what that means).

And it is downright dishonest to pretend that what’s true in reality (see above description of what that means) is only empirically available in some lab. It’s right in front of our faces all the time and we rely on accurate knowledge about it to function. We really must stop pretending that people who sow doubt about trusting in this knowledge (immediately testable and verifiable) rely on the same kind of faith woo believers exercise to maintain their ‘spiritual explanations’ about the supernatural. It’s not just different; it an exercise of hypocrisy that trusts this knowledge on behalf of their lives on a day to day, moment to moment, basis but then a rationalization using such fallacious arguments like the Courtier’s Reply and sneaky word substitutions to suspends this same knowledge to make room for some woo-soaked apologetic belief in oogity boogity.

What does gullibility look like in print?

Check this out:

3000 Years of Science in a 21st Century Delivery System

CieAura Transparent Holographic Chips™ use a proprietary combination of homeopathic formulas consisting of intrinsic energies that affect positive health responses. CieAura Chips have the look of simple decals on the body or clothing and are totally non-invasive, without any chemical component. When placed along sensitive acupuncture meridian points, results such as increased energy, improved stamina, deeper, more restful nights, and other assorted reactions occur, depending on the program formula of the Holographic Chip and the related placement.

You might think these magical chips actually do something, mightn’t you? Thank goodness the disclaimer tells us it’s all bunk:

CieAura products are sold for learning, self-improvement and simple relaxation. No statement contained in this writing, and no information provided by any CieAura employee or retailer, should be construed as a claim or representation that these products are intended for use in the diagnosis, cure, mitigation, treatment or prevention of disease or any other medical condition. The information contained in this writing is deemed to be based on reliable and authoritative report. However, certain persons considered experts may disagree with one or more of the statements contained here. CieAura assumes no liability or risk involved in the use of the products described here. We make no warranty, expressed or implied, other than that the material conforms to applicable standard specifications.

Yet people actually buy these kinds of products because they are gullible. And they are gullible because they allow their faith-based belief in woo to guide them. The problem, however, is that belief in woo is equivalent in all ways to delusion. When we are willing to trust our delusions as if they were true, we are bound for disappointment. In the meantime, far too many of us are simply gullible… to the great profit of integrated medicine and religious industrial woo-meisters who peddle its virtues.

(h/t neurologica)

 

If homeopathy is just water, then what’s the harm?

This is the harm. These two short videos show why. The harm is real, ongoing, and completely unnecessary. Simply put, homeopathy is what we call quackery.

Why is understanding plausibility so important to how we inform our beliefs?

Plausibility is essentially an application of existing basic and clinical science to a new hypothesis, to give us an idea of how likely it is to be true. There are three broad categories of plausibility we need to appreciate:

If evidence for a direct connection between a cause and its effect can be established, then we have a highly plausible explanation upon which we can depend for consistent results.

If we have evidence for an consistent effect from some cause but do not understand the generating mechanism, then we have neutral plausibility for an explanatory hypothesis.

If we have evidence for an inconsistent effect from some perceived cause and suggest an explanatory hypothesis that violates the basic laws of science, then our explanatory hypothesis is implausible.

As Steve Novella writes over at Science-Based Medicine regarding homeopathic treatments that claim to provide efficacy to improve ‘life energy’,

Invoking an unknown fundamental energy of the universe is not a trivial assumption. Centuries of study have failed to discover such an energy, and our models of biology and physiology have made such notions unnecessary, resulting in the discarding of “life energy” as a scientific idea over a century ago.

Essentially any claim that is the functional equivalent to saying “it’s magic” and would, by necessity, require the rewriting not only of our medical texts, but physics, chemistry, and biology, can reasonably be considered, not just unknown, but implausible.

How we inform our beliefs using the plausibility standard is important and depends entirely on the quality of the explanations we rely on to do so,  whether they are about specific ideas in medicine or religion or politics or about more general policies and procedures. If our explanations are plausible, then our beliefs are plausible. If our explanations are implausible, then our beliefs are implausible. If we are considering to act on our beliefs, then we need to first undertake due diligence and establish how plausible they really are.

If the beliefs are implausible, then we know they are poorly informed and, as such, are unjustified. Acting on unjustified beliefs in our personal and private domain is our prerogative. We have the freedom to do so because the founding documents and charters and bills of our liberal secular democracies provide us with the necessary legal framework and state-sanctioned power to protect these equal freedoms. But providing what’s necessary isn’t nearly enough. We must also do our part as individuals to maintain our own equal freedoms.

In stark contrast to the freedom we have to exercise our beliefs in the private domain, acting on our implausible beliefs in the public domain is wrong and richly deserving of sustained legitimate criticism. Whenever we come across those who wish promote unjustified beliefs as if they were informed and plausible when they are neither in the public domain using public offices, we must hold them to account for their abuse of their office’s public power that allows them to cross that important boundary between the what is allowable in the private but forbidden in the public.

Our task is to maintain sustained criticism towards those who abuse public office in this way – whether they abuse the office’s power to support implausible medical therapies, implausible religious truth claims, implausible political solutions, and so on. We must insist that only informed beliefs that are plausible be made into public policies and procedures. Our collective failure to participate in our civic duty in this matter is a failure to be responsible to no only ourselves but to our fellow citizens, which has a cumulative effect of reducing our equal common rights and freedoms. We harm the very fabric of our equal rights and freedoms under a liberal secular democracy when we allow the abuse of public office to promote implausible beliefs. We allow it to continue when we choose to remain silent about this abuse. Even more damning to our equal individual freedoms  is our active support of candidates and office holders who are willing to promote our favoured implausible beliefs… again, whether those implausible beliefs are about complimentary and alternative medicines, favoured religious beliefs, political strategies, and so on. This kind of willing support to the implausible is both unpatriotic and seditious no matter how great may be the popularity of these candidates and their platforms.

The standard of plausibility is a very important concept to inform public policies – useful to each of us to determine our level of support for these public policies and procedures – although we have the freedom (and luxury) to pay it scant attention in our private lives… for now. What is essential, however, is to understand why plausibility matters so much.

What is the 10^23 campaign?

Excerpts from Neurologica Blog:

6.022137 × 10^23 – that’s Avogadro’s number. It’s the number of atoms or molecules of a substance in a number of grams of that substance equal to its atomic mass. So 1 gram of elemental hydrogen or 12 grams of carbon12 will have Avogadro’s number of atoms. This amount is also called a mole – so a mole of anything has Avogadro’s number of elementary particles – a mole of water has Avogadro’s number of water molecules.

Samuel Hahnemann invented the principles of homeopathy (he “discovered” nothing, it turns out) in the 1790s and published his first article on the topic in 1796. Hahnemann claimed that the more a substance is diluted the more potent a medicine it becomes, in violation of the chemical law of mass action which dictated that chemical reactions proceed more quickly the more substrate there is. Hahnemann also advocated such extreme dilutions, still used by homeopathy today, that many of his potions vastly exceed the dilutional limit – the point beyond which there is likely not a single atom or molecule of substance remaining. That is where Avogadro comes in .

To honor Avogadro further, and highlight the absurdity of homeopathy in the face of basic chemistry and physics, a UK group has started the 10^23 campaign. Their basic purpose is to protest continued support for homeopathy in the UK and elsewhere and to raise public awareness as to what homeopathy really is (nothing). They surmise (correctly, in my opinion) that the more people know about homeopathy the less popular it will be.

Their first major act was a mass public homeopathic suicide:

At 10:23am on January 30th, more than four hundred homeopathy sceptics nationwide took part in a mass homeopathic ‘overdose’ in protest at Boots’ continued endorsement and sale of homeopathic remedies, and to raise public awareness about the fact that homeopathic remedies have nothing in them.

It is a dramatic demonstration of the inactivity of homeopathic potions – take a massive “overdose” and suffer no ill effects. This is actually more than a stunt – it demonstrates the lack of a dose-response effect from homeopathic nostrums, which is convincing evidence that there is no effect.

Is atheism fundamentally a Straw Man argument?

There is a reprehensible opinion piece posted online at the New York Times by Ross Douthat that supposedly offers us an “illustration of militant atheism’s symbiotic relationship with religious fundamentalism.”

Specifically, Douthat criticizes Dawkins for using Pat Roberston and his diatribe of god-sanctioned blame for the devastation suffered by Haiti as an example of a ‘real’ christian (read my previous comment on Dawkins’ article and why he argues as much). This is a failure of critical thinking by Douthat. By asserting that atheism requires a Straw Man approach, Douthat fails to comprehend Dawkins’ central argument: that a willingness by today’s theological apologists to grant any credence to a religious interpretation of some holy text that focuses on what is meek and mild without accounting for the parts that are vicious and genocidal is intellectually dishonest.

Douthat’s counter argument that quotes New Testament passages to negate Robertson’s interpretation is exactly Dawkins’ point: one biblical reference is not any closer to being true or accurate than the other. The only difference is that Robertson’s interpretation takes into account the capriciousness and violence of the christian god, making such an opinion based on biblical interpretation more ‘real’ in a christian vein than one like Douthat’s which simply ignores the Old Testament’s accounts of a god that is unconscionably cruel and immoral in favour of specific passages that casts Jesus as benevolent and forgiving. Let us all remember, however, that it is from Jesus we first gain a biblical account for eternal damnation… hardly one that enhances the CV of hope and love people so often attribute to Jesus’ message.

I have read repeated criticisms of Dawkins and other New Atheists as creating a Straw Man religious argument, that is to say, that these atheists create a Robertson-ian god as the one that defines the christian god and then tear it down by revealing its obvious malevolence. But the god worshiped by most christians, this argument points out,  is not this god – the one believed in by some fringe and/or extreme fundamentalists as the one so vehemently opposed by ‘militant’ and ‘strident’ atheists – but one that is actually benevolent and wise and compassionate. The faulty conclusion then held by so many moderate religious apologists is that Dawkins and his cohorts aren’t criticizing their religious beliefs but merely the ones held by hard core fundamentalists.

They couldn’t be more wrong.

New Atheists care about what is true. They care about knowledge – about what’s probably accurate, probably correct, probably true. They care about coming to a better understanding of the natural world, of promoting honest intellectual and scientific inquiry. They also respect the rights and freedoms and dignity of individuals within a secular society. They are concerned about any influence that intentionally impedes any of these cares, and there is no greater single impediment than the false certainty of religious belief. But rather than criticize specific people’s beliefs, the New Atheists’ approach is to enter the public forum and expose unjustified beliefs – regardless whether the unjustified belief is religious, superstitious, supernatural, or just poor thinking. To do this, New Atheists point out why the unjustified foundational belief of a Robertson is no different in quality of belief than someone who insists on holding a Jesus is Love assumption. Nor is there any difference in the unjustified foundational beliefs upon which the complimentary and alternative medicine industry has been built. Belief in the supernatural, whether it be god or evil spirits or the memory of water, cannot be honest knowledge: because such ideas are beyond our ability to be examined in the natural world under natural conditions subject to natural forces and natural efficacy all which can be naturally measured, supernatural belief cannot be justified by any other measure other than more assumption and assertion. Assumption and assertion that cannot by definition undergo natural testing and rational criticism because it is supernatural is immune from honest critical inquiry. Asserted beliefs are assumed to be true because they are believed to be true. That is not a justification for the truth value of the belief but an excuse, an allowance, a willingness to suspend critical inquiry. So it doesn’t matter whether or not it is a Pat Robertson’s unjustified belief or an Ayatollah’s unjustified belief or a Pope Benedict XVI’s unjustified belief or a Sarah Palin’s unjustified belief – the common denominator pointed out by New Atheists like Dawkins is that supernatural beliefs in their entirety are equally unjustified.

When a Pat Robertson makes another disparaging public statement about suffering people deserving their suffering and backs it up with theology, it is an opportunity and not a requirement for atheists to once again point out that if not for the acceptance of the moderately religious, then the foundation of unjustified religious beliefs would be treated with the same scorn and disgust aimed at Robertson for his outrageous truth claims. Robertson and his ilk have an audience because there is widespread acceptance by religious apologists to excuse, allow, and suspend legitimate criticism in matters of religious belief. That’s a public problem and it requires a public solution.

Is unjustified belief in the supernatural and all its various promotions in the public domain in need of public criticism? My answer is an unequivocal Yes. The New Atheists like Dawkins don’t just say a meek and mild yes to this question in the privacy of their own minds; they DO something about it by bringing their arguments and expertise into the public domain to tackle the problem of a Robertson, an Ayatollah, a Pope, a Palin, head on.

So the answer to the title is No, atheism is not fundamentally a Straw Man argument but a call to action, a growing movement that will continue to challenge anyone who doesn’t care about what is true but what is unjustifiably believed to be true, and who would allow unjustified beliefs the right to take a place at any table in the public domain.

Charting the effectiveness of homeopathy treatments

Couldn’t resist.

Thanks given to webcomic.