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The SkeptVet vs Dr. Shawn—A Paradigmatic Kerfuffle
Posted: 15 February 2010 12:17 PM   [ Ignore ]   [ # 16 ]
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scepticeye - 15 February 2010 10:26 AM

I get so tired of sceptics who feel a religious kind of zeal to attack and do away with alternative medicines, almost all of which have absolutely no potential harmful effects. The word of the month (if not longer, I have only been here a while) is ad-hominem… I see it thrown around all over the place by people trying to show off their vocabulary. The truth is that almost all of the abuse comes from sceptics who have this zeal and don’t understand perspective and the fact that there is a world outside science. Also what the hell is CAM ?

CAM = Complimentary and Alternative Medicine

It’s an odd post here. What’s the harm in believing in ghosts or bigfoot? Well, part of it has to do with the fact that they don’t exist, and there is always some implicit harm in believing things without reason, and things which are false. More’s the point, what is the advantage in questioning someone who points out that beliefs are false?

Believing in things without reason usually implies accepting methods of gathering data (e.g., personal testimony as regards cause and effect) that are fallacious. It is never good to accept fallacious or worthless forms of reasoning.

But unlike belief in ghosts or bigfoot, belief in CAM is actually directly harmful. First, it is harmful because many potions and procedures which go under the rubric of CAM are themselves harmful (e.g., colonic irrigation, certain herbal remedies, etc.). Secondly, it is harmful because CAM treatments are sold under false pretenses, as curing or treating diseases which there is no evidence that they can cure or treat. That is false advertising, and material sold by false advertising is a form of cheat, or theft. That itself is a form of damage. Third, it is harmful because people taking CAM treatments are prone to forego treatments that are actually effective at treatment or cure. Certainly, this is not necessarily so; it is always possible that the person taking CAM treatments is also taking effective ones. However, as has been documented on this forum in several threads, people have died or been responsible for the deaths of their children by taking CAM treatments like homeopathy or prayer instead of actually going to a competent doctor for advice and treatment.

Of the various sorts of pseudoscience we deal with on this Forum, CAM is arguably the most pernicious.

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Posted: 15 February 2010 03:03 PM   [ Ignore ]   [ # 17 ]
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With respect Doug the big issue I have with this aspect of your world view starts with this word ‘believe’ and continues through your intolerance for people who chose a different path and your patronising view of ordinary people, shared with several others hereabouts.

The truth of the matter is that all medicine started as herbal medicine and all human treatments for illness started with what are now CAM. Almost all modern drugs come from natural sources, MANY of which were discovered not by science from scratch but from previously known beneficial effects handed down through time. These early remedies would never ever have passed any scientific analysis. But it is clear to any independent person that some of them worked, and some of them worked some of the time, others worked more of the time. It was basically hit and miss mixed with totally useless concoctions.

Today CAM is popular all over the world.  The vast majority of it’s popularity is not because large numbers of people ‘believe’ it works. If you claim that then I dispute this vehemently. I believe that the vast and overwhelming majority of people, except is specific old communities, know that it is not the same as scientific medicine. They know it does not stand up to the demands that scientific investigation demands - consistency, repeatability, fully known and understood ingredients and affects and mechanisms.  They use CAM products not because they ‘believe’ in them or ‘believe’ that they will work. They use them as the word says ... to ‘compliment’ their use of mainstream scientific medicine. They use them because they think they might work and they know that it is very unlikely they will do any harm to them. Such people worry about scientific medicines because they know they are powerful and themselves have side effects. There is an entertainment factor at play too.

So your analogy with the whole ghosts and bigfoot thing strikes me as huge overkill and hyperbole, along with your use of the ‘believe’ word.

I totally dispute your claims that there is a vast false advertising thing going on. I find your insistence on this really patronising to the majority of people. I do not believe there is any evidence that people are purchasing or using CAM products based on promised effects or cures. You may say there are some. I would say that some people believe that the characters in Day Time Soaps are real. So what.  Your tossing in of the whole prayer thing is gratuitous and silly. I suggest that the only valid element of this anti CAM hysteria is to have products labeled as not scientifically proven. I can live with that I suspect that most people would. The rest of your viewpoint is not just patronising - it is a Nanny State kind of patronising reminiscent of state censorship, state prohibition of things that people could hurt themselves with. We should allow two parallel options for free citizens - use scientific products or use non scientific products. It is the people’s choice.

You claim that these products can do physical harm. I repeat my point about your patronising approach. It is a cop out to cherry pick some rare ill affect that some CAM product can have in rare situations. People have died from taking all kinds of bizarre products like bleach, drugs ad nauseum. This is called life for stupid people. The reality is that the vast majority of CAM products are utterly harmless especially when compared with other standard daily risks. Almost all western countries prohibit harmful products and imho it is legitimate to campaign to have those banned or restricted as a totally separate issue.

All across the world many people chose to live their lives in the gray when science and pure rationality is concerned. They attend church but don’t really believe in God. They date guys who excite them, not guys who are good for them. They buy cereals because they like the advert not because they thinks it’s the best cereal. They know scientific medicine works most of the time, but they enjoy the idea that they just might get some success with some CAM products because family or friends have told them so and often there are centuries of stories of success.

Campaign for clear labeling fine - but people have a right to use whatever products they chose and the State should not prohibit them from doing so.

PS - I have abs no connection with or interest in any CAM business or relations or friends or anything else that influences my views smile

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Posted: 15 February 2010 03:33 PM   [ Ignore ]   [ # 18 ]
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You’ve misconstrued a good deal of what I said. I never argued that CAM should be banned, as you suggest by saying that “people have a right to use whatever products they choose”. My point is on clear and accurate labeling. And most importantly, it is on our duty to point out the scientific efficacy or lack thereof of purported treatments, which is what the OP of this thread is all about.

My intolerance is particularly for quacks and shills who are out selling ineffective treatments to sick people, under false pretenses. That should be prosecutable and prosecuted. And in that context your claims of “patronizing ordinary people”, I’m sorry, rings terribly hollow. One might as well say it is patronizing ordinary people to advocate for tough laws on bridge engineering and food safety.

Re. almost all modern drugs starting from natural sources, that has nothing to do with CAM, and everything to do with careful and assiduous testing of ingredients to see which work and which do not. That is the hallmark of scientific medicine, and something flouted by the quacks that push CAM treatments.

Sorry to say, I have no respect for people who push to allow provably ineffective treatments under false pretenses, due to a supposed umbrella of freedom. I find the strategy morally bankrupt.

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Posted: 15 February 2010 03:38 PM   [ Ignore ]   [ # 19 ]
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skepticeye,

You won’t be surprised, I’m sure, that I believe you’re wrong on several points. Some are simply factual, such as the issue of the harm done by CAM. I have compiled an extensive list of resources indicating both direct and, far more commonly, indirect harm done by alternative therapies. From kidney failure and lead posioning due to TCM or herbal medications to poor complaince with more effective conventional therapies, to reliance on useless homeopathic remedies for HIV treatment and malaria prevention, to the anti-vaccine crusade which has lead to resurgence in preventable infectious diseases, the specific therapies and to an even greater extent the naturalistic fallacy and other mindset errors associated with CAM do very real harm on a meaningful scale. Here are a few references to look support these claims: ONE, TWO, THREE. The evidence is voluminous, and this is just my own part-time looking into the question. There is nothing patronizing or unfair about correcting the clear misbelief that natural=safe or that CAM is automatically harmless. Everyone is entitled to their own opinion, but not their own facts.

The truth of the matter is that all medicine started as herbal medicine and all human treatments for illness started with what are now CAM

Absolutely wrong. It is true that before scientific medicine, all medicine was “alternative” in the sense that scientific standards of evidence were not applied and that we relied on tradition, faith, and personal experience to validate what we did. The reality is that we lived on average half as long and suffered routinely with illnesses we no longer have to bear in the developed world because we discovered scientific priciples that were epistemelogically superior and led to safer, more effective therapies. What is “alternative” now are those methods, traditional or made up by lone innovators like Palmer and Hahneman, that cannot meet the current standards of evidence, only the obsolete standards, but that people have faith in anyway. So it is mistaken to say medicine began as CAM just because the faith and opinion-based approach to medicine predates the scientific aproach which has largely replaced it. Most of what was once standar care has fallen away because it was ultimately unable to prove its usefullness. Sure, science occassional validates a wild and improbable medical idea, but that doesn’t have any bearing on the fact that the overwhelming majority of wild and improbable ideas are wrong and should be abandoned.

a Nanny State kind of patronising reminiscent of state censorship, state prohibition of things that people could hurt themselves with. We should allow two parallel options for free citizens - use scientific products or use non scientific products. It is the people’s choice.

Here is the real core of your objections to critiques of CAM, and it is clearly political ideology, not science or rationalism. You appear to believe in pure caveat emptor and do not accept the legitimacy of the state requiring proof of safety and efficacy before permitting someone to market a medical treatment. If I want to claim to have magic healing powers and people want to pay me to lay hands on them, the question of whether or not I am lying, deluded, or truly a magical healer is irrrelevant so long as people’s freedom to choose is not infringed.

Though it is a philosophical, not a factual point, I think that is a ridiculous argument. True liberty doesn’t require we let people sell things by lying. And if you don’t believe this happens on a major scale, look into the Andrew Wakefield or Kevin Trudeau cases, or subscribe to the Quackwatch newsletter which follows legal cases against charlatans profitting by selling false hope and bogus therapies to the desparate.

What is more, liberty does not require we ignore clearly established scientific facts. The healthcare freedom argument is misguided because a choice made based on false information and esparate irrational hope is not a free choice, it is just as constrained as any made udner more obvious forms of duress. I think the notion that there is a philosophical or ethical problem with expecting people to be required, by law, to demonstrate to some reasonable standard the safety and efficacy of the medicine they sell before selling it is indefensible. I recently responded to the same sort of “healthcare freedom” argument put forward as a bit of marketing by Dr. Messonier HERE, and while it is a popular and, at least to people of your political persuasion, compelling bit of jargon, it is misguided.

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Posted: 15 February 2010 03:45 PM   [ Ignore ]   [ # 20 ]
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Some of the harm from CAM listed here ...

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Posted: 15 February 2010 03:47 PM   [ Ignore ]   [ # 21 ]
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dougsmith - 15 February 2010 03:33 PM

Sorry to say, I have no respect for people who push to allow provably ineffective treatments under false pretenses, due to a supposed umbrella of freedom. I find the strategy morally bankrupt.

And that is your right Doug. I myself support this freedom wholeheartedly and equally vehemently as a cornerstone of our freedom.

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Posted: 15 February 2010 03:50 PM   [ Ignore ]   [ # 22 ]
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scepticeye - 15 February 2010 03:47 PM
dougsmith - 15 February 2010 03:33 PM

Sorry to say, I have no respect for people who push to allow provably ineffective treatments under false pretenses, due to a supposed umbrella of freedom. I find the strategy morally bankrupt.

And that is your right Doug. I myself support this freedom wholeheartedly and equally vehemently as a cornerstone of our freedom.

You are supporting the freedom to cheat, steal and harm others. That’s your prerogative, of course.

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Posted: 15 February 2010 04:02 PM   [ Ignore ]   [ # 23 ]
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mckenzievmd - 15 February 2010 03:38 PM

The truth of the matter is that all medicine started as herbal medicine and all human treatments for illness started with what are now CAM

Wrong. It is true that before scientific medicine, all medicine was “alternative” in the sense that scientific standards of evidence were not applied and that we relied on tradition, faith, and personal experience to validate what we did.

This is all I was saying. Nothing more.

a Nanny State kind of patronising reminiscent of state censorship, state prohibition of things that people could hurt themselves with. We should allow two parallel options for free citizens - use scientific products or use non scientific products. It is the people’s choice.

Here is the real core of your objections to critiques of CAM, and it is clearly political ideology, not science or rationalism.

What on earth is this statement supposed to mean ? It is nonsensical. All decisions about regulation and law are political, it is a nonsense to suggest that any law or any regulation of medicines, poisons, drugs, foods, products, toys are taken on some kind of pure scientific or rationalism basis. Your supposed attempt to get to the core of my views and slur them by proxy is ridiculous.

You appear to believe in pure caveat emptor and do not accept the legitimacy of the state requiring proof of safety and efficacy before permitting someone to market a medical treatment. If I want to claim to have magic healing powers and people want to pay me to lay hands on them, the question of whether or not I am lying, deluded, or truly a magical healer is irrelevant so long as people’s freedom to choose is not infringed.

Wrong again. Read what I wrote about agreeing about disclaimers. That is totally inconsistent with your claim that I believe in caveat emptor.

What is more, liberty does not require we ignore clearly established scientific facts.

Actually it does. We don’t ban people from jumping off cliffs with parachutes or climbing everest or sailing around the world alone in small boats just because scientific fact says they are very likely to die.

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Posted: 15 February 2010 04:03 PM   [ Ignore ]   [ # 24 ]
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dougsmith - 15 February 2010 03:33 PM

You’ve misconstrued a good deal of what I said.

I would never do that intentionally Doug and where I have done that I apologise without reservation.

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Posted: 15 February 2010 04:04 PM   [ Ignore ]   [ # 25 ]
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Wondering if you support the freedom of an engineer to falsify reports on bridge or building safety, or the freedom of a chef or the owner of a grocery store to sell spoiled food, or the freedom of a manufacturer to sell you a device that doesn’t work as advertised.

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Posted: 15 February 2010 04:05 PM   [ Ignore ]   [ # 26 ]
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scepticeye - 15 February 2010 04:03 PM
dougsmith - 15 February 2010 03:33 PM

You’ve misconstrued a good deal of what I said.

I would never do that intentionally Doug and where I have done that I apologise without reservation.

OK, no worries.

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Posted: 15 February 2010 04:05 PM   [ Ignore ]   [ # 27 ]
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dougsmith - 15 February 2010 03:50 PM

You are supporting the freedom to cheat, steal and harm others. That’s your prerogative, of course.

Now Doug ....... If you are going to take time to point out to me my misconstruing of your points - please don’t retaliate by bastardising what I wrote to satisfy your irritation with my views.

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Posted: 15 February 2010 04:09 PM   [ Ignore ]   [ # 28 ]
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dougsmith - 15 February 2010 04:04 PM

Wondering if you support the freedom of an engineer to falsify reports on bridge or building safety, or the freedom of a chef or the owner of a grocery store to sell spoiled food, or the freedom of a manufacturer to sell you a device that doesn’t work as advertised.

Doug if you bothered to read what I wrote before you foamed at the mouth ... this is what I included : “I suggest that the only valid element of this anti CAM hysteria is to have products labeled as not scientifically proven. I can live with that I suspect that most people would.” This makes a nonsense of your comments above.
It is unfortunate that people here find it so difficult to debate an issue with people who disagree with them.

Passion is great but constructive and good humoured debate is a lot more useful.

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Posted: 15 February 2010 04:10 PM   [ Ignore ]   [ # 29 ]
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scepticeye - 15 February 2010 04:05 PM
dougsmith - 15 February 2010 03:50 PM

You are supporting the freedom to cheat, steal and harm others. That’s your prerogative, of course.

Now Doug ....... If you are going to take time to point out to me my misconstruing of your points - please don’t retaliate by bastardising what I wrote to satisfy your irritation with my views.

Let’s take this discussion we had, above:

scepticeye - 15 February 2010 03:47 PM
dougsmith - 15 February 2010 03:33 PM

Sorry to say, I have no respect for people who push to allow provably ineffective treatments under false pretenses, due to a supposed umbrella of freedom. I find the strategy morally bankrupt.

And that is your right Doug. I myself support this freedom wholeheartedly and equally vehemently as a cornerstone of our freedom.

You say (and I’m quoting directly here) that you “support [the] freedom wholeheartedly” “to allow provably ineffective treatments under false pretenses.”

Selling something under false pretenses is cheating and lying.

Since the treatment is ineffective, and it is sold to cure or alleviate disease, it is also likely to cause harm.

So I’m sorry, but you’ll have to be clear on how I’ve misconstrued your views. It doesn’t sound to me as though I have, but I could have missed something.

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Posted: 15 February 2010 04:13 PM   [ Ignore ]   [ # 30 ]
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This strikes me as far too smart an answer for someone so intelligent.  You know well what I support as I made it clear in my post. Can we dial back the level and let it sit ?

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