By David Gorski
The major theme of the Science-Based Medicine blog is that the application of good science to medicine is the best way to maintain and improve the quality of patient care. Consequently, we spend considerable time dissecting medical treatments based on pseudoscience, bad science, and no science and trying to prevent their contaminating existing medicine with unscientific claims and treatments. Often these claims and treatments are represented as “challenging” the scientific consensus and end up being presented in the media—or, sadly, sometimes even in the scientific literature—as valid alternatives to existing medicine. Think homeopathy. Think antivaccine views. Think various alternative cancer treatments. When such pseudoscientific medicine is criticized, frequently the reaction from its proponents is to attack “consensus science.” Indeed, I’ve argued that one red flag identifying of a crank or a quack is a hostility towards the very concept of a scientific consensus.
Indeed, I even cited as an example of this attitude a Tweet by Jane Orient, MD, executive director of the American Association of Physicians and Surgeons (AAPS). This is an organization of physicians that values “mavericky-ness” above all else, in the process rejecting the scientific consensus that vaccines are safe and effective and do not cause autism or sudden infant death syndrome (SIDS), that HIV causes AIDS, and that abortion doesn’t doesn’t cause breast cancer, to name a few. Along the way the AAPS embraces some seriously wacky far right wing viewpoints such as that Medicare is unconstitutional and that doctors should not be bound by evidence-based practice guidelines because they are an affront to the primacy of the doctor-patient relationship and—or so it seems to me—the “freedom” of a doctor to do pretty much damned well anything he pleases to treat a patient.
I’ll repost Dr. Orient’s Tweet:
— Jane Orient, MD (@jorient) December 1, 2014
As I said at the time (a great example can be found here), on the surface this seems quite reasonable, but, as I’ve discussed on many occasions, science is all about coming to provisional consensuses about how the universe works. Such consensuses are challenged all the time by scientists. Sometimes they are shown to be incorrect and require revision; sometimes they are reinforced. That’s how science works.
The reason I brought up this issue again is because I came across a couple of articles relevant to this topic. The first is one by John Horgan, who blogs over at Scientific American, entitled, Everyone, Even Jenny McCarthy, Has the Right to Challenge “Scientific Experts”. Having a tendency towards snarkiness, my first thought was to simply dismiss this as a straw man argument (at least the title), because I know of no strong defender of science (least of all I) saying that non-experts—yes, even Jenny McCarthy—don’t have the right to challenge experts. When we complain about “false balance,” it’s not because we think that, for example, antivaccine activists don’t have the “right” to challenge the experts supporting the scientific consensus. Rather, it’s because we argue—correctly, I believe—that media outlets all too often present such challenges as falsely equivalent to the actual consensus science being challenged, in essence, putting someone like Jenny McCarthy on or near the same plane as actual scientists. Examples abound and have been discussed on this very blog, embracing many relevant topics, such as influenza, dubious cancer cures, homeopathy, vaccine safety and efficacy, fear mongering about food by Vani Hari (a.k.a. The Food Babe) and many other topics.
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