The Driving Analogy

Consider the following three scenarios:

1. A driver refuses to wear a seatbelt
2. A parent fails to secure their young child's seatbelt
3. Someone drives drunk

In each of these scenarios, it reflects the choice of an individual. Yet these three scenarios aren't equivalent. In the first, the person is taking a personal safety risk. If they end up in a car accident, the chances of injuring themselves are much greater. In the second, their own choice puts at risk someone who couldn't make that choice for themselves. In the third, their choice is putting at risk other people since roads are a shared resource.

When I think of health claims, I don't care so much if a person chooses to treat themselves with whatever they think were work. If they have cancer and want to cure it by homoeopathy, it's their funeral. Think that magnets or shark cartlidge will cure a bad knee? A fool and their money are soon parted. This is the equivalent of someone not wearing their seatbelt. While there might be other factors to consider (such as individuals organising together to claim that seatbelts are a propaganda device of Big Auto that cost countless lives), it's their freedom to make that choice.

The child case is a bit more tricky. After all, parents do have responsibility for their children, but it's also recognised that a child has rights beyond the parent's dominion. A parent using prayer to cure a sick child while there's actual medical intervention that could help the child a gross violation of that child's liberty. Not strapping a child in securely may be harmless in most trips, but seatbelts aren't there for most cases - they are there for when things go horribly wrong.

Many diseases are communicable. Someone infected with the flu deciding to come to work because they're "taking echinacea" is shirking their social responsibility and putting others at risk. Like the drunk driving scenario, there are potential consequences for people who didn't make that choice. Vaccines are a good example of this, as not only is it putting the individual at risk, but it also puts others at risk (as recent epidemics have sadly shown).

The idea that it's one's personal freedom to choose what "treatments" they wish to undergo only works when that ailment/treatment is only putting themselves at risk. For the latter two cases, it should be uncontroversial that it's not just their own freedom at play. It is uncontroversial in the seatbelt case because people agree that seatbelts save lives. Yet if someone believed that seatbelts not only have no effect, but actually caused harm, how do you separate out that they should be forced to use a seatbelt with their child? Or if they believed that they were a good driver no matter how much they drank, would it be seen as anything other than intrusion that they would not be allowed on the road in that condition?

The difference between driving and alt-med is that people don't dispute the facts in driving. Alt-med is filled with science-denial and paranoid conspiracies in order to justify the harm that they cause. The personal freedom many argue for harms the personal freedom of others, so they just deny the facts instead.

Alt-Med

When it comes to medicine, for the most part I really don't care whether or not people want to treat their illness with whatever they think will work. I obviously don't want people to die because they thought that homoeopathy could cure cancer, but for the most part I'm not concerned so much with every quack treatment someone thinks will work.

However I am concerned when those medical choices directly affect other people. For every person who tries to treat a cold or flu with vitamin C and zinc means that what's contagious is not being treated. In effect, many of our medical decisions have a direct medical impact on other people.

There's only so much we can do in terms of individual prevention, the communal nature of many illnesses mean that our responsibilities lie beyond just ourselves. Not just to ourselves, but to others too, we have an obligation to work towards finding out the best possible information and acting on it. If your health depends on me doing the right thing, are you really not going to be attributing some blame towards me if I acted against what was the best information for the sake of my beliefs?

My Closed Mind

"Kel you already have your mind made up my friend there is no conversation going on it is what you believe or nothing. Perhaps one day you will wake up...Good luck to you my friend....BTW I live this shit and I am as healthy as a fucking horse...Don't visit doctors nor will I take a drug...Ciao."

This was from an exchange on facebook, where my crime was questioning the generic toxins as a medical threat, as well as self-diagnosis of gut fungus as a source of said toxins. Looking back at the thread, I'm not quite sure what I have my mind made up about, here are the comments I made in the thread.

What toxins are you trying to remove?

What toxins are involved in that, and how would a sauna or steam remove them?

Jxx, what toxins are those?

But if you can't identify what those toxins are, how do you know you're not chasing an invisible bogey man? Which impurities from your food come out through your skin? How is dirt and bacteria on your skin a "toxin"?

Don't get me wrong, I love saunas. I feel great afterwards. I just don't see how it has value as a medical treatment - especially not when it's used for such an ambiguous condition.

Unless you have oral or vaginal thrush, candida really doesn't cause any health problems. What toxins does candida release?

‎"Alcohol is the main one but others are included."
So how much alcohol does this fungus produce? And what are the other ones?

"It does cause health problems in the gut which then makes its way into the organs and into the brain."
What health problems? How does [candida] cause this?
This is my problem - there's no specificity here.

"It is not widely recognised as a physically proven condition by the mainsteam medical community but I have read more than enough stories of people realising they have it to be convinced it is real."
But if it's not established through peer review, then how do you know it's causing problems? If you're not checking for causal relationships, then you run the risk of not actually identifying the problem. *post hoc, ergo propter hoc*

"I will try my best to work out what it is by eliminating possabilities."
This is why we have trained medical professionals who can run diagnostics and use the best possible evidence to identify the problem. Self-diagnosis is a terrible idea!

In the end, it's your health. If it were me, I'd be worried since I'm not a medical professional and I don't have the resources to perform tests that I'm not doing what's best for me. But that's me, and you have to make that decision for yourself.

I don't know what would be best for Pxxxxxx, my contention here is that people are creating non-existent conditions based on superficial plausibility, and instead of getting tested indulge in self-treatment.

Again the idea of detoxing through diet is an ambiguous one. What toxins are removed? How does that make for better health? Again it sounds superficially plausible, but it becomes meaningless if it's not identifying what processes are involved.

So I'm not sure what I really have to wake up to, or how it's about what I believe or nothing. I kept deferring to medical professionals and argued against self-diagnosis, especially when it came to non-specific factors.

Who would have thought that arguing for getting tested and treated with the best available treatment would be a position that would draw the ire of anyone? It seems idiotic to suggest anything but!

I Know My Body

One case where we really don't know what's best for us is when it comes to health. We may be the only ones with the internal perception of our health, but we are not in the position to judge what is wrong with us or what treatments work or not. The best we can do is talk of our perception of feeling better or worse, or indirectly in factors that are visible from the outside such as visible recovery. Our perception counts for very little in the end, especially given the range of factors involved in perception.

Morning Scepticism: Herbal

It's been said that alternative medicine at works is just called medicine. I there's a very easy indicator of success: the cost. While pharmacies do a great disservice by selling herbal products alongside real medicine, there's a clear difference in cost. Now while it could be taken as Big Pharma profiteering, the difference in price can best be explained by the fact that one works and the other doesn't. I tend to think that the price of herbal pills is a "what do I have to lose?" approach to sales, meanwhile real medicine is priced in such a way that if it didn't work then there'd be no reason to buy it. This might not be always true, but it seems a good rule of thumb.

Morning Scepticism: Hand Washing

It's quite amazing to consider that with all the advances of modern medicine that washing your hands regularly with soap is still the best way of stopping the spread of many diseases and reducing the risk of getting sick yourself. What's amazing about this is that it was discovered before there was germ theory! It's plausibility is wrapped up in the germ theory of disease now, but it goes to show that it's not necessarily necessary to need an underlying explanation to see that something works.

Big Placebo

Yesterday I went for a walk around a major shopping centre just to see what stores there were. What took my interest was that there were two stores in this centre dedicated to vitamins and other "natural" products but only one pharmacy, and even the pharmacy had a large section dedicated to natural remedies. Combine that with a massage / acupuncture / reflexology clinic called Miracle Therapy, and I couldn't help but think about the influence that Big Pharma has over us all. Big Pharma is so big that it's practically non-existent!

The ideological battle between conventional medicine and alternative medicine is far more in favour of alt-med than the rhetoric would suggest. While accusations of being in the pockets of Big Pharma are thrown out to anyone who defends anything that might have a pharmaceutical aspect to it, Big Placebo has become a multi-billion dollar industry and how people self-medicate.

That even pharmacies are selling alt-med products is a strong indicator of where the market lies. Combine this with semi-frequent news of drug recalls and conflicting reports of what is healthy and its no wonder people are turning away from science-based medicine and towards anecdotal accounts of healing. What good are magnetic pillows except as a cash cow?

The battle is not only with the availability of products and services but with information spreading too. Testimonials are the worst form of evidence yet the most easily believed. Clinical trials are the least rigorous means of testing science, but enough to give a product the appearance of evidence-based backing.

The greatest tragedy of the alt-med movement is the anti-vaxxers. vaccines are probably the greatest advance in health in human history, yet now is showing to be a victim of its own success. Don't have to worry about polio? There's a reason for that and that reason is vaccines! Measles outbreaks are happening again now that vaccination rates are lowering, the whole autism link but a tool of those promoting their ideological agenda.


While there are some driving it through ideology, it must be remembered that health is a very important issue for us all. It's no surprise that on the left that individuals are shying away from what they see as corporate-controlled medicine to something with the appearance of a community-driven approach (At all times it must be remembered that Big Pharma has a large stake in Big Placebo), just as it should be no surprise that individuals want to feel in control. Putting trust in a testimony makes a lot more sense than a doctor writing a prescription.

Another factor I feel is involved is the cost. Going to the doctor is expensive, it's paying a large amount of money for a few minutes of consultation where very little is discussed. Last visit cost me a few hours wage for a doctor to check whether I needed stitches for a head wound (I didn't thankfully). They are a valuable commodity and so is their time, which is hardly what I think is good when they are the ones with the knowledge to help us with looking after ourselves.

Going in and buying a health supplement is easy, even in supermarkets one can purchase vitamins or herbal remedies. Vitamins are almost intuitively good, even buying natural (or to an extreme organic) sounds so much better for us than artificial. That the science doesn't back this up simply doesn't come into play.

I'm all for science-based medicine, but there's a problem when something so successful can be easily replaced by pseudoscientific and nonscientific products. An overhaul of the health system (that's being proposed in Australia now) can't just be looking at waiting times, bed numbers, and hospital deaths. It needs to address the issue of why conventional medicine is suffering in the hearts and minds of the population at large.

Where's My Big Pharma Money?

Alternative medicine like any other concept has proponents who are seeking its validation. They truly believe it works, and I have no doubt that its proponents are for the most part genuine. This is an industry that has built up mostly around word of mouth, sincerity of those propagating it is vital. Even many who peddle many of these therapies seem to believe they work - even if there's no way it possibly could. And the movement itself for the most part contains intelligent and fairly-well educated people.

So smart, well-meaning people who genuinely believe in the product's efficacy, and do all this without an industry behind them are promoting what could be best for one's health. Why am I not convinced?

Every time I've had a discussion in recent years on the matter, I've had some indicators as to why other people think I reject "alternative medicine". That I'm a shill for Big Pharma is a popular one I've heard especially on the internet. Along those same lines but less extreme is that I trust Big Pharma because I haven't thought through their business model, how can I trust my health to companies that want to keep me buying their product? Then there's the close-minded accusation, that I'm not willing to accept the premise. And that goes hand in hand with my blind devotion to science. One I see coming on more recently, it's not my devotion to science, but scientists like Richard Dawkins who speak ill of "alternative medicine". They say its nonsense, so I blindingly follow them.

It may be that those criticisms are valid, I could be deluding myself into thinking otherwise. I don't think those criticisms are reflective of my position. Furthermore I feel that by putting out those criticisms it demonstrates the underlying motivations I think are behind a lot of the movement. So I want to take each criticism in point and expand to what I think it demonstrates.

Big Pharma
Corporations exist to make money, it cannot be denied. And it's no surprise that much of the alt-med crowd exists on the left side of politics, that there's a genuine distrust of large corporations is no surprise. Politically I'm very left wing too, I'm all for being sceptical of pharmaceutical companies.

Where the denialism exists comes from a very simple argument: pharmaceutical companies want to make as much money from you as possible. So it's in their interests for you not to get better, they want to keep you buying their product. And superficially that argument seems quite valid. But even without looking at many restrictive practices, consider what happens in the case of two corporations competing in the same product.

Company A and Company B have a product that works for a remedy to eczema. Company A's medication only manages the eczema, it keeps the consumer buying and buying. Meanwhile Company B want to sell to that same consumer. If Company B's product is more effective than Company A, then this should lead to people abandoning Company A's product for Company B's. Even though both companies want to get as much profit as possible, that one has a more effective product even though it sells less. Company A would lose business because their strategy relies on them being the only one in the market, while there is competition any product that can best sell to the consumer will create a metaphorical arms race where better products will emerge.

This is the general idea of why competition in the marketplace is good for the consumer. Now there are many ways to cheat the system, such as monopolies and collusion, and perhaps in some small scale these can and do occur. But the general principle from the argument so often presented doesn't hold. They make money by selling products that aid in people's health, thus any treatment that can be put on the market that is more effective breaks the equilibrium of treatment.

There are plenty of reasons to distrust Big Pharma, there are plenty of reasons to distrust large corporations - but to take that distrust and turn it into denialism about the possibility of it working is being absurd. Which leads to exploration of the other side of this argument: Big Alt-Med.

Big Alt-Med
Magicians are professional liars, but there is honesty in their lies. People come to a show expecting a magician to fool them. Meanwhile there are magicians who use the same tricks yet claim to have magic powers. These are dishonest liars, lying about their lies.

The reason I bring this up is because so much of the argument against Big Pharma has the implication that alt-med doesn't have these same problems. We live in a capitalist society, and where there's a market there is money to be made. And in alt-med, despite the numerous claims involving Big Pharma seeing no money in these apparently effective treatments, there is a multi-billion dollar industry. Ben Goldacre in Bad Science does well exposing the hypocrisy of those who ride the Big Pharma hysteria yet have their own business which happens to sell the products they endorse. It's the society we live in, if one is going to be dismissive of Big Pharma then at the same time they need to be dismissive of any treatment involving money.

Being closed minded
Next comes the accusation of being close minded, I'm apparently not open to the possibility of such proposed treatments working. This is a great throwaway statement, one anyone can throw out when someone else disagrees with you. Scepticism at times does seem indistinguishable from dismissive so I think it's no wonder I've had that accusation levelled against me. But is it a valid accusation?

To be dismissive, I think one needs to reject the possibility when there's evidence supporting it. It's not dismissive to ask for evidence, or even ask for metaphysical coherence. Any supposed treatment that relies on vitalist notions should be scrutinised on that alone. It doesn't mean the treatment is not effective, but it does mean that it cannot perform as it is advertised and that is something to be wary of. And treatments that have a physiology that is alien to our own again should be treated with extreme caution. And treatments that don't have any possible mechanisms can very easily be dismissed.

Having said all that it's also important to point out that I don't just sit on the sidelines. I've been administered homoeopathic remedies, had various herbal treatments and even bought herbal remedies of my own free will. I've had acupuncture performed on me, used detox pads on my feet, had massage performed on me, performed (admittedly guided) reflexology, practised yoga, had reiki done on me, etc.

If the evidence is there, I am more than happy to use it. In general, a word of mouth story I regard similar to tales of the miraculous where God has come down and healed someone. That's what they believe happened, but the mind is always capable of self-deception. Which is why I find it important that there's beyond the anecdotal for the efficacy of any given treatment. Which brings me to the final contention: science.

A faith in science
Science works, it's a simple statement of truth that is validated by the fact that you are reading this now. In general we love science, except the parts that we disagree with. And those are when the dismissals of the scientific method are at their loudest. If science as a method fails to validate a cherished belief, then it is the science that is wrong.

Some would like to frame science in terms of methodological naturalism, thus giving an out to any time science fails to demonstrate the validity of a particular treatment. So instead of the obvious conclusion that the idea wasn't efficacious to begin with, it must be that science can't detect what is there because of its metaphysical presuppositions.

Yet the key point there is that nothing significant can be objectively observed. In other words there's nothing to explain away. If homoeopathy works as a treatment, then it shouldn't matter if the mechanism is material or immaterial. The efficacy of the treatment is often what is being measured, and if there's no positive results then there's nothing to explain.

Science in its broadest application means following the evidence, wherever that may lead. If scientific inquiry was to validate a particular treatment such as a herbal remedy, then I see no reason to reject it as a valid means of treatment. The contrast to this are those who will readily use the findings of the scientific method when it backs their view, but will dismiss it when the evidence is against them. To follow the evidence where it leads is the antithesis of faith, to hold it as true despite the evidence against is what distinguishes faith from fact.


A growing frustration
The reason I started writing this entry was to rant about my frustration in dealing with alt-med advocates. Those complaints listed above don't come because I mock and belittle them, but simply because I argue against it. If I argue against what they know to be true, then it must be me who is motivated by some external factor.

The frustration is several fold. Firstly it's that those who advocate alt-med often do so for ideological reasons. Whether it be a distrust of large corporations or a belief in the healing powers of nature, the ideology is there. Secondly it's frustrating because it's making an ad hominem attack in place of an argument. Thirdly it's misrepresenting often how the scientific process works.

But perhaps the greatest source of frustration is that it highlights the nature of information in this modern society. While good health information is not readily available, a lot of pseudoscience is. Information is virtually free these days, so if there aren't good sources of health about then it's easy to fall into bad sources. And who do you trust more than the people who are part of your lives? It doesn't seem rational to accept the advice of a celebrity or even a friend on matters of health, but surely the emotional connection we have allows for trust where there really shouldn't be.

As a society where information is cheap, junk food is even cheaper, and there's a looming health crisis from ageing and obesity - surely this is the point of call for governments and health organisations to start working towards putting good information in the market. As a public service if nothing else, because how it is currently now is clearly undesirable. We are in a society of self-professed experts, and when it comes to matters as important as health it shouldn't be left to those who clearly don't understand to fill the information highway with garbage dressed as the miraculous.