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A Failure to Engage

by Steven Novella, May 09 2011

In my opinion society is best served with open and vigorous debate about important topics of the day. Such debates are most effective, however, when proponents of opposing views are actually engaging directly with the claims and beliefs of the other side. This requires effort – to understand what the other side believes and why they believe it. This should be taught as a basic intellectual skill in school. Whenever confronted with a controversy, make a sincere effort to understand the best case that each side is putting forward.

In my (admittedly biased) experience, what I will call “fair engagement” is more the exception than the rule. It is easy to slip into accepting a straw-man caricature of the other side. We all do it to some degree. The danger for skeptics is to focus on the most extreme examples of a belief as if they are representative, while ignoring the more reasonable (if still wrong) end of the spectrum. But while there is a continuum, there are those who make a sincere effort to treat their opponents fairly, and those who are stramenticidal maniacs (sorry for my lack of Latin scholarship, but that’s as close as I can come to someone who likes to murder straw men).

The alternative medicine (CAM) community in particular seem to enjoy engaging with straw men of their opponents. It is partly a result of their genuine lack of understanding of our criticisms, but it is also a result of their propaganda. The CAM community (at least collectively) have mastered the marketing of their ideas. They manage to frame the discussion in a way that completely distorts the actual points that are in dispute – in their favor.

My recent appearance on the Dr. Oz show is an excellent example. The discussion was frames as, “why are some doctors afraid of alternative medicine.” Throughout the discussion it was clear that Dr. Oz was making no attempt to engage with my actual points, or to understand my position. He had a cartoon version of my position in his head, and he was going to stick with it no matter what I said. In his cartoon version, what he calls “hold outs” against the coming CAM wave are dismissive, arrogant, and closed-minded.

His questions to me were all loaded with straw men. He claimed that my position was that CAM modalities were not tested, when in fact many have been. Rather, my stated position was that to the degree that they have been tested the results are largely negative.

This is just one public example. I have received hundreds of e-mails from CAM defenders who take the same positions – all straw men of the science-based medicine position. In debates I have been told that “skeptics” claim that we should only accept treatments that have a known mechanism of action. This is a setup, of course, because there are accepted mainstream treatments whose mechanisms are poorly understood.

Kimball Atwood recently pointed me toward another example – a “debate” about Traditional Chinese Medicine. It seems to be a strange debate, when all of the participants seem to be advocates. Here are some of the debating topics:

# Resolved: Acupuncture as a medical intervention technique should be disallowed because its mechanism of action cannot be scientifically proven.
# Resolved: The replacement of traditional Chinese medical vocabulary (that describes diseases, pathologies and treatments) by modern scientific medical vocabulary is an important development and should be encouraged as the standard.

The first is the very straw man I covered above. The lack of a plausible mechanism for acupuncture is surely a problem, but the far bigger problem is that the clinical data is largely negative. Regardless of mechanism, acupuncture does not seem to work.

The second topic is based upon the notion that a key difference between TCM and SBM is vocabulary – the culture in which ideas are understood and expressed. That is another straw man attack I often here – that skeptics do not like TCM or other such systems because they are not stated in the “Western” jargon with which we are familiar. Our skepticism is portrayed as just xenophobia.

I won’t say vocabulary is irrelevant, because words reflect ideas. But it is the underlying ideas that are at issue – do TCM concepts of health and illness reflect reality? Focusing on the jargon is a way of not engaging with the real issue, the real basis of our skepticism, and instead to focus on a superficial aspect that becomes a straw man of our position.

Conclusion

The examples I have given above are just a few of many examples within CAM, and there are many topics that fall into a similar pattern. I rarely, in fact, encounter a reasonable understanding of the skeptical position among proponents of any belief that is a common target of skepticism.

The same is true of many intellectual areas as well, especially wherever there is an emotional component. I have friends and family that range the political spectrum, and I find it interesting to listen to both sides completely mischaracterize the positions of the other side. It’s as if they never actually talk to each other. Each side is isolated within an echo chamber of their own reality.

To be clear – what I am saying is that this kind of behavior is common across all belief systems, and is probably the default mode of human behavior. Skeptics fall into this as well, although the very nature of skepticism involves rigorous self-examination, so hopefully we are a bit more reflective on this behavior than average. But we are certainly not immune.

It is important to remember the importance of making a sincere effort to understand a position with which you disagree, and not to prematurely or excessively focus on those aspects which are easiest to attack, or which likely represent a distorted cartoon of the position.

At the same time, it is important to remember that your position exists on a spectrum, and there are likely people who hold a weaker version of your position. When someone is arguing against a variant of your position, it does not necessarily mean they are attacking a straw man of your position. This false straw man charge is also common.

This problem is the flip side of what I have been describing above, and both seem to result in part from a failure to recognize that opinions exist on a spectrum – both our own and those of others. We should endeavor to understand and engage with the best case that can be made for a position with which we disagree, but also recognize that at times variants of our own positions will become the target of criticism.

59 Responses to “A Failure to Engage”

  1. Travis Roy says:

    One thing that I noticed recently, very depressingly, is the ability for the other side to shut down and not communicate. It’s incredibly hard when you’re talking mostly about opinion and ideas rather than the hard science. My wife posted an article on the Granite State Skeptics website about her take on feminism and skepticism, a counter point to what the Skepchicks have been posting.

    There was a heated argument on the site, and on twitter, mostly with one person specifically. What was depressing was that some people were submissive of the article, refusing to engage, and another outright blocked people that disagreed. I don’t see how this furthers what either side is attempting to do.

    It is hard to put a mirror on yourself and take a fresh look from the outside, but it’s almost a requirement if you want to make any kind of progress.

  2. Max says:

    I hear a lot of strawmen from skeptics, like the strawman that if homeopathy is right, then overdosing on homeopathic preparations should kill you.
    Or the strawman that anti-nuclear activist Helen Caldicott believes the UNSCEAR report on Chernobyl is a total cover-up, just because of her reaction when George Monbiot told her the reported death toll was 43.
    You can’t trust one side in any argument to accurately portray the opposing side.

    I’m not surprised that Dr. Oz failed to engage, because he’s working from a script, and he already prepared a scripted conclusion.
    Similarly, in a recent radio “debate”, Michael Shermer had to talk past Jesse Ventura to make some points he prepared in advance.

  3. this kind of behavior is common across all belief systems, and is probably the default mode of human behavior. Skeptics fall into this as well, although the very nature of skepticism involves rigorous self-examination, so hopefully we are a bit more reflective on this behavior than average. But we are certainly not immune.

    In my opinion, skeptics are extremely susceptible to this, perhaps more so than the general population. It’s not surprising that we’re a bit conflicted here, as we wear multiple hats. The critical or adversarial role tempts skeptics to focus on the weaknesses or vulnerabilities of the other guy’s position, while an investigative role calls for a wider engagement — and begins with the benefit of the doubt.

    It is important to remember the importance of making a sincere effort to understand a position with which you disagree, and not to prematurely or excessively focus on those aspects which are easiest to attack….

    Yes, exactly so. I’d note as well that many scientific and pseudoscientific fields are complicated. A “sincere effort” to familiarize ourselves with the literature can require years of study. For example, you are much better qualified than I am to say that when CAM modalities “have been tested the results are largely negative.” You have read the literature, and done so with the training and expertise to know what you’re looking at. I’m essentially a lay spectator regarding those questions of efficacy — at best, a journalist.

    • Daniel, tis VERY true in another way, unless the study linked below gets disconfirmed. Skeptics are apparently poorer lie detectors than highly trusting people, for whatever reason or reasons.

      http://www.spring.org.uk/2011/04/highly-trusting-people-better-lie-detectors.php

      • tmac57 says:

        I would argue that the study (for what it’s worth,being a small study) was more geared toward comparing cynics versus more trusting individuals.Cynics are not the same thing as skeptics (if done properly).You can be a generally trusting person,and still employ appropriate skepticism.

      • Tmac, on the study size, yes … I was kind of hinting at that with my “disconfirmed” comment.

        Arguably, but not necessarily so, on whether the study “fingers” cynics more than skeptics. Obviously not just replication but “tuning” of the study parameters will tell us more.

      • Max says:

        I suspect that the article omits that the cynics had more false alarms as well. Maybe they’re just looking at the wrong cues like shifty eyes. It’s like conspiracy theorists who trust Kevin Trudeau.

  4. Ashley Harron says:

    Thanks for this post. I often cringe at the tactics taken by either side in any given debate. I think one of the biggest pitfalls in the debate over alternative medicine is to lump everything together. On the side of supporters the draw is to take some failures of modern medicine and some unethical practice and apply them to the entire field. Skeptics do the same thing when they dismiss all alternative medicine claims before they can be adequately tested. There are definitely many claims that have been disproven but I think we too often betray our own bias when we dismiss prematurely. I watched Dr. Novella’s performance on Oz and was dismayed that he couldn’t turn the segment into a discussion about what medically has been proved, what hasn’t been proved yet, and what qualifies as proof. There are people out there who will buy into anything but our best hope is to reach out to the majority of people who are both skeptical and believers of some “woo”.

    • Mario says:

      Yes but regarding the testing of alternative medicine, let me tell you that enough money is already expended in that.

      One could say that some academics are resilient to lose their time and do some testing about these kind of treatment modalities, but pharmaceutic companies do not share our prejudice toward alternative medicine, cause they are always trying to increase profits that means that if there is the slight possibility that a cheap, easily marketed and at least with some efficacy new treatment can be used they throw the money at testing it, if there is some positive effect they do not keep it to themselves, they squeeze the last penny out of it; at the end the reality stays the same: most of them do not work and the ones that do work barely beat the placebo effect.

      If there is any of them that work for someone, well then great; but don’t turn it into an ideology or the new panacea cause most likely it’s not; and is quite irresponsible, to say the least, to recommend something without having nothing more than personal experience to talk about.

  5. Karla McLaren says:

    I agree with Daniel and Max (!) here. I’m very concerned at the ways in which received wisdom (rather than extensive academic or sociological study) is presented as indisputable fact within the skeptical community.

    For instance, evolutionary psychology is bad because Gould said it was, end of story (for most). But scholars with more information have done extensive critiques of evolutionary psychology and handily dismissed Gould’s claim, not as wrong, per se, but as insufficiently perceptive. Gould’s critique was a sort of reactionary smackdown in contrast to actual, serious academic considerations of the many intricately intertwined findings and theoretical-commitment-based problems within the field. Evolutionary psychology has its place; Gould’s critique was an opening, but it wasn’t the last word

    Or social science is all soft and fluff because Sokal proved it was? What? And also, everything the postmodernists ever wrote was also destroyed by Sokal, so you can’t bring them up? What? Even Sokal himself doesn’t suggest that social science and postmodernism are 1) Inextricable conflated, or 2) Forbidden areas of inquiry for the “truly skeptical.” How did this huge and multifaceted area of inquiry get summarily dismissed? I charge that it is a function of the ideological blindness I wrote about in 2004.

    My problem with the skeptical approach is that it is so often not sufficiently academic, nor in-depth, nor sincerely effortful. Concepts and ideologies that should require years of study and careful consideration are handily dismissed in blog-length posts. And those posts are very easy for people with differing positions to critique, because they’re simply not strong arguments made from deep study. They’re ideological positions that invite counter-ideological reactions. And on it goes.

    Example: let’s focus on special area of anti-CAM advocacy. As a previous used of homeopathy, I am astounded at the ideological blinkering that would make anyone think the 10:23 campaign is a good idea. It is so absurdly inappropriate, because no user of homeopathy thinks or is told that homeopathic medicines contain measurable amounts of the original substance. Actually, the whole point of homeopathy is that the remedies *don’t* contain anything of the original substance except for the essence of the supposed curative effect that is hidden deep within the energetic recesses of the substance.

    The essence (pun intended) of homeopathy is essentialism; it’s also a belief in the intrinsic wisdom of nature, in the idea that nature and our connection to it determine our health status, in the strength of gentle, yet deep inquiry into the energies that underlie the gross exterior manifestation of a substance or an illness (which also suggest the attribution of agency to these underlying energetic substances)… it’s an entire mindset that stands in direct contradiction to the seemingly harsher, nature-avoiding or nature-exploiting brutality of the “allopathic” approach.

    The straw men abound in this conflict-driven world-view, but I see equally destructive strawmen in skepticism, which handily dismisses the essentialist world-view as “deluded.”

    A brute-force, attention-getting stunt like 10:23 does nothing for the user of homeopathy, other than confirm his or her sense that people trapped in the brutality of the conventional medical model: 1) Do not understand the first thing about the purpose of homeopathy, but are merely attacking it to score points; 2) Are more interested in wild public displays than in respectful communication or worthwhile advocacy; and 3) Are insufficiently educated.

    I spoke to some of my homeopathy-using friends about 10:23, and was met with laughter about how silly and uninformed the basis of those arguments were, plus concern for the people who were using so much anger and insensitivity to get their point across. Many people suggested that a public relations professional should be consulted, stat.

    There was also a lot of concern about the possibility that the protesters might be hurt by the overdose, but then an understanding that people who were that coarse and insensitive probably wouldn’t be able to receive any of the benefits of the remedies (and therefore wouldn’t be in danger of harm).

    So instead of creating dialogue, this stunt only increased the distance between people. And of course, I’ve heard the argument that 10:23 captures the casual user of homeopathy, or the person who didn’t know that drug stores sell lots of homeopathic remedies as if they are actual medicines.

    But what it didn’t do was to provide the actual people who are actively using homeopathy any reasonable, culturally-aware communication — and it didn’t provide worthwhile education about the underlying philosophical positions upon which homeopathy and other alternative modalities are based. It just widened the chasm and made reasonable, respectful education efforts less viable.

    • Karla, following David Buller (whom I “passed on to you” on FB :) ) I distinguish between legitimate evolutionary psychology and Pop Ev Psych.

      Otherwise, per you, Somite and others, this kind of reminds me of the “Draw Muhammad Day”?

      Why?

      To riff on the old Latin philosophy phrase, “Cui bono”?

      Good “connectionist” skepticism, or secularism (thanks Mike McRae for the term) should always have that question in mind.

  6. Jim Lippard says:

    Karla, I respectfully disagree with you about homeopathy, on the grounds that I think the general public is not at all aware that homeopathic remedies are not even purported to contain any molecules of active ingredients. “Homeopathic” is frequently used as synonymous with “herbal remedy” or “natural medicine,” and to the extent the 10:23 campaign drives a wedge between those, it is doing at least something constructive and beneficial. Your point regarding the more-informed user or advocate of homeopathy, however, is well taken. (And if the 10:23 users were really engaging in a reductio ad absurdum, wouldn’t an “underdose” be more to the point than an overdose?)

  7. db says:

    GREAT ARTICLE. Would have loved to hear about individuals propensity to amplify differences due to conflict bias a la spectrum amplification. e.g. the closer opinions are aligned, the harder some will fight to show their differences. Politics is the supreme example of this manifest obsession with differentiation.

    Just to euthanize another strawman, this article was not about forms of medicine. Discuss.

  8. Karla McLaren says:

    Hi Jim!

    I agree with you that most people really don’t grok homeopathy, but for the people who ostensibly do, 10:23 was kick in the face. Why is that considered a necessary or valued tactic? This movement supposedly contains an embarrassment of IQ points. Is this honestly the best we can come up with?

    I like Ashley’s statement here:

    “On the side of supporters the draw is to take some failures of modern medicine and some unethical practice and apply them to the entire field. Skeptics do the same thing when they dismiss all alternative medicine claims before they can be adequately tested. There are definitely many claims that have been disproven but I think we too often betray our own bias when we dismiss prematurely.”

    The cure for polarization is not louder and better advertised polarization. That’s why it’s so important, when promoting any sort of change in the behavior or understanding of others, that those others be first treated as intelligent and worthy of respect. With 10:23 and other stunts like it, the assumption is that homeopaths are liars or frauds, and that homeopathic patients are unwitting victims. This assumption then creates completely expected counter-reactions, and a digging in behavior that might never have occurred if the approach was handled in a more intelligent, measured, patient, and culturally-aware way.

    • Somite says:

      ….but homeopaths are liars and frauds. By treating homeopathy as “intelligent and worthy of respect” we run the risk of legitimizing a bogus treatment that may result in delaying actual treatment and thus causing harm.

      There’s no need to be insulting. Like most applied skepticism it is just a matter of saying “No. There is no evidence or known possible mechanism to support your claim”.

      • Mike McRae says:

        Homeopaths are wrong. That does not automatically make them all ‘liars and frauds’. This is more or less what Steven was getting at – creating straw men based on sentiments rather than evidence.

        You might find it difficult to believe that a homeopath could possibly believe what they’re promoting, simply on account of their holding conflicting beliefs, but again, that does not automatically equate an intention to deceive. By maintaining that position you’re missing out on understanding what could be creating such a culture and therefore missing opportunities to actually solve the issue.

        You fear there is a legitimizing of a bogus treatment if it’s dealt with respectfully and as if the individual who arrives at their conclusion is actually intelligent. And yet this simply isn’t what happens. In fact, science progresses on account of respectful debate that treats beliefs as contentious but their advocates as intelligent. Creating a caricature of a person, denouncing them as a liar, thief, fraud, stupid or arrogant not only prevents you from identifying the real cultural traits behind their belief, it removes them from the discussion and polarises their views even further.

      • Somite says:

        If you tell a homeopath just once that there is no evidence for their claim and they continue to push their remedy they are indeed a fraud. That they sincerely believe that their treatment works is not an excuse. This is not about belief or intent, it is about accepting the evidence. You are not entitled to your own facts.

        Science progresses because claims are tested and proven (or prove as near as we can). Scientists in general will accept the results of the test and modify or discard a claim. Homeopathy and other bogus treatments have not proven to be efficacious.

        It is really not that hard to show that a drug is efficacious and safe. There are methods in place that “companies” that “manufacture” homeopathic remedies could use to prove that their methods are effective. If they don’t prove it and continue to market their products, regardless of their beliefs, they are frauds.

      • Mike McRae says:

        ‘Evidence’ is not an objective term. It describes observations that increase your confidence in a belief. Homeopaths often use a rather social way to evaluate what constitutes evidence, which conflicts with science.

        That does not make them frauds or liars – it means they don’t subscribe to scientific values. I won’t argue that this approach is faulty (of course it is), but again, your view of it necessarily making them liars and frauds is based on the view that if you don’t evaluate observations scientifically, you’re intentionally setting out to be deceitful.

      • Somite says:

        That post-modern thinking will kill us all.

      • Somite says:

        Is there another way to evaluate observations besides scientific?

      • I think this all gets back to the MoJo article of two weeks ago… people will defend their beliefs more often than reason in what others might consider a rational fashion.

        That said, to kind of go where Mike is, I think, they’re not IRrational, such folks, simply NONrational.

      • Ed Graham says:

        Mike McRae says,”…evidence, which conflicts with science.”

        Evidence is science. Evidence can conflict with belief, but it won’t change it.

        This is an interesting ppost, because there is still a stigma attached to skeptics in this country. We are and have been “of the Devil.”

      • Mike McRae says:

        Ed: If you define evidence as science, and science as the application of evidence, then we get circular reasoning. If you state that evidence is strictly defined by that which science produces, you’re risking a no true Scotsman fallacy.

        The term ‘evidence’, as it’s understood by most people, simply refers to any observation that changes your confidence in a belief. Even if you do claim it has to be scientific, it then suffers from the demarcation problem, putting us back at step one.

        Atheists might well be ‘of the devil’, but the word ‘skeptic’ carries connotations of adopting a position contrary to an otherwise popularly accepted belief. Skeptics as a movement of rationalists understand it as referring to scientific values, but this conflict between popular perceptions and the self-image of skeptics is what produces such negative stereotypes.

      • Dr Greengage says:

        One thing that seems to be missing from this discussion is trust. If you want someone to listen to your position, surely you first need to convince them that you’re not crazy and you’re not purely seeking personal gain?

  9. Martha Bunfield says:

    >The discussion was frames [sic] as, “why are some doctors afraid of alternative medicine.”
    Because they fear that as scientific medicine loses ground to unproven quack remedies, people will needlessly suffer.

  10. Mike McRae says:

    @Somite – Wow, alarmist much? ‘Kills us all’?

    I’m not quite sure how you’re using the term ‘post-modern’. If you mean it in the sociological sense; yes, it is. People do have different cultural perspectives – that’s quite factual. There are a variety of different values used to evaluate observations for their usefulness, of which those relevant to science are just a few.

    If you mean post-modern in a ‘reality’ sense, then that’s ludicrous and I implied no such thing.

    Science is the most useful at describing relationships between observations, given its success at predicting future observations. No big surprise there. But as useful as it is, it’s not the only set of values people on this planet use. Social values such as religious belief, appeal to popularity and appeal to personal experience are often treated as superior to instances of scientific evaluation, leading to special pleading for certain beliefs.

    Homeopaths might use strained logic to justify their beliefs. My point is not to claim that homeopathy is scientifically valid, or that science is just like any other evaluative system. It’s not. It’s that people do use different ways to evaluate different observations for their usefulness, and this does not make a person intentionally deceitful. For that to happen, you’d need to demonstrate they fabricated their beliefs in contrast to what they were truly confident in.

    Some might. But you’d have to have some pretty impressive evidence to convince me that you could generalise homeopaths to be mostly liars and frauds.

    • Somite says:

      Like I said your intentions and beliefs are beside the point. There are clear established ways to show a drug is efficacious and safe. The moment you continue selling a product that claims efficacy without showing it you are committing fraud. It may not be illegal (yet) but it is certainly scientifically and medically fraudulent.

      “But as useful as it is, it’s not the only set of values people on this planet use. Social values such as religious belief, appeal to popularity and appeal to personal experience are often treated as superior to instances of scientific evaluation, leading to special pleading for certain beliefs.”

      That people do this is a problem to solved. Not accepted as correct.

      • Mike McRae says:

        “Like I said your intentions and beliefs are beside the point.”

        Your claim is one of deceit. You called them ‘liars and frauds’ – the claim, therefore, is that homeopaths intend to misrepresent what they know otherwise to be true. How can define ‘lie’ and ‘fraud’ without taking into account an intention to deceive?

        “That people do this is a problem to solved. Not accepted as correct.”

        Nobody is accepting that this is ‘correct’. Social thinking is definitely problematic. No arguments there.

        What won’t solve it is a straw man representation of how others think that accuses them of nefarious, malevolent intentions. What will lead to a solution is a better understanding how why it is people hold such beliefs, and how to effectively communicate with people so they see the merit of thinking critically about such beliefs.

      • tmac57 says:

        Where would you place homeopaths who are ‘intellectually dishonest’? For example,the ones who tout scientific studies that show some small effect for a homeopathic remedy,but when confronted with problems and weaknesses for the study,and with studies that show no effect,will ignore the conflicting evidence.Are they liars?It would seem that at the very least,they are lying to themselves.

      • A philosophical question … with LOTS of permutations:

        Can people unconsciously or subconsciously lie to themselves?

        I say yes.

      • Mike McRae says:

        If they set out to deceive somebody by knowing that what they are presenting is a misrepresentation, it is a lie. I don’t see how that’s a complicated notion.

        Homeopaths – like anybody – aren’t immune to cognitive biases. They can and do cherry pick studies, seek confirmation where they should instead seek criticism, are unduly persuaded by personal experiences etc.

        This does not make them intentional liars or deceivers, as for that to be the case they’d need to hold one belief while convincing you of another. Rather, it’s more typical that their confidence in the efficacy of homeopathy is inflated beyond what science says is appropriate. Their judgment of which scientific tools are useful for evaluating their belief is impeded by a sentimental or social value.

      • Mike McRae says:

        @Socratic Gadfly: It’s an interesting question, on the nature of ‘self deceit’. I find it’s an issue of language more than of process – it’s easy to demonstrate that we are all capable of being influenced by a range of factors to defend a belief that conflicts with observations.

        The problem arises with ‘lie’ holding connotations of misrepresenting knowledge. In other words, is the contentious belief ‘known’ to the subject as false?

        This is the farm where straw men breed. :P Terms are used that carry across connotations that are inappropriate and supply meaning that doesn’t reflect the true nature of the situation, creating caricatures of an argument.

      • Mike, with my reference to unconscious or subconscious lying, I was actually going down the route of “subselves” as described by Dan Dennett, Daniel Wegner (good read) and other cognitive philosophers.

        In other words, can one of these subselves know that homeopathy has been scientifically disproven, yet lie about it to other subselves?

        (And, of course, this isn’t limited in any way to homeopathy.)

        this, too, also connects/gets back to Chris Mooney’s article about how and why we “reason.” If our “in group” is a bunch of subselves, then, we’re trying to convince a majority, or even a supermajority of a stance, not always the “truth.”

  11. Robo Sapien says:

    Dr. Novella,

    One thing I do when I train technicians at my job is to have them “train” me on the same material using their own terms and examples. This confirms to me that they don’t just know the information I’ve given them, but that they also fully comprehend it. Being able to draw an accurate analogy is a key indicator that someone truly understands the subject.

    I think it would be prudent to compose a debate format in which both participants must summarize their opponent’s stance in their own terms. The debate cannot engage until both parties agree to the other’s summary.

    • tmac57 says:

      Interesting idea.That would also serve to get all the ‘strawmen’ on to the table up front. (By the way,I also used the same training technique that you described, when I trained other telecom techs).

    • Great idea. That said, on the big issues here … homeopathy, other pseudomedicine, creationism/ID, hell, even Gnu Atheism vs. connectionists, I wouldn’t hold my breath waiting for a denouement.

  12. Trimegistus says:

    It’s rather depressing to see all the posters here trying to defend homeopathy. It’s bullshit. Really. Which means promoters of homeopathy are liars, frauds — or idiots. Trying to meet them halfway or accomodate their beliefs means skeptics must either tolerate dishonesty or accept stupidity.

    Would there be as much desire for a respectful, tolerant approach if we were talking about bogus faith healers like “Reverend” Peter Popoff? Or is it only expensive quackery purchased by wealthy idiots that needs the kid-glove approach?

  13. gdave says:

    @Somite & @Trismegistus:

    I think you are both attacking a strawman (amusingly, given the topic of this post). Not one post here so far has defended homeopathy or argued that rejection of scientific evaluation should “be accepted as correct.”

    Let me try:

    1) Homeopathy doesn’t work. The scientific evidence is conclusive. To the extent that using homeopathic remedies discourages people from using actual, effective treatments for serious conditions, it is dangerous. Convincing people of that is a Good Thing.

    2) Not all homeopaths or believers in homeopathy are liars and frauds, or idiots. It is entirely possible for intelligent, well-educated people to sincerely believe things that aren’t true. We all have cognitive blind-spots, which skeptical reasoning and the scientific method can help us overcome. But having a cognitive blind-spot doesn’t make someone a liar, fraud, or idiot. It makes him or her human.

    3) Treating homeopaths and believers in homeopathy with respect is a more effective tactic for convincing them that 1) is true than dismissing them all as liars and frauds or idiots (assuming, of course, that assumes that 2) is true). It is also a more useful tactic in convincing fence-sitters and those that simply don’t know much, if anything, about the topic, and think of homeopathy as some sort of herbal or “natural” medicine.

  14. The debate here about how to treat homeopathy is almost exactly the same as the argument about how atheists should treat religion. This has been argued to great length by much better debaters and philosophers than I am, so I don’t see any point in rehashing arguments.

    It seems to me that we will rarely, if ever, convince a dedicated homoeopath, any more than we can convince a dedicated religious believer, that their beliefs are false. What we can do, is convince people who are not already converts. What is the best way to accomplish that? Sometimes it is through careful arguments, sometime sit is through headline grabbing antics. You can’t get people to read your arguments if they don’t know you exist.

    On the 10.23 issue, I constantly read on homoeopathic web sites that administering more highly diluted substances need to be monitored by a ‘professional’. From everything I have read about homoeopathy this is one of the basic premises. That leaves me struggling with the identity of the straw man.

    • Mike McRae says:

      There is a myth that seems to be insinuated amongst a lot of rationalist discussions that conversions are typically epiphanies that occur within a conversation with a non-believer. Hence a lot of people are beyond conversion as no one non-believer could possibly hope to change their mind.

      It’s a myth because education more often resembles gradualism than it does punctuated equilibrium. There might be tipping points, however these still require numerous factors to be in place before a change can be precipitated by an encounter or a conversation, such as a propensity of critical thinking, scientific knowledge, respect for a skeptical or atheist role model etc.

      Concentrating on epiphany events and determining a course of action based on those misses 99% of the picture of how it is epistemologies evolve through a person’s life.

      • tmac57 says:

        Regarding our discussion above,I would argue that the 1st step toward a conversion,is for the person to stop lying to themselves.Once that happens,new information can be evaluated on an honest basis.

      • Somite says:

        I guess in the end I am not interested in convincing anyone or in their motivation. I just want the harmful and costly behavior to stop.

      • Dr Greengage says:

        Then, dear Somite, I fear your cause is doomed.

      • Dr Greengage says:

        … although I should add that, as homeopaths and their customers are a minority, you can win by convincing the majority that what they do is harmful and should be banned.

        This is, of course, still a path that involves convincing, and understanding of others’ motivations.

    • Of course, who’s the “professional”? If it’s a scientist with a standard double-blind process, homeopaths will say he or she doesn’t understand homeopathy and therefore can’t be a “professional.”

  15. Robo Sapien says:

    I think the most effective argument is the simplest one:

    Alternative Medicine is labeled as alternative because it is either not proven to work, or proven to not work. When it is proven to work, they call it MEDICINE.

    • Somite says:

      Exactly. There is simply no discussion to be had wihtout evidence for a claim.

    • I prefer the word *pseudomedicine.* That makes the difference even clearer.

    • Max says:

      When Dr. Oz proposed dividing CAM into edible stuff, body manipulations, and mind-body interactions, Steve said it’s “rough but fair”. The more meaningful division would be stuff that’s proven to work, not proven to work, and proven not to work, but Dr. Oz already had a script based on his categorization, complete with video clips, so there’s no way he’d budge from that.

  16. Somite says:

    Now this is more like it:

    “A bioethics expert from the University of Abertay Dundee has denounced the public funding of homeopathy…” http://tumblr.com/xvc2gsvnrj

    via @briandgregory

  17. Somite says:

    It has been argued repeatedly in this thread that “engagement” of homeopaths and the such is the best strategy. Do you have a reference for this? Because the research actually shows that we are entrenched in our erroneous beliefs and it isnvery hard to change someone’s mind.

    What we need is for the laws and regulations to be better. It would only take the requirement to demonstrate efficacy to extinguish homeopathy in one fell swoop.

    • gdave says:

      “What we need is for the laws and regulations to be better.”

      Ok, but how do you convince the lawmakers and regulators? If we can’t change anyone’s mind about homeopathy, we’re pretty much screwed, given how many members of the general public, and how many politicians, either believe in homeopathy whole-heartedly or accept it as a plausible “alternative” medical practice. We’re only going to be able to improve the laws and regulations if we can create sufficient political pressure among the general public, and sufficient political will among lawmakers and regulators, to do so – and that requires changing minds. And engaging strawmen, or dismissing all homeopaths and believers in homeopathy as liars, frauds, and idiots seems unlikely to do so. But I could be wrong.

      “It would only take the requirement to demonstrate efficacy to extinguish homeopathy in one fell swoop.”

      I’m pretty dubious about this. Requiring homeopathic remedies to abide by the same requirements as drugs for FDA approval would certainly knock them out of the mainstream market (but, again, we need to convince lawmaker, specifically Congress, to change the laws to effect this).

      However, as long as many people remain convinced homeopathy works, they will continue to seek it out. Non-approval by the FDA may convince some people, but plenty of people continue to seek out non-approved remedies (laetrile, psychic surgeons, faith healers, etc.). And just getting homeopathy off the shelves in the U.S. still leaves plenty of countries where it would be freely available (homeopathy is very popular in Europe, for example).

      I don’t think there’s a magic bullet to kill homeopathy, no “one fell swoop” that will extinguish it. It will take a lot of hard work by a lot of dedicated people to effect change at the state and national level in the U.S., and in many countries abroad, to significantly impact the use of homeopathy.

      Of course, I could be wrong. Maybe calling homeopaths liars and frauds will convince Congress to change the law and allow the FDA to regulate homeopathic remedies like mainstream drugs and treatments, and maybe the FDA will immediately ban all homeopathic remedies until their safety and effectiveness can be proven, and maybe most or all of the current believers in homeopathy will see the light, and refuse to use homeopathic remedies unless they can pass FDA review. One can always hope.

      • With Orrin Hatch deep in pseudomedicine’s pocket because of the supplements’ industry’s Utah concentration, changes like this will be hard.

        There’s been ongoing talk of “Motivation.” In politics, you can usually still find it by following the money trail.

  18. Pat Bowne says:

    Someone’s probably already made this comment, but as someone committed to teaching about evidence-based medicine to nursing students, I am not happy with what the people who want to slap down alternative medicine and placebos count as evidence. I’m sick to death of talk about p<.005, meta-analyses, random samples and double-blind trials *from people who have not looked at the genetic differences in drug processing among their study subjects.*

    Plenty of currently accepted treatments only work for some genetic subsets of the population. Plenty of people have died, rather than being cured, from the standard prescribed doses of currently accepted treatments. Until we start routinely doing the work that will explain this, how can we honestly use the fact that alternatives only work for a self-reported subset of the population as an argument against them?

  19. Pat – But that position does not make sense. There are limits to how we can apply our evidence to the general population. That is why treatments need to be followed and individualized, and why we need to follow up RCTs with real world experience.

    But we still need to use the best evidence we have to make decisions. When evidence shows that a treatment does not work, then it is not reasonable to claim that it does.

  20. Pat Bowne says:

    But when does “evidence show that a treatment does not work?”

    Is it when it fails to work for a randomly selected sample, when we have not looked at their genetic variability? Is it when it works no better for such a sample than placebos, which work very well for some people?

    All of these ‘rejected’ treatments did work for some of the people in the study. I’m not happy ignoring those people as ‘statistically insignificant’ when we have so many cases in medicine in which different responses to treatment reflect real differences in physiology.

    That doesn’t mean we have to do publicly funded research on every treatment. Public money has to be spent for the public good, and something that works for a miniscule portion of the population probably doesn’t merit public funds. But neither should we be too eager to declare things refuted once and for all, when we know so little about physiology, and include so little of what we do know in our experiments.