A comment from Science-Based Medicine: Every single time - bar none - I have had a conversation with someone about CAM and its modalities, they are absolutely astonished when I explain to them what the modality really is. One story I love telling comes from my friend in the year behind me. His parents are professional chemists and he came home one day and saw his mother had a bottle of homeopathic medicine. He asked why and she gave the typical non-committal response of "well, I thought it may help and I saw it on the shelf at the pharmacy." He explained what homeopathy actually is and they were absolutely dumbfounded. They are well aware of Avogadro's number, after all. People generally don't study what the CAM in question actually is - merely the fluff PR garbage that gets touted around and without direct and clear demonstration of harm, give it a pass as a result. After all, the business of real medicine is time consuming and difficult enough.

The gaps people have in their knowledge can be striking. Filling those gaps is an ongoing issue I have with newspapers and magazines. I have two areas where I have extensive knowledge. Infectious Diseases and pseudo-medicine, and only in infectious diseases am I truly expert. When I read the paper about a topic where I do know something I am annoyed at how often they get important details wrong. If they are wrong in about an area where I know something, how can I trust the veracity of the information on topics where I lack knowledge?  Who do I trust to help fill the breadth and depth of my ignorance?

Because it turns out that in the information age ignorance is not just the lack of knowledge but is produced in quantlty by others. There is a term for the cultural production (and study) of ignorance: Agnotology. The author of agnotology delineates several kinds of ignorance in the paper, but the form I want to focus on is

Ignorance as strategic ploy, or active construct

The focus here is on ignorance-or doubt or uncertainty-as something that is made, maintained, and manipulated by means of certain arts and sciences. The idea is one that easily lends itself to paranoia: namely, that certain people don't want you to know certain things, or will actively work to organize doubt or uncertainty or misinformation to help maintain (your) ignorance. They know, and may or may not want you to know they know, but you are not to be privy to the secret. This is an idea insufficiently explored by philosophers, that ignorance should not be viewed as a simple omission or gap, but rather as an active production. Ignorance can be actively engineered part of a deliberate plan.

 He starts the paper with a quote:

Doubt is our product. Brown & Williamson Tobacco Company, internal memo, 1969

And uses the tobacco industry as an archetype of an industry that manufactures ignorance for their benefit. The manufacture of doubt is common in the pseudo-medical world. It could not exist without it. I do not know if ignorance is bliss for pseudo-medicine, but it is a requisite.

Kevin Trudeau's former What They Don't Want You to Know empire on is based on manufacturing doubt and ignorance about medicine, a technique used, and often believed, by every pseudo-medical provider.

The false information the underlies all pseudo-medicine, from the popularity of pseudo-medicine in the US, to the efficacy of acupuncture to the safety of chiropractic to the mechanism of reiki.  It all relies on the production of massive amounts of ignorance. And so too has some aspects of real medical treatments. Pharmaceutical companies have not been hesitant to borrow methods from their tobacco brethren. Although science can be an antidote to the production of ignorance, science is small and difficult to master and ignorance is huge and easy to learn.

Dr. Gorski asked Has science-based medicine already lost to pseudoscience?.  You bet. 

All of the forces are on the side of undermining public trust in science.

Thanks to the internet, pseudo-medicine and pseudo-science are producing ignorance at a vastly higher rate than science and medicine.  It will likely always be that way and is why I lobbied for Sisyphus to be the emblem of the Society.  But that is OK.  It is all part of learning.



Points of Interest: 3/12/2014
Points of Interest: 3/11/2014