Category: Science

Columns on science and scientific reasoning, often focusing on examples of pseudoscience that reach the popular media.

Politics, science, and the art of the possible

Green policy_0Otto von Bismarck observed that politics is “the art of the possible”, but the statement holds true in many more domains than that. It’s only trivially true to say that anything is constrained by what is possible and what is not – yet that sort of retort is usually as far as the conversation might go (on social media in particular).

It’s more likely that Germany’s first Chancellor was trying to say that there’s frequently a mismatch between our ideals and what can reasonably be achieved. Not, in other words, that things are literally impossible – more that we need to bear the trade-offs in mind when making judgements as to whether people are doing a good job or not.

Cognitive biases like the Dunning-Kruger effect describe how we overemphasise our own expertise or competence, leading us to ascribe malice in situations where the explanation for someone’s screw-up is most probably simple incompetence, or simply that the job in question was actually pretty difficult, meaning that expecting perfection was always unreasonable. (As some of you would know, this paragraph describes a more gentle version of Hanlon’s Razor – “Never attribute to malice that which is adequately explained by stupidity”.)

So, instead of paying attention to the arguments and their merits when it comes to something like blood deferrals for gay men, we claim prejudice. Or, when someone dies after taking the advice of a homeopath too seriously, some of us might be too quick to call the victim stupid or overly gullible, instead of focusing on those who knowingly (because some quacks are of course victims themselves) exploit others for financial or other gain.

The point is that some problems are difficult to solve, and certainly more difficult than they appear to be from a distance, or from the perspective of 20/20 hindsight. So, when you accuse your local or national government of racism, or being anti-poor, or some other sort of malice, it’s always worth pausing to think about the problem from their point of view, as best as you are able to. They might be doing the best they can, under the circumstances.

In case you aren’t aware of two recent resources for helping us to think these things through more carefully, I’d like to draw a recent comment in the science journal Nature to your attention, as well as a response to it that was carried in the science section of The Guardian.

In late November this year, Nature offered policy-makers 20 tips for interpreting scientific claims, and even those of you who aren’t policy-makers should spend some time reading and thinking about these (though, don’t sell yourselves short in respect of not labeling yourself a policy-maker, because on one level of policy, you’d want to include for example parenting. And what you choose to feed your children, or the medicines you give them, would usually be informed – or so one would hope – on scientific claims of whatever veracity.)

The Nature piece talks about sample size, statistical significance, cherry-picking of evidence, and 17 other import issues, many of which you’d hope some scientists would themselves take on board – not only those scientists who might play fast-and-loose with some of the issues raised, but also simply in terms of how they communicate their findings to the public. If you’re asked to provide content for a newspaper, magazine or other media, the article highlights some common areas of confusion, and therefore helps you to know where you perhaps be more clear.

Second, and in response to the first piece, The Guardian (who had also re-published the Nature list) gave us the top 20 things that scientists need to know about policy-making. And this piece I’d commend to all of you, but especially the armchair legislators that routinely solve the country’s political problems on Twitter, or make bold claims about how little or how much governments might care for the poor, and so forth.

In short, making policy is difficult, and doing good science can be difficult too, because among the things we can be short of is time, money, attention, the public’s patience, and so forth. In the majority of cases, both policy-makers and scientists might be doing the best they can, under those situations of constraint. So before we tell them that they are wrong, we should try to ensure we at least know what they are trying to do, and whether they are going about it in the most reasonable way possible, given the circumstances.

They don’t get the luxury of ignoring what is possible and what is not when doing the science, or making the policy. When criticising them, we shouldn’t grant ourselves that luxury either.

Thinking Things Through (report-back)

For the interest of those of you who couldn’t attend the FSI conference last weekend, here’s a brief report-back on how the day unfolded. If you were able to attend, feel free to share your thoughts on how it went in comments.

FSI_confThe Free Society Institute (FSI) hopes to avoid the pitfalls of restrictive labels such as “atheist”, “freethinker”, “skeptic” and the like. Not only can those labels be politically problematic, in that they might cause otherwise sympathetic people to ignore what you might say, even before hearing it, but they are also ideologically loaded – people already have a sense of what they mean, and we don’t necessarily mean the same things by them.

Instead, the value proposition of the FSI is captured in the phrase “Thinking Things Through”, where the commitment to doing so will be expressed in thinking not only about religion (as with many atheist and agnostic organisations), but also about science, and social justice, and any other aspect of our lives that might benefit from discarding lazy stereotypes and instead, taking the time to think things (including our own beliefs) through.

This theme is what we intended to emphasise at the FSI’s third national conference (the previous two were held in 2009 and 2010, in Cape Town), held with the support of the International Ethical and Humanist Union (IHEU). This conference also served in part as a re-launch of the FSI, with the value proposition described above.

Our members are of course free to describe themselves as atheists, agnostics or some related term, but the FSI hopes to be an umbrella body for a broad coalition of people who care mostly for minimising the damage we can do to ourselves and society at large through believing things on the basis of poor evidence, whatever the content of those beliefs happens to be.

In short, the FSI is a South African non-profit organisation dedicated to promoting free speech, free thought and scientific reasoning. We are advocates for the values of secular humanism. The FSI hopes to help create a community, both virtual and physical, that collaborates in developing and distributing the knowledge and skills required to foster a free society.

A free society involves not only freedom from false beliefs, but also an environment in which it is easier to recognise and discard false beliefs, thanks to education, the free flow of information, the promotion of scientific literacy, and where possible, eliminating barriers to human flourishing (from the mundane examples such as misleading advertising, to the severe, such as oppressive laws).

2013 Conference: Thinking Things Through
The conference hoped to highlight the value that can be found in careful consideration of issues, and to highlight the costs associated with ignorance, for example in basic reasoning skills. In pursuit of this goal, we made sure to include presentations that spoke more broadly about these and related issues, rather than focusing on hackneyed debates regarding religion and its proper place in society. In fact, the only talk that dealt explicitly with religion was perhaps far more sympathetic to religion than many attendees would have preferred.

The speakers, in order of appearance

Conrad Koch (and occasionally, Chester Missing) was our MC for the day. Koch is a comedian and an anthropologist, while Missing is the star of the Emmy-nominated show, Late Night News, and the world’s most revolutionary puppet. The combination of these speakers and talents provided not only for raucous laughter, but also inspired some serious self-reflection among those present.

It was Koch (or Missing, I can’t recall) who asked some of the more pertinent questions of the day, including why so many of us in the audience were white, male, or both – and why secular humanism seemed to have such a demographically unrepresentative face in a country such as South Africa. International readers will know that this is a problem for all such organisations in just about every part of the world, but unless we’re made to think about it, our chances of remedying it are non-existent.

You can find Missing on Twitter at https://twitter.com/chestermissing

Cecilia Haak was the opening speaker, and offered a presentation titled “The Square Kilometre Array Telescope: Looking back in time”. Haak is eminently qualified to speak on this topic, given that she is currently an infrastructure engineer on the SKA project, working with the team that is building MeerKAT, precursor to the SKA, and the SKA radio telescope — which will be the world’s biggest. Haak was one of the contributors to the submission that secured South Africa the bulk of the hosting rights for the SKA.

Haak explained the significance and scope of the SKA project to a fascinated audience, describing what it is we hope the project will reveal to us in time. The implications for scientific research in South Africa were discussed in a very engaged question and answer session, where it became clear that the audience – even though arguably more informed on these matters than most – might have agreed with the sentiment that we could do with more (and, better) scientific journalism in South Africa. Later in the day, we would hear a presentation from Sarah Wild on exactly this issue.

You can find Haak on Twitter at https://twitter.com/ceciliahaak

David Spurrett, Professor of Philosophy at the University of KwaZulu-Natal, then presented a talk titled “Showing your working: Science, and the collaborative nature of good reasoning”. Spurrett is an active researcher in cognitive science (especially addiction and decision making), philosophy of cognitive science, and philosophy of science.

Spurrett described the method and value of scientific reasoning, emphasising that “it’s like common sense, but better”. In a highly engaging presentation, he used notable figures from the philosophy of science to make it clear how good scientific reasoning was within the average person’s ambit, and to illustrate various principles and strategies for improving our reasoning.

You can find Spurrett on Twitter at https://twitter.com/DoctorSpurt

Eusebius McKaiser, author, TV show host, and currently the host of Power Talk on PowerFM 98.7 was our next speaker. McKaiser is a widely published social commentator and political analyst, who previously studied law and philosophy at both Rhodes and Oxford. McKaiser’s talk was titled “The power of sloppy thinking: turns out Dawkins isn’t an atheist!”

The talk focused on the distinction between the labels “atheist” and “agnostic”, using Dawkins and “The God Delusion” as a springboard into that topic, rather than explicitly focusing on Dawkins himself. McKaiser’s ambition was to inspire the assembled atheists, in particular, to reflect on whether they were guilty of a similar sort of thoughtlessness as they sometimes accuse theists of, in claiming certainty in respect of things they could not be certain of.

You can find McKaiser on Twitter at https://twitter.com/eusebius

Sarah Wild, Science Editor at the Mail & Guardian, spoke next on “Spreading bad science”. The Mail & Guardian appointed Wild as Science Editor in 2013, making her one of only two dedicated science editors in the country (and lamentably, one of only 6 dedicated science journalists). Wild is the 2013 overall winner for the Pan-African Siemens Profile Awards for excellence in science journalism, and also the author of a book titled “Searching African Skies: The Square Kilometre Array and South Africa’s Quest to Hear the Songs of the Stars.”

Given her position at the Mail & Guardian, Wild was perfectly situated to inform this very receptive audience of the difficulties inherent in balancing what the public seem interested in (rather than “the public interest”) with comprehensive and informative communication about scientific research. As she pointed out, any political development always stands a good chance of bumping a science story out of that week’s newspaper, even though the political story might have far more fleeting significance.

You can find Wild on Twitter at https://twitter.com/sarahemilywild

Gareth Cliff, morning host on 5FM, judge on IdolsSA, City Press columnist, and the author of “Gareth Cliff on Everything” spoke to us next on “Sacred or profane: religion and the politics of offence”. Cliff is one of a small group of South Africans who reliably gets people talking, whether or not they agree with what he’s saying, and his presentation at Thinking Things Through was no exception.

Cliff’s presentation was very personal and honest, discussing his relationship with his radio listeners, the regulatory authorities, and generally, the sensitivities of audiences and how much they should be respected. Cliff did make it clear while the truth should never be the handmaiden of political correctness, there was nevertheless a strategic and emotional dimension to communication that could not be ignored.

You can find Cliff on Twitter at https://twitter.com/garethcliff

Jacques Rousseau, founder and chairperson of the Free Society Institute, gave the last presentation of the day, titled “Towards a Free Society: What do we do next?”. Rousseau lectures critical thinking and ethics at the University of Cape Town, South Africa. In 2009, he founded the FSI to promote secular humanism and scientific reasoning in South Africa.

Rousseau’s presentation sought to make the audience think about the large overlap in motivations and desires between religious and non-religious folk, and to ask them to consider whether we spend enough time thinking about similarities, rather than differences. Rousseau argued that the caricatured view many atheists seem to hold regarding religious folk was getting in the way of our recognising that it’s not usually religion that’s the problem, but rather poverty, in both an economic and an educational sense.

You can find Rousseau on Twitter at https://twitter.com/JacquesR

The day’s proceedings concluded with a panel discussion involving all the speakers except for Sarah Wild, who unfortunately had to leave before then. Barry Bateman, Pretoria correspondent for Eyewitness News, hosted the panel discussion, and the conversations he elicited from the speakers offered a very suitable end to an intellectually stimulating day.

You can find Bateman on Twitter at https://twitter.com/barrybateman

All the presentations were recorded, and will be uploaded to YouTube once editing has been completed and permissions obtained from the speakers. To be informed as to when the videos are released, keep an eye on the FSI homepage and/or the Twitter feed of the FSI Chairperson, @JacquesR .

Many thanks all the speakers, and to Anneleigh Jacobsen, Greg Andrews, @Dr_Rousseau and @Jonathan_Witt for some invaluable help behind the scenes. Thanks also to the @IHEU, for their financial support. If you attended, thanks for your support too!

“Addicted” to hyperbole

Some of you might have noticed that recent blog posts here have earned me some antagonism from defenders of the low-carb, high fat (LCHF) diet. In their defence, they of course think that I’m being needlessly antagonistic, especially towards someone (Prof. Tim Noakes) who they think of as doing pioneering – and very important – work in nutrition.

I’d like to try and approach the topic from a slightly different angle here, in the hopes of illustrating what I mean when I say that my criticisms are premised on a concern for exaggerating the quality and consequences of data, in a context of great uncertainty. In the same way as my language and arguments around religion have tempered significantly over the past 3 or so years, in science I’m equally concerned with the example we set as to how to think, where the claims we make should be proportional to the quality and amount of evidence we have.

A comment on one of my previous posts led me to this blog post by Prof. Grant Schofield, in which he responds to a press release from health professionals in New Zealand, decrying low-carb high-fat advocacy. Schofield’s post seems happy to embrace nuance and to acknowledge the limitations in what we can know right now about the long-term effects of LCHF diets, and is to me a great example of how to argue for an outlier position in a way that lures people into serious consideration of your case, rather than giving the impression that you’re being asked to join a religious cult.

As I wrote earlier in the week, the language of science should embrace uncertainty. We should not offer people dogma, both because it dumbs down the process of scientific reasoning, and second (an extension of the first, though) because it encourages people to think in terms of false dichotomies or other poorly defined and crude categories. What’s right is often about nuance, and doesn’t fit in a tweet or headline – and those of us who know better should not encourage a simplistic “X is right/wrong/healthy/good/bad”, especially when we know that’s what the market wants to hear.

The Doctor just tweeted a link to a great piece about “food fearmongering” that makes this point via examples of diet advice and promotions for books and movies about diet that are almost comical in their hyperbole. Food, basically, is trying to kill you – and unfortunately, you’re also addicted to it.

Until fairly recently, I was involved with a multi-disciplinary research team working in the field of pathological gambling, and as a result got to spend five years working with leading international addiction scholars, neuropsychologists, clinicians in the field of addiction, and so forth. In national prevalence studies and other research, I also got to spend a fair bit of time with people who describe themselves as addicts.

The simple takeaway, if I were to distill five years into one sentence, is that addiction is complex, and not a word to be used glibly. Today, anything we happen to like is often described as addictive, and people will talk about “brain scans show that area X lights up” when you eat a Snickers bar, while not thinking that perhaps area X happens to light up when you do stuff you enjoy. Or, that people who are inclined to addiction will find things to get addicted to, but that this doesn’t always mean that the thing in question is intrinsically addictive.

Today, people are variously addicted to sex, love, the Internet, cocaine, carbohydrates, sugar, crystal meth and so forth. But using the same word to describe all these things is profoundly misleading, and is also potentially insulting to people who suffer from the sort of unambiguous addiction that costs you your savings, your family, your health and so forth. To put a mild lack of self-control alongside heroin seems somewhat glib.

Cocaine, for example, often has no physical withdrawal effects. Psychotherapist Marty Klein says that, in 31 years of practice in the field, he’s never seen “sex addiction”, and describes it as a myth. Internet addiction was invented as a hoax in 1995, when Dr Ivan Goldberg took the diagnostic criteria for pathological gambling and adapted them to the Internet.

Internet addiction wasn’t included in the 2013 revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) – not even in the “Conditions for Further Study” chapter, that highlights things thought worthy of continued attention. “Internet gaming disorder” can be found in “Conditions for Further Study”, and “gambling disorder” does appear, in a new category for “behavioral addictions”. As I say, it’s complex.

Then, as I’ve written in the past, we might even want to be wary of treating the DSM as authoritative, perhaps especially with regard to the class of behavioural addictions, accused of making a “mental disorder of everything we like to do a lot”. My point is simply that this one word, “addiction”, is being made to do a lot of work – and a term that broad can sometimes appear rather meaningless in consequence.

It’s of course not meaningless for people who do suffer with an addiction of their own. The question I’m asking here: if we start speaking of anything that people struggle with as an “addiction”, what are the consequences of that? I fear that we’re not only encouraging shoddy thinking about addiction (and science, in general), but we’re also encouraging victimhood in that my lack of self-control can now simply be ascribed to the fact that I’ve been snared by the evil Internet, or the seductive candy bar.

And finally, there’s the danger of insensitivity – almost insult – to people who struggle with addictions that destroy lives. While being badgered by a LCHF devotee on Twitter, I was asked “do you have ANY experience with addiction that is not related to some scientific study? So much more to it than that.” In other words, I was being asked if I was an addict.

Now, this was Twitter, so you might say that this sort of thing comes with the territory. But what if I was an addict, really struggling with something, perhaps have just lost a job, or a spouse, or somesuch? Might one not think the question rude, crude, inappropriate – even indefensible? (Regardless, of course, of whether it was relevant or not, in that I was being asked “never mind the data, but do you have an anecdote?”)

I’d certainly think it inappropriate, perhaps even “triggering“, in the contemporary language of social justice. When it comes from someone who works at an addiction clinic, of all places, I’d be even more convinced.

And in this case, that’s exactly where it came from – a person offering treatment for “sugar and carbohydrate addiction”. The field of addiction – and addicts themselves – could do with us being a little more careful about the language we employ, and the categories we use to describe the things we enjoy.

Honest communication about science

It’s easy to lose objectivity when we feel strongly about an issue. Some of the things we feel strongly about might also be of great consequence, making it even more difficult to separate the strength of your emotional commitment from the strength of your argument. Some of the comment following my blog posts regarding Prof. Tim Noakes‘ research (especially on Twitter, where nuance is sometimes in short supply) ask why people like me focus on these issues, when obesity (or diabetes, or whatever) are such enormous problems – and the answer is simple, albeit two-fold.

First, because the more important something is, the more important it also becomes that our reasoning be sound, so that we can stand a better chance of convincing doubters. And second, because there are more problems in the world than simply obesity (etc.), and just because one of those is your focus, doesn’t mean it has to be mine. Furthermore, in what might come as a shock to some, it’s possible to focus on more than one of those problems at a time – you can promote critical reasoning while also caring about public health, for example.

I attended EthicsXchange this morning, a TEDx-style event where 11 speakers spoke on ethical challenges and potential responses to them. The Doctor has written about this event also, focusing on some of the hyperbole (such as the ‘addictive’ nature of sugar) we encountered on the day. Besides a general grumble regarding the oddity of an ethics conference that featured no ethicists, it was a worthwhile event. My favourite presentations were the ones that focused on the complexities and apparent contradictions we sometimes encounter in seeking the good, and I thought that my Vice Chancellor, Dr. Max Price, and Peter Bruce of Business Day did the best job of raising those issues.

It’s the talks on scientific themes that I want to briefly address here. I do so mostly as a prompt to those of us who speak or write about science to remember that we do live in an age of celebrity, short attention-spans and a lack of patience for complex arguments. What this adds up to is beautifully illustrated by a recent xkcd panel, reproduced below:

xkcd on headlines as clickbait

Sensation and hyperbole grab attention. TEDx-style talks are meant to be slick, yes – and it’s also not a bad thing to make science compelling (quite the contrary, in fact). But we should remember that science is about the method, not the conclusion. When we forget to reinforce the method of good science in expressing our conclusions, we’re sending the message that things are a) more certain and b) easier than they actually are. Of course there are permissible shortcuts, or liberties. When we say that we know, for certain, that smoking is a cause of cancer, it’s only a pedant who asks you to confess that yes, of course, nothing is ever absolutely certain and there might be some other factor we haven’t spotted, with smoking and cancer being caused by that, etc.

When we get to a certain level of justification, we can say we “know” something – even though what/where that level of justification is can (rightly) be contested. But what we should not do is say things like:

  • “The literature says that X” – when we know full well that some of the literature says X, while other literature says Y, with no clear consensus having yet emerged.
  • “We now know that X” – where X is really your preferred view, and not at all “known” but instead the subject of significant dispute

And then, there are some words that we just know – going in to our talk, or sitting down to write our column – that people are going to invest with greater significance than is merited. Words like “caused”, or “proven”, or even sometimes, “evidence”.

I’m not saying that we need to include a ream of disclaimers with every sentence. But if a popular science talk or piece of writing doesn’t make it quite clear that there’s room for reasonable doubt, it’s doing a disservice to the goal of getting people to think more critically and clearly about knowledge-claims.

No matter how important the scientific subject under discussion, the goal of promoting sound reasoning is a worthy one too. And there’s no reason why one of these goals has to be pursued at the expense of the other.

 

Thinking Things Through: A national conference on secular humanism and science

On Sunday, December 1 2013, the SciBono Discovery Centre in Newtown will host the 3rd national conference of the Free Society Institute (FSI). The conference theme is “Thinking Things Through”, and it will focus on resources and ideas that help us to make more informed decisions about what to believe, and why.

Why “Thinking Things Through”?

We all make choices every day – decisions that impact the way we live, the health of our families, and the things we spend our money on.  The FSI believes that taking time to carefully think things through leads to better choices, and that better choices lead to better lives, and help to foster freer societies. This conference is dedicated to the idea of thinking things through – and we hope it’s just the start!

What is the Free Society Institute? What are their goals?

The FSI believes in the value of thinking things through, and that every person can improve the choices they make and the lives they live with better thinking.

We work to keep people accountable; to challenge those who take advantage of others; to make debates more informed, and to be a rational voice on issues such as free speech, free thought and other values – in short, on the things that matter in our society. We believe that thinking things through can improve the quality of life for everyone – and that we all deserve the best life possible.

Who should attend?

Anyone with an interest in science, secular humanism, skepticism and the role of religion in society will benefit from attending Thinking Things Through. The conference will address these and other themes, with an emphasis on showing how careful consideration of issues can lead us to more robust – even if sometimes surprising – conclusions!

Who will be speaking?

Chester Missing, Cecilia Haak, David Spurrett, Eusebius McKaiser, Sarah Wild, Gareth Cliff, Jacques Rousseau and Barry Bateman

For more, visit: http://thinkingthingsthrough.co.za

 

Contact: Jacques Rousseau / Jacques.Rousseau@fsi.org.za

More lessons in bad science (and reasoning) from Noakes

In case you missed it, there’s a 1400 word comment from Prof. Tim Noakes on my previous blog post. Seeing as the bulk of his comment is entirely unrelated to the subject of that blog post, I thought it offered a handy opportunity to provide an additional example of reasoning gone wrong, this time both in basic logic, and again in science. (Also, I’d need another 800 or so words to match his word-count.) So, below you’ll find block-quotes of his full comment, and an explanation of the errors committed. If you want to see his quote in context, please visit the original piece, Lessons in bad science – Tim Noakes and the SAMJ.

Apologies, but this will be somewhat lengthy. I’ll try to keep each unit of quote and response comprehensible on its own, though. Those of you who get bored, please do scroll down and read the bit headed (in bold) “A very important bit” before you leave.

And a reminder – my post the other day wasn’t about the diet itself. This post isn’t about the diet either. It would be fantastic if Noakes/Taubes and the rest were correct in this instance, in that they would have re-discovered or popularised a highly cost-effective way to treat an a highly significant public health problem. Or, various problems, including obesity and diabetes. That would be something to be celebrated, and I’ll be one of those celebrating.

However, if we can arrive at that outcome while supporting (and reinforcing) the scientific method and basic logic, surely that’s an even better outcome?

Noakes begins by re-stating a powerful anecdote:

What is really so funny is that this is a report of how 127 people felt their lives had been dramatically improved by following a particular diet. Included were 14 who claimed they had been “cured” of Type 2 diabetes – confirmed in 3 cases I investigated further. To my knowledge the SAMJ has never before carried a report in which patients with an “incurable” condition (type 2 diabetes) were cured of that condition. One doctor who had told his wife he would be dead in 7 years because he had 5 “incurable” conditions, was completely healed of all conditions (no more medications required) when he restricted his carbohydrate intake.

Everything else he had ever tried (according to his conventional medical training) including treatment by the best medical specialists in Cape Town had done little for his health. Naturally this medical practitioner who had never in 57 years been exposed to this information (why not?), concluded that the dietary advice I gave him had produced a “miracle”. He now includes this method in his treatment options for his patients with obesity/diabetes/metabolic syndrome. He now informs me at least monthly of how much success he is having with this dietary treatment for these patients.

After the words “felt”, “claimed” and then the quotation marks around “cured” in the first two sentences, the thing you’ll note about this anecdote is that it uses language that is entirely inappropriate to the level of evidence available. Imagine yourself to be someone who has Type 2 diabetes, or who is overweight, and who then reads the two paragraphs above. If your level of scientific literacy was that of the average person, you’d come away thinking that there’s something akin to certainty that this diet is effective.

If you’re a marketer, this tactic is completely understandable, and appropriate. But science should be a domain of reason and evidence, not of hyperbole, and not of presenting contested evidence as if it obviously demonstrates something that it is not known to demonstrate. Second, as I’ve said in my original piece, if the evidence exists, you wouldn’t need the anecdotes. Unless, of course, Noakes has so little confidence in the acumen of his peers that he thinks that they would be equally persuaded by either.

Paragraph two contains the quite typical injection of conspiracy theory, with its suggestion that something must be afoot for this medical practitioner to not have heard this dietary advice before. And yes, it’s possible that something was and is afoot – that there is a systematic bias against this approach to diet. If so, that’s a problem that should be remedied. But it has no bearing on whether the advice is in fact good or bad advice. It can have a bearing on how much evidence we have, in that research might have been stymied or inappropriately directed. (Noakes, however, keeps insisting that the evidence is clear, so it seems that this problem is surmountable.)

I wrote the article to alert my colleagues to the fact that there is a simple dietary option that might be able to reverse the very conditions that our profession finds so difficult to treat – obesity, type 2 diabetes, metabolic syndrome. I also referred to the extensive scientific literature showing why and how this dietary intervention does and should work for people with these conditions. The explanations are simple, obvious and proven.

But then perhaps you need a training in the medical sciences to understand those mechanisms, Without some understanding of biochemistry, it is not possible to follow that argument. What one cannot understand, one naturally dismisses as irrelevant.

As I’ve asked before, if the “extensive scientific literature” makes the case, why do we need the anecdotes? As above, the use of the word “proven” massively overstates the case, and again indicates a failure to understand why he comes across as pseudoscientific in these regards. If it were “proven”, there would be far less disagreement in the medical profession than there seems to be about this sort of diet’s efficacy.

In general, though, to quote from a comment I made on the previous post, “the issue is that if non-anecdotal evidence for the same conclusion exists (as he asserts), that evidence would be sufficient by itself. So, either it doesn’t exist, and he needs to rely on the anecdotal evidence (which teaches a bad lesson regarding scientific reasoning), or it does exist, but he thinks that the anecdotal evidence adds weight to the conclusion (which it doesn’t, as he should know)”.

The last paragraph contains another fairly typical tactic for Noakes, namely an attempt to discredit an opponent through focusing on something irrelevant or personal, as we saw in the “fat-shaming” comment in the previous post. Because there are two possibilities here: first, that he’s right that we need medical training to understand this. If so, I’m mystified as to why Noakes does all this public speaking to laypeople, and also that he writes on these matters in (almost exclusively) lay publications and books as much as he does, seeing as he knows none of those audience-members can understand what he’s saying.

Alternatively, he’s subtly suggesting I’m too thick to “get it”. But again, seeing as my post was not about the diet, but about what evidence and arguments look like, I’d have to protest and tell him that I “get that” very well, and that of all the medical practitioners who have commented or Tweeted about the post in question, everyone except Noakes thinks I’m on to something. Not, I again remind you, about whether the diet is good or bad, seeing as I don’t express a view on that, but simply that this sort of “research” or “study” sets a very low standard in terms of what we should aspire to as scientists.

At no point in the article is the claim ever made that this is an attempt at a scientific proof of a particular diet. That is why the title includes the words – Occasional Survey. It is simply a group of case reports showing that some patients achieve remarkable cures for their intractable medical conditions simply by following advice, the key point of which is that it normalises hunger. For the truth is that these patients are not dying of obesity etc, so much as they are dying of hunger. Once their hunger is controlled by simple dietary advice, they can start to cure the conditions caused by the overconsumption of addictive, highly processed, carbohydrate-rich foods (made worse by their insulin-resistant state).

I have been in science long enough to understand how people try to divert attention from the message. I wrote about this extensively in Challenging Beliefs. First they always question the methods. The methods I used in this study are entirely appropriate for the extremely limited goals of this paper. That simple goal was to show that some people benefit dramatically and in some cases miraculously from this simple advice. Whether or not they would have benefitted equally from other advice is utterly irrelevant since I am not trying to prove (in this article) that one treatment is better than another. Of course I would guess that 100% of the 127 had all tried the conventional advice and it had failed for them. But I only made that claim if I it was supported by the information I had.

A group of “case reports”? I don’t know about you, but that seems an awfully strong description for a series of self-reported and completely uncontrolled and in most cases unverified narratives. But it’s nevertheless a legitimate description, with a track record in medical literature.

However, because a large group of case reports, as in this case, can create an impression of generalisability or significance where there might be none, we find Johns Hopkins, for example, requiring IRB (institutional review board) clearance for any case studies (or a case series, in this instance) involving more than three participants. No clearance is mentioned in this case.

Again, I remind you that I’m simply saying that the study offers little of scientific merit, and that the SAMJ erred in accepting it for publication – not that the anecdotes are false. (It’s that we can’t know whether they are false or not that is part of the problem.)

As for “I have been in science long enough to know” – I refer you to the point about deflection and conspiracy mentioned earlier. The fact that methods are questioned isn’t evidence that the scientist is a martyr for the truth, as Noakes seems to want to imagine himself here. As Occam’s Razor suggests, it might also be because the methods are questionable.

It’s entirely relevant to question whether the participants would have benefited equally from other advice, precisely because 127 cases offers an impression of significance or generalisability. The goal was “to show that some people benefit dramatically and in some cases miraculously from this simple advice” (my emphasis) – and how do you show that through 127 unverified self-reported anecdotes? If the science already shows this, then it can stand alone, with the anecdotes as illustrations if one so desires. Noakes says (in the paper) that this “data” is “of value” and “challenges current conventional wisdom” – and yes, it would, if we had reason to believe it was replicable. It might well be replicable, but the anecdotes are not evidence for that conclusion.

A key point about South African medical ethics is that if there is more than one treatment options it is ethically unacceptable for a South African practitioner to prescribe only one. My ethical responsibility as an educator and scientist is to bring the attention of my colleagues to the established fact that there is more than one option for the treatment of obesity, diabetes and metabolic syndrome and that the scientific evidence for this is well established in the literature (as recently accepted by the highest Swedish medical authorities).

Having been involved in high-level research ethics myself, of course I’d agree in the main. Except, Noakes is leaving something crucial out of the summary: it’s not only when there is simply “more than one treatment option”. Instead, it’s when there is “more than one effective/proven/viable/etc. treatment option”. This might well become known to be one of those options, perhaps even the best one. But it isn’t known to be that as yet, which is a reality Noakes again evades in the above quotation.

A very important bit

Above, Noakes says “as recently accepted by the highest Swedish medical authorities”. This, in a nutshell, demonstrates his rather casual relationship with reality when it comes to promoting the conclusion he wishes to. You’ll note, as a starting point, that the language is unambiguous – a trusting reader will be left utterly convinced that the Swedes have accepted LCHF as obviously the recommended diet. So, let’s look at the evidence. The quote from his paper reads as follows:

The Swedish National Board of Health and Welfare has concluded that ‘low carb diets can today be seen as compatible with scientific evidence and best practice for weight reduction for patients with overweight or diabetes type 2, as a number of studies have shown effect in the short term and no evidence of harm has emerged … ’

It’s a direct quote, so you’d expect a reference (and quotation marks, which might look a little alien to some potential readers). We have both in this case, and the reference given is to the Swedish Board in question…. oops. No, sorry, my mistake – the reference is to a blog post titled Low-carb for You. The Swedes are eating more butter! In another interesting development, the full quote reads (my emphasis):

Professor Christian Berne, one of Sweden’s leading diabetes experts, had carefully investigated the case against Dr. Dahlqvist and presented his findings to the Swedish National Board of Health and Welfare. He said, “…a low-carbohydrate diet can today be said to be in accordance with science and well-tried experience for reducing [obesity] and type 2 diabetes…a number of trials has shown no effects in the shorter run and that no evidence for it being harmful has emerged in systematic literature researches performed so far. [There is] no scientific support yet for treatments in excess of 1 year. A thorough evaluation of long time treatment results is therefore an important demand on the practitioner.”

So what we learn here is:

  • In the source Noakes refers to in order to support a very strong claim, we find Berne reporting findings to the Board
  • But that quote is presented by Noakes as a resolution of the Board, rather than an opinion expressed to the Board
  • An important bit of the quote is left out, because it’s inconvenient (namely, that there is no scientific support for treatments “in excess of one year“)
  • Notice that this question – around long-term efficacy – was a central theme of my previous blog post that inspired this Noakes essay in response – and his own source makes the same point
  • Lastly, we learn that quotation marks don’t mean the same thing for Noakes as they might to you, in that a sentence like “a low-carbohydrate diet can today be said to be in accordance with science and well-tried experience for reducing [obesity] and type 2 diabetes” morphs, in Noakes’ version, into “low carb diets can today be seen as compatible with scientific evidence and best practice for weight reduction for patients with overweight or diabetes type 2” (I’m not asserting here that he changed the meaning – it’s just odd to quote-and-not-quote at the same time).

The SBU (Swedish Council on Health Technology Assessment) have however published guidelines on diet and obesity – but unfortunately, they’re not yet available in English, so Noakes couldn’t easily have quoted from them in an English-language journal. But let’s see what Google translate can do for us, seeing as we’re able to take such liberties on a blog post.

“SBU has previously addressed food for people with diabetes [link to English pdf]. The results for people with obesity and diabetes, pointing at large in the same direction.”

That direction, according to the English diabetes report, includes bits like this (my emphasis):

  • Scientific evidence is not available to evaluate the long-term safety of moderate and extreme low-carbohydrate diets. This includes cardiovascular morbidity and other complications of diabetes.
  • There is strong scientific evidence that lifestyle intervention, combining a low-fat diet with high fiber intake and increased physical activity, prevents diabetes in people that would otherwise be at high risk for the disease

Back to the Google translate version of the obesity report, which also says (my emphasis):

  • In the short term (six months) is advice on strict or moderate carbohydrate diet more effective for weight loss than low-fat diets advice. In the long run there are no differences in efficacy between weight loss tips on strict and moderate carbohydrate diet, low-fat diets, högproteinkost, Mediterranean diet, diet focuses on low-glycemic load diet or a high proportion of monounsaturated fats.
  • After that obese people have lost weight they can maintain their weight better with advice on low-fat diets with low glycemic index and / or high protein content than with low-fat diets with high glycemic index and / or low protein content. There is no basis for assessing whether even advice, eg, low-carbohydrate diet and the Mediterranean diet is effective in preventing weight gain after weight loss

Once again, it might one day be common knowlege that Noakes et. al. are right. But that day doesn’t seem to have arrived yet, and in the meanwhile, it certainly looks as if support is being appropriated where it doesn’t quite (as yet) exist. This, again, is bad science, if not simply dishonest.

Back to the Noakes comment

The reasons why this information is not taught more widely across the world is not material to this article and whether or not there is a conspiracy is not relevant. The point is that students in South Africa (as in most other countries) are currently taught only one side of a two-sided story. As far as patient care is concerned, that is unethical.

Sentence one, and then two and three seem somewhat contradictory. If students are being misled into providing unethical patient care, surely that must be relevant? But in any case, my point was that if something was obvious, and as evidence-based as Noakes keeps asserting, it would be taught all over the world. He constantly refers to conspiratorial reasons why that isn’t the case, rather than considering the possibility that others don’t think the evidence is as clear as he thinks it is.

Three years ago I decided that it my ethical responsibility to acknowledge publicly that my advice on high carbohydrate diets for runners, widely read in Lore or Running, was wrong for those with insulin resistance/type 2 diabetes/metabolic syndrome since it would contribute to their ill-health in the long term as it has to mine. This article is one outcome of that admission.

I could have kept quiet and hidden my error but I chose not to. Now that this article has been published in the SAMJ (and I have spoken about it at the most recent SAMA conference), South African medical practitioners, perhaps for the first time, have been exposed to the evidence that there is an alternative option that they might like to consider in future for the treatment of these conditions.

The result is that if the 127 patients reported here are any indication, many patients in South Africa with these conditions will be offered another treatment option that before they would not have been offered. I suspect that many will do much better on that therapy than if they continue to follow advice that does not work (for them).

Nothing to add here, except to repeat that the point is precisely that we have no reason to believe that the 127 patients reported here in fact are any indication.

So this focus of this discussion should not be about whether or not I am a good scientist who understands what is and what is not good science.

Erm, no. I choose what the focus of the discussion is on my own website, thanks.

Fortunately in science, there are simple markers of our standing as scientists that are based on hard measureables and not on the opinions of others. These are the h-Index and the number of citations. Anyone who wishes to determine my status as a scientist is welcome to find those numbers and what they mean. Those are measures of scientific influence over a life-time, not as the result of one single good or bad article.

Yes, they are indeed “simple” markers. “Crude” might be another appropriate word, as Prof. Noakes knows full well. They offer a valuable heuristic in making snap judgments, but they aren’t any sort of guarantee of sense or quality in perpetuity. I don’t dispute, and have no reason to dispute, that Noakes has done tremendous work in the past. But that tells us nothing about the present topic, except to make it statistically more probable that he’s worth paying attention to here than many others might be, because of that track record. This doesn’t mean that – once you look at a particular case – you need to grant extra authority to that person if they present weak arguments.

To do so would be to commit the informal fallacy of making (or rather, falling for) an appeal to authority. It’s particularly disappointing when the authority him or herself makes the appeal on their own behalves.

It is sad that this article which should be a celebration of how simple dietary advice may be able to reverse intractable medical conditions in some people (it would have been valuable even if it had reported just a single “cure”) has been used by some to argue what a dreadful scientist I am, who is trying to push some sort of devious agenda that has no scientific basis.

It’s arguably more sad when eminent scientists start practicing bad science, and then doubly so when they defend it as weakly as this. “This article”, meaning my blog post, is about that topic, not about the diet. Readers, or subjects of a post, don’t get to say what a post “should be” about. Furthermore, nobody is being described as being “devious”, or having an “agenda”. Someone is being described as making poor arguments for a conclusion.

My agenda is clear. I want my profession to teach more than one option for the management of obesity/diabetes/metabolic syndrome and to understand that our current dietary advice is in my opinion the cause of so much of our ill-health.

My agenda is also clear. I teach critical thinking, and the Noakes paper, and his responses to criticisms of it (and, general criticisms on social media) provide great classroom examples of how reputations are no guarantee of good sense.

I have spent 3 years researching this topic and am happy that the scientific evidence supporting this position is as powerful as any evidence I have touted in the past (see Challenging Beliefs). However the topic is much more important that anything I have ever tackled since it is the single most important medical problem in the world and is currently out of control and getting worse by the day.

Agreed entirely, which is why I want the science supporting it to be beyond reproach, especially on such obvious grounds.

What this paper shows it that there may be simple answers for what seem to be intractable conditions. That is why the final sentence of the article calls for a properly funded and designed study to test the hypothesis (not proof) advanced by the finding of this Occasional Survey.

As argued above, the occasional survey doesn’t present a case for doing so, because of the quality of the data. Furthermore, we are told by Noakes that non-anecdotal evidence exists – and if this is the case, the anecdotes are superfluous. This was the topic of my last post, so I won’t repeat the argument here.

I would be only too happy if that trial disproves me. But if it shows that a carbohydrate-restricted diet can reverse intractable obesity and some cases of Type 2 diabetes, then we will have shown that the causes of the obesity and diabetes epidemics are much simpler than we believe and that we might be able to do something to protect our future generations from these diseases. Of course, it there is a conspiracy, then it will do all it can to insure that we do not ever make that finding.

Agreed entirely. And of course a scientist should be happy to be corrected (even if it’s sometimes difficult to swallow).

Perhaps we can move the debate forward by focusing on what this paper actually found and how that might be of value in trying to understand what is causing the obesity and diabetes epidemics globally. Then we will be making a positive contribution to the future health of the world.

No, there are different debates. Noakes, and his peers, can move that debate forward. My focus is critical thinking, logical fallacies, the standard of education and so forth. That’s the debate I’m going to “move forward”, and these sorts of examples are great resources for doing so. In fact, they allow for us to make a positive contribution to the current – and future – health of the world too, by helping to inculcate and reinforce clear and cogent reasoning, without which medical science is doomed.

Thanks for the opportunity to express myself more fully and I look forward to your contribution to that agenda should you think it sufficiently important.

It’s vital. But also, that agenda is not my field. This one is.

Lessons in bad science – Tim Noakes and the SAMJ

As I’ve said before, Professor Tim Noakes might well be right in his advocacy for a low carb, high fat diet. Whether he is right or wrong is however – to some extent, at least – a separate issue from whether he’s providing an example of sound scientific reasoning in reaching the conclusions he does.

It’s understandable that people outside of science, academia, or any overtly evidence-based work might confuse personal experience, anecdotes and badly drawn samples for good evidence. However, the principles of scientific reasoning (even as taught to first-year students, as I’ve done for years), remind us of these and other common errors. Once you know about confirmation bias, you shouldn’t flaunt the fact that you deploy it, but rather regret that you (like everyone) are prone to quite typical errors.

As a practitioner of evidence-based something-or-other, you’d know and understand counter-intuitive things, for example that a conclusion can sometimes be the correct one, regardless of how poor the argument for that conclusion is. And, that a good argument can sometimes result in a false conclusion.

Most important, perhaps, is that you’d know of the various resources we have for making it more likely that we reach the correct conclusion, and you’d know of the sorts of errors to avoid because they tend to lead us to false conclusions. And given that you care most of all for getting closer to the truth of the matter, you’d be aware of your responsibilities to set an example to others of sound reasoning about science – especially if you are perceived to be an authority figure.

When a scientist like Noakes seems willing to ignore most of these principles in favour of promoting a conclusion – through whatever support comes along – he doesn’t sound passionate, committed, maverick and so forth. He sounds like a quack (and sometimes, even a conspiracy theorist, at least when citing some of the reasons why his “obvious” (to him) truths are somehow not adopted by everyone). To Noakes, all research that disagrees with him is “industry-funded” or otherwise tainted, but never treated as counter-evidence.

Among those that Noakes has quoted in support of either his view or his approach to science are the evolution-denier and proponent of scientific racism that is Louis Agassiz, and the anti-vaccine Weston Price Foundation. He’ll tweet links to pieces arguing that carbohydrates might have played a role in the Newtown shootings. And when challenged on whether his approach is sound, he says things like this:

Worst of all, he doesn’t seem to really understand what the stakes are, even as he speaks of a decades-old diet lie that is apparently killing us all. He’s embraced the false dichotomy that we have a choice between the “orthodox” dietary advice (that is harming us) and his model (that will make us thin, cure diabetes and so forth). On his model, choosing option B (his model) has no risks, even though we have no long-term data regarding the possible harmful consequences of a high-fat diet.

This doesn’t mean people won’t be persuaded by Noakes. They will be and are being persuaded in their droves, thanks partly to positive short-term results on the diet, and also to some very engaged PR on Twitter, radio, magazines and television. But they’re also being persuaded because – like most people – they are prone to overstating the value of anecdotes in supporting a conclusion.

The fact that they are persuaded is not, however, further evidence for your conclusion.

Yet, according to Noakes, perhaps it is. And sadly, South Africa’s flagship medical journal, the SAMJ, has published a Noakes paper that is a textbook example of bad science in this and other ways. Somehow, this paper got through peer-review, but I can pretty much guarantee you that if we did a Sokal-type experiment, submitting this under fictitious names, it would never get published. It’s solely on the basis of the authority of the “name” of an acclaimed scientist that it was published as a study, rather than on the letters pages or somewhere less notable.

Here’s the 140-character summary of why this shouldn’t have been published as a study, or made it through peer review:

Basically, the “study” is confirmation bias run amok. If I were a UFO conspiracy theorist, and led a society dedicated to discussing our abduction experiences, the letters I might receive from prospective members might appear to me to be further evidence that UFOs exist. But I’d be wrong. They’re not, because my letter-writing audience are self-selected (we can predict, in advance, that they are likely to share my conclusion) and unreliable (they are offering anecdotes, and we have no idea how reliable their testimony is).

People who try the “Noakes diet” to no effect will not write letters to him saying so. And as for those who do write, we have no knowledge (or control) over any other factors relevant to their weight-loss experiences. It’s plausible that someone trying a new diet will, for example, also be motivated to exercise more – but we can’t control for that.

In response to these and other criticisms on Twitter, Noakes asked his critics why we were focusing on the anecdotes, rather than the controlled trials that agreed with the anecdotes. But this again misses the point – one wouldn’t need the anecdotes to make the case if the data did so already. To include the anecdotes means that you see them as adding some value, and you shouldn’t do so.

It’s not everyone else’s job to defeat your anecdotal evidence (that should never even be presented). It’s your job to gather non-anecdotal evidence. And if you don’t have that as yet, it’s not someone else’s responsibility to get it for you, as in comments like

(This, because of another elementary principle of scientific reasoning, namely the burden of proof.)

To wrap this up: I agree that a trial is needed. But there’s a different issue at stake also, and this is that Noakes is encouraging incompetent and pseudoscientific thinking on matters of science, and encouraging a cultish adherence to a model that hasn’t yet been scrutinised in full, and for which we have no long-term data. This is irresponsible, and an abrogation of his responsibility as a scientist and an educator.

But these are no doubt all irrelevances to Noakes, even perhaps evidence of bias or conspiracy. After all, at the end of the day, the ultimate evidence is remarkably elegant: the thinnest person in the argument wins, and obese people can’t be right.

P.S. Prof Noakes has left a substantial comment below. Unfortunately, it does his cause absolutely no good, as I explain in this follow-up post.

We “orgone” to die. No matter what the quacks say.

mq1The message at The Amaz!ng Meeting (or, TAM) earlier this year was “Fight the Fakers”, with the point being that it’s no much use ridiculing the victims of quackery or woo-woo for being taken in by charlatans. Sometimes, we’re desperate for a cure, or for hope, and this leads us to believe things we might not otherwise.

Also, some quacks and fakers genuinely believe that they have magical powers, or that they have cottoned on to some sort of secret. For example, even though I haven’t been shy of expressing my view that Professor Tim Noakes sounds increasingly like a pseudoscientist, I have no doubt that he’s sincere in believing what he tells his disciples, whether or not he ends up being right or wrong.

Of course there are difficult boundary cases, where we really should know better, and can’t escape taking on a healthy portion of the blame either for misleading others, or allowing ourselves to be misled. The distinction I’m making, though, highlights that there is more that is blameworthy about your conduct if you know you’re deceiving people, or if you’re knowingly on the side of deceivers.

An example of the latter – being on the side of the deceivers, and against common-sense, or science – has recently come to my attention via 6000, and involves a TEDx organising committee ignoring the lessons learnt in the Sheldrake affair. In case you’re not familiar with Sheldrake, he’s a fairly controversial scientist who wants you to to believe in “email telepathy” (never mind the humdrum sort of telepathy in dogs and other non-human animals) in addition to various other odd things.

Sheldrake (and Graham Hancock, he who believes the Ark of the Covenant is real, and that aliens built the pyramids) spoke at TEDx events, but  both of their talks were removed from the TEDx archives following widespread protest regarding TEDx being used as a vehicle to promote pseudoscience. These episodes led to a joint TED (the mother-ship) and TEDx policy reminder that pseudoscience was not welcome at these events.

So why, then, is Ivan Jakobović, inventor of the water-powered car and the “orgonic launcher” (which – as you no doubt know already – fires the universal life force “orgon” into the air, to strip pollution from the atmosphere), speaking at TEDxMaksimir today? And furthermore, why is it that Željko Svedic has been banned from today’s TEDx event for pointing out that Jakobović is a crank, and that TEDx events are not supposed to host cranks?

You can read all about it on Svedic’s blog, including what he recalls of the abusive phone call he received from the TEDxMaksimir folk, before they deleted his comments from their Facebook page, refunded his registration fee, and posted the following announcement:

Mr Zeljko just got a phone call he will be refunded entrance fee.. ..We need to protect speaker reputation.. ..Ivan Jakobović will speak about his rich experience as an inventor.. ..one of the inventions Mr Zeljko is criticizing (ozonic exhaust) was already presented by Ivan on our first TEDx event in 2010.. ..that invention was sold and is successfully produced in Canada.. ..Thank you Mr Ivan Jakobović for sharing your rich experience with us and for honoring us again.. Karlo Matić, TEDxMaksimir license holder

There are numerous fantastic talks on both TED and TEDx. But by contrast to when TED began, and you could normally expect a fairly high level of quality (and, sanity) in the presentations, it now seems to be more and more of a lottery. The TED – and especially the TEDx – brand no longer offers any guarantee of the content being worth watching, and judging from this episode, some licence-holders of TEDx events don’t seem at all concerned about upholding the standards they’re supposed to.

It’s about time that TED either enforce those standards more rigorously, or instead shuck off the TEDx brand entirely. The latter seems to make more sense, seeing as there seems to be a TEDx on every street corner these days, never mind in every big city – making it an impossible undertaking to ensure quality is maintained. But until something changes, I’ll keep ignoring TEDx entirely, except for when it’s someone I know on the programme.

“World-views” and secular education

imagesFourth-year medical students at a local university were yesterday witness to a panel discussion on various world-views, with the intention of familiarising them with some of the different points of view that their patients might one day hold. I was invited to participate in this panel, which I gladly did, seeing as these sorts of public interventions are one of the values we can easily, and cheaply, give to “the cause”, as it were.

Joining me on the panel were an Imam, an Anglican priest, a Hindu doctor and the daughter of an African traditional healer (who was also a student in the class). The point of the panel wasn’t to debate who was right and who was wrong, but more to sensitise the students to the differences, and to prompt them to how they might approach sensitive topics of conversation with these various sorts of world-views.

It was an interesting experience, partly because it again brought to the fore just how normal, and just how abnormal, a largely materialist, or naturalist, point of view was – even in a room of about 200 people trained in the scientific method. The student who arranged to have me invited to participate reported that around 70% of his classmates were religious, and after yesterday, I fear that might be an under-estimate. One horror-story he told me is of a group of students training in psychiatry who decided to pray over someone that was clearly experiencing some sort of mental episode, rather than getting her to somewhere she could be diagnosed and treated.

But it’s not only the uncommonness of a naturalistic outlook that struck me – it’s also how alien it seemed to be to the audience. The tenor of some of the questions seemed to regard me as some sort of curiosity, or exhibit – a rare creature from a strange and distant land. Over and over, for example, I had to repeat the point that they should think of me as representing the “secular” world view, because religious folk can be secular too. Secular doesn’t mean lacking in belief, it means leaving your (metaphysical) beliefs at home when you go to work, especially in the public sector.

Then, the usual questions also came up: how can love just be in the brain (well, it is, but that doesn’t make it any less special); where do you get your morals from (the same place as you, the same place as the apes, etc.); what is your purpose in life (that question loads the dice – I reject the need for an “ultimate” purpose).

So, when I sat at the end of the panel to talk to the local atheist and agnostic society about how to grow their society and build capacity, I stressed something they could do, that I fear many smaller, community-based groups forget: education. Take your core membership, and have them learn about the history of skepticism/secularism/humanism/etc. – and not simply learn to recite cutting lines from Hitchens, or the names of a bunch of logical fallacies.

We need people to go out there are dispell myths and misconceptions, and that requires the knowledge to do so. If you’ve got some of it, and also have access to a younger group of people wanting to promote the secular, scientific, humanist world view, help them to learn how to educate others about what we believe and don’t, but more importantly, why we believe and disbelieve. Even when you don’t persuade, the conversations will nevertheless be far more interesting as a result.

Censors, sex and the age of consent

imagesSouth African readers have most likely heard that Jahmil X.T. Qubeka’s “Of Good Report” could not be screened at the Durban International Film Festival, after the Film & Publication Board’s (FPB) refusal to classify it. Not giving the film an age-restriction means that the FPB has made it a criminal offence to show or watch the film, so a refusal to classify has the same effect as a ban. Their stated reason for this is that they believe the film to contain child pornography, in that it contains a scene of a woman receiving oral sex, closely followed by that woman being revealed as a 16 year-old schoolgirl.

I mentioned on Twitter that it was odd for us to have 16 as the legal age of consent, while sex acts could not be recorded or screened unless the participants were both 18. There are no doubt a lot of criminal 16 and 17 year-olds out there, thanks to the ubiquity of cellphone cameras and sexting. And this commend led to a rather fruitless exchange of views with the cartoonist Jerm (or, Jeremy Nell), on the appropriateness of age restrictions. You can read more about the movie ‘banning’ on Daily Maverick or Africa is a country. The rest of this post will focus on the general issue of age restrictions.

https://twitter.com/mynameisjerm/status/359230229773955072

In response to the Tweet posted above, I agreed that any particular age of consent was arbitrary, just as age limits on driving or drinking are, but said that there was no efficient and also principled way to do it without imposing an arbitrary age. In a future world where we can track capacity for factors like reason and consent in real-time, we’d perhaps not need these arbitrary limits, and particularly co-ordinated, willing and fearless 13 year-olds could get emancipated and go fight wars if they like.

But in the meanwhile, we need to work on expected or probable capacity to perform the function in question, whether it be drinking, driving, voting or consenting to sex. And yes, while it’s true that sex used to be legal at an earlier age (as Jerm points out), it’s partly because of predation that it was increased. An age of consent makes it easier to prosecute sex offenders, on the assumption that in general, people either aren’t consenting, or aren’t sure what they are consenting to (so, not consenting) below the age stipulated.

https://twitter.com/mynameisjerm/status/359231394045624320

While we can get these various ages wrong, and various jurisdictions disagree on where to set them (or so do inconsistently), I can’t see any merit in the suggestion that this should be a family matter, rather than a state matter. In fact, I find the suggestion even less principled than a state-imposed limit, because we have no reason to trust the family’s entirely subjective judgement in these matters more than we should trust the aggregate gaze that a state could apply.

https://twitter.com/mynameisjerm/status/359231995563765760

As I said above, the precise age is always going to be arbitrary, because there is no age that guarantees “full” maturity or competence. What we’re aiming for is “adequate” maturity or competence, such that we limit as little freedom as possible while protecting the largest proportion of various vulnerable populations that we can. And here’s the thing: it is possible to triangulate on the appropriate age in general, even if individuals might not fit the norm. But as I’ve previously argued, the exceptional cases should not be the basis for policy:

laws or insurance premiums can’t be tailored to individuals. As much as we are individuals to ourselves, interventions intended to work on aggregate have to treat us as belonging to a category – and the question then becomes how those categories are defined. And here, we need to start thinking about the least wrong way of doing this, and perhaps being more willing to tolerate principled ways of treating us simply as a number.

If we can find the approximately appropriate age, then we know that we’d be making fewer mistakes (in terms of restricting freedom) the closer someone is to that age, and doing more good (in terms of protecting more people from harm) the further away (younger) someone is from that age. Jerm seems to think that the law shouldn’t be about morality at all, though,

https://twitter.com/mynameisjerm/status/359234687882887168

which seems rather odd, seeing as we couldn’t have any laws against theft or torture if that were the case. But let’s assume he’s talking about only sexual morality – even then, I’d not be comfortable with the absence of a legal prohibition against incest with toddlers. The point is that laws shouldn’t impose arbitrary morality – that I agree with. Again, if we know that in general, consent is likely to be absent, we’re taking pragmatic steps to protect people from harm rather than imposing a moral standard when we say that it’s illegal to have sex with a 15 year-old.

So while we can debate what an appropriate age is, I don’t see room for discarding the concept of establishing and maintaining a guideline. And, as for how to set these guidelines in the least arbitrary way possible, we do have relevant knowledge. It would be a simple matter to track road accidents, for example, and do some analysis of factors like the age of drivers, and their levels of intoxication. (One might even suggest that insurance companies have cottoned on to these arcana.)

If it turns out that 16 year-old drivers look to be as safe as 20 year-old drivers, we know that we should either a) let 16 year-olds apply for licensing or b) not let 20 year-olds do so. And if a blood alcohol level of X gives you the same risk profile as a level of 0, we know that X is safe, etc. The fact that states might take shortcuts in figuring this stuff out and making the laws doesn’t mean there aren’t sound principles by which to do so, if we had the time and desire to.

Then, more generally – we know that it’s only at age 25 or so (for men) and 23 or so (for women) that the prefrontal cortex (PFC) reaches maturity. The PFC is the last part of the brain to develop, and (unfortunately for parents) is the part of the brain that governs impulse control, risk-seeking/aversion, and that encourages hyperbolic discounting (in short, we need a developed PFC to balance short-term rewards against long term goals). Putting that together, what we have is a brain that conduces to driving too fast, on too many drugs or too much booze, to get to a place where you’ll enjoy lots of sex with too many strangers and too few condoms.

In other words, it wouldn’t be at all arbitrary to say that 24 (to pick the mid-point) would be an efficient and justified way to limit all sorts of activities. But asking people to wait a third of their lives before driving or having a drink seems excessive, so we pick a younger age (exactly how young can vary, depending on the severity of risk in question) where most people are likely to be competent, even if some mistakes will be made. It’s a question of pragmatism, not of morality.