Don’t contaminate your water with water

imagesAs is so often the case, seriously-intentioned pieces of writing – if written by quacks – can be rather funny. And so it is with a report on a recent homeopathy conference in Barcelona, which I was alerted to by Andy Lewis (who is responsible for the excellent Quackometer website). If you read the report, you’ll discover that homeopathy is even more powerful than you might currently believe. For example:

physical contact with a remedy may not be required to feel its affects. So presumably, individuals in a placebo or control group could still be affected by the action of a remedy.

Translation: homeopathy is unfalsifiable, and we don’t care. In fact, it’s a virtue.

Dr. Gustavo Bracho, an immunologist from Cuba, … discovered completely by accident,that if he stored water (for his control / placebo group) next to a homeopathic dilution of the extract, the water would take on the same properties as the remedy.

Translation: one sample of water, with no detectable traces of the homeopathic “remedy”, tested as having the same properties as another sample of water with no detectable traces of the homeopathic “remedy”.

But on his reasoning,

if a remedy is already imprinted, it cannot be affected by another. So word of warning to homeopaths, and homeopathic aficionados out there – make sure you keep your blank pellets and water far away from your remedies.

Because imagine the panic that might set in if you’re racing against the clock to cure someone’s dread disease, and all of the water you thought was “blank” had brushed against the glass containing water intended to banish faeries (or something. I’m not quite sure how this is supposed to work.)

Minds are what brains do

Originally published in the Daily Maverick

brainzAt the time when I was most uncharitable towards psychology, it struck me as obviously absurd that we’d devote centuries of scholarship towards treating something grounded in fiction. Our devotion wasn’t limited to time spent in study, but also included resources such as the time and money of those who sought out and were treated by what seemed little more than modern equivalents of physicians curing anything and everything via bloodletting with leeches.

The fiction I refer to is the idea that there’s anything to treat besides the brain. A related fiction would then be that there was any room for academics, clinicians, couches and so forth, all dedicated to addressing exhaust fumes of neurological processes – the perceived “mind” rather than the brain. In short, I argued that while the mind might want conversation, the brain would benefit most from medication.

While I’m still fully committed to the stance best captured in Minksy’s phrase “minds are what brains do”, my lack of charity was nevertheless misguided and simple-minded. Even if the best way of treating most things might one day be a pill, that doesn’t mean that there’s never any value in stopgap approaches, nor that there aren’t a variety of things that are best treated through other means.

The concern, though, was that psychology begins with an essentially dualist philosophy of mind, where there is a body and also a mind – rather than “simply” a body that includes a brain, which somehow produces minded-ness. The dualist assumption leads to research and treatment premised in treating something that doesn’t exist – or so I smugly asserted.

Leaving aside the sort of over-reaching I describe above, though, it remains true that knowing what sort of an entity you’re attempting to treat (is it merely a worried human being, or it is a human being with a neurological disorder?), and then accurately diagnosing its ailment, are essential to being able to provide relief or a cure.

Doing either of those things is difficult. But that can’t excuse us from the reality that we might sometimes get one – or both – of the identification and then the diagnosis horribly wrong, simply because we’re relying on an out-dated model of what the organism is, or of what might be wrong with it.

The same problem occurs in psychiatry. One of those books that I (for a time) tried to persuade everyone to read is Dominic Murphy’s “Psychiatry in the scientific image” (2006), in which he argued for a scientific (rather than medical) approach to understanding mental illness, much like the research program we’ve seen blossom in the cognitive neurosciences over the last 5 or so years.

Murphy argued that our concepts and language for describing mental illness depend far too much on observed symptoms, and are frequently also historical artefacts that have not been revised in light of more recent knowledge. A scientific approach would look for causal explanations, sometimes involving neuroscience at the molecular level, sometimes genes or biochemisty (to mention only a few possibilities).

He’s wary of reducing explanations to the lowest, or fully reductionist, level. In Murphy’s view, what we’re aiming for is a level of “robustness”, where an explanation accounts for a disorder across a variety of contexts, and eliminates much of the subjectivity involved in assessing disorders through interpreting symptoms.

In his concluding chapters, Murphy applies these ideas in criticising the Diagnostic and Statistical Manual of Mental Disorders, or DSM, which at the time stood at revision IV. The DSM, put simply, is the authority when it comes to mental disorders. If it’s in the DSM, it’s real, and if it’s not, your chances of claiming from medical aid immediately plummet to vanishingly small.

While a disorder being “real” means that it can now be diagnosed, it remains debatable whether some disorders are in fact “real” in the typical sense of the word – in other words something like fidgeting versus ADHD. While the latter is probably real, it’s also a useful catchall for describing the average child, who might not have been diagnosed with anything more worrisome than “causes annoyance to adults” in the years before we developed medication for ADHD.

The DSM V, due to be released later this month, has attracted significant criticism for both what it has removed (things that are no longer real, in the diagnostic sense) as well as what is now considered disordered, and therefore suddenly real. The class of “behavioural addictions”, for example, has been accused of making a “mental disorder of everything we like to do a lot”.

In arguing that the DSM should classify based on causal explanations, Murphy was fully aware that a causal taxonomy of various disorders would be very difficult to develop, but he nevertheless thought that the work should start, because some progress was possible even in the absence of all the relevant data.

That progress would most likely include – even at this relatively early stage of knowledge in fields like neuroscience – not listing first-time drug users alongside addicts (as the DSM V is apparently set to do), because the explanation for dabbling with a drug will quite often not be the same as the explanation for why someone becomes addicted to that drug.

It’s therefore pleasing to be able to report that progress towards a scientific psychiatry has recently taken a sharp upwards turn, with the National Institutes of Mental Health (NIMH) announcement in April that they will no longer be conducting research in accordance with the DSM V categories.

Instead, they have launched a 10-year Research Domain Criteria project “to transform diagnosis by incorporating genetics, imaging, cognitive science, and other levels of information to lay the foundation for a new classification system”, where that system will be based “on the emerging research data, not on the current symptom-based categories”.

This decision is sure to attract criticism, but we should save the strongest criticism for fields of research, scientists and medical professionals that have access to new data, but choose to ignore or downplay that data in favour of avoiding revolution. As the NIMH statement concludes: “At the end of the 19th century, it was logical to use a simple diagnostic approach that offered reasonable prognostic validity. At the beginning of the 21st century, we must set our sights higher”.

Since writing this, I’ve been alerted to Gary Greenberg’s blog which discusses this and related issues, and is well-worth spending some time exploring.

Cansa indulges the quacks (and students indulge the homeopaths)

So, as mentioned in a Daily Maverick column, I was recently asked to grant a student an extension on an assignment deadline. Her request was accompanied by the “medical certificate” below:

sicknote

Yes, that is from a naturopath, who also advertises skills related to iridology (your eyes, the iris in particular, being a reliable source of information about your health), herbal tinctures, and homeopathy. And in what you’d hope is a joke, but isn’t, the course in question is explicitly about evidence-based decision-making. Worse still – during the week this particular assignment was due, the lecture topic was pseudoscience, with explicit reference to homeopathy.

A reader encouraged me to submit a complaint to the Registrar of the Allied Health Professions Council, which I’ve done as per the text below:

I would like to formally bring a matter to your attention, as Registrar of the Allied Health Professions Council. The attached note, bearing the letterhead of Renata Zijp (Reg A9803; Prac 0805564) was submitted in support of a student’s application to be granted an extension on an assignment in my course at the University of Cape Town.

While I realise that it’s not within your purview to completely eliminate pseudoscientific professions such as homeopathy, I would hope that legislation and common sense both argue against practitioners in these fields issuing certificates such as the one attached.

The certificate makes no mention of the ailment that was diagnosed, nor does it offer any information as to when the student would be fit to return to her studies. In other words, as a piece of testimony as to the medical condition of the student, it is useless for two reasons: the fact that Zijp is a practitioner of professions of dubious value; and even within those professions, has offered testimony that is useless and even misleading.

It is misleading because, in using the imprimatur of science, a less attentive or more gullible member of the academic community might accept such a certificate as a legitimate reason to grant the student an extension. It is not, and presenting certificates such as these is an insult to those who suffer from genuine ailments, and to the professionals who treat them.

Finally, even though the AHPC must of course concern itself with matters directly related to the professions in question, we arguably all have a responsibility to hold other citizens to account for the contributions played in promoting reason and rationality, or the converse of those. Students (ironically, in this case students in a course teaching evidence-based decision-making) should not be given the impression that these sorts of certificates have any merit, and practitioners should be dissuaded – if not barred – from issuing them.

If you encounter any similar instances, you can get in touch with the Registrar of the Allied Health Professions Council, Dr Louis Mullinder, at registrar@ahpcsa.co.za to officially lodge a complaint.

Incidentally, my complaint might bear some fruit, seeing as I’m reliably informed that the practitioner in question “is registered as a naturopath, but not as a homoeopath. It is a breach of the Regulations to the Act to give the impression that she is registered as a homoeopath. I expect that the Registrar will deal with it harshly – quite apart from the highly problematic wording of the actual certificate.”

While on the subject of quackery: CANSA, the country’s main cancer advocacy organisation, is promoting and marketing an untested supplement. Prof. Roy Jobson of Rhodes University pharmacology dept criticised them, and they responded with a lawyer’s letter threatening to sue.

Can frankensalmon triumph over uninformed ad-hoc opinions?

Originally published in the Daily Maverick

tumblr_lys10lmgnS1qdm7sdo1_500Consumers have a history of caution in adopting technological innovations in food. Pasteurised milk took years to gain acceptance, and words like “Frankenfood” are used to describe food that is produced in a lab. But what starts out frightening can rapidly become commonplace. Nearly two decades ago, genetically modified soy beans were Frankenfood, and today they account for 85% of soy bean production in the US.

Labels like “Frankenfood” are emotive, and imply that a wrong has been committed. Unfortunately, the debate often ends here, as moral claims – no matter how un-articulated – are frequently treated as privileged or even as trump-cards, in that if you find something morally objectionable, your objection is typically afforded respect regardless of its merit.

So it is with Frankensalmon, or to give this delectable fish its proper name, AquAdvantage salmon, fresh from the labs of AquaBounty Technologies, Inc. A combination of Atlantic Salmon, Chinook, and Ocean Eel Pout. The Chinook salmon provides a growth hormone gene, while the Ocean Eel Pout contributes an antifreeze protein gene. What we end up with is a salmon that reaches market age twice as fast as the one you’d normally find on your plate.

What we also end up with, at least according to some commenters on the FDA’s website, is either something that will make you fat directly (“Pls don’t allow ge salmon. Please. Usa is obese enough”, says Vera) or play a part in destroying regular salmon, a food which apparently keeps you thin. According to Sandra, that is, who says “I am finally finding out why i have had a problem with my weight and health for the last few decades. Now you are prepared to take one of the healthiest foods away”.

Comments also include the predictable lamentations regarding Monsanto (who have nothing to do with AquAdvantage), big pharma, government and assorted other (also big, I imagine) villains. Mostly, though, it’s sheer hysteria and the occasional attempt at something that looks like a threat (“my family will never buy this!”) – albeit not a threat you’d imagine at all efficacious.

“It’s not nice to fool mother nature”, and “we need to stick with the basics and consume food in the form in which it has been consumed by human beings for millions of years” is the common sentiment, repeated over 24 pages with various degrees of anger. But as I noted in a previous column on doping in sport, the appeal to nature is often nothing but simple prejudice dressed up as argument.

There are arguments that could be had here, and evidence that would be relevant to whether this GM salmon should be approved or not. One concern would be whether these fish would be reproductively superior to traditional salmon, threatening their existence in the long run.

Even though AquaBounty claim that they are bred to be sterile, a Change.org petition reports that 5% of them are in fact fertile. Other issues are raised in the petition, such as the fish causing increased allergic reactions, and apparently also (at one production site) having been “infected with a new strain of infectious Salmon Anaemia, a deadly fish flu which has been devastating fish stocks around the world”.

It’s that sort of language – on the petition and on the FDA site – that should give cause for decreased concern, rather than the escalated hysteria that hysteria tends to breed. Salmon anaemia has been observed since 1984 – before this fish existed – and also seems to be something that salmon are prone to, whether or not they are GM. And seeing as viruses mutate, speaking of salmon being “infected with a new strain” can only result in readers imagining Dr. Strangelove cackling as he plots to hand Karl Rove the keys to the world.

It’s difficult to find examples of scientists, rather than frightened laypeople or environmental activists, urging caution about this fish. It might certainly be unsafe, but if it’s evidence and argument that should inform choices like these, we’ve got very little, if any, reason to be concerned.

What I’m more concerned about is the increasing trend of mistaking the popular voice for an opinion worth taking seriously. Christopher Hitchens coined a wonderful phrase in referring to conspiracy theories, dubbing them “exhaust fumes of democracy”, and one could say something similar about calls for public participation, like this one from the FDA (closing on February 25, if you want to get a rant in).

A checkbox which asks something like “is there any particular reason to take your viewpoint seriously” should perhaps be added to any such website, poll or evaluation, with an upload facility for your credentials. As Mitchell and Webb put it, a frequent response to the feedback we get could be something like “thank you for sharing with us the full majesty of your uninformed ad-hoc reckon”.

In summary, the problem seems to be that the democratising of, well, just about everything has resulted in too many of us thinking we have something worthwhile to say on anything, where sometimes, the most valuable contribution we could make might be our silence.

Let them have EPO!

Originally published in the Daily Maverick. Sports scientist Ross Tucker and I had a brief debate/exchange of views on this topic on CapeTalk567 on the day of publication, and you can listen to that here.

120824060051-lance-armstrong-2-single-image-cut

Lance Armstrong certainly lied, and by most people’s standards, acted unethically in doing so. We’ll also find broad agreement that it was an moral failing for him to retaliate against whistle-blowers, attempting to destroy credibility and careers in an effort to keep his multiple deceptions a secret.

It is likewise true that he broke the rules in taking performance-enhancing substances, and in that sense deserves whatever punishment is laid down for those rule-violations. But the rules in question are inconsistent or even incoherent, and Armstrong’s fall from grace will hopefully lead to their revision.

The problem is this: for those of us who can only admire sporting prowess from afar rather than exhibit it ourselves, the narrative of purity is a compelling one. There we see a beautifully sculpted physique, capable of feats we can only imagine, that has been nurtured and honed in order to perform those feats. Or sometimes, someone more ordinary has perfected a skill through years of dedicated effort.

In both cases, though, we can imagine the sacrifices and dedication – the purity of purpose, and the fact that they achieved these goals through natural ability, exploiting the gifts bestowed on them by nature.

The immediate problem with this, though, is that it’s a complete fabrication. Some of us will always be advantaged in some respect and others disadvantaged, and anyone’s “natural” state will already include those asymmetries. You could fill a library with books on the philosophical concept of “moral luck”, Bernard Williams’ phrase for the inconsistent ways in which we attribute praise and blame for things that might or might not be in the agent’s control.

It’s not only that you might be born into a family that has the material means to buy you a bicycle or some running shoes, or send you to training camps. Your natural advantages might rest in the fact that you grew up at high altitude, or near a beach so that you built strength by running in the sand. For every Mfuneko Ngam, whose international cricket career was (arguably) curtailed by the dietary deficiencies he experienced growing up, and which later led to frequent injuries, you could point to someone whose body developed to be stronger or faster thanks to environmental factors.

And what are performance-enhancing drugs but simply one more factor like these, available to some and not to others by virtue of nothing more than simple luck? Once we discard the illusion of the Athenian athlete, running naked save for a loincloth (perhaps alongside Bambi), it should become clear that drawing the line at drugs is as arbitrary as drawing it at any other point, and that the issue of whether or not someone broke the rules is an entirely separate one to whether the rules are sensible.

In the case of professional sport and drugs, the line-drawing currently seems to rest on a version of the naturalistic fallacy, namely the mistake of thinking that natural is good and unnatural bad. In morality, people (mistakenly) use this fallacy against homosexuality, and in medicine perhaps in support of homeopathy instead of chemotherapy (if you’ll forgive that very loose usage of the word “medicine”).

But these examples are cherry-picked, and easily refuted by pointing to cancer (natural) or the wearing of spectacles (unnatural, in that the nose and ears were not evolved for the purpose of supporting spectacles). So our moral judgements – including our attributions of praise and blame – should not rest on a conception of the natural.

What about fairness? If we are to allow drugs in professional sport, some argue, then it will be doctors who win races, rather than athletes. As I point out above, though, this is already the case – not only for doctors, who might prescribe better drugs to some of us than others while growing up, leading to healthier starts to life, but also to parents who have unequal means to support us. It’s already parents who win races, not athletes, so why not let doctors also win a few medals?

Yes, there will be some who can exploit the chemical resources better than others can, but we need a good reason to treat this sort of resource differently to any other. Currently, our reason seems to be an interpretation of the “spirit” of sport that allows for the manipulation of all sorts of parameters (diet, lifestyle, training regimen) excepting one, namely your drug intake.

Even this exception is applied inconsistently, in that it seems entirely arbitrary to say that paracetamol is permitted (as it is for Olympic athletes) and another drug not, seeing as a splitting headache would surely impact on performance in something like a game of tennis. These are matters of degree, not of kind, and operate on a spectrum ranging from whether you were breast-fed to whether you take EPO.

I would offer a similar response to those who are concerned about pressures on young athletes, who might do themselves long-term health damage through taking drugs from an early age. Again, this sort of objection doesn’t seem to operate in the real world, where professional athletes already do themselves significant damage through obsessive training at a young age. We need to account for the possibility that taking drugs would allow for fewer, not more, cases of retired 35 year-olds’ with various permanent aches and pains thanks to aptitude for some professional sport.

The drugs will only get better the more we are allowed to take them. They will also get cheaper, and safer, if the user-base is expanded. And just as technologies at the high end of motorsport make our road cards safer, perhaps the non-athlete will also benefit from improved medication at the end of the day.

But first, we need to recognise that professional sport is not pure, and never has been. More importantly, we need to recognise that one sort of corrupting influence might not be as easily distinguishable from another as we might think, or hope. Within the lifetimes of most of us, biological enhancements will most likely be the norm, and it will be even clearer that our obsession with some sort of pastoral narrative in sport is increasingly naïve.

Tiger Woods is allowed to compete after having laser surgery that by some accounts left his eyesight at 20/15, compared to the normal 20/20, which would mean that he could see at 20 feet what a normal person could see at 15 feet. Golf returns to the Olympics in 2016, and I’ve heard nothing suggesting that he (and many others) will be disqualified, even though this would surely advantage him on the golf course.

Thinking ahead: if corrective eye surgery of this sort is permitted, as is the wearing of contact lenses to make your vision 20/15 or even 20/10, as for baseball’s Mark McGwire, what will we do when our poor vision can be corrected through the replacement of the eye with something off a robotics assembly line? Or would we just claim that that’s somehow “different”, and ignore all the ways in which sport is already not the pure contest we imagine it to be?

Read more:

Blood deferrals – too important to take personally

Originally published in the Daily Maverick

14983260-blood-donation-medical-buttonOne of the things that allowed this species to survive into the 21st century is our ability to detect patterns, and to make predictions based on those patterns. If you were a hunter, you’d have needed to be able to predict the movement of the beasts you hunt with some degree of accuracy. If you were a farmer, some rough understanding of seasons would have been rather useful, lest you waste all your seed, your water, and all your effort.

We’re here and it’s 2013, which means that our forebears got these sorts of things right with reasonable regularity. Sufficient numbers of them managed to feed themselves, and avoided walking off the edges of cliffs or getting eaten by carnivores. But all of that pattern-recognition and the accompanying storytelling can be a liability, in that it gets in the way of our realising that we are simply one data point, usually interesting only to ourselves and our immediate circle.

And, it gets in the way of seeing other potential stories. Not just the stories of others (helping us to escape our subjectivities), but also the story the data tells by itself, without our fears, hopes, and histories being allowed to corrupt it.

You know your own examples, but the sorts of corruption I mean would include our thinking that problem gambling is significantly prevalent in South Africa just because Aunt Sally has a problem. It’s not, at least not by international standards. Or, when your cold goes away a couple of days after taking some homeopathic remedy, when your confirmation bias allows you to ignore the fact that a cold typically only lasts for a couple of days in any case.

The storytelling I speak of is not just in ascribing patterns to potentially unconnected events, but also in finding intentionality or causality where none might exist. Intentionality, such as that we imagine when describing a tragedy as part of “God’s plan”, because doing so helps to shield us from the fact that we are meaningless. Causality, of the sort we might think we’ve found when some sort of “lucky” token or behaviour correlates with a random moment of good fortune.

The cognitive rules of thumb (or heuristics) that we use in developing these responses served a purpose in allowing us to get this far, and still serve a purpose today. But we no longer need to be as reliant on them, and are increasingly irrational when we do so, because the volume of data available to us is mostly far better suited to analysis by machines than by humans.

The South African National Blood Service illustrates the problem well, introducing all sorts of moral complications at the same time. As reported in the Cape Argus, a gay couple recently had their blood donation deferred (or rejected), thanks to the SANBS policy of deferring donations from men who have had sex with other men in the last six months.

One narrative that fits this policy is that the SANBS is homophobic, and this narrative has enjoyed strong support on social media for the last few days. But as I wrote in a 2011 column, deferring blood from this category of donor isn’t atypical, and South Africa’s blood service is in fact fairly liberal in this regard. In the UK, the deferral period is one year, while in the US a lifetime restriction applies for men who have had any sexual encounter with another man at any time since 1977.

Now, there’s no principled reason why we should think the US or UK a good guide to policy in this or any other instance. But there’s also no reason to be guided by the perception of discrimination based on moral judgement, where the discrimination might instead be based on cold, impersonal data.

As I note above, this is exactly the problem: we struggle to think of ourselves as mere data points, and instead wish for the world to bend to shape our anecdotal experiences (or anecdata). I have little reason to doubt the statistics reported – across various international jurisdictions – on the Centers for Disease Control website, or the FDA’s reasoning for why they defer blood donations from men who have sex with other men.

The statistics show that this group are “at increased risk for HIV, hepatitis B and certain other infections that can be transmitted by transfusion”. This claim is either true or false, and whether it is true or false is not a matter of morality or preference – just like it’s either true or false that tattoos and body piercings lead to increased risk of hepatitis C (the current motivation for a 6-month deferral period in Canada).

So, we can either contest the claim on empirical grounds, and refute the claim of increased risk from blood donations from men who have sex with other men, or we can claim inconsistency, saying that if this is true, that there is also increased risk from heterosexual couples who have anal sex.

In a recent interview on CapeTalk567, a representative of the SANBS seemed to concede the possibility of this sort of inconsistency, saying that they would be considering this in the upcoming revisions to their donation forms.

But even if this inconsistency is borne out by the data – in other words, if other categories of donor exist whose blood donations are, in general, at least as (or more) dangerous than this category is – this wouldn’t mean that more gay men should donate blood. It would mean that they still shouldn’t, and that neither should some other people. So the complaints to the SANBS regarding discrimination are never likely to bear the fruit that some potential gay donors are hoping it does, unless it’s empirically false that this category of donated blood is more risky.

My use of the word “shouldn’t” (as opposed to couldn’t) in the previous paragraph alludes to an important point. As much as we’d all like to give blood, another aspect of treating ourselves as a data point – at least when thinking about public policy – is that we’ve got very strong reasons for wanting to be able to trust that we could receive donated blood safely. So the issue of which deferrals are legitimate, and which are not, is important enough to merit resolution by careful reflection and analysis, rather than to simply be the subject of this week’s bout of righteous indignation.

Doing Reiki in your sleep

newvoiceOne of the many benefits of believing utter bulls**t is that your claims need to be limited by nothing other than your imagination. I was alerted to a goldmine of quackery today via an Andy Lewis tweet about Siri for homeopaths. Not simply the sort of Siri that can answer questions like “where can I buy 10 000 sugar pills” – a Siri that can actually make “medicine” for you.

It’s true (at least, the fact that someone makes this claim is true). The picture at top-left is is a “voice-programmed remedy maker“, which is a marvel of efficiency and simplicity.

In use, the device is held close to the mouth, a button on the side of the Remedy Maker is pressed in, and you speak the name of a Remedy you want immediately followed by the Potency (if any). The button is then released and a “beep” sound is heard confirming that a remedy has been recorded and stored. Then the device is placed on a table or flat surface and a small bottle of tablets, or even just one or two tablets can be placed in the small 30.3mm ( 1. 3/16″ ) diameter Stainless Steel Well that is fitted in the device. A switch next to the Well is operated and held down for about 3 seconds, and then released, and the device again beeps to confirm that your remedy has been made.

What’s that? You’ve run out of tablets? That’s no problem at all – simply place your finger in that metal well, operate the switch, and marvel as the device transfers “the vibrations directly into the body. This makes the device ideal to use as an emergancy first aid device, for example it could be used to make Apis Mellifica, which is a powerful Bee Sting Treatment, or one could give a dose of Malaria Officinalis, which is considered by many to be useful in Malaria prevention.”

At a bargain price of 395USD, this is Profitus Maximus (seeing as we’re talking sciencey).

The makers have thought of everything. It matters not if you have a thick accent or speak in a strange dialect, because “Words are used to represent a thing or situation. Many different words (even different in language) can be used to represent the same thing.” The device understands abbreviations. If you’re speaking in a loud, crowded environment, no matter – it only listens to your voice.

And you don’t even need to know which “medicine” you need! “The special beauty of this device is that within seconds you can be making vibrational remedies from literally anything you can think of, … even the illness itself. “My Throat problem”, for example, or “The pain in my leg” etc.”

If you feel like some light entertainment, spend a few minutes browsing the site. If you ever wished you could do Reiki while sleeping, or talking on the phone, go find out about the White Mountain Energy Copier, which makes this possible. Worried about the end of the world? There’s info on that, as well as a handy (for Muslims) description of why and how the Kabbah needs fixing.

For skeptics, Randi “and other closed-minded behaviour”, there’s a message for you too, which concludes with:

We don’t feel we need to prove or justify anything, our products work and we have thousands of satisfied customers, many of which are busy using our devices to save lives right now, or using these devices to improve their own wellbeing.

If you are one of the skeptics, all I can say is I am very sorry for you, and I hope one day that you will choose to open your eyes. In the meantime don’t bother to email me with your abusive and childish comments as your emails will not be opened and read.

Then there’s a link to a website called Coping with Disbelief – but the URL currently redirects to a website advertising a “Fiber One” breakfast bars and cereals. Handy, for those who are full of s**t. (This might be intended as a joke on the part of White Mountain, which would certainly offer reassurance that they’re not completely crazy).

By the way, if you don’t know Andy’s site The Quackometer – dedicated to debunking quack medicine, be sure to check it out, especially his detailed work on Steiner-Waldorf racism, mysticism and other reasons for parents to run a mile.

Body Worlds – a collision of materialism with dignity?

Originally published in Daily Maverick

Respect should not be granted unreservedly. Not to people, because they need to be reminded that they aren’t gods. Nor to ideas, because we stand little chance of discovering that we are wrong if we don’t ask questions. It can be impolite and for some, perhaps even offensive to talk ill of the dead. But even so, we’re less likely to cause offence when remembering the misdeeds of a Stalin and more so with a Mandela, because of the difference degrees to which they merit our respect.

South African religiosity in decline? Not likely.

Previously published in the Daily Maverick

Wanting to believe something to be true has no effect on whether it is, or becomes true. We all know this, at least in the abstract (except for Rhonda Byrne and her readers). Nevertheless, in the race to be the first to compress some insight or factoid into a 140 character tweet or a provocative headline, confirmation bias can take over. Instead of suspending judgement until we know all the facts, we sometimes ignore our doubts and regard incomplete, misleading or even false information as persuasive.

Scientific literacy is the biggest loser here, because in the struggle to make sense of things, we forget that our beliefs become better justified through surviving our attempts at falsifying them – not when we confirm them, or think that we’ve done so thanks to unreliable information. A trivial example of this can be found in many of the 330 (at the time of writing) comments to the News24 article describing the results of a recent survey on religious belief.

According to the article, the Win-Gallup International Religiosity and Atheism Index found that the percentage of South African people who consider themselves religious has dropped from 83% in 2005 to 64% in 2012. Now, all the local media houses that covered this simply reproduced the South African Press Association (Sapa) newsfeed, so there isn’t a science journalist or editor that I can call to ask why nobody did any rudimentary fact-checking before reproducing this and other claims.

Because spending merely a couple of minutes on the survey data (pdf) reveals that – by contrast to the claim offered on page six that “in each country a national probability sample of around 1000 men and women” were surveyed, the country-by-country breakdown on page 15 tells us that only 200 South Africans were surveyed.

Assuming that this sample was a representative one, the margin of error now becomes something closer to 7% rather than the 3-5% claimed by Win-Gallup. And if a similarly low number of South Africans were surveyed in 2005 (that data is not publicly available), a pessimistic reading of the data results in a shift from 76% to 73% in the number of people who consider themselves religious.

Alternatively, if the sample was drawn entirely from a certain Province or biased in some other fashion, the results from 200 interviews become virtually meaningless. Unfortunately, although the MD of the Gauteng-based Topline Research Solutions (who are listed as having conducted the survey work in South Africa) responded to my email enquiry, he referred questions regarding the sampling methodology to Gallup’s “Group Head for Opinion Research” – based in Pakistan.

Emails to the other two Topline staffers listed on the Gallup poll bounced with a “user unknown” error – even though one of the two is still listed as being the Sales and Marketing Manager on their website. Make of this what you will, but I can’t say that I’m left feeling confident that the South African sample exists at all, never mind being representative.

There are other reasons to immediately be suspicious of this data. The 2001 census counted 79.77% of South Africans as being Christian, never mind the more general “religious”. The 2011 census data won’t provide any update on this percentage, seeing as the question on religion was dropped, but a drop from 84% (all except the non-religious and “undetermined” in the 2001 census) to 64% seems highly implausible, judging by the frequency with which religious sentiments are uttered and endorsed in popular discussion.

Implausible doesn’t mean untrue, of course – it might well be that the numbers have shifted as described in the survey. But if they have, South Africa would be less religious than the United Kingdom is, at least according to their 2011 census which had the non-religious accounting for 33% of their population. And if you believe that we’re more godless than the UK, your name is probably Errol Naidoo.

Then, the language of the (single) question in the Win-Gallup poll doesn’t allow for quality data. Respondents were asked the following question: “Irrespective of whether you attend a place of worship or not, would you say you are a religious person, not a religious person or a convinced atheist?”

“Religious person” is somewhat ambiguous, as it could imply something formal, whether or not the responded attends a place of worship. If I were one of those New Ager-types who thought I had a personal relationship with something ineffable, whether god or angel, I might say that I’m not religious, while any sane onlooker would assert that I most certainly am. Being “religious” is a label of identity, and is chosen or rejected for a range of idiosyncratic reasons, making this question very difficult to answer or interpret.

Likewise, I’m not even sure that I’d call myself a “convinced atheist”, because while the existence of god(s) might well be the thing that I doubt most, if being “convinced” requires being certain, I’d have to tick the “not a religious person” box. And again, all who know me would most likely have predicted a different selection.

A finer-grained account of what being “religious” means to those who describe themselves as such is a different matter, because it can inform strategy whether you’re on the religious or the non-religious side of the debate. The data from the Win-Gallup poll, on the other hand, simply feeds into our confirmation bias. It allows for the religious to lament and the irreligious to gloat, neither for any good or principled reason.

And speaking of principle and good reason, a concluding note on those non-existent science journalists: we might never again see such a job description, except for the few who still survive at a handful of newspapers. But this isn’t an excuse to simply recycle wire copy, whether you’re a newspaper or a member of the public. The fact that experts are no longer doing the filtering for us means we need to pay more attention – not simply become more gullible.

What’s the harm? Well, homeopathy could (indirectly) kill you.

The letters Penelope Dingle sent to Francine Scrayen make for very sad reading. Scrayen was “treating” Dingle’s cancer, diagnosed in February 2003. Dingle’s sister is now suing Scrayen, and it’s easy to understand her motivations for this on reading not only the letters, but also the coroners report following Dingle’s death :

In my view the deceased’s rectal cancer was present and causing bleeding and other symptoms from at least 31 October 2001. During the period 31 October 2001 until at least the end of November 2002, the deceased regularly described the symptoms of her rectal cancer to a homeopath, Francine Scrayen. It was not until November 2002 that Mrs Scrayen and the deceased discussed the possibility of reporting her rectal bleeding to a medical practitioner and it was not until 5 December 2002 that she first reported those problems to a doctor.

I accept that Mrs Scrayen believed that the deceased had suffered from haemorrhoids years earlier and the bleeding and pain was “an old symptom coming back”, but a competent health professional would have been alarmed by the developing symptoms and would have strongly advised that appropriate medical investigations be conducted without delay.

As I’ve said before, pseudoscience doesn’t only cause the (relatively trivial) harm of lightening the wallets of the gullible. When it’s taken seriously, it can not only result in these sorts of tragic stories, but also helps to contribute to a general climate of unreason, where people become less discerning about what to believe and why to believe it. In fact, an increasing concern is the ways in which this climate of unreason can be leveraged in favour of political and economic interests. Conspiracies are attractive to many folk, because we sometimes prefer grand narratives to the conclusions reached via the application of Occam’s Razor (on this topic, Rosenberg’s new book The Atheists Guide to Reality makes for good reading).

Alternative medicine that works is simply called “medicine”, as Dara o’Briain reminds us here:

The Dingle story is now a few years old, but it’s back in the public eye thanks to the recent publication of the coroners report and Dan Buzzard’s highlighting of that report’s contents. And now, Scrayen has sent Buzzard a cease and desist letter, demanding that he retract his allegations regarding her complicity in Dingle’s suffering and her potentially avoidable death. You can read Buzzard’s two posts on Scrayen via that last link, and it’s difficult to see how Scrayen thinks he’s done anything wrong – except, of course, for exposing her as a dangerous quack.

It is ultimately the consumer’s fault if she makes choices which endanger her own life. The issue here, though, is that while Dingle (and most of us) live(d) in a society which protects us from all sorts of misrepresentation and fraud, that protection is absent in the case of things like homeopathy. The politically-correct, relativistic way in which opinions and evidence are treated make us afraid to tell people that what they believe is sometimes nonsense, and sometimes dangerous nonsense.

Medical aid schemes should of course not reimburse for homeopathic treatments. Pharmacies, who are associated with treatment and good health, should ideally not sell them, no matter how profitable exploiting the gullible can be. Pharmacies are of course free to sell anything legal, though – my point is more that it’s unfortunate that they often don’t take any proactive role in reminding consumers that what they’re buying is pure placebo, and shouldn’t take the place of medicine.

Most important, perhaps, is that in an age of manic labelling of everything consumable, down to the most minuscule ingredient, it’s an almost criminal neglect that legislation doesn’t exist to force producers of homeopathic remedies to spell out the simple fact that a glass of water will “treat” your ailment just as effectively as a homeopathic “remedy” will.

Also see Angela Meadon’s post on this, reminding Scrayen that she can’t bully Buzzard into silence, and that the Streisand effect might well result in her attempts to do so having the opposite effect to what she hopes.