My son loves doing battles with his toys against me or my husband, but typical of all children his age, he will often add new clauses as he goes along to assure that his guy can’t die. Last night was no different when, during our robot fight, he quickly remembered a rule that he’d forgotten: that if a robot’s head came off, he didn’t die, but rather “grew a new one” so as to continue the fight. Oh yeah, and T-rexes can’t kill robots either.
Cute as it is, it’s obvious that these rules only come in to play if they work to his advantage, like say when I use a nearby Tyrannosaurus to obliterate his lego-bot. He’s no dummy. He knows that if the rules stay the same from the start, that it means he just lost, and that’s unacceptable. In scientific rhetoric, this is what’s called moving the goal posts. A result doesn’t come out your way, so you change the rules so that the results you did achieve can now be considered a success.
Adults and children alike exploit this tactic, sometimes as an innocent quest for feel-good wins, and sometimes for political or monetary gain. When you think about why our society implements rules, it boils down to having a level playing field for all players. In politics, in industry, and in science, this is imperative if we are to achieve ingenuous progress. After all, what is science but a set of rules to guide the process of finding truth?
Unfortunately, confirmation biases infiltrate all investigations, because our human nature is programmed to reward our intuition with affirming data. As famed physicist Richard Feynman puts it, “The first principle is that you must not fool yourself — and you are the easiest person to fool.”
Evidence-based trials are sometimes guilty of this. In fact, many people have criticized the recent Vertex Ivacator/ Lumacaftor drug combo for double F508del for scaling back their original expectations of measurable improvement so that by the end of the trial, they could report to their investors the overwhelming success of the new variation of Kalydeco for cystic fibrosis. (Sources for this are word-of-mouth from patients and CF specialists).
Though, one may have reason to be wary of some science-based treatment recommendations, the vast majority of empirical study is honorable and trustworthy; and more importantly seeks to be more rigorous and fairly tested. Most good experiments are designed to be falsifiable, and critique is welcome as it often leads to the expansion of available knowledge as well as honing in the details of what we already know. In the world of naturopathy though, the opposite is true.
Faith based medicine works backwards. They decide the result they want to be true, and design experiments to prove it so. If it can’t, they move the goal posts; they say that conventional science can’t accurately explain the mechanics of the mystical. Absence of evidence is not evidence of absence, they’ll say. They flip the hierarchy of reliable evidence on its head, rating anecdotal evidence higher than double-blind randomized placebo-controlled trials. Critical analysis is often met with hostility, defensiveness, and accusations of conspiracy. Oddly enough, when standard methodologies can give the positive results they were looking for, science is their friend, even if the experiment is an anomaly among similarly designed negative studies.
In other words, they decide what rules apply after they see the results. When a negative result occurs, it’s not because the treatment doesn’t work, only that the methodology used to test it failed. X treatment works, but this study failed to demonstrate that fact. That is a dishonest way of performing scientific studies.
Also dishonest, is the re-branding of models that are currently not acceptable forms of evidence, to be less factual but sound more credible. Much in the way a PR consultant will call for a creative new talking point to replace a label with bad press, natural medicine advocates will suggest dropping the word anecdotal from the vernacular in favor of “uncontrolled clinical observations.” A bit easier to swallow for those who are not savvy research professionals.
Since the creation of OAM (Office of Alternative Medicine) by the United States Congress in 1992 strong-armed by CAM friendly Senator Tom Harkin of Iowa, the National Center for Complementary and Alternative Medicine has played a different game than the rest of National Institute of Health standards. Because they couldn’t get funding playing by regular NIH rules, Tom Harkin and his committee instituted different rules so that grants could be permitted to fund studies of treatments which had been previously discredited or shown unreliable.
Even after a number of years of ineffective treatments continue receiving multiplying portions of the federal budget, there are still very few people calling for the reevaluation of this system of “alternatives.” Furthermore, the more extreme of alternative treatments that by any other standard would be considered unethical, are now protected in many states by “health freedom” laws, especially when the patient is considered terminal and has reached the end of the line as far as conventional medicine. Hmm…double standard much?
While I am not against the dignity of a person who is dying to choose how they want to be treated, it is my opinion that those who would offer an unproven, non-FDA approved treatment method for desperate patients are practicing unethically. Even if the treatment in question would not be at high risk for causing greater harm (which, frighteningly, many of them do), a placebo-type therapy is also unethical, because the practitioner is essentially lying to patients for a profit. These same practitioners are usually sheltered from malpractice suits because, again, they are playing by a different set of rules.
When a person or a group decides to change the already established rules, it is only for their benefit. Whether it’s to avoid punishment, financial loss, strategic disadvantage, or emotional disappointment, it’s a selfish act. As a child, that’s to be expected and is just part of growing up. When adults do it, it’s unfair to the other players, and disregards the societal responsibility of which we are all bestowed. Believers in natural medicine are sometimes the worst offenders, and this, to me, undermines the very trust that is required for a mutual transaction.