Monday, November 8, 2010

Righteous Indignation

Righteous Indignation

I was not going to post on this week's episode.  Space out the posts, and try not to bore the loyal reader.  However, I had to post a few comments after listening.

I apologize for the rough language, but . . .

This week's guest Dr. Brian Kaplan was a quite a forward and vociferous speaker.  fucking asshole.*  He is just a loud and bombastic medical doctor who practices at a homeopathic hospital, and used his rhetoric to defend the continuing support of homeopathy by the U.K.'s National Health Service.  Parliament has discussed cutting funding to homeopathic hospitals due to the lack of evidence supporting their homeopathic treatment modalities. Dr. Kaplan made numerous arguments in support of continued government support of homeopathy including that because the NHS supports therapies such as psychotherapy, certain anti-depression medications, and cough medications which have weak evidence to support their efficacy, that the government support of homeopathy such be continued or otherwise the lack of funding would be hypocritical.  He also raised "the stuff works" argument, and if there was the proper study performed it would prove what he sees in his practice.  However, his single central thesis seemed to be political.  Since six homeopathic hospitals were included into the NHS when it was begun in the 1940's, he feels therefore it would not be fair to take away this pre-existing choice.

This argument for a treatment being continued to be supported by Her Majesty's taxpayer simply because it has been in the past is inane.  It is basically arguing to freeze medical treatment in a moment in time just because it was considered correct or at least useful over sixty years ago.  It is a good thing the NHS was not started under George III, or blood letting would have to be allowed since the balance of the four humors was all the rage in 1800.  Can't take that choice away.  Finally, Dr. Kaplan argued that he is a libertarian.  As a libertarian, Dr. Kaplan argued it is only right and fitting that the government support the choice of homeopathy.  Yes, the hands off libertarian is arguing for the furtherance of government largess in a particular and peculiar form of medical treatment.  (Jonah Goldberg, conservative commentator, once noted that many people are a little bit libertarian just on things they do not wish the government to interfere in.  This turns that argument on its head.)


Also covered on the show was a discussion of how far anti-abortion activists should go in expressing their opinion and in attempting to stop those availing themselves of the medical procedure.  This is a pretty darn weighty political and ethical topic.  It is not something one typically expects a skeptical podcast to cover.  Although the show never seems to go out of its way to avoid topics of controversy either.  It seems one of the few exports flowing from the United States to Great Britain is religious based anti-abortion activism.

The high point of the episode was Marsh describing a burn treating phone service based out of the United States (another export!  The Great Recession must end soon, right?).  When one is burned, you call this service and they help heal the burn over the phone.  That's it.  You need to get them a picture of the victim and some other information such as birth name for some reason.  The best part about Marsh's presentation was his reading of testimonials from the service's website.  The testimonials were from various states in the Union and Marsh read them in a hilarious American accent, which spans from Nascar Ozark hick to pseudo surfer dude.  Not a bland Chris Wallace accent was in sight.  It was quite a high mark for Marsh to announce his leaving the show.

Yes.  You read correctly.  Michael "Marsh" Marshall is leaving for other pastures on a new Podcast, Strang Quarks, that is going to be carried on "The Guardian."  I wish Marsh the best of luck in the new endeavor.  Marsh characterized this as a sabbatical.  Perhaps it will be.  Either way I hope it is a smashing success.  It could be worse.  It could be Hayley Stevens departing, and then my co-hort Karl would be inconsolable.  I would have to drive all the way up to Toronto, and take him for drinks and a movie.  Maybe drag him to Philadelphia to meet up some of Lady's friends to "forget" if for only a brief time the loss.  She's staying so all is not so bad, right?  We here at SkepReview worldwide HQ wish Marsh the best, and he will be quite missed.


It was a bitter-sweet episode.  A highly interesting interview, an interesting talk on abortion, a hilarious bit on crap burn cure pseudo-scam science, and Marsh leaving.  How could I not comment?


*Edit*Upon reflection such language is beneath what I am attempting to accomplish with this blog.  While Dr. Kaplan can clearly be noted as bombastic and quite strident, the use of such low language takes away rather than adds to the discussion.  My apologies to any and all readers.  The better angels lost out on this one.

12 comments:

  1. Thanks for the kind and gentle words about me, Nige. Don't quite see the connection between what you say and the flattering epithet with which you describe me. But who cares? People who disagree with YOU deserve to be complimented in that way. Luckily I believe in free speech and as a libertarian am firmly against libel laws :-) so at least we can agree on something, hey?

    Brian Kaplan

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  2. Brian Kaplan argument seemed largely based on a tu quoque fallacy. "Only 20% of medical interventions are backed by good science therefore homeopathy should be okay too." The main problems 1) some still have evidence (homeopathy, zip) 2) some still have biological plausibility (homeopathy, zip) 3) Because some people choose to combat homeopathy doesn't mean, say, ineffective anti-depressants aren't opposed by another group. Marsh only has so much time in the day. He can't take on all meds. 4) Medical science WILL eventually get around to removing poorly backed treatments from the standard of care. There are researchers and advocates dedicated to that. That does not exist within the field of homeopathy. Despite countless trials showing it's placebo, homeopaths will continue without change.

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  3. @ Nigel St. Whitehall What do you mean 'edit done'? Your insult is still there but now crossed out - but perhaps you think that's funny. In psychoanalytic terms your behaviour can be explained as projection.

    @ Puffin Watch "Marsh only has so much time in the day" etc. I've said many times. Let Marsh and any other detractor of NHS homeopathy openly state WHAT LEVEL OF EVIDENCE they would require for the inclusion of ANY intervention on the NHS. Nobody does this. Thus I adjudge the attack on NHS homeopathy to be not only disingenuous but actually an assault on liberty.

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  4. Brian, it's not the job of a non-doctor like Marsh to set what level of evidence is required for a treatment to be part of the standard of care. That should be determined by doctors and debate within the medical literature. The point is if an intervention in traditional medicine lacks sufficient evidence, it appears to lay skeptics that such an intervention will be eventually removed from the standard of care. For example, they no longer do ligation for angina because the evidence did not support it. As Dr. Novella and Dr. Crislip note doctors change their practice all the time as new evidence comes in.

    Further there are many groups, both within medicine and without, that campaign to have certain evidence poor treatments removed. Seriously, listen to Crislip's various ID podcasts or Dr. Orman's ERCast for monthly discussions about medical interventions that lack evidence and should no longer be followed.

    Also, I think your premise that all interventions require the same level of evidence and someone should state this one golden standard is faulty. Nothing complex, especially human biology, works like that. We can't even well define "species" or "gene". Again as Dr. Crislip note, the hallmark of the Alt Med type is binary thinking (which you're falling into by demanding this single rule for evidence). Alt med types fall into the belief something is a cure all or a poison.

    The problem is Marsh and most skeptics don't feel homeopaths EVER change their standard of care based on the vast body of double blind placebo controlled evidence and the utter, utter lack of scientific plausibility. Homeos just keep issuing their nostrums. Since there appears to be no self critical or effective self critical body within alt med like there is in evidence and science based medicine (where we can see the standard of care changing based on evidence), it falls upon skeptics like Marsh to take the facts to the public.

    And please, next time, have something more than a tu quoque fallacy.

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  5. @ Puffin Watch

    Cost of apparently non-proven homeopathy to the taxpayer: £10 million per annum

    Cost of apparently non-proven SSRI anti-depressants to the taxpayer: £232 million

    Action Taken by 'Sceptics'
    Against Homeopathy: A vicious campaign to damage and deletimise homeopathy
    Against SSRIs: Virtually nothing.

    Double standards? You bet? Not even your sophistry can get you out of that one dear Puffin Watch.

    ReplyDelete
  6. Brian, you're clearly not reading my arguments. Skeptics are rather confident the efficacy of SSRI is a matter debate within the literature and if found to be worthless skeptics are rather confident their use will be removed from the standard of care.

    There appears to skeptics to be little debate within alt med about discontinuing homeopathy despite desks full of well designed negative trials. Despite the overwhelming evidence against it within the scientific literature, homeopaths still take their claims to the public. Hence the reason some skeptics have chosen to take their own claims to the public.

    I'm not sure how much clearer I can make what the issue is truly about.

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  7. Puffin Watch you have your idea of what this issue is about and I have mine. I think I'm clear about mine and you think you are clear about yours. Enough said.

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  8. Brian, if I recall you were making claims about what you viewed as inconsistency and countenancing a double standard on the part of skeptics. I've tried to explain why skeptics don't view their position as being inconsistent. You can either attempt to understand their position or you can simply stick your fingers in your ears and go "lalalalalalalalallalalalalala".

    You appear to have chosen the latter since you've had a couple chances now to show me where my position is flawed. Instead you've simply returned to restate your premise.

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  9. @ Puffin Watch
    You say: "We can't even well define "species" or "gene". Again as Dr. Crislip note, the hallmark of the Alt Med type is binary thinking (which you're falling into by demanding this single rule for evidence). Alt med types fall into the belief something is a cure all or a poison."

    There are so many holes in this pathetic justification of NOT wanting to adopt a single NHS standard of evidence, that I cannot even begin to discuss this with you. I don't even support a single standard of evidence but I am 'righteously indignant' about the obvious application of double standards to this issue. and this has quite obviously been driven by the needs of 'corporate science'. That really is my final word. Happy sceptical thinking to you all!

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  10. Again, you return touting your same initial premise. Curiously, you claim you have arguments against one line of argumentation I've made but fail to even deliver it.

    Again, as I've laid out several times, there is no double standard. "Skeptics attack x but they don't attack y and z!" I've shown clearly why skeptics attack x and are entirely consistent in not attacking y and z.

    Maybe you're used to preaching to the choir, where your fellow travelers can't grasp the difference between a logical argument and someone simply repeating the same premise over and over again. But you're not preaching to a choir here. Your premise has been critically examined and found fallacious.

    Yes, if your final word is simply repetition and "lalalalalalalalala" I fear I'm forced to conclude you know you've been solidly beaten.

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  11. At last!
    the end of alternative medicine at
    www.mindblowingdecisions.com

    thank you
    steve ransom

    ReplyDelete

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