Monday, May 23, 2016

2330. Dear "Skeptics," Bash Homeopathy and Bigfoot Less, Mammograms and War More

By John Horgan, Scientific American, May 16, 2016

Yesterday I spoke at the Northeast Conference on Science and Skepticism, NECSS, a “celebration of science and critical thinking” held May 12-15 in New York City. Philosopher Massimo Pigliucci, whom I met recently, got me invited, and he might regret that, because I decided to treat the skeptics skeptically. I originally titled my talk “Skepticism: Hard Versus Soft Targets.” The references to “Bigfoot” in the headline above and text below were inspired by a conversation I had with conference Emcee Jamy Ian Swiss before I went on stage. He asked what I planned to say, and I told him, and he furiously defended his opposition to belief in Bigfoot. He wasn’t kidding. I hadn’t brought up Bigfoot, but I decided to mention him in my talk. Swiss didn’t let me take questions, so I promised the audience that I would post the talk here (slightly edited) and would welcome skeptical comments or emails. [See also my follow-up posts here and here.] –-John Horgan

I hate preaching to the converted. If you were Buddhists, I’d bash Buddhism. But you’re skeptics, so I have to bash skepticism.

I’m a science journalist. I don’t celebrate science, I criticize it, because science needs critics more than cheerleaders. I point out gaps between scientific hype and reality. That keeps me busy, because, as you know, most peer-reviewed scientific claims are wrong.

So I’m a skeptic, but with a small S, not capital S. I don’t belong to skeptical societies. I don’t hang out with people who self-identify as capital-S Skeptics. Or Atheists. Or Rationalists.

When people like this get together, they become tribal. They pat each other on the back and tell each other how smart they are compared to those outside the tribe. But belonging to a tribe often makes you dumber.

Here’s an example involving two idols of Capital-S Skepticism: biologist Richard Dawkins and physicist Lawrence Krauss. Krauss recently wrote a book, A Universe from Nothing. He claims that physics is answering the old question, Why is there something rather than nothing?

Krauss’s book doesn’t come close to fulfilling the promise of its title, but Dawkins loved it. He writes in the book’s afterword: "If On the Origin of Species was biology's deadliest blow to supernaturalism, we may come to see A Universe From Nothing as the equivalent from cosmology.”

Just to be clear: Dawkins is comparing Lawrence Krauss to Charles Darwin. Why would Dawkins say something so foolish? Because he hates religion so much that it impairs his scientific judgment. He succumbs to what you might call “The Science Delusion.”

“The Science Delusion” is common among Capital-S Skeptics. You don’t apply your skepticism equally. You are extremely critical of belief in God, ghosts, heaven, ESP, astrology, homeopathy and Bigfoot. You also attack disbelief in global warming, vaccines and genetically modified food.

These beliefs and disbeliefs deserve criticism, but they are what I call “soft targets.” That’s because, for the most part, you’re bashing people outside your tribe, who ignore you. You end up preaching to the converted.

Meanwhile, you neglect what I call hard targets. These are dubious and even harmful claims promoted by major scientists and institutions. In the rest of this talk, I’ll give you examples of hard targets from physics, medicine and biology. I’ll wrap up with a rant about war, the hardest target of all.

Multiverses and the Singularity
First, physics. For decades, physicists like Stephen Hawking, Brian Greene and Leonard Susskind have touted string and multiverse theories as our deepest descriptions of reality.

Here’s the problem: strings and multiverses can’t be experimentally detected. The theories aren’t falsifiable, which makes them pseudo-scientific, like astrology and Freudian psychoanalysis.

Some string and multiverse true believers, like Sean Carroll, have argued that falsifiability should be discarded as a method for distinguishing science from pseudo-science. You’re losing the game, so you try to change the rules.

Physicists are even promoting the idea that our universe is a simulation created by super-intelligent aliens. Last month, Neil de Grasse Tyson said “the likelihood may be very high” that we’re living in a simulation. Again, this isn’t science, it’s a stoner thought experiment pretending to be science.

So is the Singularity, the idea that we’re on the verge of digitizing our psyches and uploading them into computers, where we can live forever. Some powerful people are believers, including Google’s director of engineering, Ray Kurzweil. But the Singularity is an apocalyptic cult, with science substituted for God.

When high-status scientists promote flaky ideas like the Singularity and multiverse, they hurt science. They undermine its credibility on issues like global warming.

Overtested and Overtreated for Cancer
Now let’s take a look at medicine, not the soft target of alternative medicine but the hard target of mainstream medicine. During the debate over Obama-care, we often heard that American medicine is the best in the world. That’s a lie.

The U.S. spends much more on health care per capita than any other nation in the world. And yet we rank 34th in longevity. We’re tied with Costa Rica, which spends one tenth what we spend per capita. How could this happen? Perhaps because the health-care industry prioritizes profits over health.

Over the past half-century, physicians and hospitals have introduced increasingly sophisticated, expensive tests. They assure us that early detection of disease will lead to better health.

But tests often do more harm than good. For every woman whose life is extended because a mammogram detected a tumor, up to 33 receive unnecessary treatment, including biopsies, surgery, radiation and chemotherapy. For men diagnosed with prostate cancer after a PSA test, the ratio is 47 to one. Similar data are emerging on colonoscopies and other tests.

Europeans have lower cancer morality rates than Americans even though they smoke more and spend less on cancer care. Americans are over-tested, over-treated and over-charged.

If you want to learn more about this immense problem, read Overdiagnosed by Gilbert Welch, a courageous health-care analyst at Dartmouth. His subtitle is “Making People Sick in Pursuit of Health.”

Mental-Illness Over-Medication
Mental-health care suffers from similar problems. Over the last few decades, American psychiatry has morphed into a marketing branch of Big Pharma. I started critiquing medications for mental illness more than 20 years ago, pointing out that antidepressants like Prozac are scarcely more effective than placebos.

In retrospect, my criticism was too mild. Psychiatric drugs help some people in the short term, but over time, in the aggregate, they make people sicker. Journalist Robert Whitaker reaches this conclusion in his book Anatomy of an Epidemic.

He documents the huge surge in prescriptions for psychiatric drugs since the late 1980s. The biggest increase has been among children. If the medications really work, rates of mental illness should decline. Right?

Instead, rates of mental disability have increased sharply, especially among children. Whitaker builds a strong case that medications are causing the epidemic.
Given the flaws of mainstream medicine, can you blame people for turning to alternative medicine?

Gene-Whiz Science
Another hard target that needs your attention is behavioral genetics, which seeks the genes that make us tick. I call it gene-whiz science, because the media and the public love it.

Over the past several decades, geneticists have announced the discovery of "genes for" virtually every trait or disorder. We’ve had the God gene, gay gene, alcoholism gene, warrior gene, liberal gene, intelligence gene, schizophrenia gene, and on and on.

None of these linkages of single genes to complex traits or disorders has been confirmed. None! But gene-whiz claims keep coming.

Last year, The New York Times published two gene-whiz essays by Richard Friedman, a psychiatrist at Cornell Medical College. He claims scientists have found a feel-good gene” that makes you happy, and an infidelity gene” that makes women cheat on their partners. The Times should be ashamed for publishing this nonsense.

The Deep-Roots Theory of War
The biological theory that really drives me nuts is the deep-roots theory of war. According to the theory, lethal group violence is in our genes. Its roots reach back millions of years, all the way to our common ancestor with chimpanzees.

The deep-roots theory is promoted by scientific heavy hitters like Harvard’s Steven Pinker, Richard Wrangham and Edward Wilson. Skeptic Michael Shermer tirelessly touts the theory, and the media love it, because it involves lurid stories about bloodthirsty chimps and Stone Age humans.

But the evidence is overwhelming that war was a cultural innovation--like agriculture, religion, or slavery--that emerged less than 12,000 years ago.

I hate the deep-roots theory not only because it’s wrong, but also because it encourages fatalism toward war. War is our most urgent problem, more urgent than global warming, poverty, disease or political oppression. War makes these and other problems worse, directly or indirectly, by diverting resources away from their solution.

But war is a really hard target. Most people—most of you, probably--dismiss world peace as a pipe dream. Perhaps you believe the deep-roots theory. If war is ancient and innate, it must also be inevitable, right?

You might also think that religious fanaticism—and especially Muslim fanaticism--is the greatest threat to peace. That’s the claim of religion-bashers like Dawkins, Krauss, Sam Harris, Jerry Coyne and the late, great warmonger Christopher Hitchens.

The United States, I submit, is the greatest threat to peace. Since 9/11, U.S. wars in Afghanistan, Iraq and Pakistan have killed 370,000 people. That includes more than 210,000 civilians, many of them children. These are conservative estimates.

Far from solving the problem of Muslim militancy, U.S. actions have made it worse. ISIS is a reaction to the anti-Muslim violence of the U.S. and its allies.

The U.S. spends almost as much on what we disingenuously call defense as all other nations combined, and we are the leading innovator in and peddler of weapons. Barack Obama, who pledged to rid the world of nuclear weapons, has approved a $1 trillion plan to modernize our arsenal.

The antiwar movement is terribly weak. Not a single genuine antiwar candidate ran in this Presidential race, and that includes Bernie Sanders. Many Americans have embraced their nation’s militarism. They flocked to see American Sniper, a film that celebrates a killer of women and children.

In the last century, prominent scientists spoke out against U.S. militarism and called for the end of war. Scientists like Einstein, Linus Pauling, and the great skeptic Carl Sagan. Where are their successors? Noam Chomsky is still bashing U.S. imperialism, but he’s almost 90. He needs help!

Far from criticizing militarism, some scholars, like economist Tyler Cowen, claim war is beneficial, because it spurs innovation. That’s like arguing for the economic benefits of slavery.

So, just to recap. I’m asking you skeptics to spend less time bashing soft targets like homeopathy and Bigfoot and more time bashing hard targets like multiverses, cancer tests, psychiatric drugs and war, the hardest target of all.

I don’t expect you to agree with my framing of these issues. All I ask is that you examine your own views skeptically. And ask yourself this: Shouldn’t ending war be a moral imperative, like ending slavery or the subjugation of women? How can we not end war?

UPDATE (AS OF MAY 23, 2016):
For more on reactions to this essay, and my counter-reactions, please read my follow-up posts here and here. I’m inserting this “Update” here because I’m reacting to especially important reactions, and I want to maximize readership.

My Response to Steven Pinker
Steve Pinker demolishes John Horgan’s view of war.” This is the fourth attack launched against me from Jerry Coyne’s blog Why Evolution Is True. I have great respect for Pinker. In a review for Slate, I called The Better Angels of Our Nature, which documents historical declines in war and other forms of violence, a “monumental achievement” that “should make it much harder for pessimists to cling to their gloomy vision of the future.” But I have also faulted Pinker for embracing a Hobbesian perspective, in which civilization, especially as embodied by western, post-Enlightenment states, is helping us overcome our savage nature. This ideological commitment leads Pinker to overstate the violence of pre-historic humans and to downplay the violence perpetrated by modern states, notably the U.S.
One more point: Pinker says I have “endorsed the non sequitur” that if war is innate it must also be inevitable. As he knows, because I have discussed the issue with him, I don’t “endorse” this fatalistic view, and I know Pinker doesn’t either. But many other people are deep-roots fatalists, from my students to Barack Obama, who while accepting the Nobel Peace Prize (!) said war “appeared with the first man” and “we will not eradicate violent conflict in our lifetimes.” That’s why I’m so upset that Pinker and other prominent scientists continue to propagate the deep-roots theory of war in spite of its lack of empirical support. (For more detailed critiques of Pinker’s work, see this, this and this. Also, if you’re curious about the Napoleon Chagnon affair, to which Pinker alludes, see this.)

My (Latest) Response to David Gorski and Steven Novella
Since David Gorski continues to bash me online, I’ve looked a bit more carefully at the writings of him and his fellow physician-skeptic Steven Novella. As recent posts on their blog Science-Based Medicine make clear, their primary target is alternative medicine, which they attack aggressively, and rightfully so.

The problem is that they are not equally aggressive in criticizing mainstream medicine, of which they tend to be protective. Gorski and Novella no doubt worry that acknowledging the flaws of mainstream medicine will give aid and comfort to quacks, but they end up adhering to a double standard that undermines their credibility.

This double standard is displayed when Gorski and Novella dismiss evidence that psychiatric drugs might be doing more harm than good, and when Gorski downplays a recent study on deaths caused by medical errors. Similarly, when Gorski, a breast-cancer surgeon, discusses mammograms, he always ends up affirming their value, however limited.

Skeptics seeking more objective evaluations of medicine should check out the invaluable Cochrane Collaboration, which consists of 37,000 medical experts dedicated to producing (according to the website) “credible, accessible health information that is free from commercial sponsorship and other conflicts of interest.”

Peter Gotzsche, a physician and medical researcher who heads the Nordic branch of the Cochran Collaboration, has concluded that both mammograms and antidepressants might do more harm than good. Gotzsche is a true skeptic. He isn’t necessarily right, but I trust his judgment more than that of Gorski and Novella.

Further Reading:

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