A book based on his column, Bad Science, offers a more comprehensive critique of some of these familiar targets while providing a primer in evidence-based medicine for the general reader. Like Goldacre’s column, his book is enlightening, shocking and often hilarious.
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Bad Science offers an entertaining romp through the wacky world of the once alternative, but now sadly mainstream, homeopaths and nutrititionists. Goldacre ridicules their sugar pills, their homeopathic solutions with ‘memories’ of dissolved molecules, their detox regimes, vitamins, anti-oxidants and supplements. This is a market in which McKeith’s ‘Fast Formula Horny Goat Weed Complex’ for enhanced sexual satisfaction (now withdrawn after complaints from the medicines regulatory authorities) once competed with Holford’s ‘Q-Link’ pendant offering protection against electromagnetic radiation (constituents worth 0.5p, retail price £69.99). Goldacre also exposes the preposterous claims of the promoters of ‘Brain Gym’ techniques, now apparently widely used in UK schools, and the bogus research claiming that omega-3 fish oils can improve exam performance.
“Goldacre repeatedly endorses the benefits of what he characterises as a ‘healthy lifestyle’”
Yet other examples of pseudoscience that have, arguably, greater influence on the life and health of the nation remain curiously neglected in Goldacre’s account. For example, as recent contributions to spiked have argued, controversies over population, passive smoking, the HIV/Aids epidemic and the links between diet and health are characterised by the subordination of science to propaganda. Indeed, all these issues provide examples of the sort of statistical scams and scientific sharp practice (such as extrapolation from inadequate data, confusion of observational and intervention studies, over-interpretation of laboratory studies, cherry picking and data dredging) that Goldacre describes.
While Bad Science savages the nutritionists’ dogmatic dietary advice, Goldacre repeatedly endorses the benefits of what he characterises as a ‘healthy lifestyle’. With uncharacteristic adherence to dull convention, Goldacre repeats the litany that people should be advised to stop smoking, to follow a ‘healthy diet’ of fruit, vegetables and natural fibre and take regular exercise. But, whereas there is strong evidence against smoking, the same cannot be said for recommending any particular diet – and even less for the virtues of exercise. It is striking that, though Goldacre subsequently acknowledges that two major intervention studies - the Multiple Risk Factor Intervention Trial (MRFIT) and the Women’s Health Initiative - failed to show any benefit from dietary change, in defiance of his own strictures about evidence-based medicine, he continues to preach the healthy-living gospel.
‘Why do clever people believe stupid things?’, asks Goldacre. Part of his explanation for the popular impact of pseudoscience goes some way towards explaining the inconsistency of his own approach: ‘Our values are socially reinforced by conformity, by the company we keep’, he writes, emphasising the ‘phenomenal impact of conformity’. It appears that while Goldacre is prepared to challenge some of the anti-scientific prejudices of his Guardian readers, he shares some of the wider values that have acquired a pervasive influence in modern society.
These include a pessimistic outlook towards the prospects for nature and society, reflected in the popularity of apocalyptic and doomsday scenarios of all kinds, and notably in a willingness to embrace the likelihood of catastrophe from epidemic disease (whether in the form of AIDS, mad cow disease, SARS, bird flu or mere obesity). They also include a misanthropic outlook towards humanity, expressed in contemptuous attitudes towards the masses, notably towards people who vote for George W Bush or against the EU, those who smoke or are overweight. A third theme is a growing sympathy for authoritarian interventions to deal with social problems, whether the issue is AIDS, banning smoking, banning trans fats, or banning advertising for ‘junk food’.
“Some forms of pseudoscience remain curiously neglected in Goldacre’s account”
A combination of these attitudes - among scientists and politicians as much as in the general public - leads to an inclination to turn a blind eye towards pseudoscience if it furthers the wider social agenda that follows from them.
Goldacre is ambivalent in his attitude towards the public. On the one hand, he proclaims – almost as an afterthought in his epilogue - that ‘people aren’t stupid’. On the other, in the course of a familiar radical tirade against the evils of direct advertising in the USA by Big Pharma, he writes that ‘patients are so much more easily led than doctors by drug company advertising’. Again forsaking his scientific principles, he provides no evidence for a proposition that is no more than a personal prejudice, though no doubt one shared by most of his medical colleagues and his Guardian readers. In fact, Goldacre’s account provides numerous examples of how doctors have been misled by drug companies. I see no reason why patients, provided they have access to the appropriate information, should not be capable of making rational decisions in these matters.
‘The greatest problem of all is dumbing down’, concludes Goldacre. But this problem starts at the top, among scientists who share the loss of confidence and authority that afflicts the elite of contemporary society. The very fact that it has been left to a junior hospital doctor to take the lead in challenging important areas of pseudoscience in modern society reflects the abdication of responsibility by the scientific establishment. This – rather than the role of the media, abject though that has been – is the real lesson of the imbroglio over the MMR vaccine, itself the subject of an excellent chapter in Bad Science.
Senior scientists must take up their responsibility to explain and defend science in public, and to set their own house in order by tackling fraud, exposing junk science and calling a halt to the abuse of university titles and academic qualifications. Then, even the arts graduates who (to Goldacre’s distaste) dominate the media will soon learn to read a paper critically and provide an informed account to their readers.
As the autism expert Laura Schreibman puts it in her book The Science and Fiction of Autism: ‘One need not be a scientist in order to know how to evaluate information critically; one just needs to be appropriately critical.’
Dr Michael Fitzpatrick is the author of MMR and Autism: What Parents Need to Know (buy this book from Amazon(UK)) and The Tyranny of Health: Doctors and the Regulation of Lifestyle (buy this book from Amazon(UK)). He is speaking in the session Boozy Britain at the Battle of Ideas festival on 1&2 November at the Royal College of Art, London.
Bad Science, by Ben Goldacre, is published by Fourth Estate Ltd. (Buy this book from Amazon(UK).)
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Bad Science, by Ben Goldacre