Junk medicine and Canada’s cabinet

2008-11-28

in Canada, Politics, Rants, Science

Given the evidence that acupuncture doesn’t work (except possibly for some kinds of pain and nausea) and chiropractic is downright dangerous, it is a bit saddening that Gary Goodyear – Canada’s Minister of State for Science and Technology – has fellowships in both.

Is it too much to ask that the cabinet minister in charge of science actually have scientific training or, at the very least, not be personally invested in demonstrated forms of pseudo-science? The chiropractic connection is especially worrisome, given the kooky beliefs espoused by practitioners (such as that all illness is caused by ‘subluxations’ of the spine) and the evidence that chiropractic treatments cause vascular damage, especially when necks are manipulated or it is practiced on adolescents or children.

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{ 12 comments… read them below or add one }

Tristan November 28, 2008 at 11:10 pm

If you think that chiropractic or acupuncture are pseudo-sciences, then isn’t the fact they are both widely regarded as accepted and mainstream a larger problem than what the health minister specializes in?

The larger question is: why should we expect a minister of the state to lead the “purification” of scientific practice? That seems incredibly interventionist, and a violation of the independence of medical science.

The large question is “Who gets to decide what medical treatments are valid”, and it seems unambiguously the case that the medical profession should get to decide, not the state. The fact there is a schism between different branches of medical science, if this is a state issue, might concern the relation between medicine, philosophy of science, and political science. I am an expert in none of these.

Milan November 28, 2008 at 11:39 pm

[I]sn’t the fact they are both widely regarded as accepted and mainstream a larger problem than what the health minister specializes in?

This is the Canada’s Minister of State for Science and Technology, not the health minister. It would be even sadder if the health minister had such certifications.

The larger question is: why should we expect a minister of the state to lead the “purification” of scientific practice? That seems incredibly interventionist, and a violation of the independence of medical science.

We should certainly hope our science minister isn’t a quack. Having a degree in an actual scientific field would be a plus.

The large question is “Who gets to decide what medical treatments are valid”, and it seems unambiguously the case that the medical profession should get to decide, not the state.

When the state pays, it certainly needs to have a role in deciding. The first question is whether any particular approach works. In the case of acupuncture and chiropractic, the evidence isn’t there. I am not sure what ‘validity’ means in the context of a medical treatment. ‘Effectiveness’ seems a more impartial criterion, and one poorly satisfied by these two forms of pseudo-medicine.

The fact there is a schism between different branches of medical science, if this is a state issue, might concern the relation between medicine, philosophy of science, and political science.

Chiropractic and acupuncture aren’t “branches of medical science,” because they do not satisfy the basic requirements of being a science. That is to say, they are not based on theories that are accepted or rejected on the basis of the best evidence we have available. While some practitioners choose which elements of these disciplines to accept or reject, in doing so they are no more scientific than Christians who accept some elements of biology while rejecting others.

All we need in order to determine whether these sorts of techniques make a genuine contribution to medicine is empirical evidence that shows they have healing potential over and above placebo effects. The standard for them being sciences is higher, since there then needs to be some kind of plausible explanation for the relationships between causes and effects.

Milan November 28, 2008 at 11:52 pm

On acupuncture

On chiropractic

For much more information, please read this book.

Anonymous November 29, 2008 at 1:19 am

It is definitely sad and pathetic.

At the same time, political conservatism is arguably more and more the product of ignorance about science.

Tristan November 29, 2008 at 9:59 am

The fact that these medical practices don’t fullfill the basic requirements for being a science simply pushes back my question one level.

Premise (a): Experts in the field of medicin, not Government officials, should decide what counts as “real medicine”.

Premise (b): There is a real schism between “experts” in medicine currently, some of which think science is the be all and end all, and some which believe science fails to explain our best current medical methods. There are lots of times in history when “what worked” either wasn’t scientific or was based on a scientific theory we now believe to be “wrong”.

Conclusion: It’s up to the medical discipline, i.e. their associations, to work out these discrepancies, and they should do so independent of state decrees as to “what constitutes science” or “what constitutes medicine”. Imagine if states had intervened in the discussion about whether relativity should be adopted? We would look back and talk about how backwards it was for the state to attempt to answer questions only adjudicate by experts.

Milan November 29, 2008 at 12:07 pm

There is a real schism between “experts” in medicine currently, some of which think science is the be all and end all, and some which believe science fails to explain our best current medical methods.

I only think this is true if you count acupuncturists, chiropracters, and so forth as “experts” in medicine: a premise I reject. That isn’t to say they couldn’t have an influence from the outside. If they provided empirical evidence their approaches worked, then the onus would be on medical researchers to explain why.

At present, they are in the same boat as crystal healers and homeopaths. At best, they do not deserve to be taken seriously and consumers should be warned their practices do not have demonstrated effectiveness. At worst, they are causing some people to avoid real medical treatments (such as vaccinations, or anti-malarial drugs), because they are being told that wearing some crystal pendant on their neck or drinking a super-dilute solution of cayenne pepper will somehow help them.

I don’t think the determination of which treatments work is something only medical professionals can effectively assess. All you need is the ability to organize and conduct well-designed clinical trials. Basing our beliefs on the effectiveness of treatments on the results of such trials is far superior to trusting some grand council of experts: whether they wear lab coats or wizards robes.

. November 29, 2008 at 12:08 pm

Previously on homeopathy:

Homeopathy is fraud
November 24, 2007

Tristan November 29, 2008 at 7:39 pm

You might think clinical trials and scientific explanation is the be-all and end-all, but you are not the majority opinion (apparently).

Who gets to decide that these trials are “better” than trusting the experts? Who exactly runs these trials and advocates for them anyway? I believe it is the experts.

I’m sure you agree that the state should not decide which scientific theory is correct, so why do you think the state should decide which medical theories are correct? Can’t we have a free-market of ideas?

Milan November 29, 2008 at 7:45 pm

Can’t we have a free-market of ideas?

Yes, but people are easily tricked. Look at something like regression to the mean. It makes it easy to convince people with temporary illnesses – or chronic ones of variable impact – that worthless treatments are effective.

Clinical trials tap into the very root of empirical examination. They are fundamentally more credible than experts because, when done correctly, they have no biases.

The majority opinion is irrelevant here. There have been many instances where the majority of people believed incorrect things. There are probably lots of incorrect things we believe now. That being said, by continuing to design empirical examinations based on the best of our knowledge and solid methodology, we can get closer to the truth.

What makes acupuncture different from a scientologist telling you that your health problems are caused by thetans, and the only solution is to join the cult? Is allowing scientologists to do that desirable? Is it a ‘free market of ideas?’

. March 17, 2009 at 11:46 am

You have our sympathies, Canada

Canada has Gary Goodyear, the chiropractor who has been vaulted into the position of minister in charge of science and technology. He does not have a good reputation — his management style leaves much to be desired, and likes to accuse scientists of conspiring to lie to the public — and there are suspicions that he is a closet creationist, so he was recently asked outright if he believed in evolution.

“I’m not going to answer that question. I am a Christian, and I don’t think anybody asking a question about my religion is appropriate,” Gary Goodyear, the federal Minister of State for Science and Technology, said in an interview with The Globe and Mail.

Anon August 28, 2009 at 11:10 am
. April 25, 2011 at 5:53 pm

In 2009, Harper appointed a Minister of Science who refused to say whether he believed in evolution. Harper then cut science research funding by $138 Million (while the US invested $2.75 Billion). Since 2007 Harper has forced scientists at Environment Canada to get permission to do interviews, often screening their answers. As a result media coverage of climate change science was reduced by 80%.

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