Let's get skeptical

Egalitarian

I do not think the press are exclusively to blame for the blatant misrepresentation of quackery and anti-scientific prejudice today. The inability of the medical profession and scientific community to reject this nonsense is more a reflection of their own lack of confidence in these matters. It would assist the general public if doctors were more prepared to openly denounce alternative/complementary medicine for what it is. As it is, we find doctors openly touting all sorts of nonsense, whilst the medical profession diminishes its own scientific authority by conceding to such stupid things as ethics committees and participatory forums.

I would far rather have decisions and practice based on medical expertise than on democratic understanding of science. Science is not easy, and I do not understand the ins and outs of each and every subject. So let's get our own house in order, and demand that scientists' views be determined solely by their peers and not by ignorance. The press are not responsible for the low-standing of medicine and science, it is scientists' failure to commit to scientific expertise and rigour and reject the hollow claims of prejudice. A good example is illustrated by the raft of responses to unsubstantiated claims such as the MMR panic, mobile phone enquiry, mad cow disease etc. On each occasion, the reports refused to calm the public's anxiety. Instead they sought to 'appreciate public concerns', whatever that means. The public would trust scientists more if they were not patronised, and told that these claims are without substance. FULL STOP!

The press have always inflamed popular anxieties, the difference today is that doctors, nurses and researchers no longer have confidence in the scientific method over and above personal anxiety. Skepticism demands us to ask for the proof, cynics simply dismiss the truth. The Lancet proved itself more a cynic last week, in the way it has distanced itself from Dr Wakefield's MMR paper. Rather than accept responsibility for not reviewing the veracity of the methodology and substance, the journal has used the cynic's weapon of accusation by association. If this prestigious medical journal is unable to interrogate skeptically, then our desire to lambast the popular press is more likely a knee-jerk response to blame the public. For those of us who trust the public, we need to recover some skeptical reasoning which promotes the authority of medical science and is uncompromising about quackery and falsehood.

williamgrogan

Hear! Hear!

PS

What bit don't you understand?

PaulP

I have to defend the Lancet, although I am often among its attackers.

Its main problem with the Wakefield paper is that the MMR section was not based on a random sample. The only way to be aware of this would have been if Wakefield or one of his co-authors had explicitly described in the paper how the sample was selected. In the absence of such information the sample was taken to be random.
Wakefield now says he wrote to the Lancet three months later with information on how the sample was chosen. Which leaves me wondering why this was not in the paper itself, where it belonged.

Egalitarian

I am not so sure I would be so forgiving of the Lancet. The Lancet accusation of a conflict of interest in the MMR study is self defeating. Rather than challenge the methodology of the study without reference to the mud throwing, and question why a study which had no evidence to substantiate the MMR link to autism other than speculation was published in a peer review journal, the Lancet has chosen to suggest that pecuniary interest and/or third party interests resulted in selectivity bias. Unfortunately, this gives the impression that Wakefield's study and results were biased and that personal motivation or solidarity is necessarily a bad thing. As many medics have found to their cost, guilt by association is a pernicious charge thrown about by every opponent of scientific expertise. This does not win the argument for science, but inflames irrational distrust of scientists - as was clear in BBC Question Time (26/2/04) and last night's Tonight with Trevor McDonald on ITV. The salience of 'conflict of interest' nowadays has been imposed on the scientific community so that journals like the BMJ and the Lancet routinely suspect the work of scientists based on association to the tobacco, fertility and food industries. It is important for us to reject this cynical trend and demand that the key question of a study should focus on the quality of the research and experiment, and ensure that conclusions are evidence based.

More damaging is the way that the Lancet's attempt to discredit Dr Wakefield implies that there was a kernel of truth in the speculative link between MMR and autism, but based on a biased sample. Unfortunately, this is far from the truth. The original study offered no substantiation of the alleged link even with the group of potential litigants included. Is it not incumbent of the medical profession to refuse publication of speculative studies in peer reviewed journals? This is not an argument of censorship, since there is ample scope for the heterodox researcher to publish on the internet. Indeed, I am wholly in favour of more critical work. However, if prestigious review teams do not draw the line then we can not expect the public to do so.