On people who just don’t seem to ‘get’ it…
by Jim Caryl
What we end up doing is waging a battle of wits and reason with the truly and irredeemably unreasonable.
People have the right to make up their own mind about matters that concern their health and their wealth, thus being able to make informed choices based upon reliable and testable evidence is a good thing.
Some people, however, are deeply recalcitrant, and seem immune to modern scientific sources of evidence. How do you convince people that such evidence not only exists, but that it abounds? And why do some people refuse to ‘see‘ such evidence?
This week I’ve been asking people these questions, dutifully seeking the opinions of research colleagues, other sceptic friends and a smattering of individuals who were simply trying to get past me to the bar for an ale.
These were some of the suggestions:
1. One of the problems is that many people have no concept of evidence, which is down to education, and yet ironically, many people will have a unconscious concept of evidence, i.e. they are aware of the proceedings of a courtroom drama, but seem unable equate this basis of evidence with real life. In another example, someone suggested that people could recognise evidence, such as the the tell tale signs that your dog has done something. Actually, I had to step in and spoil this perfectly reasonable stab at an example by pointing out that in a recent study it was shown that the look of guilt in dogs is actually a reflection of the owner’s body language when the owner expects, or suspects, that the dog has done something bad, even if it hasn’t. Thus this is another win for systematic evidence rather than casual observational evidence.
One good example of a well-meaning, but thoroughly (and stubbornly) mis-informed individual, with little concept of evidence, can be seen here in an edition of the Canadian version of Dragon’s Den, incidentally being given short-shift by the Dragons (via Cath Ennis‘s blog)
There is no particular suggestion that he is aware that what he is peddling is actually snake-oil; he genuinely doesn’t seem to recognise it himself, or that the soggy pamphlet he proffers is not ‘medical research’. However, the idea that he thinks he can pull the wool over other people’s eyes is laughable.
This last fact is perhaps most irksome, the belief that you’re stupid enough to swallow what people such as him are saying.
I’ve written previously about what happens when we listen to hocum, instead of modern evidence, in the first-aid treatment of burns:
“Treatment involved applying to a burn “on the first day” a mixture of milk from a woman who had just given birth to a son, gum, and ram’s hair, together with a spoken incantation: “Your son Horus has burned himself in the desert. Is water here? There is no water here. Water is in my mouth, a Nile is between my thighs, I have come to put out the fire. Flow out, burn!”. Since that time in history where plant and animal extracts were popular, many other topical treatments have been used, such as vinegar and wine in Roman times, oily mixtures in the 1800s, tannic and picric acids from the early 1900s, and finally cold water.”
So, assuming you have no lactating women around, no gum, no choice snippets of hair from a Ram, then you can always rely on the incanted threat of having your burn spat on, or pissed on. Invariably over the years, you would be oiled, wined or burned with wood acid or an explosive. I wonder whether there is some sense of irony given that every remedy seems poised to complete the cooking of meat that you’ve already started, complete with some basting?
Finally, from modern evidence we learn that cold water that has the documented benefits of: decreasing mortality, pain relief, decreasing cell damage, decreasing skin temperature to below dangerous level, decreasing cell metabolism in hypoxic tissue for greater cell survival, stabilising vasculature, reducing oedema, improving wound healing and scar formation and decreasing inflammatory response. The above is a victory for common sense, and documented evidence-based medicine, rather than the hocus of old.
2. People may have a personal concept of evidence which may, to varying degrees, merely be tacit observation of cause and effect. Thus, as with the old adage, seeing is believing. Forgetting of course that correlation does not infer causation. Here there is a need to resolve the conflict between what people often want to be true, and what is actually true. I would guess that most of the trolls I come across in various forums, from evo-devo to complementary & alternative medicine, have developed a personal sense of what evidence is, but their tenuous grasp is often made painfully obvious by their inability to determine the validity of their source of evidence.
These people are terrific time-wasters, throwing in cut&paste rhetoric and tedious bit of information that is often decades old and has been refuted resolutely. Still, made them look good for a little while on the forum as the sceptic spends an hour investigating the outrageous claim, only to discover it’s yet another red herring.
In this regard, journals such as the Homeopathy, a peer-reviewed (meaning nothing in this case) journal published by Elsevier (shame on them) who otherwise publish well respected scientific journals, do a great dis-service by masquerading as ‘scientific’. To a non-scientist, a paper selected from here may look and sound scientific, but to a trained scientist they often have glaringly obvious omissions. One particular example of so-called evidence for homeopathy bounded around this week was a study on a remedy called ‘Coli 30K’, which was used to treat infectious diarrhoea in pigs. Studies like this are a favourite with homeopathists trying to escape the fact that their treatments have little effect beyond placebo. They reason that if their treatments work on pigs, who evidently (though we can’t be sure – read Nineteen Eighty-Four?) don’t respond to the psychology of placebo, then the treatments must de facto work.
In any case, to cut a long-story short, Richard Grant over at the F1000 blog has beaten me to the take-down, but one of the most obvious caveats of the study was that when they tried to determine the presence of an infectious agent (a coliform such as E. coli or Salmonella spp.) in the diarrhoea, they didn’t find any. But, they surmised, that didn’t mean it wasn’t on the farm somewhere, thus they used the appearance of the diarrhoea as their sole diagnostic measure. They also did a naughty bit of cherry-picking their results to get them a nice p-value statistic. Tsk, tsk.
Where was I? Oh yes…
3. People don’t like to be handed facts, especially in an authoritarian manner, and especially when it goes against something that they like, or believe in. As many of us lament of believers, it takes one single tantalisingly small piece of evidence to convince someone of something that they already believe, but 10,000+ pieces of evidence to convince them otherwise. Such people will cling on to their one piece of (usually) pseudo-evidence, and refuse to see anything that contradicts it.
There’s not a whole hell of a lot you can do with people like this.
Ultimately, the scientific position of many of the most frustrating trollers in the forums resolve down to little more than reckonings. These are people who may not know anything about a subject, but that won’t stop them telling you what they reckon.
4. The guy at the bar, incidentally a medic, said that even if someone was willing to find the current evidence for a particular practise, there’s a good chance that they won’t know where to go to find it. Even if they do, there’s a strong chance that it will be behind a pay-wall, as many scientific publications unfortunately are, and even if they do gain access to these sources of evidence, they may then me limited due to a technical language barrier. Thus it falls to the effective communication of such evidence, which is what sites like Scienceblogs, ResearchBlogging and public information sites like NHS Science, and 10:23 (Homeopathy: there’s nothing in it), are all about.
Despite committing the last 10 years of my life to the active scientific pursuit of evidence generation and validation, I will continue to pitch myself into arguments with the type of people who, to borrow an analogy from here, would put a twig on their head and expect you to believe that they’re a tree, and where anything you say to rebuke them is taken as further evidence of their being a tree.
I’d actually love to have other people’s opinions, or reckonings