Facing Our Own Mortality: Richard Dawkins and Alternative Medicine
On the recommendation of several members of the blogosphere, I’ve been watching a new British TV Series called “The Enemies of Reason” hosted by Richard Dawkins, a noted atheist and evolutionary biologist at Oxford. The series offers a skeptical review of the claims of alternative medicine practitioners, strung together with Michael Moore-like skill, and designed to showcase the fringiest believers as they concoct wild, pseudoscientific explanations for the mechanism of action of their therapies. It is entertaining and whimsical – though Dawkins himself appears dogmatic and cold as he ultimately builds a case for science as a religion.
Although I agree with Dawkins on many points, I think his approach is somewhat superficial and unnecessarily adversarial. Instead of unmasking kookiness and labeling people as “enemies of reason,” I think it would be more interesting to ask: why are people seeking out pseudoscience? What is the deeper need that scientific medicine is not satisfying? Why are billions spent on alternative therapies? (Please note that the “alternative therapies” that Dawkins evaluates include things like quantum homeopathy, magnetic healing, angelic guidance, and other treatments that don’t have evidence-based underpinnings.)
I think that at the very heart of the matter is that we humans want to feel in control. For millennia we’ve been conjuring up bizarre theories in order to believe that we can influence our destinies and our health. Just take for example the elaborate Egyptian religious myths (health was controlled by one’s ka which required regular food and drink offerings – not to mention all the elaborate embalming rituals to influence a good afterlife). All of these rituals provided the Egyptians with a sense of control over their lives, deaths, and reincarnations. I’m not entirely sure that we humans today are much different in our desire to control our lives. We just manifest it in other ways.
Ironically, science feeds pseudoscience – the more we know, the more definitive we can be about a disease or its prognosis – and the greater the desire to buck against that. And so as we advance in medical understanding, it is not surprising that there is renewed interest in magic as a means of influencing our clinical course as the inalterable progression becomes clearer and clearer. Add to that the fact that the physician-patient relationship has been undermined by a series of unfortunate historical circumstances (the rise of health insurance middle men, decreasing reimbursements, administrative red tape, etc.) and you have a group of dissatisfied patients with chronic diseases that have predictable complications – all seeking alternative outcomes at the hands of any compassionate person who promises to give them some control back. Of course, our “quick fix” culture also gives rise to a preference for simple solutions, rather than complex (though effective) ones. Is there any wonder that snake oil has emerged as a major player in this climate?
Dawkins makes the convincing argument that certain alternative medicine practices rely entirely upon the placebo effect. If this is the case, practitioners of these therapies cannot admit that their remedies are placebos – in so doing they would undermine their potential effects. Therefore, one cannot expect a rational response from them when confronted with evidence that their strategies do not work or are implausible. For the remedies to have a perceived effect, they only need to be believed in by the recipient. The millions of dollars spent by the National Health Service and National Institutes of Health attempting to uncover the mechanism of action of implausible therapies (such as homeopathy) will not influence the millions of faithful believers who turn to such practices for their health. I suppose that once the placebo effect has been scientifically proven, only the skeptics will be convinced by the data.
In the end however, Dawkins’ “war” is not between the evidence based medicine camp and the placebo based medicine group, it’s really an internal battle that each of us faces about our own mortality. The process of coming to terms with health and disease is uniquely personal – some want to be (as Dawkins puts it) coddled, others want the cold hard facts. As for me, all I want is for patients to be able to make informed decisions, not to be misled about therapeutic safety or efficacy, and not to be guided away from known effective treatments and towards known ineffective treatments. I suspect that this is what most people want as well.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
You and I are pretty much beating the same drum. Or at least different drums in the same drum line; the beat is the same. Well said.
Incredibly insightful Val. Thank you for sharing this. I would like to add another perspective to “we humans want to be in control…” I agree, but I think there is the opposite to that working also. We humans want to believe in supernatural powers guiding us and protecting us. While we want to be in control, we hate to think that we alone are in charge of our lives, including our health. Belief, even in superstitions, allows us to have a sense of supernatural forces taking care of us is very comforting. This, I think, has a lot to do with the resurgence of fundamentalist religions, with beliefs that are just as inconsitent with known history as the health beliefs are inconsistent with known science.
Dino – we’ve got the same rhythm! Cool.
Joe – Interesting… but I’ve noted that hyper-religiosity is often a control issue as well. They come up with elaborate prayers and fasting and self-flagellation to bend God’s will to their own. The more “freeing” form of religion (in my view at least) is one where we use our God-given brains to seek out scientific enlightenment – and leave the rest up to Him. Kind of like the Serenity Prayer (“God grant me the
serenity to accept the things I cannot change; courage to change the things I can; and wisdom to know the difference.”) Bottom line for me: science doesn’t disprove the existence of God, it proves that our understanding of Him is incredibly limited.
I am a scientist and an agnostic. Several years ago I would have told you that I was a strong believer in medical science. I would not have considered alternative therapies that were unproven. But when illness stuck, and the road to a diagnosis was long and endless, I didn’t feel cared for. I was just a symptom, a test result, not a person whose illness resonated through my entire being. And when conventional medicine fails you, where do you go? I don’t have the problems with access with the alternative providers I have seen. They spend more time and treat me like a whole person. Perhaps the placebo is feeling cared for.
I would add that Dawkins has invented and practices his own religion, has crafted his own mythology, which he asserts is more ‘catholic’ than mere science. The history of science, of course is an iterative process of one prevailing theory or paradigm replacing another, and that is because, although the scientific method is sound, and is based upon repeatable observation and the accumulation of these observations, they sustain a process of model building. This is no different than myth making. Building models is the way that our brain always practices ‘pattern recognition’ by filling in the voids in information with what would be there if the pattern were ‘this’ or ‘that’, which is why we see stampeding herds in clouds, or Jesus in a grilled cheese sandwich–or why Dawkins sees science as another form of religion. Wittgenstein identified this problem a long time ago–their are limits, constraints, and boundaries imposed upon our epistemologies by the nature and structure of language itself. The domain of the environment, the ‘problem’ domain, is by definition, larger than our collection of linguistic representations of it. Our cognitive view is always smaller than the total set of possibilities. Given this predicament, we must abandon the notion of finding absolutes in any field of human knowledge. Our knowledge is always and only conditional, qualified, and knowledge is without value unless it provides a way to accomplish something worthwhile. The rest of it is speculation with no more value than attempting to quantify the number of angels spinning in infinity. The French existentialist Gabriel Marcel pointed out the difference between genuine mystery, and problems to be solved, the struggle to protect one’s subjectivity from annihilation by modern materialism and a technology oriented society. Marcel argued that scientific egoism replaces the
“mystery” of being with a false scenario of human life composed of
technical “problems” and “solutions.” The human subject cannot exist in
the technological world, instead being replaced by a human object. In Man Against Mass Society and other works,
technology has a privileged authority with which it persuades the
subject to accept her place as “she” in the internal dialogue of
science; and as a result, man is convinced by science to rejoice in her
own annihilation. But mystery is not always a problem to be solved. There is a domain of problems that can have a solution–but this domain does not map across the entire Universe–it is a limited subset–and to dismiss the efficacy of ‘cure’ as ‘placebo’ explains nothing–the mystery behind the ‘curative process’ remains–and true insight slips away.