We can’t prove it, but….Faith-based medicine and special pleading

CAM proponents often engage in the rhetorical fallacy known as special pleading. Wikipedia’s definition of this is adequate: “a form of spurious argumentation where a position in a dispute introduces favorable details or excludes unfavorable details by alleging a need to apply additional considerations without proper criticism of these considerations themselves. Essentially, this involves someone attempting to cite something as an exemption to a generally accepted rule, principle, etc. without justifying the exemption.”

Because many forms of CAM, such as homeopathy and various “energy” and “mind-body” therapies are based on principles inconsistent with established scientific knowledge, their advocates sometimes have to try and find ways to justify why these methods should be taken seriously despite this major weakness. They frequently argue that their methods rely on principles science does not yet, or perhaps cannot, understand. They argue that, despite the incontrovertible success in the last few hundred years of established methods of scientific investigation in figuring out and manipulating phenomena in the real world, these methods are culturally defined (i.e. “Western”) and only apply to their cultural of origin, or that they are incapable of dealing with new kind of phenomena.

These arguments seem pretty weak in the face of historical reality, but there is of course always a chance that a given “paradigm shift” or “revolutionary” new principle of biology, medicine, or physics has been discovered that turns all we know out the door.  However, this is an extraordinary claim, and it cannot be defended simply by pointing to a few anecdotes, one’s personal experience, or the ultimate foundation I believe it really rests on, faith. The whole reason we even have a category of medicine called “alternative” (or as I prefer to call it, “faith-based medicine”) is because people believe things they cannot convincingly demonstrate to those who do not share their faith or their trust in personal experience.

In 2008, there was a symposium held at the UCLA Center for East West Medicine (note the postmodernist bias that all knowledge is culturally relative even in the very name of the organization) and reported in eCAM. The purpose of the symposium was, as always, to try and convince mainstream medicine and the public of the scientific legitimacy of CAM.

“Its purpose was to address the finding by the National Center for Complementary and Alternative Medicine (NCCAM) that IRB’s may be unfamiliar and/or uncomfortable with unconventional medical modalities thus apt to disapprove studies of those modalities. The hope was to better this state of affairs by familiarizing the audience with some of the major controversies surrounding CAIM research and its regulation.”

NCCAM has been widely criticized for being a tool of the CAM political lobby and of wasting taxpayer money trying to validate implausible therapies only because they are favored by powerful politicians or well-funded lobbies. This criticism, and questions about the scientific legitimacy and ethics of NCCAM-funded research was raised by critics at the UCLA symposium, and the responses of CAM advocates are enlightening in that they demonstrate the special pleading CAM requires because it cannot meet the evidentiary standards of scientific medicine.

According to the eCAM article, “Dr Ary Goldberger, Director of the Margret & H. A. Rey Institute for Nonlinear Dynamics in Medicine at Boston’s Beth Israel Deaconess Medical Center and Professor of Medicine at Harvard Medical School….suggested that conservatism in science extends to the underlying approach to physiological systems, often wrongly privileging homeostasis (‘constancy as the wisdom of the body’) over complex adaptability, multi-scale dynamics and emergent properties. In as much as they are non-linear, non-stationary, non-additive and show time irreversibility, however, complex systems may be inaccessible to conventional analytic techniques, according to the speaker. Dr Goldberger left the impression that he believes both investigators and NIH Centers in general ought to be more open to novel but rigorous research designs and methodology.”

So here’s the claim that because CAM methods don’t seem to get validated by conventional scientific investigations, the flaw must be not with those methods but with the very nature of science. We need to invent new ways of studying nature, despite the wild success of our current approach, because the methods he favors don’t get validated the way we do things now. Again, paradigm shifts do happen, but they are rare, and the vast majority of revolutions proclaimed by outsiders in science are nothing more than desperate attempts to defend failed ideas.

Next, Distinguished Professor Edwin Cooper (Editor in Chief, Evidence Based Complementary and Alternative Medicine) “raised questions about what passes for good research methodology, asking whether studying ancient, whole systems of medicine using Western, reductionistic techniques doesn’t strip them of essential features.”

Here again is the postmodernist notion that truth is culturally relative, and that science somehow only applies to ideas that originated in the culture that most directly contributed to the creation of modern scientific methods. This is blatantly ridiculous, as any Chinese or Indian or other “Eastern” patient benefiting from modern scientific medicine could tell you. Our physiology doesn’t care where we live or what language we speak, physics doesn’t work differently on different continents, and while values depend heavily on culture, the truth about how our bodies work doesn’t. Millennia of traditional folk methods in India or China or anywhere else failed to eradicate infectious diseases like polio, lower infant mortality, raise life average expectancy, or otherwise improve human health and well-being to anything like the extent “Western” science has in only a few hundred years. The notion that other cultures have other medical realities is at best a sincere but weak defense of implausible or outright failed ideas based on the inappropriate translation of cultural relativism to the scientific domain. At worst, it is simply old-fashioned orientalism with the patina of scientific “open-mindedness.”

My favorite comment, though, comes from Professor-in-Residence Mark Cohen. First continuing the special pleading approach, he “expressed the view that current research tools may be inadequate for measuring the effects of some CAIM treatments.” Yeah, well prove it. But he then went on to all but admit that CAM is a faith-based belief system much more like religion than science: “he noted that taxpayers already support faith-based initiatives and questioned whether conventional science has a ‘special entitlement’ to public funds, given that orientation.” Here he is saying that because a large number of Americans accept giving government money to religious organizations for performing services previously considered the responsibility of a secular government, we should similarly support giving taxpayer dollars to study CAM rather pretending conventional science should have a special claim to research money just because it is a proven and effective approach and CAM is mostly a hodgepodge of vitalism, folk traditions, and stuff outright made up by unappreciated lone genius or know charlatans. Our faith, our belief alone should be sufficient to justify it. It isn’t possible to be much clearer about the philosophy behind alternative medicine than that.

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2 Responses to We can’t prove it, but….Faith-based medicine and special pleading

  1. Mark Cohen says:

    Did you in fact receive my reply to this post? I see no record of it.

  2. skeptvet says:

    I have no record of a previous comment from you on this post. Please feel free to attempt posting it again, or to e-mail it to me if for some reason that doesn’t work.

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