Sunday, April 6, 2014

Conspiracy theories: The dark heart of alternative medicine

If there’s one thing a budding skeptic quickly learns is that at the core of any good woo almost invariably lurks at least one conspiracy theory. At the risk of flirting a little too close to Godwin territory, this simple fact about pseudoscience, pseudohistory, and other non-evidence-based belief systems was first driven home to me around 15 years ago when I first started becoming interested in Holocaust denial. It didn’t take too long for me to discover that at the heart of Holocaust denial are various conspiracy theories. Somehow the Jews, we are told, conspired to exaggerate the number of Jewish dead in World War II, to make up stories about poor uncle Adolf that make it look as though he planned on killing all the Jews in Europe, when really all he wanted to do was to eject them (as if that were OK).

Often at the basis of these conspiracy theories (more here) was the simple fact that the Holocaust did start out with Hitler’s desire for Lebensraum (or “living space” to the east), free of Jews. When Poland and then later the western Soviet Union was occupied by the Nazis, thus bringing millions of European Jews under Nazi control, in Hitler’s mind that necessitated removing the Jews from Nazi-occupied territories. As I’ve been reminded by reading in Timothy Snyder’s excellent book Bloodlands: Europe Between Hitler and Stalin, early on the German plan was to deport the Jews farther east. The plan later evolved to different variants, the last of which involved shipping the Jews all to Madagascar. (I’m totally serious; the Nazis did contemplate that.) Unfortunately, with Britain still fighting on and its navy still ruling the seas, there was no realistic way to accomplish this feat. So ultimately, the plan evolved to become extermination through a combination of starvation, shooting, and ultimately gassing in industrialized death camps. Of course, in the conspiracy theory mindset of Holocaust deniers, the claim that the Nazis planned on exterminating the Jews is a lie spread by Jews and, of course, the Allies, in order to discredit Hitler and as a guilt-inducing plan to keep Germany from ever rising again.

I exaggerate, but only a little. In practice, this conspiracy theory postulates that, although there were mass murders of Jews by the Nazis, it was the heat of war and there never was a plan to exterminate European Jewry, and, above all, there were no homicidal death chambers. (Oh, and by the way, Stalin was worse—at least in the minds of Holocaust deniers.) These are then often tied into ancient antisemitic conspiracy theories, like The protocols of The Learned Elders of Zion.

This post is not about Holocaust denial, though. I only mention it because it’s the first conspiracy theory that I delved deeply into and the one that, more than anything else, launched me into skepticism back in the late 1990s. What it is about is how conspiracy theories underlie just about every bit of pseudoscience and pseudohistory, even medical quackery. It turns out that there was an editorial/study published a couple of days ago that readers sent me. I had intended to write about it yesterday, but, then—wouldn’t you know?—Dr. Bob Sears had to go and write something incredibly stupid about measles and vaccines, compelling Orac to do what Orac does best. So now I’ve made it back to the study, which is basically a poll of Americans about medical conspiracy theory beliefs published in JAMA Internal Medicine, authored by Eric Oliver and Thomas Wood.

In brief, the letter, which was characterized as a Research Letter, consists of a report of the results of a survey about conspiratorial thinking in medicine designed to determine the extent of what the authors call “medical conspiracism” in the American public. Basically, a nationally representative online survey sample of 1,351 adutls was collected in August and September 2013 by an Internet research company YouGov. Survey results were then weighted to provide a representative sample of the population, which the authors claim will produce the same degree of accuracy as in-person or telephone surveys. I must admit, I’m a bit skeptical of this claim and would need to see a lot more evidence than a single cited study. But for the moment, let’s assume that a carefully curated, opt-in Internet survey can produce results that approximate those of a well-designed in-person or telephone survey and look at what the survey found. Unfortunately, medical conspiracy theories are common and enjoy a large amount of support:

Table 1 lists the proportions of Americans who report having heard of 6 popular medical conspiracy theories (the full wording is in the table) and their levels of agreement with each. Conspiracy theories about cancer cures, vaccines, and cell phones are familiar to at least half of the sample. These theories also enjoy relatively large levels of support: 37% of the sample agreed that the Food and Drug Administration is intentionally suppressing natural cures for cancer because of drug company pressure; 20% agreed either that corporations were preventing public health officials from releasing data linking cell phones to cancer or that physicians still want to vaccinate children even though they know such vaccines to be dangerous. Conspiracy theories about water fluoridation, genetically modified foods, and the link between the human immunodeficiency virus and the US Central Intelligence Agency were less well known: less than one-third of the sample said that they had heard of these conspiracy narratives and only 12% of respondents agreed with each. In sum, 49% of Americans agree with at least 1 medical conspiracy theory and 18% agree with 3 or more. These percentages are largely consistent with those found by surveys about political conspiracy theories.

Here’s the table:

To be honest, I’m rather surprised that some of these conspiracy theories come in with such low numbers. At the very minimum, I’m referring to the one about the FDA supposedly “suppressing natural cancer cures” to protect pharmaceutical company profits. To me 37% believing these conspiracy theories sounds about right. It would also go a long way towards explaining the susceptibility of so many people to the blandishments of, for example, Stanislaw Burzynski, whose cancer treatment known as antineoplastons has never been approved by the FDA and who has never published a completed phase II trial of antineoplastons, easily and skillfully taps into this vein of “medical conspiracism” by portraying himself as being “persecuted” by the FDA, under the influence of big pharma. It’s not just Burzynski patients, either. There is a large amount of support for patients with cancer seeking out Burzynski for treatment. I’ve seen it time and time again. No matter how much it is pointed out that Stanislaw Burzynski has no compelling evidence that antineoplastons are safe and efficacious in treating cancer, no matter how much it is pointed out that Burzynski takes advantage of vulnerable patients, there are always people who distrust the FDA far more than is warranted who will tend to be more aligned with the patients and families than with the forces that they perceive to be keeping such families from Burzynski’s natural cure.

The second part of the survey started to look at the potential consequences of such beliefs, which were found to be correlated with a variety of health behaviors. Not surprisingly, conspiracism was found to correlate with greater use of alternative medicine and the avoidance of conventional medicine, a greater likelihood of using of herbal supplement and to purchase organic foods, and a lesser likelihood of getting the flu vaccine, seeing the doctor or dentist regularly, or using sunscreen. None of this is surprising. Unfortunately these sorts of beliefs appear to be very common.

One disadvantage of waiting a day to blog about this is that everyone and his grandmother’s already commented on this particular survey. One advantage of waiting a day to blog this is that it gave the cranks a chance to react. One crank, in particular, took up the banner, virtually proving everything in the study. Yes, I’m talking about our old “friend” Mike Adams, who posted a breathless piece—aren’t all of his pieces breathless?—entitled Top ten REAL medical conspiracies that actually happened. Unfortunately, the very title alone is link bait, virtually guaranteed to get him high traffic through the typical sources that fall for link bait, such as Reddit, Facebook memes, and the like. (What is it about various lists and link bait? But I digress.)

As is frequently the case with Mike Adams Health Danger rants, the introduction is gut-bustingly hilarious:

The mainstream media is focused this week on trying to convince you that “medical conspiracy theories” are whacky and untrue. Published by Reuters, USA Today and other mainstream media outlets, a false story based on distorted research is now trying to convince you that there is no such thing as a “medical conspiracy.” No, drug companies never conducted experiments on children, killing many in the process. No, the NIH never took part in criminal medical experiments on prisoners. No, the U.S. government never lied to you, or covered up natural cures, or conspired with Big Pharma. GMOs were created by people who LOVE the ecosystem, too!

That’s the nonsense we’re all supposed to believe, according to the mainstream media.

By invoking the phrase “conspiracy theories,” junk science authors and corporate-sellout journalists try to marginalize the true history of Big Pharma felony crimes, medical experiments on children, factual government collusion with industry and the incredible harm which has been perpetrated on the American people by the medical industrial complex.

In fact, the mainstream media’s coverage of all this is truly Orwellian, as if the Ministry of Truth is trying to rewrite U.S. history to eliminate all the parts where drug companies, the NIH and the U.S. government quite literally murdered prisoners, blacks, babies and soldiers in the name of “scientific medicine.”

Of course, this is all a massive straw man, as this study said nothing regarding the existence of various misbehaviors and abuses on the part of the medical system and pharmaceutical industry. Rather, it only looked at conspiracy theories that are common but known not to be true, such as the claim that doctors keep vaccinating even though they “know” that vaccines cause autism, that health officials “know” that cell phones cause cancer (they don’t, as far as can be determined and can’t based on currently understood mechanisms of carcinogenesis) but hide it, and that the FDA is hiding an effective “natural” cure for cancer. Yes, of course pharmaceutical companies have done bad things. Such malfeasance does indeed feed conspiracy myths, but they aren’t “real conspiracies” themselves of the type that the study examined. Conspiracies. You keep using that word. I do not think it means what you think it means, Mikey. I don’t have time to look at everything on his list (I’ll leave this as an exercise for the interested reader); so I’ll “cherry pick” a handful of examples.

While individual pharmaceutical companies might have hidden data that were unfavorable to their products (as a couple of Adams’ examples indicate), it’s not the same thing as a conspiracy theory, nor does it validate conspiracy theories, as Adams tries to “prove.” Of course, many of the rest of Adams’ examples are right off the charts. Adams cites the reaction of the mainstream medical community to an execrable anti-GMO (genetically modified organism) study by Professor Gilles-Eric Séralini that claimed that GMOs cause cancers in lab rats. I deconstructed that study, as did many others. (Where’s my check from Monsanto”) The reason the mainstream scientific community reacted so poorly to that study was not because there’s a “conspiracy” to “suppress” studies finding danger in GMOs, it was because Seralini’s science was so damned bad. Not that that stops Adams from ranting:

The mainstream media wants you to believe that you are a “conspiracy theorist” if you believe in biochemical cause and effect. Don’t worry, Monsanto loves you! And so do pesticide companies, whose chemicals are so safe that you should be eating them for breakfast!

I’ll pass on the pesticides, but load up my plate with foods made of GMOs.

Not surprisingly, Adams also cites a “The massive academic fraud and conspiracy to discredit Dr. Andrew Wakefield by spreading provably false lies about his research.” One notes, of course, that Adams can’t then cite any actual “provable lies” about Wakefield. The fact is, if there was anyone engaged in a conspiracy, it was Wakefield, as he hooked up with a trial lawyer seeking to sue vaccine manufacturers for “vaccine-induced autism,” received a large grant to do research to support such a case, and even had a competing vaccine for when the MMR was “discredited.” Ultimately, he appears to have committed research fraud in his quest to discredit the MMR, after having basically invented “autistic enterocolitis.”

Then, of course, Adams cites examples of what he considers “gunpoint medicine” but what I consider rare cases of governments actually trying to act to save children from medical quackery. Naturally, he gets all in a lather over Sarah Hershberger, the Amish girl whose parents refused chemotherapy and has become a libertarian/”health freedom” cause célèbre. He also mentions Abraham Cherrix, but doesn’t mention that Cherrix’s cancer has returned and that when last he appeared in the public eye he was battling recurrences of his lymphoma, and Katie Wernecke, who appears to have been very lucky in that she is still around despite her parents’ refusal to complete her conventional therapy. None of these cases are related, but Adams relates them as part of a grand “conspiracy” on the part of health authorities to force children to be injected with “toxic chemicals” against their will. In reality, if anything, health authorities tend to be too deferential to parental “rights” and prerogatives, to the point that children die because they are treated with quackery or faith healing instead of real medicine, but not to Mikey.

Come to think of it, Mike Adams appears to be the best example of medical conspiracism I’ve ever seen. I’m hard pressed to think of anyone more steeped in conspiracy theories than he is. Garry Null, maybe, but only because he’s had about 20 or 30 more years to work on his conspiracy theories than Mike Adams. No conspiracy is too bizarre. No conspiracy is too unbelievable, implausible, or improbable for him. Just don’t tell Lord Draconis Zeneca that Adams is on to him. Perhaps we should send a drone to pick him up. I await your command, O Scaly One!

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