NHS physician Goldacre writes a column for The Guardian about bad science, and maintains a website on the same topic. Bad Science the book, which could have been a collection of columns, is an impressive overview of the manifold ways in which the scientifically illiterate public are manipulated and mislead by skewed findings, poor evidence, flawed research, faulty data, media spin and government hype to believe any number of erroneous things.
In most cases Goldacre uses a well-known example to illustrate a greater overall problem, though some individual issues are targeted for themselves as well. For example, dissecting homeopathy not only explains why evidenced-based medicine is the way to go (and what stringent research involves) but also opens the way for a comprehensive and fascinating discussion about the placebo effect.
While he reserves his greatest ire for ridiculous ideas embraced by government (the most notable of these, to a non-Brit, being the Brain Gym program introduced to a wide range of British schools), there's no shortage of other legitimate other targets.
Quite possibly my favourite chapter deals with Gillian McKeith, the self-styled nutritional guru and bowel obsessive who berates fat people on her popular TV show (and book of the same name) You Are What You Eat (as UK comic Dara O’Briain says, in that case she must mostly eat shrew). Goldacre examines her more dubious claims, like the ‘fact’ that eating plant foods high in chlorophyll will “oxygenate your blood” or that ‘skid mark stools’ are a “sign of dampness in your body” (believe me, you want your bowel to be damp – a dry bowel will perforate and haemorrhage in no time at all). He also dissects her apparently scholastic work (that references such peer-reviewed journals as Health Store News), and her credentials (which is how I discovered that the non-affiliated Australasian College of Heath Sciences is in Portland, Oregon). Most powerfully, he articulates the indisputable but often ignored fact that the biggest contributors to life expectancy and morbidity (and how well you are as well as how long you live) are not whether or not you eat walnuts for selenium and goji berries for their antioxidant properties but your socioeconomic status, income and education level – “you are what you eat, and people die young because they deserve it. They chose death, through ignorance and laziness, but you chose life, fresh fish, olive oil, and that’s why you’re healthy. You’re going to see eighty. You deserve it. Not like them.” Which reminds me strongly of Alain de Botton’s observation that the downside of living in a (perceived) meritocracy, where anyone can succeed as long as they just try hard enough, is that those who don’t succeed are therefore seen as lazy, stupid and/or deserving of their fate (see here for an interesting interview with him on the subject).
His chapters on communal reinforcement (where what peers think becomes reality to the extent that it can override what we see and know – think of the Emperor’s New Clothes) and the power of placebo are worth the price of admission in themselves. On top of that, though, are an admirable clarity of expression, transparent and logically constructed arguments, and a distressing revelation of how much of our perceived understanding of medical and scientific advances are dumbed down, distorted and misshaped by the media. As Goldacre points out, journalists see no need to dumb down other areas where there are technical and significant details that the uneducated layperson doesn’t understand (sport and finance, for example), that specialist rather than general journalists are expected to do the writing. But for science stories these rules change. I don’t know that I agree with his explanation of why this is – Goldacre, on several occasions, argues that arts students, intimidated at university by science they couldn’t and/or wouldn’t understand, now have the opportunity to turn the tables, and that they think it must be the same gobbledegook for everyone as it is for them. I do think that this idea that everyone has the right to an opinion and that all opinions are equally valid, and that if one ‘side’ of an argument is printed the other side have a right to reply, is oft times ridiculous. For example, there have been dozens of studies looking at a link between the MMR vaccine and autism. None of the valid studies (some of which, like the 7-year Danish study, have included thousands of children over an extended period of time) have shown any link at all. We know that vaccines protect children from devastating diseases, but parents still decide against vaccination based on a variety of reasons including the ‘other side’ of the MMR ‘debate’ – anecdotal information and fear. Goldacre says that, if he had a slogan for the book it would be “I think you’ll find it’s a bit more complicated than that.” I think this will be my new slogan for a whole range of things, from the cause/s of autism to indigenous affairs, the Middle East, Northern Ireland, drug and alcohol addiction, weight loss and maintenance, health care, global finance... and science. – Alex
No comments:
Post a Comment