David Colquhoun at the University of Toronto

As was advertised ad nauseum on TFP over the past few weeks, Royal Society member and noted skeptic David Colquhoun spoke at the University of Toronto last night. Colquhoun’s presentation was this year’s main event of the University of Toronto Secular Alliance, and it was a great success.

Despite being held on a cold Friday night in January at a large urban university where approximately 75% of students live off campus, there was a great turnout. I’m not sure of the official headcount, but there had to be a good two or three hundred people in attendance. The pre-event reception at CFI Toronto was also well-attended, with probably around 50 attendees. Word of mouth suggests that a number of people heard about this event on blogs such as Respectful Insolence, Larry Moran’s Sandwalk, Colquhoun’s DCScience, Jacks of Science, Liberal Debutante, The Frame Problem, and others.

I was planning on giving a fairly indepth review of the event but being slightly “under the weather” impeded my absorption of information. Briefly, though, Colquhoun discussed 1) what homeopathy is and how it has managed to become popular despite its patent nonsensicality; 2) how a number of educational institutions in the UK and North America have introduced education and research programs for a number of alternative and complementary medicine approaches; 3) how despite there being a number of institutions supposedly dedicated to teaching and researching homeopathy, the evidence is still absent; 4) the absurdity of the costs of a number of alternative medicines given their cost to produce and the evidence of their efficacy; 5) deceitful practices of many alternative medicine proponents (e.g., saying that their product is more effective than anything the medical sciences have come up with, that the scientific community doesn’t want you to know X, or saying that their product actually does have a certain effect); and 6) that advocacy for alternative medicine can in some cases be dangerous (e.g., when people are encouraged to take it rather than receive scientifically verified medical treatment).

Some interesting things happened after Colquhoun finished speaking. During the question period I was particularly stunned by comments made by a medical doctor in attendance. The doctor began by criticizing the audience for largely agreeing with and not challenging Colquhoun. What is there to challenge when the speaker simply says that we should be wary of people selling us things that claim to do X but for which the evidence is lacking? Similarly, he accused Colquhoun of being a fundamentalist, to which Colquhoun replied by asking the gentleman in what way he had acted as a fundamentalist when his entire position was that we should be dubious of people trying to sell us products that they claim do X without providing the evidence for it? Perhaps more mind-boggling was when the medical doctor asserted that absence of evidence is not evidence of absence, at which point I had to yell out “Then why don’t we just believe in the Flying Spaghetti Monster!?”. I am not a doctor nor a medical student so I don’t know much about medical school curricula. But I would hope that students are taught that it is reasonable to form opinions based on sound evidence, and that belief in anything which has not been disconfirmed is not a justified position as it opens the doors to an infinite number of beliefs. Imagine the doctor that does not determine medical procedures based on evidence, and that perhaps tries to solve a patient’s appendicitis by pouring saline over the patient’s left hip—it hasn’t been disconfirmed so it just might work!

In discussion with some members of the audience, I learned some valuable things that have made me a bit more open to alternative medicine. My position was that alternative medicine is medicine that is not evidentially-based—if it were evidentially-based, it would just be medicine, not alternative medicine. Thus, I was automatically highly dubious of alt med. Counterarguments to this position had to do with money. Who would fund research to see if ginger tea had some sort of beneficial effect? It’s not like a pharmaceuticals company could patent this product. If they can’t patent it, why would any of them decide to invest millions in researching it? My rebuttal is: what about national governments? Wouldn’t national research agencies like NSF or NIH in the US, or NSERC or CIHR in Canada, be interested in research into these sorts of unpatentable potential medical tools? As a comparison, extensive research has gone into studying the effects of mindfulness meditation on physical and psychological health. Who is going to patent mindfulness meditation? If there were reason to believe in the beneficiality of alternative medicine X, why wouldn’t the sorts of agencies that fund research on meditation fund research on X? The second point made by my conversation partners were that big pharm companies would be resistant to the study of alternative medicines that are claimed to address ailments addressed by existing pharmaceutical products, as supportive findings could make these alt meds major market competitors—though now they would be viewed simply as medicine given the empirical support. After all, why wouldn’t people want to take an alt med which claims to be similarly effective to synthetic meds but without some of the side effects, for instance? But by the same token, how has so much research gone into Cognitive Behavioural Therapy and mindfulness meditation? Each of these practices would pose a potential threat to producers of psychoactive medicines.

While I can appreciate the arguments of these individuals—and they have opened my mind to some degree toward alt meds, my skeptical reflex is still being activated by the considerations just discussed.

If it is indeed true that a great number of alt meds are not studied extensively because of the sorts of financial reasons discussed above, then we have a new problem: how do we recognize the good alt meds from the crap that preys on credulity and attempts to trick people by couching their garbage in the terminology of science (e.g., “bio-energy”, references to quantum physics) and that of “ancient wisdom”? I posed this question to the audience members I had been speaking to. While they admitted that it was indeed a problem, one response was simply to listen to those you trust. Your mother, for instance, is not going to lie to you. There are problems with this, though. Firstly, your mother may have been helped simply by a placebo effect. Given that the placebo is a real effect and if it helps it helps, it could be said that as long as one trusts their mother they will be able to enjoy a placebo effect of their own. But that introduces the question of whether or not we want to fund opportunistic liars? Is the reality of the placebo effect sufficient justification for charlatanry? And what if the individual takes the alt med to the exclusion of proven scientific medical treatment? The second counterargument against taking the word of trusted individuals is that people tend to seek unconventional medical treatments when their illness gets particularly bad and their desperation for relief is high. When a person is feeling overwhelmingly terrible, there is a good chance that any further change in their experience could be an improvement—when you hit rock bottom, there’s only one direction to go. So, improvement may have been inevitable with or without the alt med. Of course the person could die, but the dead person isn’t going to be giving you alternative medicine advice. Moreover, alt med proponents could simply argue that the person waited too long before they began their alt med treatment, and that is why they died—or that the death was caused by something else. And if the person continues to get worse while they take the alternative medicine, the alt med practitioner can simply say that the alt med is currently flushing out toxins and that’s why it feels worse; it’s good that it feels worse, that means it’s working!

Maybe there are some truly beneficial alt meds out there. How do we recognize them?

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Comments
5 Responses to “David Colquhoun at the University of Toronto”
  1. Carol says:

    Good review of the talk. As DC said, the alties don’t need to do research because people are buying the products and services as they are and good research is most likely to turn up nothing beneficial to business. However research is being done on treatments that have some plausibility, e.g. the NIH now has a CAM division. Nothing very impressive has come out of it (yet). Check it out.
    DC did not stress the fact that CAM practitioners give people the time and attention they don’t get from most MDs. If we could figure out an honest way of giving people with chronic somatic and psychosocial problems the kind of care they are seeking, they wouldn’t need the woo to go along with it.

  2. Stoobs says:

    The money problem involved with testing alternative medicines is a very real issue, not only in alternative medicine, but even in conventional medicine. See, for example, the case with DCA as a cancer medication. Initial testing has shown it to be extremely efficacious in rats, but because the substance can not be patented, the drug would not be a profitable one. As a result, funds for human testing are being raised by advertising on the internet. This is not some psudo-scientist in a basement lab, this is the medical department of the University of Alberta begging for online donations to raise funds so that they can perform the testing necessary to clear the drug for human use. The government of Canada has provided some funds, but has not come close to covering the costs.

    Ultimately, government grants in these matters are written as cash giveaways to corporations, not as serious funding sources. They are intended solely to put money in the pockets of CEOs, not to assist in bringing cheap, effective medications to the general public.

  3. Kieran says:

    Great post! I was similarly dumbfounded with the statements made by the medical doctor from the audience. And yes, the “absence of evidence is not evidence of absence” remark was probably not a great thing to say to a room full of atheists 🙂

    There was another interesting question from an audience member that was something along the lines of “Wouldn’t shutting down homeopathic/natural medicine departments in universities reduce the amount of research being done on these types of medicine even further?”. Prof. Calquhoun responded that these departments aren’t doing the right kind of research (i.e. empirical, properly controlled) anyway, so their existence is not really justified. However, I think your idea of having grants that are dedicated to testing alt-meds is a great one. Not only would it help control the insanity that is homeopathy, but potentially validate the use of herbal/vitamin/natural remedies as actual medicines.

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