“Who am I? Why am I here?”
Who could forget that memorable quote from Admiral James Stockdale, candidate for Vice President running with Ross Perot in 1992, during the first Vice Presidential debate? In a way, as the seemingly junior member of the crew of bloggers assembled here at Science-Based Medicine, I feel as though I should be asking that question, although I hope that, in the weeks to come, I won’t end up giving the same impression in comparison to the rest of the august crew here as Admiral Stockdale unfortunately did during his debate with, of all people, Dan Quayle. No, I don’t want to be leading readers to wonder just what on earth Steve Novella was thinking when he invited me to blog here as a weekly regular. It doesn’t matter that I’m an NIH-funded surgical researcher who’s also been funded by the Department of Defense and the American Society of Clinical Oncology. All that says is that I’m pretty good at science and cancer research (or, if you’re more cynical, that I’m really good at persuading study sections that I do worthwhile research). Without a track record comparable to that of my co-bloggers writing about the issues that this blog will highlight, you might ask: Why should I be taken seriously?
“Either homeopathy works or controlled trials don’t!”
—Scottish homeopath David Reilly at the 2001 Harvard Medical School Complementary and Integrative Medicine Conference.
Reilly based that assertion on his own series of four small studies of homeopathic treatments of hay fever, asthma, and allergic rhinitis, the outcomes of which had been inconsistent and largely subjective. (1) Later he explained that small-minded skeptics in “conventional medicine” assume “homeopathy doesn’t work because it can’t work,” a view echoed by conference host Dr. David Eisenberg, then the Director of the Center for Alternative Medicine Research and Education at Harvard Medical School (now of the Osher Center); these comments were met with appreciative laughter from the partisan audience. If such charges were valid, it would indeed be fortunate that Harvard Medical School, several other medical schools, and the National Center for Complementary and Alternative Medicine (NCCAM) are promoting homeopathy, both as a clinical method and as a topic worthy of research.
A recent web feature produced by the New York Times tells the story of Chris Kilham, “The Medicine Hunter.” Specifically it recounts his thoughts on the use of maca, a root native to South America, “said to have energy and libido enhancing properties,” according to the piece. The brief piece reflects the current attitudes popular in the public and promoted by mainstream media reflecting a false dichotomy between medicinal plants and pharmaceuticals. This false dichotomy is extremely counterproductive and ultimately harmful to consumers.
Kilham represents this false dichotomy when he says:
“My goal is to have more people using safe, effective, proven, healthful herbs, and fewer people using toxic, overly expensive, marginally effective, potentially lethal pharmaceutical drugs.”
There are many unwarranted assumptions in this statement. It seems to be implying that herbs are inherently more safe, less toxic, and more healthful than pharmaceuticals. It also assumes that there is a real difference between the two. Therefore Kilham seems to be saying something meaningful when he is actually just reflecting biased assumptions. This is made clear if we simply reverse his statement. Most people, for example, would agree if I said that “My goal is to have more people using safe, effective, proven, healthful pharmaceuticals, and fewer people using toxic, overly expensive, marginally effective, potentially lethal herbs.”
Science-Based Medicine is a new daily science blog dedicated to promoting the highest standards and traditions of science in medicine and health care. The mission of this blog is to scientifically examine medical and health topics of interest to the public. This includes reviewing newly published studies, examining dubious products and claims, providing much needed scientific balance to the often credulous health reporting, and exploring issues related to the regulation of scientific quality in medicine.
The philosophy of this blog, at its core, is simple: Safe and effective health care is critical to to everyone’s quality of life; so much so that it is generally considered a basic human right. The best method for determining which interventions and health products are safe and effective is, without question, good science. Therefore it is in everyone’s best interest for health care to be systematically evaluated by the best science available.
Too often the nature of science itself is misunderstood or misrepresented to the public. Science is not an arcane and privileged discipline. By its very nature it is meant to be transparent and public. Science is nothing more than a systematic and careful use of evidence and logic to evaluate factual claims. And good science possesses certain virtues that are not unique to science but generic to all intellectual endeavors: fairly accounting for all available evidence, using valid and internally consistent logic, using unambiguous concepts and language, proper use of statistics, being quantitatively precise and accurate, and above all being honest.