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Demonizing “Big Pharma”

To be blunt up front – SBM is not apologetic about the pharmaceutical industry. We get zero funding from any company, and have no ties of any kind to “big pharma.” In today’s world I have to spend time making that clear, because despite the reality critics are free to assume and falsely claim that our message is coming straight from the bowels of hell (a.k.a. the pharmaceutical industry).

We promote science-based medicine and criticize pharmaceutical companies along with everyone else when they place other concerns ahead of scientific validity, or promote bad science, for whatever reason.

It has become fashionable, however, to not only criticize the pharmaceutical industry but to demonize them – and the term “big pharma” has come to represent this demonization. Cynicism is a cheap imitation of skepticism – it is the assumption of the worst, without careful thought or any hint of fairness.

A recent article by Martha Rosenberg is an excellent representation of the mindless demonization of the pharmaceutical industry – good for scoring cheap points, but very counterproductive. She essentially accuses big pharma of inventing diseases in order to sell their products.

The premise strikes me as profoundly naive – which diagnostic entities are considered legitimate diseases is actually a complex question that is debated within the medical field. Rosenberg acts as if diseases can be invented out of whole cloth and then imposed upon medicine by a pharmaceutical executive. It is a grand-conspiracy type of thinking which erodes under scrutiny.

After hinting at anti-vaccine leanings, she writes:

Now pharma is back to creating new diseases, patients, risks and “awareness campaigns” faster than you can say thimerosal (the vaccine preservative that started the backlash.)

No – thimerosal did not start the backlash, Andrew Wakefield demonstrably did, with the MMR vaccine that never contained thimerosal. Thimerosal was simply act 2, after the evidence failed to find a link between MMR and autism (and of course there is also no link between thimerosal and autism either). But Rosenberg acts as if the anti-vaccine movement is a justified backlash against the excesses of big pharma – nice historical revisionism.

The sad fact is, Rosenberg might have a kernel of a legitimate point if she did not come across with her anti-scientific conspiracy mongering. That is why such demonization is so counterproductive – it actually backfires and let’s pharmaceutical companies off the hook for their real excesses.

Harriet Hall, for example, wrote an excellent piece on osteopenia – (Osteoporosis Drugs: Good Medicine or Big Pharma Scam?) which takes a properly nuanced and balanced approach to such questions. Do we really need to be treating pre-osteoporosis? The evidence should ultimately guide us. What pharma is guilty of doing is jumping prematurely on the bandwagon of a questionable diagnosis because it is a new market for them.

I think the same is true of the drugs that are now approved for the treatment of fibromyalgia – a controversial diagnosis, to say the least. But here we see more complexity and nuance. The FDA requires that a drug be indicated to treat a disease – not a syndrome or symptom. So there is no drug indicated for treating neuropathic pain as a symptom – drugs have to be indicated for diabetic neuropathy or post-herpetic neuralgia.

This forces pharmaceutical companies to find a disease, even when they have a drug that can potentially alleviate a symptom. Fibromyalgia is the perfect example of this – the very diagnosis itself is mostly used as a garbage pail diagnosis for vague syndromes of muscle pain and tenderness with fatigue and poor sleep. But you cannot get FDA approval to treat vague muscle pain.

Meanwhile, doctors are struggling to understand these syndromes and come up with a proper system of labeling what we find. We don’t want to prematurely use the “disease” label, but we also need to recognize patterns of patient complaints. I prefer terms like “myofascial pain syndrome” because it says what it is without implying a specific disease.

But regulation exists in its own world, and the FDA demands a disease label. So we have drugs, which are likely fine for the symptomatic treatment of myofascial pain, indicated for a dubious diagnosis (at least as it is often applied) like fibromyalgia. But it is doctors that invented the concept of fibromyalgia, and we still debate about it.

Rosenberg, however, cuts through all this nuance and goes for the simplistic and cynical conspiracy theory – pharma “invented” fibromyalgia to sell its drugs. She writes:

Nothing proves pharma’s when-the-medication-is-ready credo better than the legions of people who have fibromyalgia now that Cymbalta, Savella and Lyrica are available to treat it.

This is more historical revisionism. Having lived, and practiced medicine, through the fibromyalgia controversy it is clear that what happened is fibromyalgia became a popular diagnosis for the common vague syndrome I described above. Much after fibromyalgia became a popular diagnosis, some pharmaceutical companies saw it as a potential market. Rosenberg therefore has it backwards.

What we do have to recognize is that, now that there are drugs indicated for fibromyalgia, those pharmaceutical companies that make those drugs are invested in the reality and popularity of the diagnosis. They may therefore seek to distort the debate in that direction.

Rosenberg also embarrasses herself by criticizing the notion that there is an epidemic of sleep disorders in our society – the evidence suggests that there is, and it is under-treated. She further goes after adult ADHD and adult autism. The alternative is that autism and ADHD are childhood diseases only and always spontaneously resolve by adulthood – a scientifically untenable, and even laughable, position.

She further completely distorts the notion of “treatment resistant” conditions. She misinterprets that fact that many drugs are initially approved for adjunctive (add-on) therapy. This is not because the notion of “treatment resistance” was invented by big pharma. It is partly due to the fact that it is easier to do clinical trials where a new treatment is added to an established treatment, rather than to prove equivalence as stand alone therapy. So pharmaceutical companies go after the low-hanging fruit to maximize their return on investment.

Also – some patients are difficult to treat, and when one approach is not adequate it is nice to have more options. Rosenberg somehow turns this into a negative.

Conclusion

Rosenberg’s approach to this complex issue is simplistic, naive, and conspiracy-mongering. She brings no useful insight to the discussion.  She also demonstrates nicely the method of “demonizing” a convenient target – re-write history, white wash over all complexity and nuance, and cast everything into a maximally sinister light.

But further Rosenberg shows that taking such an approach is highly counterproductive. The pharmaceutical industry, like every industry, needs an effective watchdog to guard against abuse and excess. I also think they require thoughtful and effective regulation (although this question is difficult to disentangle from political ideology).

Rosenberg and other big pharma conspiracy theorists make ineffective watchdogs and critics, because their criticisms are paper thin and easily countered . By not recognizing the complexity of the issues involved, or making any attempt at fairness, Rosenberg is easily dismissed.

If I were a conspiracy nut I might even suspect that people like Rosenberg are actually fronts for big pharma, used to create a straw man of criticism that they can then easily knock down to show that all criticism is weak and invalid.

Posted in: Science and Medicine

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325 thoughts on “Demonizing “Big Pharma”

  1. No – thimerosal did not start the backlacsh, Andrew Wakefield demonstrably did, with the MMR vaccine that never contained thimerosal. Thimerosal was simply act 2, after the evidence failed to find a link between MMR and autism (and of course there is also no link between thimerosal and autism either).

    Pardon the vaguely Godwinian tone, but I can’t help but think it: Thimerosal started the backlash in much the same manner as the Jews started the Holocaust: It was there, was convenient to blame, and as one of those dirty, scary “chemicals” it was easy to foment hatred against it.

  2. WilliamLawrenceUtridge says:

    Seeing pharmaceutical companies as actively evil is so…stupid. They’re out to make a profit, as substantial a one as possible, but it’s not like they’re developing drugs specifically designed to kill people in sneaky ways. Companies do all sorts of short-sighted, harmful and profit-before-people things, but they also make nearly every thing we need to live in the world (or, in the case of unprocessed foods, ship it to where we live in the world). They are a necessary presence in the world that affords a high standard of living, cheap computing, delicious and convenient (but often unhealthy) food, off-the-rack clothing, cars and the fuel to drive them, and the drugs that treat our diseases. If Rosenberg gets an infection, who makes the antibiotics? If she gets cancer, who makes the monoclonal antibodies? If her lover gets impaired penile blood flow, who makes the sildenafil? Drugs have side effects but they also improve our lives (by preventing death, alleviating symptoms, or in some cases simply making things a little easier, more interesting or more fun – I’m looking at you caffeine, alcohol and sildenafil) and the companies that make them are profit-making entities, not saints, but that’s why we have doctors prescribing them, not pharmaceutical reps.

    I’ve been toying with what I think is an interesting idea – rather than public institutions accepting funds from companies, it would be better to have the funds pass through a third-party entity (i.e. a government agency) so the taint of influence is less. Let the NIH stand firmly between researchers and private funding so new drugs can be tested more fairly. Drug company wants to test their new molecule, they have to give the money to the government, who will run a peer review panel to decide who should run the study, and prohibit all contact between the entities. The research needs to be done, the drugs need to be developed, but the negative aspects of the current system (direct contact and influence between drug companies and researchers) need to be limited as much as possible. Wonder if it would work…

  3. Versus says:

    Could you please add information about who Martha Rosenberg is and where this article appears?

    I thought that Cymbalta and Lyrica were already existing anti-depressents and/or anxiety drugs that were adopted for use for fibromyalgia, and are approved by the FDA for that use. Both have proven to be effective for symptoms of fibromyalgia. Not sure how Ms. Rosenberg could find fault with that.

  4. And yes – Cymbalta and Lyrica were already approved for other indications. Fibromyalgia in both cases was an added indication.

  5. Robin says:

    What is the difference between a syndrome and a disease? Is it a merely the lack of knowledge or discovery of the underlying cause? Or is it an ambiguous classification that is the medical equivalent of “we’re not sure WTF this is”?

    I’m confused because there are some well syndromes whose cause is understood: AIDS, Down syndrome, Marfan syndrome, etc. While others are yet mysterious like SIDS.

    They’re not any less serious than diseases for the people suffering from them.

    The FDA requires that a drug be indicated to treat a disease – not a syndrome or symptom.

    What is the reasoning for this?

    Martha Rosenberg probably missed the controversy in the investing community about the approval Lyrica for Fibromyalgia. Each drug is watched carefully and speculated upon. A debate about the validity of Fibromyalgia occurred in the business pages. Businesses don’t want that kind of controversy. It’s just not clear cut — financial incentive can either encourage careful choices in pharmaceuticals, or succeed in putting total crap on the market (see Claritin, which is barely better than placebo but makes tons of $).

  6. The term “disease” refers to a specific pathophysiological entity.

    The term “syndrome” has multiple uses. It can refer to a disease that a host of signs and symptoms, and is often used particularly in genetic diseases where “genetic syndrome” has a specific use. But it can also refer to an identified set of signs and symptoms that tend to occur together, prior to a specific disease being identified. In many cases, a syndrome can be many diseases all with similar manifestations. So it’s confusing.

    The FDA takes the most conservative approach. You cannot even approve a drug for MS or epilepsy – you have to go for relapsing remitting MS or adjunctive treatment of adults with partial onset epilepsy. There is some justification for this, as these entities do respond differently to medications, but it is important to realize they take the most narrow approach.

  7. TimonT says:

    Dr. Novella said:

    We don’t want to prematurely use the “disease” label, but we also need to recognize patterns of patient complaints. I prefer terms like “myofascial pain syndrome” because it says what it is without implying a specific disease.

    Another term that has been proposed is “medically unexplained physical symptoms (MUPS)”, as discussed in “Evaluation and management of medically unexplained physical symptoms.” (Neurologist. 2004 Jan;10(1):18-30.).

  8. cervantes says:

    Peter Conrad discusses this issue at length, in a reasonably Fair and Balanced Way, in The Medicalization of Society (JHU Press, 2007). There is no question but that pharmaceutical companies have invented and promoted diseases. The ontological status of numerous disease entities is most certainly debatable, particularly but not exclusively psychiatric diagnoses. And there are plenty of cases where the pharmaceutical remedies for the invented diseases have ultimately been found harmful.

    E.g., menopause is not a disease and hormone replacement is not the remedy.

    That doesn’t translate into a blanket indictment of the industry, or of all pharmaceuticals, but they aren’t in business for their health, or yours. They are in business to make money, and they have shown repeatedly and incontrovertibly that ethics mean nothing to them. That’s why we have an FDA.

    Advocates of science based medicine, more than anyone, should be screaming this from the rooftops, not disparaging it.

  9. PeterGabriel says:

    “The alternative is that autism and ADHD are childhood diseases only and always spontaneously resolve by adulthood – a scientifically untenable, and even laughable, position.”

    I disagree strongly that that is a laughable position. With respect to ADHD, I believe the behavior associated with that diagnosis is typically the type of behavior that changes in individuals as they mature. Granted, it’s not smart to assume such behavior always resolves in adulthood, but I don’t think its laughable to think ADHD is a childhood disease. At least, I wouldn’t laugh in someone’s face for saying such a thing.

  10. Zoe237 says:

    Okay, you disagree with Rosenberg that austism/AdHD can be adult disorders, that insomnia is not a real problem, and think that instead of “inventing diseases” big pharma is “jumping on the bandwagon too soon” for a quick profit. I agree that she oversimplifies but…

    It seems odd to me that the skeptical movement is mostly limited to being skeptical of alt med, psychics, ghosts, and religion. Why can’t one be skeptical of government or corporations? For example, that article said some pretty shocking things about asthma drugs. I have no idea if this true but I would think if it was, it’d be covered on a site calling itself science based medicine. While alt med is certainly influential, I can’t tell they have the power or pull of the pharmaceutical companies to actually kill a good number of people with their products (like vioxx). I’m totally against crap like “dreamwater” but I’m skeptical that so many people who can’t sleep at night need pharmaceuticals. What’s the right balance?

    I can just imagine if there were more watchdog doctors guarding within the system, those like Crislip who refuse to take bribes, how influential that would be. I’d love to see an sbm 2 take on these issues within the system rather than limiting their criticisms to the outsiders. Both are needed I think.

    Iow, agree with cervantes. Do other countries with universal health care have this problem?

  11. weing says:

    “It seems odd to me that the skeptical movement is mostly limited to being skeptical of alt med, psychics, ghosts, and religion. Why can’t one be skeptical of government or corporations? ”

    I’m skeptical of all of those, including skeptics. I’m skeptical of invented diseases, and skeptical that some diseases are invented. Meds like Vioxx, and estrogen replacement therapy have risk benefit ratios. In some people the benefits may, and still do, outweigh the risks. I am very skeptical that they are bad for everyone. As, I believe, Aristotle once said, “One man’s meat is another man’s poison.”

  12. Tsuken says:

    “Having marketed adult diseases like depression, bipolar disorder and schizophrenia in 4-year-olds to death,…”

    That’s right. Big Pharma invented these – or at least the notion that they’re serious enough to pay attention to. The ancient Greeks didn’t describe melancholia and mania after all; it was Eli Lilly.

    Schizophrenia in 4 year olds? Puh-lease.

    … though some schizophrenias probably are a neurodevelopmental disease and as such there might well be manifestations in childhood – but still!

    She’s a crank. There is no evidence of logical thought in any bit of that article. Its function then is (a) to reinforce the beliefs of those on the anti-medicine/science/logic side of things, and (b) to cause rational people to to ignore/invalidate everything she says – even that which might hold some truth (somewhere deeeeeeeep within).

    I do in fact have some disquiet about the drug companies. The latest thing that’s bugged me is that quetiapine here in Australia is now licensed for schizophrenia, and acute treatment of mania, maintenance treatment of bipolar disorder, recently bipolar depression, an nooooow unipolar depression, and generalised anxiety disorder. Well excellent. I don’t have to think any more; I’ll just give everyone quetiapine. The marketing unfortunately reflects my facetious statement, and every pill is presented as a panacea.

    Also, a disturbingly large chunk of the studies showing the 2nd generation antipsychotics to be useful in mood disorders are not just sponsored by the companies – but performed by them. The psychiatric literature is in a mess.

    Doesn’t make it any more rational or useful to demonise “Big Pharma” though ;)

  13. wales says:

    Zoe said “It seems odd to me that the skeptical movement is mostly limited to being skeptical of alt med, psychics, ghosts, and religion.”

    Some have criticized self-labeled “skeptics” as “pseudo-skeptics” who practice a type of asymmetrical skepticism; for example rather than a truly skeptical perspective, (agnostic or doubting), the pseudo-skeptic consistently takes a denialist stance against certain ideas. “The true skeptic takes an agnostic position, one that says the claim is not proved rather than disproved.”

    http://www.anomalist.com/commentaries/pseudo.html

    There’s a book I’ve got on my “to read” list called “Don’t Get Fooled Again” by Richard Wilson. Here’s a brief review of it http://www.guardian.co.uk/books/2008/oct/11/richard-wilson

    “Confusingly, many of the people we ought to be sceptical of pretend to be sceptics themselves. The giveaway, as Wilson nicely shows, is that their scepticism is asymmetrical: no evidence is ever enough for someone “sceptical” about anthropogenic global warming (an example not included in this book), and yet they are remarkably credulous about any alternative factoids that might seem to support their own view.”

  14. Zoe237 says:

    “Some have criticized self-labeled “skeptics” as “pseudo-skeptics” who practice a type of asymmetrical skepticism; for example rather than a truly skeptical perspective, (agnostic or doubting), the pseudo-skeptic consistently takes a denialist stance against certain ideas. “The true skeptic takes an agnostic position, one that says the claim is not proved rather than disproved.””

    Now that is true. I’ve said on here before that an extreme skeptic is a denialist. Are people who “don’t believe in” AGW skeptical or denying? What about homeopathy- skeptical it works or denying it works? I have no medical background but time has taught me to be cautious of anybody who a)is a little too passionate/ unbiased about their cause (not tha passion or idealogy is always bad) or b) somebody who can’t tell you what it would realistically take to change their minds (falsification) or c) pulls an “us vs. them” routine. That applies to the big pharma is always evil arguments too.

    weing:
    “Meds like Vioxx, and estrogen replacement therapy have risk benefit ratios. In some people the benefits may, and still do, outweigh the risks. I am very skeptical that they are bad for everyone. As, I believe, Aristotle once said, “One man’s meat is another man’s poison.””

    I agree with you, but how do you know that ratio if the company is cooking the data for monetary profit? Or if all the researchers are being paid by the company?

  15. Mark P says:

    The giveaway, as Wilson nicely shows, is that their scepticism is asymmetrical

    But often asymmetric scepticism is all that is required. If someone says they can read minds, then if they fail to read mine I will pretty much automatically discount them. I will largely ignore any evidence they can read others, by assuming it is either biased or false. I will not go to the bother of actively investigating it.

    That is because an unlikely idea needs more than just present some evidence.

    no evidence is ever enough for someone “sceptical” about anthropogenic global warming

    Works both ways. Some are persuaded easily of AGW, because it suits their mindset (anti-Industrial, anti-Western, desire to sell CO2 credits, whatever) and are not interested in even the slightest evidence to the contrary.

    If you claim only that only the other side is asymmetric, it is often merely a sign that you are too. Because you feel that it’s so “obvious” that no-one can doubt it.

    On the whole, therefore, I think the concept of claiming the other side is not sceptical enough is a waste of time. Each issue needs to be proved on its own merits. There is no “cookie cutter” amount of scepticism.

  16. Daniel M says:

    Zoe237,

    You wrote “It seems odd to me that the skeptical movement is mostly limited to being skeptical of alt med, psychics, ghosts, and religion. Why can’t one be skeptical of government or corporations?”

    There is actually a very large wing of the skeptical movement that is libertarian; who are generally very skeptical of the government. I know Penn and Teller, Michael Shermer, Brian Dunning, Trey Parker, Matt Stone, and some of the people from the CSI seem to have libertarian leanings, to varying degree.

    I think most skeptics I’ve interacted with, even the non-libertarians, are skeptical of the government and corporations (we just aren’t into unproven conspiracy theories). Libertarians are usually more skeptical of the government, and liberals of corporations, but I don’t think most are as unskeptical of these groups as you seem to think.

  17. Anarres says:

    “The true skeptic takes an agnostic position, one that says the claim is not proved rather than disproved.”

    IMHO not true, scepticism is not solipsism, there are facts out there, the earth is like a ball and the heart pumps the blood. No doubt here. Facts are the keystone.

  18. GeoffreyCoe says:

    Surely skeptism needs to be informed by the progress of science. When the Greek mathematician Eratosthenes estimated the circumference of the Earth by the shadows cast by the sun at different locations perhaps the first evidence was provided that the earth was round. It would remain appropriate to be skeptical about such a theory of the round earth; an agnostic approach was fully acceptable. But as the weight of scientific evidence for the curviness of the earth overwhelmed us as time progressed, through the hundreds of thousands of observations using many different methods of observation. it would be ridiculous to maintain that agnosticism. The same goes for refuting creationism, homeopathy, and the paranormal. Yes we never have absolute certainty about the lack of validity of these phenomena but in practice it becomes a waste of time to maintain a skeptical agnositc position. It is time to move on.

    …the trouble is as a society are we ready?

  19. weing says:

    “I agree with you, but how do you know that ratio if the company is cooking the data for monetary profit? Or if all the researchers are being paid by the company?”

    As the great Reagan said “Trust, but verify.” One of the first things I do is to check the financial disclosures of the authors. Yes, you may get scumbags like Wakefield who won’t disclose their ties. That’s why one study doesn’t cut it. Just because a company stands to make a profit, doesn’t mean the research is cooked. I remember the PROVE-IT study, that showed that the sponsoring company’s drug was inferior. They published it. I can just imagine the board meeting they must have had about it.

  20. BillyJoe says:

    “but that’s why we have doctors prescribing them, not pharmaceutical reps.”

    um…well…er…

    (perhaps if they ban pharmaceutical company sponsoring of CME events and visits to doctors surgeries…)

  21. Brandon T. Bisceglia says:

    “I’ve been toying with what I think is an interesting idea – rather than public institutions accepting funds from companies, it would be better to have the funds pass through a third-party entity (i.e. a government agency) so the taint of influence is less. Let the NIH stand firmly between researchers and private funding so new drugs can be tested more fairly. Drug company wants to test their new molecule, they have to give the money to the government, who will run a peer review panel to decide who should run the study, and prohibit all contact between the entities. The research needs to be done, the drugs need to be developed, but the negative aspects of the current system (direct contact and influence between drug companies and researchers) need to be limited as much as possible. Wonder if it would work…”

    I can see two potential problems with this idea, WilliamLawrenceUtridge. The first is that there is no guarantee that the NIH or any other intermediary won’t be just as influenced by political and business concerns as the researchers themselves. It becomes especially likely to happen if you make any single organization the “authority” on a subject, to which all others must defer for their regular activities. That kind of power concentrated within one organization makes that organization a natural target.

    The second issue that could arise involves the added layer of administrative and government costs for taking on that responsibility. This is a practical concern, particularly if the proposed intermediary is a government-funded organization. Depending on the political and economic climate, the organization could easily suffer from political influence, lax oversight, or a sudden slash in its funding.

    Distributed and varied systems do exist already that vet research and weigh the influence of corporations. There are government intermediaries, market relations, and – most importantly – the open forum of comments, ideas, and critical analyses. It is a hodge-podge, and far from perfect. There are aspects of the system that certainly are in need of reform, perhaps some that might even use the method you described. But I’d be extremely concerned if only one agency could dole out research funding.

    “It seems odd to me that the skeptical movement is mostly limited to being skeptical of alt med, psychics, ghosts, and religion. Why can’t one be skeptical of government or corporations?”

    There definitely is not a dichotomy. As mentioned in other comments, most people who call themselves skeptics also have considerations about companies and government.

    The reason you may not hear about these issues as much is that skeptics of those institutions have long had a large public forum in which to analyze and counter-argue. The press has historically remained relevant by capitalizing on the expertise of skeptics of governments and businesses.

    They haven’t done the same with scientific, religious, or a few other issues, though. There are understandable reasons for that, but it’s been undeniably damaging to the public, who have not been kept abreast of the traditionally “academic” pursuits.

    Scientists and other researchers are, if anything, late to the game of public education. So that’s where we see what gets called the “skeptical movement.” Really, it’s a democratization of knowledge and ideas that was once provided only to a relatively small subset of the population.

    That, I think, is the movement’s angle on politics. The people who are finding a voice at the moment are not generally those with a concentration of knowledge about business or government, because those topics already had wide public recognition and distribution. And the scientific skeptics narrow their public discourse to topics with which they have deeper experience.

    That’s probably why it seems that bulk of the deliberation is limited to certain subjects. And I think that’s a fair way for skeptics to proceed. No one can be an expert on everything at once.

  22. WilliamLawrenceUtridge says:

    @BillyJoe

    Yes, I agree, and Mistakes Were Made makes this point – even tiny tokens like pens, post-it notes and free samples have a significant, measureable effect on the behaviour of physicians. CME events, visits with practitioners, free copies of articles or whole journals, all have the potential to bias people. Even worse, people don’t realize they are being biased. The effect is subtle, insidious, and ubiquitous throughout all of humanity. I wish I had an answer too! Having unbiased information would be one way, that way you could ignore the pharma rep and CME credit in favour of actual, reliable research that hasn’t been massaged, fished, or hidden in a file drawer somewhere. A (government) clearing house, in which drug companies deposit funds and sample pills, and researchers apply for access to them to run trials, all anonymized and all preregistered so negative studies can be reported. You’d still have drug companies that go straight to universities to try to bribe, you’d still have CME courses, lobster dinners with powerpoint presentations about the wonders of Pfizer’s new wonder drug, but hopefully you could offset that to a certain extent with more reliable info.

    Those paragons of scientific medicine Scrubs and House both had episodes touching on this, and made the point well – Big Pharma will do a lot to get there drugs prescribed, including hiring only hot representatives to stroke the balding heads of ageing doctors. Not quite illegal but certainly tainted. But if we’re going to complain about it, might as well try to come up with some solutions, even if they’re tentative and not perfect. The only answer I see is better information that more easily reaches the doctors.

    The whole “big pharma is evil” knee-jerk reaction irritates me. The pharmaceutical industry is a necessary entity, not an evil one. Inevitably you need a company to manufacture any good and provide most services. An a priori assumption that any entity is good or bad, should or should not be listened to, is solely beneficial or solely evil, is just stupid. The only reasonable path is a combination of regulations, reliable information and buyer-beware.

    And on a somewhat related tangent, the alt medies that criticize big pharma for their corruption while ignoring the fact that their supplies are also made by companies, and ones that do not bear any burden of proof, also annoys me.

  23. wales says:

    Mark P: If you die during heart surgery will you deny that it works for others?

    I don’t claim that any “side” is more asymmetric than the other. By definition, a “side” is asymmetric. The only non-asymmetric stance is an agnostic stance. Now I’m certain someone will chime in with “but if you don’t stand for something you stand for nothing” or “if you’re not with us you’re against us”. Those are opinions, based upon binary thinking.

  24. weing says:

    “By definition, a “side” is asymmetric. The only non-asymmetric stance is an agnostic stance.”

    So you are for the agnostic side? But surely there must be some things that you can know.

  25. “But surely there must be some things that you can know.”

    Cogito ergo sum!

  26. weing says:

    Dubito ergo sum! would be better.

  27. wales says:

    agnosticism isn’t solipsism. yes there are “knowable” facts, but proving and adhering to objectivity is difficult.

  28. Sides: in medicine the relevant sides are reality vs fantasy. Fantasy has its place, but that place is not medicine.

    If you want to assert that 30% of “reality” is probably “a completely novel paradigm that is beyond our ken at this stage of humanity’s cognitive evolution,” fine.

    That part of your “real” human body that is beyond your ken at your stage of your cognitive evolution can have “real” human medicine that is also beyond your ken at your stage of your cognitive evolution. Personally I would call that fantasy, but as long as the fantasy medicine is only to treat the fantasy body, then it’s six of one and half a dozen of another.

    But the part of my real human body that I am aware of and that participates in a perceptible way in my existence requires real medicine that has detectable effects and outcomes that I am aware of.

  29. wales says:

    Alison: I guess you’re speaking to me as you’ve used my percentages. But you forgot the 30% to scientific theory. I am not denying that scientific medicine has its place. I am just doubtful that it is a panacea.

  30. marilynmann says:

    “SBM is not apologetic about the pharmaceutical industry”

    I am wondering if you meant to say that “SBM is not an apologist for the pharmaceutical industry.” That would fit in better with the rest of the paragraph.

    I tend to agree with you about Martha Rosenberg. I think she is advocating a particular point of view and trying to fit the facts to her point of view.

  31. Wales, I didn’t forget. This is what you said:

    “If I had to bet on what is the basis of reality I would bet that scientific theory has it 30% right, spiritual theory has it 30% right, and the remaining [40%] of the pie is composed of A) a creative, integrative synthesis of ideas from those two realms or B) a completely novel paradigm that is beyond our ken at this stage of humanity’s cognitive evolution.”

    What you mean by “reality” or “having it right” is obscure, but you obviously mean something concrete because you are able to be very specific in your numbers.

    By “reality,” do you mean me? Do you mean that 30% of my weight is made up of particles described by physics, 30% of my weight is my immortal soul, and 40% of my weight is a completely novel paradigm that we can’t even imagine? That interpretation makes sense, because you are describing measurement error. For instance, if physics can only account for 24 kilos of me then there are 56 kilos that have to be accounted for by some other, non-physical theory. The error is completely measurable and allows you to generate the kinds of percentages that you proposed. Especially if you happen to know that the average immortal soul also weighs about 24 kilos, leaving 32 kilos of me that need to be accounted for by a non-physical, non-spiritual paradigm.

    If current physics generated this kind of error, then I would be completely justified in thinking that I needed something more than current physics to account for my existence. However, as far as I am aware, physical theories account for all 80 kilos of me down to the microgram. There is no need to invoke any other kind of theory. Do you know something about measurement error with respect to people that I don’t… and that nobody who actually studies people knows has noticed?

    Or by “reality” do you mean… what? The sum of things that can be detected (like people) and undetectable things (that by definition, nobody is aware of, not even you)? That’s fine, but since medicine treats that which is detectable (people), the other stuff is irrelevant to medicine. (And if it’s undetectable, what makes you think it’s probably 70% of reality?)

    Perhaps you mean that “dark energy” is spiritual and “dark matter” is another paradigm. Current physics can describe these things, it knows they’re there, but it doesn’t completely know what they are. But if that’s what you mean, you have your percentages wrong. As far as we can tell, what we’re calling dark energy is 74% of the total mass-energy of the universe, dark matter is 23% and ordinary matter is 4.6%. Still irrelevant to medicine, because medicine is practiced by doctors on beings made of ordinary matter, not by astrophysicists on galaxy clusters.

    If you are talking about undetectable things that have no bearing on anything we can know about or understand or describe or perceive, then on what basis do you call these things “reality” and not “fantasy”? What do you think reality means, and in what way is that definition useful and helpful?

  32. Pete D says:

    Could someone please describe the potential influences pharmaceutical companies have on CME events? My wife (IM/Peds) attends these once a year for several days at a time. In reviewing the itineraries, I don’t remember noticing anything that would signficantly affected.

  33. GinaPera says:

    Thank you, Steven, for this comprehensively intelligent post!

    I am with you on all points.

    Fibromyalgia:

    I was diagnosed with this 10 years ago and was essentially bed-ridden. Rheumatologist after orthopedic specialist after physiatrist pronounced gloomy prognoses. Life was bleak. Medication didn’t work and often made things worse.

    Finally, I visited a physician who actually knew how to order and read lab work. First she noticed that my red blood cells were enlarged, among other things. Flipping through the weighty stack of my medical history, she concluded, with a bit of disgust: “How could all these physicians have missed these basics?” Good question. What has helped me the most to regain health and energy? Magnesium, coenzymated sublingual B vitamins, and more aerobic exercise.

    Big Pharma:

    “Gina Pera wants to inject your fetus with medication!”

    Actually, no I don’t. But in my years as an advocate in the ADHD community (in person and online) and author of a popular book on adult ADHD, I’ve taken some amazing Internet-based hits over the years. (Fortunately, these have lessened as time goes on.)

    Like you, Steven, I’ve taken not one cent from “Big Pharma” — though the opportunity was there. The attacks came merely because I tried to set the record straight on the medications used to treat ADHD. There is enough stigma around this condition; we don’t need to add to it by letting dangerous myths about truly life-changing and even life-saving medication go unchallenged. (And in my experience, the biggest pharma/psychiatric diagnosis critics are renegades from psychiatric care.)

    At the same time, we are experiencing a huge backlash against these medications, which only feeds the paranoia and alleged muckraking, especially among the we-love-personal-narratives-crowd and alleged journalists out to score an easy bestseller. Why? Because of sloppy, careless prescribing. The stories I hear on a daily basis leave me incredibly saddened; so much opportunity lost.

    Two books that typify the Big Pharma is Bad phenomenon are:

    Our Daily Meds: How the Pharmaceutical Companies Transformed Themselves into Slick Marketing Machines and Hooked the Nation on Prescription Drugs http://tinyurl.com/2g47ch6

    Shyness: How Normal Behavior Became a Sickness
    http://tinyurl.com/252ffz7

    (The links point to my reviews. Check out the comments to see prime examples of Kill the Pharma Messenger Syndrome. Moreover, see the many accolades from reviewers who should know better; do our liberal arts friends partake in ANY science education these days?)

    Moreover, the prescribing physicians often don’t know how to assess a person for other health challenges that affect cognition — metabolic issues, food allergies and sensitivities, neurotransmitter precursors and catalysts (amino acids, vitamins and minerals, etc.)
    This medication myopia among physicians only adds to Pharma Fear. Healthcare reform? We must start with the physicians.

    In the last few years — perhaps coincidental with a more realistic economy — the froth seems to be settling around ADHD in particular. And while those two titles above opened with a splash, their current Amazon ranking is 564,000 and 167,000, respectively; my book is currently 2,300, almost two years after publication. Truth will out. Eventually.

    Thanks for your blog. I appreciate the time you put into thinking about and writing about these issues.

    Gina Pera, author
    Is It You, Me, or Adult A.D.D.?
    http://www.ADHDRollerCoaster.org

  34. kencamargo says:

    While I fully agree that it is easy to go overboard on criticising the pharmaceutical industry, and I agree with most of your assessment of the paper, it seems to me that occasionally you may have veered too much in the opposite direction…
    The pharmaceutical industry has not exactly a stellar record; just consider Marcia Angell’s “The truth about the drug companies” and there is plenty there to justify a lot of their bad reputation. Just one of the examples she gives, which was also the subject of a peer-reviewed paper (1), that of the marketing strategies around gabapentin, raises red flags all over the place.
    As for the industry creating new diagnoses or extending current definitions, there is also documented evidence of that, a whole issue of PLoS/Medicine was dedicated to discussing disease mongering (2).
    So, all in all, I’d say that your criticism of the paper was as exaggerate (in the opposite direction) as the paper itself…
    Cordially,
    Ken
    (1) Steinman MA, Bero LA, Chren MM, Landefeld CS. Narrative review: the promotion of gabapentin: an analysis of internal industry documents. Ann Intern Med. 2006;145(4):284-93.
    (2) http://www.plosmedicine.org/article/browse.action?field=date&month=4&year=2006&day=11

  35. wales says:

    Alison: Let’s examine your example of weight. We are composed of atoms. The atom is about 100,000 times larger than its nucleus. One analogy is that if the nucleus is ping pong ball size, then the electrons would be orbiting approximately 1 kilometer away. Of course the concept of “orbiting electrons” is a simplification of the electron probability cloud. How do we account for the “reality” of all that empty space between electrons and nucleus at the atomic level? How does that empty space contribute to your 80 kilos?

  36. weing says:

    “I am not denying that scientific medicine has its place. I am just doubtful that it is a panacea.”

    I’ll tell you right now that it is not a panacea. Whoever told you it was, lied to you. I hope it wasn’t one of us. Are you looking for a panacea? There’s a lot of sCAM artists claiming to have it. They are also lying.

  37. wales says:

    Thanks for your honesty Weing. No I don’t believe there are any panaceas.

  38. Wales on subatomic particles:
    “How does that empty space contribute to your 80 kilos?”

    I’m not a physicist, and there’s probably something to do with gravitons that I’m missing, but as far as I know, it doesn’t.

    Physics describes the orbitals, the electron, the “empty” space and my weight. As far as I know, there is no need for a non-physical explanation of my body. Phyisics explains it quite well. Much better than 30%.

    I am not aware that my immortal soul explains any of this. And I don’t know what medicine needs an unimaginable paradigm to explain.

    I am real, and medicine really addresses the real things I need it to.

    What is real that science can’t — by definition — address? How do you know it’s real?

    What do you mean by reality? What non-scientific methods do you use to distinguish reality from fantasy?

  39. wales says:

    I cannot and have no desire to condense my beliefs about reality into a blog-sized report. Even if I could, this is not the appropriate venue and I doubt that anyone here is interested.

    What is beneath the apparent reality we see everyday? How do you explain quantum nonlocality, and other quantum weirdness? Most scientists (physicists included) just shrug and sheepishly reply “no one understands quantum physics”. Science has not yet been able to answer all the questions about physical matter, how can science possibly prove that physical matter is all that exists?

    If you’re saying that science can explain away all the mysteries of life, I disagree. Perhaps it’s just that many people don’t see any mystery, that’s fine too. Bye for now.

  40. wales says:

    BTW, Alison said: “I am real” – No one said you were not.

  41. wales,

    I was giving myself as an example of something that is real. I am also an example of something to which the practice of medicine applies, and I can see the correspondence directly.

    I was hoping that you could give me examples of other things that were real to which science does not apply, but which are relevant to medicine.

  42. rosemary says:

    First, I am not a Skeptic. I majored in Philosophy and the one thing I took away from that is that you can be perfectly logical and perfectly wrong because you didn’t get the facts right. IMO, science uses objective, controlled experiments to determine facts and then applies logic and reason to arrive at conclusions. It is far from perfect and it never completely eliminates errors, mistakes or personal biases, but it comes much closer than anything else man has thought up and it has brought civilization out of the Dark Ages into the Modern Era. The huge benefits to mankind are especially obvious in scientific medicine, something not much more than 100 years old. I think I may be older than most of you and I actually remember a bit of the bad old days and have known many people who actually lived in them.

    My education and life experience have taught me that when I have the resources and the situation is serious to look at the evidence, the primary sources and also to listen to and weigh what experienced experts have to say. I use that criteria to evaluate everything like approved drugs and “alt remedies”. I don’t have a double standard. However, most of my energy is devoted to trying to expose alt. med. rather than drug companies for several reasons the biggest of which is that alt med is trying to replace scientific medicine with the system used in the dark ages, belief-based medicine, fantasy medicine – a religion or philosophy about health and wellbeing based on faith rather than on consistently reproducible test results. IMO, that represents a huge danger to humanity and to each and every human being. To make matters worse and more dangerous, few in the general public realize that and that is exactly the way that alt medders want it, some because it is so very good for their businesses, others because they are ignorant or deluded and don’t know the difference themselves.

    Homeo remedies and dietary supplements are sold side by side in pharmacies with OTCs. Most consumers don’t know the difference. Neither do they realize that a lot of AM therapies are not evidence-based because there are so many celebrity MDs with excellent scientific credentials promoting them in the mainstream media as if they were.

    Most people on the other hand know very well that drug companies are businesses, huge businesses, out to make money. Compared to alt. med businesses they are highly regulated. Both the mainstream and scientific media continually expose drug companies whereas the mainstream media often fawns on alt. med.

    To attempt to expose either business requires research and knowledge. I don’t have the time to research every possible abuse so I have to focus. My focus is dietary supplements, a topic which is also very personal for me.

    There are several public interest groups, some quite powerful like Public Citizen, who carefully follow the pharmaceutical industry trying to keep them honest, or relatively honest, and trying to warn the public when they catch them being dishonest.

    Lawyers watch drug companies like hawks too and are ready to pounce with lawsuits if they feel that they are engaging in dangerous or illegal behavior. Lawyers do not watch alt companies anywhere near as closely. For one reason many alt practitioners and companies don’t have funds lawyers can locate if they win cases against them. When people are injured by alt remedies and therapies, the victims often don’t make the connection, see the cause of the effect, because marketers have convinced them that the stuff is natural and therefore harmless. Those who do realize that they were injured, or relatives who realized their loved ones were killed, often won’t sue because they blame themselves for being stupid or else they wait too long and the statute of limitations expires. I know this because I’ve worked with victims and their lawyers.

    I can’t speak for anyone else, but my ranting about alt medders and not drug companies doesn’t mean that I think drug companies are wonderful. It just means that I have to pick my battles. So I go after alts because: I think that by trying to replace scientific medicine with fantasy medicine that they are endangering all of us far more than drug companies; this is were I have the most expertise; and, there are lots of powerful individuals and groups watching and exposing drug companies but very few doing that with alts.

    Actually, I usually prefer to see groups and individuals focus on the problems with either alt. med. or scientific med. because I think that when the same groups or individuals go back and forth between the two that many laypeople come away with the erroneous impression that there is not a fundamental difference between AM and scientific med. They don’t realize that AM is rejecting science and trying to bring us back to the Dark Ages, something which IMO is far more dangerous than the evils of the drug companies.

    I don’t know how well I’m expressing any of that. Most of you write so much better than I do.

  43. wales on scientific and unscientific realities:
    “What is beneath the apparent reality we see everyday? How do you explain quantum nonlocality, and other quantum weirdness? Most scientists (physicists included) just shrug and sheepishly reply “no one understands quantum physics”. Science has not yet been able to answer all the questions about physical matter, how can science possibly prove that physical matter is all that exists?”

    Ok, so if I understand you correctly, quantum physics is science, but the explanations of quantum physics are mostly non-scientific, for instance a spiritual immortal soul or an unknowable paradigm.

    How will we determine that 30% of the explanation of quantum physics is spiritual? Will physicists postulate the existence of something to explain their data that they will call “spirit”? That can’t be what you mean, because that postulated something will by definition be scientific, not non-scientific.

    Perhaps very spiritual people will meditate and agree that 30% of quantum physics can be explained by meditation. That would be properly non-scientific. But this still doesn’t work. If physicists can’t incorporate this spiritual finding into quantum physics, then it’s not an explanation; if they can, it’s science.

    Or perhaps you are just saying that there’s no reason to think that any particular thing is understandable. That anything you don’t believe anyone understands has a 70:30 likelihood of being fundamentally inexplicable.

    Fair enough. But does “fundamentally inexplicable” mean that we need a further, non-scientific account for it, or might it mean that we have completely understood it?

    The number 1, for instance. It pretty much has the status of an axiom. We don’t look for explanations of 1, we use 1 to explain other things. Does that mean that 1 needs to be further explained in terms of spirituality and unknowable paradigms? Or does it mean that 1 doesn’t need more understanding than we give it?

    In what way would a spiritual understanding of 1 contribute to the practice of medicine? And how would we know that this spiritual understanding of 1 represented something real?

    Or maybe you just mean that human brains probably can’t manage the 70% of the fancy math necessary to describe the universe. You wouldn’t be the first person to harbour this suspicion, and I wouldn’t be surprised if you were right.

    In that case, you and I share the same conception of reality, but what you refer to as “spirituality” and “unknowable paradigms” I refer to as “really hard math.”

    That might be something we could agree on, but then we run into a problem. 200,000 years ago there don’t seem to have been people around who could have understood modern chemistry. Does that mean that modern chemistry was spiritual reality 200,000 years ago but physical reality today? If my dog doesn’t understand chemistry but I do, does food have a real and spiritual effect on her body and a real and scientific effect on mine? What does using the word “spiritual” to refer to anything not-understood add?

    wales, I’m really trying to understand what you are trying to tell us. What do you mean by reality?

    wales on mystery:
    If you’re saying that science can explain away all the mysteries of life, I disagree. Perhaps it’s just that many people don’t see any mystery, that’s fine too.

    Perhaps I would understand you better if you could give an example of a mystery that 1) you know could never be explained by science and 2) you know is real. I personally feel I have an example of such a mystery (note “feel,” not “know”). I’m just wondering what your examples are.

    I don’t even understand what you mean when you say “that’s fine too.” If I saw someone walk through a wall, and you were with me and said no, that person walked through a door in the wall, I would want to know more. How come you see a door and I don’t? What can I learn by understanding the difference between what we perceive?

    Basically, aren’t you curious about why other people don’t always see mysteries where you do? I’m certainly interested in why you see mysteries where I don’t. I think this discrepancy is extremely interesting and an opportunity to learn.

  44. rosemary says:

    Gina, alts seem to insist that everyone who disagrees with them does so because they are paid by by someone bad. I think some may actually be crazy or naive enough to believe that that is the only reason anyone would possibly disagree with them. Others do it because what you say is bad for their business. They don’t have evidence to show that you are wrong so they attack you personally in an effort to distract listeners who they hope will dismiss what you say because they don’t trust you rather than realize that they, the alts, haven’t presented any evidence indicating that you are wrong.

    I’ve been accused many times of being funded by “the medical establishment, the drug cartel and the government”. I’ve been telling my accusers for years to please, please, please give me the names and contact #s of anyone who will pay me to say what I say because I can use all the help that I can get. So far I haven’t been given one name but the accusations continue.
    http://rosemaryjacobs.com

  45. IndianaFran says:

    I strongly agree with the opinion of kencamargo above.

    While you accuse Ms Rosenberg of oversimplification and you ask for complexity and nuance, you then oversimplify in the opposite direction.
    “The FDA requires that a drug be indicated to treat a disease – not a syndrome or symptom.” I respectfully ask on what authority you make that claim?
    Browsing in http://www.centerwatch.com/drug-information/fda-approvals/ , I find plenty of entries that look like
    Botox (onabotulinumtoxinA); Allergan; For the treatment of upper limb spasticity, Approved March 2010
    Exalgo (hydromorphone hydrochloride) extended release; Alza; For the management of moderate to severe pain, Approved March 2010
    Silenor (doxepin); Somaxon Pharma; For the treatment of insomnia, Approved March 2010
    Gelnique (oxybutynin chloride); Watson Pharmaceuticals; For the treatment of overactive bladder, Approved January 2009
    Evamist (estradiol); Vivus; For the treatment of moderate to severe vasomotor symptoms due to menopause, Approved July 2007

    It appears that the FDA does indeed license drugs targeted at symptoms rather than diseases. Or do all of the indications listed meet your criteria for “a specific pathophysiological entity”?. And of course many drugs and other products have been licensed over the years for the purpose of contraception, and normal fertility does not qualify as a disease. Pregnancy prevention is absolutely an important health goal for many people, but it is not disease treatment. (And manufacturers do not have to hide behind wording like “for the prevention of postpartum sepsis associated with frequent pregnancy”).

    As for osteopenia, the pharma industry did not just jump on a bandwagon, they built it from scratch. Can you find an example of a pre-existing desire from within the medical community to identify individuals with sub-optimal bone density? That bandwagon would have been parked out behind the shed on the back forty if the pharma industry didn’t give it wheels and a spiffy coat of paint.

    It may be an overstatement for Ms Rosenberg to claim that diseases are “invented” or “created” by marketers. However, it is certainly true that many “conditions” are elevated by marketing hype into disease states (at least as perceived by the lay audience) for the specific purpose of expanding potential markets.

    I have no doubt that as individuals, the vast majority of people in the pharma industry (as well as medical devices, etc) are primarily interested in promoting health and helping other people. But the reality is that the corporate entities are primarily interested in generating profits. And that is just as true of the corporate entities that promote alternative treatments. And they are sometimes the same entities.
    In an ideal world, the path to maximum profit would coincide with the path to promoting maximal health. But not on this planet.

  46. wales says:

    Alison: Your long thoughtful response deserves a better response than I have time for now. I will think on it and try to get back this weekend.

  47. GinaPera says:

    @Rosemary — You wrote:
    “I’ve been telling my accusers for years to please, please, please give me the names and contact #s of anyone who will pay me to say what I say because I can use all the help that I can get. So far I haven’t been given one name but the accusations continue.”

    haha! Love it! Yes, please! Would love to have financial backing for my “agenda.”

    Yes, I agree: Vested interests can contribute to the “denial” — such as certain branches of psychoanalytic therapy. For example, even those in allied fields — Christopher Lane, author of that Shyness book I referenced and an historian, of all things — seem personally invested in retaining the interesting personal narratives offered by psychiatric patients. But surely these people deserve better fates in life than entertaining their therapists!

    One of my readers wrote to say that, after 6 years of intensive psychotherapy, he finally learned about ADHD and demanded that his psychiatrist prescribe medication for him on this proviso: “That you still come to therapy each week and we talk about books or movies, something interesting.”

    g

  48. JMB says:

    @wales

    “Science has not yet been able to answer all the questions about physical matter, how can science possibly prove that physical matter is all that exists?”

    368 years of science and we end up with a dicey answer! I think the currently accepted scientific proof in physics is that there is no physical reality beyond the probability distributions that can be accurately described with the equations of quantum physics (no hidden local variables by disproof of Bell’s inequality). Perhaps it is better to ask, “how can science possibly prove that there is anything beyond the play of the dice?”

  49. weing says:

    I heard of a guy who after 6 years of psychotherapy was brought to tears by what his psychiatrist said. “No hablo ingles.”

  50. Wolfy says:

    Something I’ve found interesting is frequently those who condemn “big pharma,” for many of the reasons Ms. Rosenberg describes, often praise the natural supplement industry for their commitment to natural health, wellness, and healing–as if the bottom line of the natural supplement industry is rooted in anything more than dollars and cents.

  51. BillyJoe says:

    Wolfy,

    Ben Goldacre, in his book “Bad Science” mentions a certain part owner of a big altmed company who spouts on about the evils of “Big Pharma” but whose own company is 30% owned by a large pharmaceutical company.
    They apparently know where the money is thank you very much.

  52. Wolfy says:

    BillyJoe: It doesn’t surprise me in the least. The bottom line of industry is to make a buck; doesn’t matter if its auto, financial, “big pharma,” or naturo-ceutical BS.

    “It all makes perfect sense, expressed in dollars and cents, pounds, shillings and pence.” –Roger Waters

  53. BillyJoe says:

    wales

    “What is beneath the apparent reality we see everyday? How do you explain quantum nonlocality, and other quantum weirdness?”

    Firstly, quantum weirdness such as entanglement and uncertainty do not make an appearance at the macroscopic level. Therefore any mystery that you might see at the microscopic level of quantum particles does not affect macroscopic world of everyday experience.

    Secondly, regardless of these apparent mysteries, experiments in quantum physics based on the assumption that everything is physical are the most predictable and accurate of any field of science. So, where is there room for any supernatural agency? The supernatural just fails to show up anywhere in any of their experiments!

    Thirdly, in the face of the above, there is not even any need for a supernatural assumption let alone any reason to assume it. It’s like not being able to find your keys and assuming that it is possible that a supernatural agent has whisked them away and they will never be found. There is no reason to assume that, just as there is no reason to assume supernatural agency in the explanation of entanglement and uncertainty.

    “Most scientists (physicists included) just shrug and sheepishly reply “no one understands quantum physics”. Science has not yet been able to answer all the questions about physical matter, how can science possibly prove that physical matter is all that exists?”

    Absolute proof is difficult. However the pertinent question is: Is there any reason to believe in the non-physical. There absolutely is not. Science assumes that everything is physical and there has never been any counterexample. That is actually reason enough to not beleive in the non-physical.

  54. BillyJoe says:

    wales,

    rosemary said: “I majored in Philosophy and the one thing I took away from that is that you can be perfectly logical and perfectly wrong because you didn’t get the facts right.”

    In science that translates as: you can be perfectly logical and perfectly wrong because you didn’t get the *assumption* right.

    The assumption of science that everthing is physical or that everything has a physical explanation has, without exception, not been wrong for hundreds of years. Not a single instance of a non-physical explanation ever. Why should we believe that it will be any different in the future?

  55. BillyJoe says:

    wales,

    JMB said: “368 years of science and we end up with a dicey answer! I think the currently accepted scientific proof in physics is that there is no physical reality beyond the probability distributions that can be accurately described with the equations of quantum physics (no hidden local variables by disproof of Bell’s inequality). Perhaps it is better to ask, “how can science possibly prove that there is anything beyond the play of the dice?”

    Of course, that’s just the microscopic world of quantum particles. In the macroscopic world of everyday experince, we have deterministic newtonian physics. For the very fast, we have relativity theory and for gravity we have general relativity.

    At each level we have how questions that remain unexplained:

    Quantum: how can entanglement and uncertainty be explained.
    Newton: how can inertia be explained.
    Special relativity: how can the constancy of the speed of light be explained.
    General elativity: how can the distortion of space and time by mass be explained.

    In none of these how questions has the supernatural ever risen up out of the observations of these phenomena as an explanation for any of them.
    Really, it is time to put the supernatural/non-physical/immaterial assumption to rest.

  56. JMB says:

    “In none of these how questions has the supernatural ever risen up out of the observations of these phenomena as an explanation for any of them.
    Really, it is time to put the supernatural/non-physical/immaterial assumption to rest.” from BillyJoe.

    “Quantum mechanics is certainly imposing. But an inner voice tells me that it is not yet the real thing. The theory says a lot, but does not really bring us any closer to the secret of the ‘old one’. I, at any rate, am convinced that He does not throw dice.” from Albert Einstein, in a letter to Max Born.

  57. JMB,

    Are you interpreting Einstein as saying that there is a supernatural explanation for quantum phenomena? (Little ghosts driving around the electrons, perhaps?) I’ve never heard that interpretation of this very famous quote. I understand him as saying that there must be a physical, deterministic explanation underlying quantum probabilities, and that’s the interpretation I’ve always seen elsewhere.

  58. weing says:

    I second Alison’s comment. Also Quantum mechanics works. It allows you to use a cellphone, computer, etc. It’s weird, but it does the job when you apply the knowledge from it.

  59. JMB says:

    I believe Einstein was stating his intuition was that quantum mechanics was an incomplete theory. Science is by (Galileo’s) design devoid of supernatural/religious beliefs in arguments, hypotheses, and explanations. That does not mean that inspiration and underlying assumptions are devoid of belief systems, they are just not expressed in scientific literature (but may be expressed in personal communication). Einstein was inspired by his belief to search for more equations to complete quantum theory.

    A scientific statement is devoid of religion. That does not mean that the inspiration for the statement was devoid of religion. It does mean that for the statement to be accepted as scientific, there must be a way we can devise an experiment to test the statement, and that the observations from the experiment may support or reject the statement, and that those observations can be observed by multiple different observers regardless of their bias.

    “God does not play dice with the universe” is not a scientific statement, the EPR paradox was a scientific statement.

    Science doesn’t need religion, but it cannot answer everybody’s thirst for knowledge. If you are never tempted to ask “why?”, then you can accept the answers provided by science as complete. When a scientist asks “why?”, then they may be inspired to advance science further.

    Science may disprove statements made by religious leaders, but I don’t think that science can prove that it is the only source for knowledge.

  60. Fifi says:

    “Evil” is a religious notion, I’m not sure it applies here if we’re dealing in reality. The question is whether Big Pharma trustworthy and ethical – not in comparison to Big sCAM or other industries but according to the guidelines it’s meant to follow and based upon the actions of the major big pharmaceutical companies. Does this handful of extremely powerful international organizations promote science or pseudoscience within their own practice and in regards to how they try to influence government and academic policies regarding science and research? Do they try to conflate science with industry to try to pretend that anyone who critiques them is against scientific medicine?

  61. JMB says:

    @Allison

    “Are you interpreting Einstein as saying that there is a supernatural explanation for quantum phenomena? ”

    In some ways, Einstein was saying that there is a supernatural explanation for everything. Science progresses when we can discover how some of those supernatural explanations work. Through scientific discovery, we convert a supernatural explanation into a natural explanation. They are little ghosts to our misunderstanding minds until we discover the equation(s) that makes them natural.

    BillyJoe was asserting that arguments about supernatural/religious beliefs never arise from scientific observations or explanations. IMHO, that is by Galileo’s design. That should not be taken as proof that there is no God. The design is a consequence of trying to separate the kind of knowledge that can be gained from religion from the kind of knowledge that can be gained from science (and avoid persecution or oversight by papal authority).

    If you decide that, science has not yet shown us any proof of God so there cannot be a God, then you are making a leap of disbelief. Science has not come close to knowing even a small fraction of the universe. Is it possible for science to disprove the existence of God before we know everything in the universe? Heisenberg’s uncertainty principle states that we can never know everything about the universe. Therefore, can science ever disprove the existence of God?

  62. JMB says:

    Science is practiced in big pharma in their research labs. The marketing and lobbying arms practice pseudoscience. Is that any surprise?

  63. JMB says:

    Sorry about being so off topic again, but there is an interesting corollary about big pharma and big medicine. When the pharmaceutical company is small, its direction is dominated by the pharmaceutical scientist. As the company grows, marketing becomes more important. When it becomes big pharma, the pharmaceutical scientist is outnumbered by the marketers, lobbyists, and lawyers. Then the direction of the company drifts, and the science gets lost in the pseudoscience and avoidance of liability.

    There are many economists that argue that medicine can become more economically efficient by morphing from a cottage industry into a big company industry. However, medicine will likely lose its direction much the same way big pharma has.

  64. JMB on knowledge:
    “The design is a consequence of trying to separate the kind of knowledge that can be gained from religion from the kind of knowledge that can be gained from science.”

    Can you give an example of knowledge that can be gained from religion?

    JMB on the limits of science:
    “[C]an science ever disprove the existence of God?”

    Science cannot disprove the existence of anything. Not Russell’s teapot* and not god. You know that, so I’m not sure what you’re trying to get at.

    What I am trying to get at is what people are thinking when they say that science can only explain part of reality; that there are parts of reality that are beyond the scope of the scientific method.

    If we allow that observable things are within the scope of the scientific method, then the part of reality that is outside the scope of science must be unobservable. What does it mean to assert that unobservable things are “real”?

    By choosing to define as “supernatural” anything that you personally do not understand you don’t add anything to our understanding of the world; that definition certainly doesn’t carry the status of an explanation. From the point of view of a virus, everything would be supernatural including itself. Yet we, not being viruses, can observe viruses and use the scientific method to develop effective anti-virals.

    *“If I were to suggest that between the Earth and Mars there is a china teapot revolving about the sun in an elliptical orbit, nobody would be able to disprove my assertion provided I were careful to add that the teapot is too small to be revealed even by our most powerful telescopes. But if I were to go on to say that, since my assertion cannot be disproved, it is an intolerable presumption on the part of human reason to doubt it, I should rightly be thought to be talking nonsense. If, however, the existence of such a teapot were affirmed in ancient books, taught as the sacred truth every Sunday, and instilled into the minds of children at school, hesitation to believe in its existence would become a mark of eccentricity and entitle the doubter to the attentions of the psychiatrist in an enlightened age or of the Inquisitor in an earlier time.”
    — Bertrand Russell, 1952

  65. rosemary says:

    Fifi, “The question is whether Big Pharma trustworthy and ethical – not in comparison to Big sCAM or other industries but according to the guidelines it’s meant to follow and based upon the actions of the major big pharmaceutical companies.”

    There is a question as to whether or not Big Pharma is trustworthy and ethical? I didn’t think so. I thought that the vast majority of people realized that it is not for the reasons already stated.

    I also thought that some readers falsely assume that many people here frequently target alt med in their debunking because, for various reasons, they want to give Big Pharma a free ride, when that for me personally, and I suspect for all of the others as well, is not the case at all.

    Evil may have started as a religious concept but I seriously doubt that there is anyone today, religious or not, who does not believe that evil exists to varying degrees. One of the main things most expect their governments to do is to regulate businesses in an effort to keep them honest and ethical because they know that wherever there are humans there will be some only out for their own good willing to harm others to attain it.

  66. JMB says:

    “Can you give an example of knowledge that can be gained from religion? ”

    I don’t want delve too much into different theologies, so a generic question to search for knowledge from religion would be, “Do you keep on living because you are afraid of dying, or because there are people you love and want to show your love to?” Another could be, “when your father/mother died, had you reached some understanding between the two of you about your life together.”

    “Science cannot disprove the existence of anything. Not Russell’s teapot* and not god. You know that, so I’m not sure what you’re trying to get at. ”

    The question that I was addressing was, what would it take for science to disprove the existence of God? My argument is that answer must come from philosophy outside of science. Until science can achieve complete reduction of uncertainty in the universe, it cannot answer that question. Ultimately, if you say that science disproves the existence of god, you are using some philosophic method, not a scientific method.

    “By choosing to define as “supernatural” anything that you personally do not understand you don’t add anything to our understanding of the world; that definition certainly doesn’t carry the status of an explanation. ”

    It doesn’t add to our understanding of the world, it just becomes a motivation to study more. Einstein was motivated to search for more equations in quantum theory because he would not accept the prevailing theory as complete, he felt that there were laws governing nature created by God that had not yet been discovered.

    “What does it mean to assert that unobservable things are “real”?”

    Feelings are real, but we can only observe the effects of feelings in others.

    “that there are parts of reality that are beyond the scope of the scientific method.”

    When we work with a patient, the patient wants to know that they will get better, or avoid bad consequence, when they follow our advice. The information we have from medical science is in the form of probabilities, 50% will get better, 5% will avoid death. Although our ability to make better predictions and prognosis will improve in time, it will ultimately be limited by chaos. The knowledge we need as physicians is how to prepare the patient for either eventuality, and when the outcome becomes apparent, how to help the patient cope with what has become real.

    When you are faced with a decision about whether to have screening mammography beginning at age 40 or 50, science can tell you that 1 in 1904 women will be saved by a screening mammogram beginning at age 40, and 1 in 1330 will be saved by starting screening mammography at age 50. Science cannot tell you when to start, it is your value judgment that determines when you start (if at all).

  67. wales says:

    JMB: Thanks for your succinct summary of what I was trying to articulate with all my wordiness: “Science doesn’t need religion, but it cannot answer everybody’s thirst for knowledge. If you are never tempted to ask “why?”, then you can accept the answers provided by science as complete.” And “What I am trying to get at is what people are thinking when they say that science can only explain part of reality; that there are parts of reality that are beyond the scope of the scientific method.”

    JMB also said “A scientific statement is devoid of religion. That does not mean that the inspiration for the statement was devoid of religion.”

    A good example of this is Copernicus. From “The Non-Local Universe: The New Physics and Matters of the Mind”: “The placement of the sun at the center of the universe, which seemed right and necessary to Copernicus, was not a result of making careful astronomical observations. In fact, he made very few observations in the course of developing his theory, and then only to ascertain if his prior conclusions seemed correct. The Copernican system was also not any more useful in making astronomical calculations than the accepted model was, and in some ways, much more difficult to implement. What, then, was his motivation for creating the model and his reasons for presuming the model was correct? Copernicus felt that the placement of the sun at the center of the universe made sense because he viewed the sun as the symbol of the presence of a supremely intelligent and intelligible god in a man-centered world. “

    Here is another interesting Einstein quote, which seems to indicate that at the very least Einstein acknowledged some sort of holism rather than reductionism with regard to consciousness. I love his phrase “optical delusion of consciousness”.

    “A human being is a part of the whole, called by us “Universe”, a part limited in time and space. He experiences himself, his thoughts and feelings as something separated from the rest — a kind of optical delusion of his consciousness. This delusion is a kind of prison for us, restricting us to our personal desires and to affection for a few persons nearest to us. Our task must be to free ourselves from this prison by widening our circle of compassion to embrace all living creatures and the whole of nature in its beauty. Nobody is able to achieve this completely, but the striving for such achievement is in itself a part of the liberation and a foundation for inner security.”

    Letter of 1950, as quoted in The New York Times (29 March 1972) and The New York Post (28 November 1972)

    There are several Einstein quotes referencing god. It is widely acknowledged that Einstein was referring to “god” in the larger sense of a creator/designer, not as a personal god. Even so, it is witness to a brilliant but humble personality who did not believe that science has all the answers.

  68. JMB on spiritual motivation:
    “Einstein was inspired by his belief to search for more equations to complete quantum theory.”

    Einstein was inspired by his own aesthetic preferences to search for more equations to complete quantum theory. He attributed his aesthetic preferences to the Old One, but it doesn’t follow that religion offers a better explanation of quantum theory than science does.

    JMB on religious knowledge:
    [A] generic question to search for knowledge from religion would be, “Do you keep on living because you are afraid of dying, or because there are people you love and want to show your love to?” Another could be, “when your father/mother died, had you reached some understanding between the two of you about your life together.”

    You don’t need religion to be either afraid or unafraid of death. What religions tell us about the afterlife is not knowledge, it is fantasy or projection. (It’s possible that there is a religious projection that happens to be accurate but we don’t know that.)

    You don’t need religion to love, or to endure suffering on behalf of your young: birds and mammals generally appear to do both without the benefit of a holy book. Attachment and sacrifice are not knowledge, though people may benefit from the insights of their forebears who have also loved and sacrificed; these insights may or may not be passed down in the form of religion, and that which is passed down in the form of religion may or may not be beneficial.

    The accommodation people reach with their parents is not religious knowledge. It can be achieved with or without religion; religious people may or may not reach it.

    Your examples seem to flow somewhere between insight and good feelings. They don’t go anywhere near suggesting that religion can offer better explanations of the physiology of sleep than science can.

    JMB on proving a negative:
    “Ultimately, if you say that science disproves the existence of god, you are using some philosophic method, not a scientific method.”

    I don’t think science disproves the existence of god, just as I don’t think it disproves Russell’s teapot. However, science does better when it rejects the god of the gaps and instead seeks to find out what really is there in the gaps.

    “What does it mean to assert that unobservable things are “real”?”
    Feelings are real, but we can only observe the effects of feelings in others.

    Do you require the supernatural to have or to explain feelings? Or are feelings explicable by what we know about the brain and evolution?

    I don’t see how anything you have said supports wales’ claim that probably only 30% of reality can be explained with the scientific method and that some supernatural means are required to explain the remaining 70% of reality.

    “When you are faced with a decision about whether to have screening mammography beginning at age 40 or 50, science can tell you that 1 in 1904 women will be saved by a screening mammogram beginning at age 40, and 1 in 1330 will be saved by starting screening mammography at age 50. Science cannot tell you when to start, it is your value judgment that determines when you start (if at all).”

    Is your value judgement spiritual, or an unknowable paradigm? Is it fundamentally impossible to describe how someone arrives at a value judgement? Science can certainly help you gather different kinds of information to help you decide when to start. (How much does it cost? What is the NNH to compare to the NNT?)

    The knowledge we need as physicians is how to prepare the patient for either eventuality, and when the outcome becomes apparent, how to help the patient cope with what has become real.

    Yes. That knowledge is gained in many ways, most observational. Observing yourself; listening to people who have been through similar experiences in the past; listening to people who are going through them now; watching other people help patients; reading or hearing about effective interactions. And so on. People are more or less empathetic and more or less able to translate this information into effective support. But there’s nothing supernatural about it.

    *** *** ***
    When I was at my most depressed, I wished I had a religion that could tell me that my suffering had meaning. To suffer pointlessly seemed worst of all. But religion doesn’t necessarily help. People who are depressed stop taking pleasure and comfort from the things that had pleased and comforted them before. That includes religion. Now that I am much less depressed, my experience of suffering has made me more compassionate. I am still not religious. Even if I had believed that my suffering was pleasing to god in some way, and taken comfort from the thought, that wouldn’t have made it true.

    Religious people often believe that they are compassionate because they are religious. But religious people have been observed to lack compassion, feeling that suffering is a private issue between the sufferer and their god. Atheists may be compassionate because they know that suffering has no meaning and they know that there is nobody else to alleviate suffering: if suffering is to be alleviated, they must do it themselves.

    When I attended an evangelical Christian high school, we were repeatedly told that religions were not equivalent. Yes, all religions come with similar codes of behaviour to make community life possible, but that’s just decoration. That’s the secular part of religion, an add-on. The codes of behaviour are true and important, but what makes Christianity a religion, and the only true religion, is not the behaviour codes but the resurrection of Jesus Christ. I thought that was a pretty impressive insight for evangelicals to have.

  69. wales,

    When you say that science can probably only explain 30% of reality, that 70% of reality probably needs an unknowable supernatural explanation, you really mean that science is not yet complete and that people need to be compassionate and aware of their small place in the universe?

    I’m glad you explained yourself, because I see absolutely no link between what you said and what you meant. And I don’t think any poster here disagrees with what you mean.

    Also, I was the one who said, “What I am trying to get at is what people are thinking when they say that science can only explain part of reality; that there are parts of reality that are beyond the scope of the scientific method.”

  70. BillyJoe says:

    wales,

    Copernicus was a religious man like virtually all men of the 14th and 15th centuries. Whether he was a particularly religious man compared to his peers I don’t know. The point is that it is irrelevant. If he was not religious he might have found inspiration elsewhere. As it was, religion was the pervading ethos and that is where he found his inspiration. The other point is that we have come a long way in 500 years and religious ideas are no longer tenable.

    Einstein was not religious in the ususal sense. He used the word religion purely as metahpor. He certainly rejected the personal god as you say:

    “I do not believe in a personal God and I have never denied this but have expressed it clearly. If something is in me which can be called religious then it is the unbounded admiration for the structure of the world so far as our science can reveal it.”

    His god was a sort of god-in-nature or pantheism:

    “A knowledge of the existence of something we cannot penetrate, of the manifestations of the profoundest reason and the most radiant beauty – it is this knowledge and this emotion that constitute the truly religious attitude; in this sense, and in this alone, I am a deeply religious man.”

    As for the quote about consciousness, I think you have misinterpreted it. He is simply saying that, if the world is to survive, we need to focus our attention away from our own and our immediate family concerns and onto the whole global community and the natural environment. It has nothing to do specifically with consciousness or religion. Here is the complete quote:

    “A human being is part of the whole called by us universe, a part limited in time and space. We experience ourselves, our thoughts and feelings as something separate from the rest. A kind of optical delusion of consciousness. This delusion is a kind of prison for us, restricting us to our personal desires and to affection for a few persons nearest to us. Our task must be to free ourselves from the prison by widening our circle of compassion to embrace all living creatures and the whole of nature in its beauty. The true value of a human being is determined by the measure and the sense in which they have obtained liberation from the self. We shall require a substantially new manner of thinking if humanity is to survive.”

  71. wales says:

    Alison: No, I don’t think I meant exactly what you think I meant. That is a start, but not the whole story. I think it’s impossible to carry on this conversation with blog comments, for me anyway. As with all subtle subjects, even lengthy explanatory comments are subject to misinterpretation. I am always amazed at how I spend considerable time trying to articulate clearly and then someone misinterprets what I am saying. I think this is a universal problem, or perhaps speaks to my lack of writing skill.

    BJ: See, you think I misinterpreted Einstein, I think you did. Anyway, the Wikipedia Einstein entry is replete with Einstein quotes on religion, personal vs. cosmic religion, religion and science, god, etc. Einstein also expressed a distaste for “fanatical atheists” who he believed were just as bigoted as their fanatical religious counterparts. There is so much misunderstanding and misinterpretation about what is meant by religion and spirituality, and those words trigger so many emotions.

  72. wales,

    I think it’s extremely common to have a hard time conveying what one means when ones own thoughts aren’t clear to oneself. We can have strong feelings that something must be right, but have trouble explaining our intuition in words because it is based on emotion, not thought. When things that are so obvious to us remain frustratingly opaque to our interlocutors, it’s often a clue that we need to rethink and do some more work on our own logic.

    It can be the opposite, of course; our interlocutors could be the ones who are so stuck in ideas that are so obvious to them that they can’t hear. Which is what makes dialogue and the effort to listen so crucial, for everyone. We never want to be the ones mistaking intuition and emotion for thought, and it can be really hard to tell the difference.

  73. wales says:

    Alison: I think it’s difficult to convey thoughts even when they are clear. My thoughts are clear to me. Thanks for the free head shrink though.

  74. wales says:

    To say that Einstein’s “brand” of religion/spirituality (cosmic, not personal god) is acceptable and that the personal god type of religion is not acceptable is just another example of personal judgment; one group imposing its “truth” on others.

    If I were somehow forced to choose I would lean toward the Einstein cosmic “brand” myself, but I don’t think that necessitates doing away with the other types of belief in which people take comfort.

    I’ll play devil’s advocate for a moment. Say for example that science had proven there is no spiritual reality (as Billy Joe believes). In this scenario the “personal god” religions have been proven to be simply an “opiate” (which I do not feel that I or anyone else is qualified to judge) so we dispense with all religion, it is now illegal. Shall we also dispense with other forms of human “opiates” such as recreational and medical mind altering substances?

  75. Harriet Hall says:

    In Victor Stenger’s book “God: The Failed Hypothesis” he argues that science has ruled out the possibility of a personal god.

  76. BillyJoe says:

    JMB,

    Sorry for this long post.

    “I believe Einstein was stating his intuition was that quantum mechanics was an incomplete theory.”

    Einstein did not believe in the roll of the dice. In other words, he did not believe in the probability that seemed to be inherent in quantum theory. He proposed that there must be “hidden variables” that would transform that probability into deterministic cause and effect. He was wrong. Probability is real.

    “Einstein was inspired by his belief to search for more equations to complete quantum theory.”

    Einstein was inspired by what science had already revealled of, to quote his words, “the marvelllous structure” of the world and the mysteries that still remained to be solved.

    “Science doesn’t need religion, but it cannot answer everybody’s thirst for knowledge. If you are never tempted to ask “why?”, then you can accept the answers provided by science as complete. When a scientist asks “why?”, then they may be inspired to advance science further.”

    The scientist asks “how?”.
    There may be no reasons for how things are.
    In other words, “why?” questions may be irrelevant.

    “I don’t think that science can prove that it is the only source for knowledge.”

    Science is the only source of reliable knowledge. Can it prove that it is the only source of reliable knowledge? Perhaps not, but it’s been doing a pretty good job of eliminating the opposition for the past several hundred years.

    “In some ways, Einstein was saying that there is a supernatural explanation for everything. “

    Einstein did not believe in the supernatural:
    “Scientific research is based on the idea that everything that takes place is determined by laws of Nature…a research scientist will hardly be inclined to believe that events could be influenced…by a wish addressed to a Supernatural Being.”
    “I do not believe in immortality of the individual, and I consider ethics to be an exclusively human concern with no superhuman authority behind it.”
    “What I see in Nature is a magnificent structure that we can comprehend only very imperfectly, and that must fill a thinking person with a feeling of “humility.” This is a genuinely religious feeling that has nothing to do with mysticism.”

    “Science progresses when we can discover how some of those supernatural explanations work. Through scientific discovery, we convert a supernatural explanation into a natural explanation. They are little ghosts to our misunderstanding minds until we discover the equation(s) that makes them natural.”

    In Australia we would call this a “Claytons” supernatural. Claytons is a brand of beer without any alcoholic content: “the beer you have when you’re not having a beer”! A Claytons supernatural would be a supernatural you have when you don’t have a supernatural.

    “BillyJoe was asserting that arguments about supernatural/religious beliefs never arise from scientific observations or explanations. IMHO, that is by Galileo’s design. That should not be taken as proof that there is no God. The design is a consequence of trying to separate the kind of knowledge that can be gained from religion from the kind of knowledge that can be gained from science .”

    Yet above you said that science converts supernatural explanations into natural explanations. So how is this not saying that science can disprove religion/god? But now you want to separate supernatural explanations (religion) from natural explanations (science) into separate magisteria. History has shown that you were right the first time.

    “If you decide that, science has not yet shown us any proof of God so there cannot be a God, then you are making a leap of disbelief. “

    Science and logic has shown that the only tenable god is the non-interventionist deist god, and logic tells us that such a god is unnecessary. It replaces one unanswered “how” question: “How did something arise from nothing?” with another unanswered “how” question: “How did the deist god come to be?”

    “Science has not come close to knowing even a small fraction of the universe. Is it possible for science to disprove the existence of God before we know everything in the universe?”

    Probably not? But do we need to? Science and logic has shown that the god hypothesis is an unnecessary hypothesis. Why is the god hyothesis so important to you that you are demanding that it be treated differently to all other useless hypotheses which go the way of Ockham’s razor (especially coinsidering that we are talking here of a non-interventionist deist god who doesn’t help us, doesn’t save us, and doesn’t reward us).

    “Heisenberg’s uncertainty principle states that we can never know everything about the universe.”

    The Heisenberg Uncertainty Principle is part of a modelling of quantum physics that, in experimental tests, gives the most reliable of any results in physics. In other words, the result of this “uncertainty” are completely predictable. The “unknown” you are talking about is perhaps better characterised as “counterintuitive” – a word that simply means that it doesn’t corresponds to our everyday experience. We can’t expect it to.

    “a generic question to search for knowledge from religion would be, “Do you keep on living because you are afraid of dying, or because there are people you love and want to show your love to?” Another could be, “when your father/mother died, had you reached some understanding between the two of you about your life together.”

    Why are these religious questions? How does religion aswer them satisfactorily as opposed to, say, secular humanism?

    Ultimately, if you say that science disproves the existence of god, you are using some philosophic method, not a scientific method.”

    But you can use the scientifically backed philosophical assumption that everything is physical or has physical causes. It sounds circular but it is sort of circular like “survival of the fittest” is circular. The underlying philosophy of science consists of its only assumption: everything is physical. As long as everything continues to be explained in physical terms and as long as nothing is shown to have a supernatural explanation – and nothing has – then the results of science continue to confirm its underlying asssumption that everything is physical.

    “Einstein was motivated to search for more equations in quantum theory because he would not accept the prevailing theory as complete, he felt that there were laws governing nature created by God that had not yet been discovered.”

    Well, Einstein was looking for “hidden variables” to explain away the probability inherent in quantum physics. He was wrong. There are no “hidden variable”. “God” does roll dice. So, if he was motivated by a belief in god, god let him down badly.

    “What does it mean to assert that unobservable things are “real”? “Feelings are real, but we can only observe the effects of feelings in others.”

    There is a physical explanation for emotion. It consists of, amongst other things, hormonal changes and changes in neuronal activity in the brain. No supernatural element has ever been detected to explain emotions so we continue to assume that emotions are physical.

    “When you are faced with a decision about whether to have screening mammography .. science can tell you that. Science cannot tell you when to start, it is your value judgment that determines when you start…”

    What is your “value judgement” based on? Science tells us that everything at the macroscopic level is deterministic. Your genetic code is deterministically inherited from your parents (together with any mutations that were either deterministic or caused by probability wave of decay of radioactive particles). The development of your brain and body was determined by the interaction of your genetic blueprint and your environment, which includes the physical and social environment in which you found yourself. All the inputs from the environment have been filtered by your sense organs and further filtered into short term and long term memory, both of which determine, together with your present filtered sensory input to determine the responses you put out today, right now. Including what you call your “value judgement”.
    Science all the way down. It just doesn’t feel like it because the output (“value judgement” in this case) is connected in an extremely complex and multilayered way to the all the parameters that have determined it.

  77. BillyJoe says:

    Harriet,

    “In Victor Stenger’s book “God: The Failed Hypothesis” he argues that science has ruled out the possibility of a personal god.”

    The Theistic God is a failed hypothesis.
    The Deistic God is an unnecessary hypothesis.
    Really, what is left of the god hypothesis.
    And then what is left of religion.

  78. weing says:

    “The marketing and lobbying arms practice pseudoscience.”

    I disagree. I think marketing is a science. It is also very effective. And not just with pharmaceuticals. I think that we, as physicians, are fighting a losing battle against marketing. We have only a few minutes with the patient to advise regarding eating, smoking, etc. The patient is exposed to marketing by all sorts of manufacturers between our visits. It’s a wonder any of them follow our advice.

    Regarding religion. God is outside the purview of science, and therefore, science cannot say anything about her existence. It’s simply a waste of time. Just because someone uses the word God in conversation does not mean they are believers. I’ve heard many atheists say, “OMG”.

  79. wales,

    It wasn’t a head shrink. It was writing advice. If anyone’s writing isn’t clear, it strongly suggests that their thoughts aren’t clear.

    If you cannot communicate your thoughts clearly to your own satisfaction, it’s a suggestion that your thoughts may not be as clear as they feel to you. That doesn’t mean they are wrong.

  80. BillyJoe says:

    wales,

    “BJ: See, you think I misinterpreted Einstein, I think you did.”

    Yes, but the truth is that you did. ;)

    “Einstein also expressed a distaste for “fanatical atheists”"

    I have no interest in converting anyone, but I believe in stating what I believe to be true, regardless of religious sensitivities.

    “There is so much misunderstanding and misinterpretation about what is meant by religion and spirituality, and those words trigger so many emotions.”

    Yes, I think we should think natural v supernatural. Or the expanded natural/physical/material v supernatural/nonphysical/immaterial.
    Einstein believed in natural explanations. His “religion” or “spirituality” consisted of awe in the face of nature as revealed by science and the mysteries still to be unfolded:

    “A knowledge of the existence of something we cannot penetrate, of the manifestations of the profoundest reason and the most radiant beauty – it is this knowledge and this emotion that constitute the truly religious attitude; in this sense, and in this alone, I am a deeply religious man.”

  81. BillyJoe says:

    weing,

    “God is outside the purview of science, and therefore, science cannot say anything about her existence.”

    The non overlapping magisteria concept is dead.
    Long live science! :)

  82. BillyJoe on failed hypotheses:
    “And then what is left of religion.”

    Buddhism? Judaism?

    Many modern Jews say that whether God exists or not is irrelevant, that the practice of Judaism is what’s important. Many Buddhists also claim Buddhism as a practice and not a set of absolute beliefs in supernatural events and beings.

    While none of the useful practices of religions depend on the reality of a personal or impersonal god to be useful, in practical terms a community of practice can be helpful. Physical exercise is good for us with or without a god, no matter where we live, but we’re less likely to actually get it if we live in the suburbs and drive a car. It takes a lot of personal discipline to go to the gym, and not everyone does.

    Meditation, self-reflection, fasting and community engagement are good for us with or without a god, no matter where we live, but people with a religious community are much more likely to actually do these things. The american civil rights movement of the fifties was centred on churches and inspired by the Hindu non-violence of Ghandi.

  83. wales says:

    Alison: Again, I did express my thoughts to my satisfaction. I was misinterpreted.

    Harriet: Arguments for atheism abound. Proof?

    BJ: We can cherry pick Einstein quotes all day long: “The highest principles for our aspirations and judgments are given to us in the Jewish-Christian religious tradition. It is a very high goal which, with our weak powers, we can reach only very inadequately, but which gives a sure foundation to our aspirations and valuations.” On religion and society, in Out of My Later Years (1950), p. 27.

    http://en.wikiquote.org/wiki/Albert_Einstein

  84. BillyJoe and Alison – Regarding religion – I often find myself in agreement with you, but on religion I think I either must differ or possibly that I misunderstand you.

    Historically, many great minds (and small ones as well, I’m know) from various religions have written observations on the human condition, ethics, finding meaning in the face of despair or even coping with every day nuisances, etc. While I would not ever recommend taking any writings as “truth” I think to label these efforts as “untenable” or not useful on the grounds that is does not advance scientific knowledge or that one premise of those writing is not factual, is to ignore a broad swath of very compelling human history and thought.

    But then I am a mixed media artist who uses found objects, so I am quite happy with picking through junk to find something useful.

    On supernatural – Why would a god be supernatural or non-scientific rather than just not-discovered yet? If there was a god(s), would they in fact not be a part of nature that called for an expansion of the laws of physics and science? God-Yenti, for me, the same.

  85. Tangentially from the tangent –

    Someone asked about an example of something that is mysterious that could not be explained by science now or in the future.

    I’m terrible at fill in the blanks, but I was reflecting on this. My example is not supernatural, only a mystery.

    Why only us? Here we are on this lush planet populated by I can not say how many forms of life and yet there is no solid evidence (I think) of such life elsewhere. We believe it is possible, but isn’t it kinda amazing all of those stars, planets, etc out there for so very, very long a time and we have seen no direct evidence of something built, no evidence of developed life? Maybe it is not so amazing considering how far away everything is…but pretty mysterious. I think.

    Which leads me to my next tangential thought. Exactly how far can science take us in discovering knowledge. What is our brain capable of? Recalling Einstein and his search for a unified field theory as well as string theory, which seems to be quite difficult for even people in the field (could be wrong here) makes me wonder if our knowledge is becoming increasingly specialized and understandable to fewer people. Will there be a point were the advancement of knowledge is slowed or halted by our brains individual abilities to comprehend or remember information? Will an increasing specialization cause an insurmountable disconnect between specialties causing us to miss the connections needed to make new discoveries? Is this already happening?

    Also since we are quoting Einstein I had to share my favorite.
    “The most beautiful thing we can experience is the mysterious.”

  86. wales says:

    Einstein also said: “Everything that the human race has done and thought is concerned with the satisfaction of deeply felt needs and the assuagement of pain. One has to keep this constantly in mind if one wishes to understand spiritual movements and their development.” So where does that leave the “ignorant” masses after we do away with religion? Are antidepressants going to replace religion/spirituality?

  87. JMB says:

    Science picks out those arguments for which there is a test that should settle the argument. This discussion is a good example of an argument in which we may not be able to reach agreement, because it is not something to which we can apply scientific method. It is still an interesting discussion.

    My only point was to say you can be a scientist and still believe in God. You must invoke logic with Occam’s razor, or some other philosophy to conclude that there is no God. Ultimately it is your choice of disbelief or faith, not a matter of science. I am not trying to influence anybody’s choice. I am not trying to prove there is a God.

    In regards to whether quantum theory is complete, stay tuned, Einstein might still prove correct.

    In regards to how deterministic we can become in medicine, there are limitations in our determinism based on various theorems in mathematics and iterative procedures. The biggest limitation on determinism is the unpredictability of human choice.

    One other factor about knowledge that we have not discussed is information/entropy/uncertainty. While we may have many equations that are very accurate in predicting measures observed in experiments, we do not much information about the universe, much less our own world. You must have both information on the current state and equations of the operators governing the change in state with time to have complete knowledge of a system. Most of our discussions have focused on the scientific discovery of those causal relationships, and the percentage of those things that we observe that can be explained by our scientific discovery. The percentage of information that we have that would be required to approach determinism, is infinitesimal.

  88. “All the inputs from the environment have been filtered by your sense organs and further filtered into short term and long term memory, both of which determine, together with your present filtered sensory input to determine the responses you put out today, right now. Including what you call your “value judgement”.

    HeHe – BillyJoe, do you have a algorithm for that? Cause today it’s cold and rainy and the weather report said “warm and sunny”. Sure a “value judgement” is created by our organic brain and the environment. But that organic brain is an incredibly fast system that learns on the fly. I think it going to be a long time before science can give us any accurate representation of how a person is feeling that is better than self-reporting.

    But we can look to how science based medicine today operates for some insight into that. What is one of the most reliable sources of knowledge when a doctor wants to know how much pain a patient is in? To ask the patient, they might also ask the patient what kind of pain they are having, sharp, burning, dull, etc…I have to wonder when science will provide a more reliable tools than self-reporting for that, because the neo-natal units will snap that tool up.

    Also, I haven’t seen anything in JMB’s comments that indicate support of supernatural beliefs. Philosophy is not supernatural. Ethics are not supernatural. I only see an indication that he believes that science is not the best or most reliable tool for every problem.

  89. Harriet Hall says:

    “Harriet: Arguments for atheism abound. Proof?”

    Atheism to my mind is a lack of belief in gods, (a-theism =”without theism”) not a belief that there is no god. A subtle difference, but one I think is important. And of course you should know that it is up to theists to show evidence for the existence of their gods, not the responsiblity of non-theists to prove gods don’t exist. I don’t believe Santa is real, but I can’t prove he doesn’t exist. I don’t define myself as an asantaist because it doesn’t make sense to define myself in terms of belief or nonbelief in a being that all the evidence indicates is imaginary.

    Stenger thinks a personal god who answers prayers and performs miracles has been ruled out by science. That hypothesis is simply incompatible with a huge body of evidence. Read his book.

  90. Wales “So where does that leave the “ignorant” masses after we do away with religion?”

    I genuinely don’t believe that you could do away with religion any more than you can do away with love. Perhaps worship may take a direction over time…different Gods, different afterlifes, same impulse.

  91. wales says:

    Michele I agree, besides it’s been tried (Russia, China, France during the Revolution….)

    Harriet yes I didn’t mean to say proof of atheism, I meant proof that a spiritual reality does not exist. I already read Dawkins and didn’t see any proof, does Stenger have any original arguments?

    What I find disturbing about Billy Joe’s comments is not that he is an atheist, he is entitled to his beliefs, but that he thinks he is “right” and others are “wrong” and “ignorant”. This kind of black/white, right/wrong attitude carried to extremes is the ultimate cause of the atrocities committed in the name of religion and nationalism. Religion, science and government have usefulness, which is why they are still around, but they are all subject to “hijacking” by those who want to act destructively. (Of course I am not implying that Billy Joe is one of those destructive individuals.)

  92. Zoe237 says:

    “Are you interpreting Einstein as saying that there is a supernatural explanation for quantum phenomena? (Little ghosts driving around the electrons, perhaps?) I’ve never heard that interpretation of this very famous quote. I understand him as saying that there must be a physical, deterministic explanation underlying quantum probabilities, and that’s the interpretation I’ve always seen elsewhere.”

    My (very limited) understanding is that Einstein was clearly wrong about Heisenberg and quantum mechanics. The rumor is that Neils Bohr responded to the “god does not play dice” quote by saying “Albert, stop telling god what to do with his dice!” (although I don’t think he actually said it).

    Eistein was clearly not a theist and attempts by religionists to prove him such annoy me.

    I’m not sure who I agree with here, parts of BJ and Alison and Michelle. I do not believe that science has all the answers, but mostly because of the failings and biases of scientists rather than a fundamental flaw in the process itself. I do not believe there is any personal god, am agnostic, and yet I believe that things like love and memories and fear cannot be reduced to mere brain waves and neuron exchanges. Or at least, if they are, we will never be able to sort it out. I think Dr. Novella argues the opposite, but I am not convinced, any moreso that I am that the “divine calculation” is possible. I have more confidence in the complexity of evolution and the human mind than I do machines. You don’t need a personal god to believe there is more.

    RE: life on other planets/unsolvable mysteries. My feeling is that astronomers feel that there probably is other life (because of the vastness of the universe), while biologists say probably not (because of the extremely unlikely conditions needed to evolve any life, not to mention intelligent life that is capable of communicating and around at this point in our time). Interesting that Carl Sagan’s SETI project is put in the same category of pseudoscience of acupuncture and chiropractor by Michael Shermer’s “Borderlands of Science.”

  93. micheleinmichigan on the existence of god:
    “Historically, many great minds (and small ones as well, I’m know) from various religions have written observations on the human condition, ethics, finding meaning in the face of despair or even coping with every day nuisances, etc. While I would not ever recommend taking any writings as “truth” I think to label these efforts as “untenable” or not useful on the grounds that is does not advance scientific knowledge or that one premise of those writing is not factual, is to ignore a broad swath of very compelling human history and thought.”

    I don’t think I ever said otherwise. I just said that the useful part is not the part where there’s an eternal tyrant yelling at you. One of the most useful concepts I have ever learned is that of grace: that I am held to a standard of perfection, that I will fail, and that I am forgiven and loved anyway. While I learned it from reading the Sermon on the Mount and the works of St Paul, the premise that we don’t actually deserve what we have and we don’t have to has gotten me through some pretty dark days.

    I like the conclusion of the Book of Job that some things just suck and we shouldn’t try to attribute meaning to them. In the book this conclusion was announced by God speaking out of the whirlwind, but the conclusion is valid anyway.

    If the insights of religious people were absolutely dependent on belief in a god, they would be suspect. I don’t find the traditional christian belief that God sends us bad things to try us at all compelling. It doesn’t seem to be adaptable to non-theistic philosophy – and I suspect it’s even bad theology.

  94. squirrelelite says:

    On the subject of possible alien intelligent species, Stephen Hawking has some interesting thoughts in his new documentary which are summarized here:

    http://www.msnbc.msn.com/id/36769422/?GT1=43001

  95. squirrelelite says:

    The relationship among science and skepticism and religion or non-religion/atheism is an awkward one at best. It continually intrudes on discussions of other topics, but it seems in the last month or so to have taken on renewed life, perhaps helped a bit by the discussion on SGU a few weeks ago. I have some more extensive ideas I plan to express but haven’t had time yet to give them the clear and careful exposition they deserve.

    Real Soon Now! ( :) )

    In the mean time, I enjoy perusing your comments on the subject.

    It also seems to be a popular subject on the podcast Point of Inquiry. I noticed they had a recent episode featuring Victor Stenger, which I haven’t listened to yet:

    http://www.pointofinquiry.org/victor_stenger_taking_a_stand_for_science_and_reason/

    I did recently listen to the podcast featuring J. J. Altizer, one of the theologians who articulated the “Death of God” theology. I didn’t agree with much of what I heard, but I found his ideas to be challenging and worthy of some consideration.

    http://www.pointofinquiry.org/thomas_j.j._altizer_the_death_of_god/

  96. wales says:

    I have two questions for Billy Joe:

    1) Where are the published results of rigorous, controlled, repeatable empirical testing proving theories about the non existence of a spiritual reality? Without the “beef” these theories and arguments amount to philosophical speculation, not scientific fact. The old saw “where’s the beef?” comes to mind.

    2) If religion/spiritual beliefs are so detrimental to humanity, why hasn’t natural selection eliminated them by now?

  97. BillyJoe says:

    Harriet,

    “Atheism to my mind is a lack of belief in gods, (a-theism =”without theism”) not a belief that there is no god. A subtle difference, but one I think is important.”

    Some refer to strong and weak forms of atheism
    Weak atheism is a lack of belief in god because there is no evidence that he exists.
    Strong atheism is an active disbelief in god because there is evidence that he does not exist.

    “And of course you should know that it is up to theists to show evidence for the existence of their gods, not the responsiblity of non-theists to prove gods don’t exist.”

    The first task of the believer is to actually define god.
    It is actually difficult to define god in such as way as to make him untouchable (and refutable!) by science and logic. What is usually left is some form of invisible non-interventionist god. In effect we are reduced to a defintion of god which very few people actually believe in or want to believe in! After all what’s the good of a god who doesn’t provide us with an afterlife!

    “I don’t believe Santa is real, but I can’t prove he doesn’t exist. “

    Again, a definition would be useful.
    Once defined, it is easy to see how both logic and science can disprove most, if not all, the presumed attributes of Santa.

  98. BillyJoe says:

    wales,

    “1) Where are the published results of rigorous, controlled, repeatable empirical testing proving theories about the non existence of a spiritual reality? Without the “beef” these theories and arguments amount to philosophical speculation, not scientific fact. The old saw “where’s the beef?” comes to mind.”

    You still don’t get it.
    It is the *assumption* of science that everthing is physical.
    That is the philosophical part.
    Now here is the practical part:
    You can see all around you how far this *assumption* has taken us. Everything you use every day is practically al the result of science working on the basis of that *assumption*.

    The longer that all phenomena continue to be shown to have natural explanations and the longer supernatural explanations remain conspicuous by their absence, the more confident we can be that everthing is physical.

    Supernatural ideas make their appearance only outside of science in the minds of the hopeful. And, once defined, these supernatural idea can be shown via logic and science to be false.

    “2) If religion/spiritual beliefs are so detrimental to humanity, why hasn’t natural selection eliminated them by now?”

    First of all I have not made that claim.
    But if you are asking: Some believers interpret their religion in such a way that it certainly does lead to behaviour that is detrimental to humanity. Suicide bombers for example. Others interpret their religion in ways that are advantageous to both themselves and others. There are others who don’t make a difference. Mixed bag really.

    But “why hasn’t natural selection eliminated them by now?”
    Well, let’s just say that you could ask that question only if you don’t understand evolution.

  99. BillyJoe says:

    michelinmichigan,

    “HeHe – BillyJoe, do you have a algorithm for that? Cause today it’s cold and rainy and the weather report said “warm and sunny”. Sure a “value judgement” is created by our organic brain and the environment. But that organic brain is an incredibly fast system that learns on the fly. I think it going to be a long time before science can give us any accurate representation of how a person is feeling that is better than self-reporting.”

    Yes, isn’t evolution marvellous!

    :)

    And, yes, no simple algorithm. A complex interviewing mutlilayered web of interaction is more like it. And it’s not going to be written down any time soon. Yet there is no reason to believe there is anything but natural cause and effect operating inside the brain.

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