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How not to debate a “pro-vaxer”

When people debating against vaccines win, children lose.

When people debating against vaccines win, children lose.

To say that the relationship that antivaccine activists have with science and fact is a tenuous, twisted one is a major understatement. Despite mountains of science that says otherwise, antivaccinationists still cling to the three core tenets of their faith, namely that (1) vaccines are ineffective (or at least nowhere near as effective as health officials claim; (2) vaccines are dangerous, causing autism, autoimmune disease, neurodevelopmental disorders, diabetes, sudden infant death syndrome, and a syndrome that is misdiagnosed as shaken baby syndrome; and, of course, (3) the Truth (capital-T, of course!) is being covered up by a nefarious combination of big pharma, the medical profession, and the government (in the US, primarily the Centers for Disease Control and Prevention, which works with pediatricians to produce the recommended schedule of vaccines). Because vaccine rejectors don’t have science on their side, they have to resort strategies common to science denialists like those who reject the scientific consensus about evolution or human-caused global climate change. These fallacious strategies include (but are not limited to) selective citation of evidence (i.e., cherry picking), misrepresentation and logical fallacies, impossible expectations about what science can deliver (e.g., vaccine denialists expecting 100% efficacy and 100% safety from vaccines or cancer quacks expecting 100% cure rates and no side effects from chemotherapy); fake experts (e.g., Andrew Wakefield); and, of course, conspiracy theories. Add to that appeals to personal freedom and “health choiceüber alles and painting any form of vaccine mandate as incipient totalitarianism, with those rejecting vaccines taking on the role of the Jews in Hitler’s Germany, and you have a pretty good idea of the sorts of arguments antivaccine activists resort to.

Not surprisingly, even the most diehard antivaccine advocate can get frustrated. After all, it must be very frustrating to have one’s posterior handed to one in arguments on the science of vaccines time and time again. Of course, for that purpose, like most science denialists, antivaccine activists have the Internet. In particular, they’ve taken full advantage of Facebook, and, more recently, Twitter. One such online gathering place is the public group known as Vaccine Resistance Movement (VRM). I encourage pro-science advocates to peruse this group, just to see that when I refer to people being anti-vaccine, there is no doubt that that is what they are. It was there that I found a rather telling document posted, for the benefit of antivaccine advocates everywhere.
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Posted in: Critical Thinking, Vaccines

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Steve Novella vs. Julian Whitaker on vaccines at FreedomFest

Steve Novella vs. Julian Whitaker on vaccines at FreedomFest

I’ve just returned from TAM, along with Steve Novella and Harriet Hall. While there, we joined up with Rachael Dunlop to do what has become a yearly feature of TAM, the Science-Based Medicine workshop, as well as a panel discussion on one of our favorite subjects, “integrative” medicine. Between it all, I did the usual TAM thing, meeting up with old friends, taking in some talks, and, of course, spending the evenings imbibing more alcohol than I probably should have so that I could look and feel my best for our morning sessions, particularly given my difficulty adapting to the time change. One thing I did was completely unexpected, something I learned about the night before our workshop when I happened to run into Evan Bernstein. He informed me of something that our fearless leader Steve Novella was going to do the next day right after our workshop. In a nutshell, Evan told me that Steve was going to debate an antivaccinationist. Evan didn’t know any details other than that Michael Shermer had arranged it and that Steve had been tapped at the last minute. Evan didn’t even know who the antivaccinationist was going to be or what the event was. Naturally, I was intrigued.

So, the next morning I asked Steve about it. I turns out that the event was FreedomFest, a right-wing/Libertarian confab that happened to be going on at the same time as TAM up the road a piece on the Strip at Bally’s. Steve didn’t know who the antivaccinationist was going to be either, which made me marvel at him. I don’t know that I’d have the confidence agree to walk into the lion’s den with less than a day’s notice not even knowing who my opponent is. Steve was more than happy to invite me along. Clearly, this was was an opportunity that I couldn’t resist. So we met up with Michael Shermer, and it was from him that I learned that Steve’s opponent was to be Dr. Julian Whitaker.

My eyes lit up.
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Posted in: Neuroscience/Mental Health, Politics and Regulation, Vaccines

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Playing by the Rules

I recently read Flock of Dodos (no relation to the movie of the same name). It’s a hilarious no-holds-barred send-up of the lies and poor reasoning of the intelligent design movement. I was particularly struck by a quotation from William Dembski’s Intelligent Design.

We are dealing here with something more than a straightforward determination of scientific facts or confirmation of scientific theories. Rather we are dealing with competing world-views and incompatible metaphysical systems.

That cuts to the essence of what we are confronting on Science-Based Medicine. We are trying to evaluate the science behind claims that are often not based on science but on beliefs that are incompatible with science. The claimants are happy to use science when it supports them, but when it doesn’t they are likely to unfairly critique the science or even to dismiss the entire scientific enterprise as a “materialistic world view” or “closed-minded.” We are talking at cross purposes. How can we communicate if we say “this variety of apple is red” and they insist “it feels green to me”?

We get frustrated when we show these folks the scientific evidence and they refuse to accept it. Homeopathy is not only implausible, but it has been tested and has failed the tests. Yet proponents refuse to acknowledge those failures and still want to talk about data from the 19th century and make claims for the memory of water. We have to realize we are not even speaking the same language. We are trying to play a civilized game of gin rummy and they are dribbling a basketball all over the card table. Before getting into a debate, doesn’t it make sense to define what game you’re playing and what the rules are?

Science has been a very successful self-correcting group endeavor. It wouldn’t be successful if it didn’t follow a strict set of rules designed to avoid errors. [Note: there are no rules written in stone; I’m talking about conventions that are generally understood and accepted by scientists, conventions that grow naturally out of reason and critical thinking.] If proponents of alternative medicine want to play the science game, they ought to play by the rules. If they won’t play by the rules, they effectively take themselves out of the scientific arena and into the metaphysical arena. In that case, it is useless for us to talk to them about science.
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Posted in: Science and Medicine

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RCT Plausibility Scale

After a few intro paragraphs, I want to present a scale of probability to estimate a value of a “prior” to plug into the formula for obtaining a Bayes Factor. The scale can help to estimate a value, but will still rely on an estimate, the non-quantitative element in Bayesian simulations. However, the checklist may at least provide some objective bases on which to hang a value, and that value would actually make a semi-quantitative statement of its own. Although that value would retain some subjective quality, it would at least be backed by known quantities and laws of nature.

Begging your patience again, I became aware of this problem in 1999 when asked to moderate an online (BioMednet.com) debate on “CAM” among 4 physicians. My role soon morphed into participant-debater when I could not get all to agree on what I thought was obvious common ground to proceed with the discussion – that 1) concepts that violate scientific laws do not have to be subjected to clinical trial (RCT) and that trial results had to be interpreted in light of previous knowledge; and 2) clinical trials could not constitute adequate evidence in the absence of plausibility because their results were too varied and inconsistent. The matter was p-recipitated by systematic reviews (SRs) showing efficacy of acupuncture in back pain. I was truly surprised when one of the participants (Dr. Edzard Ernst) assured me that indeed, RCTs were now the gold standard for efficacy. The debate went downhill from there. (more…)

Posted in: Clinical Trials, Science and Medicine

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