Props to Simon Singh, who brings us news of an "Interesting skeptical approach to the upcoming General Election" via a Tweet (a twitter, a twit, a titter - I dunno, still getting used to this new-fangled micro-blogging malarkey...!). He's referring to Skeptical Voter, a new website dedicated to discovering and publicising the stance that MPs and prospective Parliamentary candidates take on issues that 'skeptics' are interested in - including
evidence-based policy, the role of the libel laws in science, and the teaching of creationism in schools.
They've even started a wiki, cataloguing what MPs have said and how they have voted on a range of issues. Thus far the info on said wiki is pretty scant as the project's only just gotten off the ground, but it's likely to prove an interesting portal for those of use interested in how our elected representatives think and vote on issues of scientific import.
Perhaps I don't need to write that post anymore - earlier in the year The Lay Scientist and Sciencepunk blogs teamed up to analyse the views on matters scientific of various parties standing in the European elections, and increasingly it seems that politicians are being held to account on points of scientific fact and scrutinised for their decision-making from an evidence-based angle.
The more this happens the better - so rather than have me witter on about how politics and science mix (or sometimes don't), pay the skeptical voter site for yourself and see for yourself.
This article first appeared on November 4th, 2009, on Liberal Democrat Voice. I've written on this excellent site a few times, you can read my previous contributions here.
Firstly, a disclaimer: I am a scientist, who is also interested in governance and politics, so the following post may come across as somewhat heated. Apologies, but I do feel that the recent furore over Prof. David Nutt’s sacking as Chair of the Advisory Council on the Misuse of Drugs (ACMD) goes right to the heart of why I took up both science and politics as profession and interest respectively.
I thought it worthwhile to go into the details of how Nutt came to his conclusions because this process – of evaluating evidence and coming to a conclusion based on objective data where possible – is familiar to me as a scientist, indeed it’s the bedrock of the profession. Often, evidence on emotive issues such as drug use can be counter-intuitive, strikingly odd, perverse even. But that’s the point – evidence trumps pre-suppositions, guesses, intuition, anecdotes, the lot. And here’s the choice policy-makers are faced with – claim that your policy is evidence-based, in which case you take the evidence as presented and fit your policy around it, or base your policy on any number of considerations other than evidence, from morals to popularity.
Fair enough – unless you want it both ways, which appears to be the current government’s position. On a host of policy issues, from military to medical, high profile government advisers are appointed, meetings are arranged, reports are published and... well, not much else really happens, as the policy which emerges from this process, given the veneer of respectability, authenticity and objectiveness by the independent advisers, all too often flies in the face of the very advice they offer. Which brings us back to Prof. Nutt. He had the temerity to reinforce his stance (a stance based, lest we forget, on objective evidence) on both the classification of cannabis and the harm caused by alcohol and tobacco – and was dismissed (or ‘asked to leave’) by Home Secretary Alan Johnson. His predecessor, Jacqui Smith, had already clashed with Nutt earlier in the year over the ecstasy non-reclassification, and this latest (perceived) foray into politics provoked his removal as the head of the government’s drugs advisory council. Johnson’s justification for sacking Nutt was that the latter had” "crossed the line between offering advice and then campaigning against the government on political decisions".
Nutt is understandably aggrieved – in an interview with the journal Nature (hat tip - Gimpy) he expresses his disappointment at how he came to be sacked, and at how the government has overtly ignored advice the ACMD has provided. But the repercussions of his sacking may well stretch beyond even the ‘mass resignations’ of the rest of the ACMD reported to be planned – two have already quit in anger – into so many fields of policy-making.
Having a respected scientist, military man, economist or some such expert report on the evidence in a given field could, could, add much-needed legitimacy, ‘stardust’ even, to government policy – provided said expert is not hounded out and banished for daring to publish inconvenient truths deemed to be politically uncomfortable. Indeed, given Jacqui Smith’s maxim, enunciated on last week’s Question Time (‘advisers advise, Ministers decide’), it’s all the more vital that good advice based on solid evidence is provided to them so that Ministers can in fact make the right decisions. For if we are to ensure that policy decisions are not made on emotive hunches, on opinion polls in newspapers or on some other arbitrary reasoning, but rather is based on evidence of what works, we need the best advice to be heeded and acted upon – and at this rate no self-respecting expert will ever volunteer to be a government adviser again, for fear of being silenced for publishing what is ostensibly the truth.
In sacking Nutt, Johnson said
"What you cannot have is a chief adviser at the same time stepping into the political field and campaigning against government decisions. You can do one or the other. You can't do both."
With respect Mr. Johnson, what you cannot have is a government claiming that its policy is based on evidence, then sacking its advisers for not agreeing with policies which defy said evidence. You can have one or the other, you can’t have both.
Edited to add: Since I put this post together, some rather good blog posts on this issue have apppeared from bloggers somewhat quicker off the mark than I am - check these out at Apathy Sketchpad and The Lay Scientist.
In order for libel law to be reformed, however, lawmakers need to be brought into the fold, committing themselves to an overhaul of the current legislation; last week in Bournemouth the Liberal Democrats made just such a commitment, accepting proposals to reform libel law to safeguard free expression and debtate - here's how.
As I blogged about over on libdemvoice, I organised a fringe event relating to this urgent issue - you can watch the video below - apologies for the necessarily amateur quality, I am after all an amateur!! (I also have an audio file if you're interested, blogger/blogspot software doesn't seem to like it though so I can't upload it...)
Sile Lane from senseaboutscience opened the meeting and invited Simon and Ben to share their experiences of being sued for libel, which they did with clarity and honesty - it can't be easy for either to speak of their battles, which in Ben's case ended successfully but which continue for Simon, costing him time and money - £100k so far, with the prospect of more bills to come and with the knowledge that libel defendants hardly ever recoup all their costs even when they win. Simon spoke of how his investigation into chiropractic, as part of his book on alternative medicine, came to symbolise not only how a lack of evidence is no barrier to the extravagant claims made by alternative therapists, but how those with so much at stake react to criticism not by debating, nor by counter-arguments, but by resorting to suing for libel, leaving the dissenter in question with a stark choice - retract the criticism (no matter how valid), or fight on through years of legal wranglings.
This adverse reaction to criticism, this defensive attempt to silence critics using libel law,is completely antithetical to the core prinicples of scientific enquiry - as Ben told the delegates, not only does science approve of critical thought, it positively thrives on it, with eminent Professors often cut down to size by PhD students at academic meetings. Resorting to libel action, knowing that the very act of issuing a writ can silence even the most convincing and measured criticism, is nothing short of cowardly - as a Professor being sued by chiropractors in a separate case famously said, "let's hear your evidence, not your legal muscle."
Of course it's not only the high-profile cases that make it to court that demosntrate just how effective our current libel laws are at silencing debate - hundreds of articles appear in lifestyle magazines and Sunday Supplements advocating a plethora of unproven and baseless treatments for all sorts of conditions, but articles critical of such practices often don't even make it into the public realm for fear of triggering legal action; hence Ben's remark that the libel laws of this country are now 'a danger to public health,' as they leave the public with an impression that many such treatments are legitimate and effective when in fact they are often no better than placebo (at best) and sometimes downright damaging (at worst).
Of course the libel laws aren't just used to suppress scientific debate, as political journalist Nick Cohen explained. This phenomenon of 'libel tourism' makes London a plaintiff's paradise, the libel capital of the world where men (and it's usually men) of dubious repute sue anyone that dares criticise them in public, knowing that arrangements such as no win, no fee and the presumption of defamation will more often than not see them win. Nick spoke of countless cases, some well-publicised and others not, which are shameful examples of how the freedom of expression is sacrificed to the vested interests of the monied and the powerful; he also put forward an interesting theory that the bias towards the plaintiff is a relic of Britain's colonial and feudal past, where it was deemed heretic to criticise those high up in society and the law therefore assumed that comments claimed to be defamatory were in fact so, ipso facto. He contrasted this to the libel law of the USA, a nation founded on the principle of free expression, where the complainant has to "prove that what was written was not only untrue but published maliciously and recklessly." Infinitely fairer than the law we currently have in England and Wales.
And it was on this point of exactly how the law can be reformed that we heard from Evan Harris MP, who spoke about the need for legislation to reflect the centrality of free debate not only to science and medicine but to all spheres.
Going beyond the conference fringe, Evan and I put together an amendment to a civil liberties policy motion debated at conference, which was proposed by none other than Professor Richard Dawkins. Prof. Dawkins was given special leave to address conference despite not being a party member (he just happens to live in Evan Harris' constituency and votes Lib Dem at every election), and he eloquently proposed the amendment which endorsed the reform of libel law to
ensure that a better balance is provided between free speech, responsible journalism, scientific discourse and the public interest on the one hand and powerful corporations, wealthy individuals and vested interests on the other.
Prof. Dawkins (in a speech you can watch here or read a version of here) brought Simon and Ben's cases to the attention of conference, emphasising how unfair the current libel laws are and how, in science and medicine in particular, open debate is not just a matter of principle - open discussion of ideas and criticism of accepted practices are not just tolerated, they're absolutely central to how progress is made. In a rousing speech, Prof. Dawkins urged conference to amend the motion on civil liberties with a commitment to reform libel law, particularly as
if Singh loses, it would have major implications on the freedom of scientists, researchers and other commentators to engage in robust criticism of scientific, and pseudoscientific, work.
Carried by a unanimous vote, the amendment was given also strong support by Lib Dem shadow justice minister David Howarth, whose legal team is now looking into specific areas of libel law that need reforming and at potential ways in which the best aspects of libel law in other countries can be applied here.
This policy amendment has attracted quite some support in all quarters of the media (all the more so for Prof. Dawkins' support no doubt, for which Evan Harris is to be thanked!), both old (institutions as far apart on the political specturm as The Telegraph, The Guardian, The Times and the BBC carried the story) and new (the quackometer blog and politics.co.uk amongst others). Somewhat unsurprising perhaps given that journalists themselves are often victim of the chilling effect of legal action, actual or threatened - nonetheless the campaign for reform gathers momentum, and those who are interested in how Simon's case in particular and the battle to reform the libel laws proceeds should look out for developments at Jack of Kent's excellent blog, at senseaboutscience.org, or of course here.
I'll finish with something of a response to Ben Goldacre's excellent write-up of the fringe event he spoke at, which you can find over at The Guardian's Comment is Free blog. Ben, I know that for some folk politics inspires nothing but skepticism, and I know that this is often rightly so. I know also that no matter what stance the Liberal Democrats may take on an issue, we (and I say this as a member but in a personal capacity...) are unlikely to form a majority government just yet so our policy positions may not immediately translate into a change in the law. (And I know you were on a rail replacement bus when you submitted the story, which no doubt explains in part the tone of what you wrote!). But Ben, one thing's for certain - the stance you've taken against the unfair, unjust and illiberal libel laws of England and Wales, the stance that supports Simon in his quest for justice and that you rightly believe is of paramount importance from the public health perspective - this stance will only lead to a change in the law with the support of the public at large and more importantly of Parliamentarians. The more of the latter we recruit to the cause the greater the publicity we generate amongst the former, and the greater the momentum for change to occur - so hang on in there Ben, because whether or not the law actually changes, we musn't rest until we've campaigned our hearts out as it's quite simply the right thing to do.
Today on "things that shouldn't really be true in a fair democracy but somehow doesn't seem too shocking in the UK," we bring you the news that the Metropolitan police, as part of their heroic attempts to frisk every Londoner several times over, have used their powers of stop and search to, well stop and search 58 (fifty-eight) children (kids, bairns, young 'uns, wee whipper-snapppers) under the age of 10 (ten, one-more-than-nine, too young to be considered criminally responsible).
Liberal Democrat peer Lord Carlile, responsible for oversight of anti-terror laws, laments their use on children of such a young age:
"I find these figures uncomfortable. There is absolutely no evidence of children in this country being involved in acts of terrorism." He described the fact that more than 2000 children aged 15 or under had been stopped under section 44 as a "very high figure" and added: "It shows some evidence that section 44 stops may have been used as an instrument of general policing rather than for the special purpose for which they were designed, which is not acceptable."
Quite.
Give a police force/council/any authority sweeping powers to do as it pleases and it will, repeat will, lose perspective. There's an inevitabilty about it. And as for the Met's defence of its actions, I'm afraid
The threat to London from terrorism is real and serious and these powers are an important tactic in our counter-terrorism strategy
is nothing more than a straw man. The threat from terrorism may well be real (how large it is is up for discussion of course), but that doesn't justify stopping and searching kids too young to watch the latest Harry Potter movie unaccompanied.
And calling stop-and-search an important tactic in our counter-terrorism strategy is not unlike the claims made by the chap throwing pellets out of his train window in Arizona - when asked what he was doing, he replies, "Why, I'm throwing anti-elephant pellets out to keep the elephants away." The bemused onlooker points out that there are of course very few, if any, elephants in Arizona; "Must be workin' then!" replies our protagonist - the absence of a serious terrorist atrocity since 7/7 is not necessarily because of, or linked to in any way, the stopping and searching of nine year old boys and girls.
Some practitioners claim it is a cure-all, but the research suggests chiropractic therapy has mixed results - and can even be lethal, says Simon Singh.
You might be surprised to know that the founder of chiropractic therapy, Daniel David Palmer, wrote that ‘99% of all diseases are caused by displaced vertebrae’. In the 1860s, Palmer began to develop his theory that the spine was involved in almost every illness because the spinal cord connects the brain to the rest of the body. Therefore any misalignment could cause a problem in distant parts of the body. In fact, Palmer’s first chiropractic intervention supposedly cured a man who had been profoundly deaf for 17 years. His second treatment was equally strange, because he claimed that he treated a patient with heart trouble by correcting a displaced vertebra. You might think that modern chiropractors restrict themselves to treating back problems, but in fact some still possess quite wacky ideas. The fundamentalists argue that they can cure anything, including helping treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying - even though there is not a jot of evidence. I can confidently label these assertions as utter nonsense because I have co-authored a book about alternative medicine with the world’s first professor of complementary medicine, Edzard Ernst. He learned chiropractic techniques himself and used them as a doctor. This is when he began to see the need for some critical evaluation. Among other projects, he examined the evidence from 70 trials exploring the benefits of chiropractic therapy in conditions unrelated to the back. He found no evidence to suggest that chiropractors could treat any such conditions. But what about chiropractic in the context of treating back problems? Manipulating the spine can cure some problems, but results are mixed. To be fair, conventional approaches, such as physiotherapy, also struggle to treat back problems with any consistency. Nevertheless, conventional therapy is still preferable because of the serious dangers associated with chiropractic. In 2001, a systematic review of five studies revealed that roughly half of all chiropractic patients experience temporary adverse effects, such as pain, numbness, stiffness, dizziness and headaches. These are relatively minor effects, but the frequency is very high, and this has to be weighed against the limited benefit offered by chiropractors. More worryingly, the hallmark technique of the chiropractor, known as high-velocity, low-amplitude thrust, carries much more significant risks. This involves pushing joints beyond their natural range of motion by applying a short, sharp force. Although this is a safe procedure for most patients, others can suffer dislocations and fractures. Worse still, manipulation of the neck can damage the vertebral arteries, which supply blood to the brain. So-called vertebral dissection can ultimately cut off the blood supply, which in turn can lead to a stroke and even death. Because there is usually a delay between the vertebral dissection and the blockage of blood to the brain, the link between chiropractic and strokes went unnoticed for many years. Recently, however, it has been possible to identify cases where spinal manipulation has certainly been the cause of vertebral dissection. Laurie Mathiason was a 20-year-old Canadian waitress who visited a chiropractor 21 times between 1997 and 1998 to relieve her low-back pain. On her penultimate visit she complained of stiffness in her neck. That evening she began dropping plates at the restaurant, so she returned to the chiropractor. As the chiropractor manipulated her neck, Mathiason began to cry, her eyes started to roll, she foamed at the mouth and her body began to convulse. She was rushed to hospital, slipped into a coma and died three days later. At the inquest, the coroner declared: ‘Laurie died of a ruptured vertebral artery, which occurred in association with a chiropractic manipulation of the neck.’ This case is not unique. In Canada alone there have been several other women who have died after receiving chiropractic therapy, and Edzard Ernst has identified about 700 cases of serious complications among the medical literature. This should be a major concern for health officials, particularly as under-reporting will mean that the actual number of cases is much higher. If spinal manipulation were a drug with such serious adverse effects and so little demonstrable benefit, then it would almost certainly have been taken off the market.
What this does show, to me, is that no amount of legal pressure, lawsuits, bullying, no amount of scare-tactics can supress reasoned debate, not in the age of teh internets. The allegedly defamatory character of this article has had to be gutted out to avoid the bloggers I've listed above themselves being left vulnerable to being sued, but I think the thrust of the article remains - and the criticism of chiropractic remains legitimate and based in sound evidence, which no amount of legal chill can change.
The author describes how the initial observation that reactive oxygen species (ROS, or free radicals that are formed as a by-product of most cellular activity and can damage proteins and DNA) play a role in many disease processes lead to the use of antioxidants (anything that mops up free radicals) as dietary supplements. The interesting point for me is that the article, written by a Justine Davies, has a very clear chronology not usually seen in pieces like this (honourable exceptions such as those from Dr. Ben Goldacre aside...). The grounds for belief X (i.e. that because free radicals have a role in disease, and because antioxindants mop them up, and because those with diets rich in antioxidant-rich fruit & veg live longer and healthier) are first set up almost dispassionately - reading about this you get the impression that up to this point scientists had got it pretty much spot on, which of course they had. Then the way in which industry latched onto belief X and created range of products Y, which were touted as powerful protectants against ageing/cancer/heart disease/itch eyes. Finally, the evidence that Y can actually do the opposite of what's intended is dealt with well.
Davies explains how the diet pill industry really got excited about antioxidants - all you have to do is visit holfordwatch.info to see just how excited - to the extent that tens of millions now take dietary supplements containing antioxidant vitamins. Only the science didn't stop there, and neither does the article. The key is that instead of credulously buying into the attractive mantra that antioxidants would help avoid cancer/heart disease/everything under the sun, Davies examines new evidence from large RCTs and meta-analyses that either show just how ineffective these supplements are, or indeed how damaging they can be.
The details are in the article itself, go and read it - my point here is that the way it's written reallty ought to form a model for science reporting. Careful analysis of evidence regardless of how difficult it may be to stomach (the supplement pill industry is worth billions), easy-to read explanations of the science involved, clear conclusions that align with current scientific consensus. Well done, now let's have more like this...!
Hold the front pages - or maybe you shouldn't bother.
Some months ago Sean Ellislaunched an e-petition demanding that the Complementary and Natural Healthcare Council (CNHC, better know on teh internets as OfQuack...) ask for evidence of efficacy of the treatments that their registered practitioners, err, practice. At first this seems an entirely logical premise - a government-backed body that publishes what is effectively a list of 'approved' practitioners ought to have, as one of its criteria for inclusion on said list, whether or not the services they offer effective for what they claim them to be.
The Complementary and Natural Healthcare Council (CNHC) does not promote the efficacy of disciplines practised by its registrants
is how the response begins. Perhaps not, but it does give the public a sense that by consulting with someone registered with CNHC, they're getting a therapy from a reliable source - in other words, the register legitimises all practitioners thereon, regardless of whether what they dish out/stick pins in/squeeze/dilute has any effect or is safe.
Regulation, whether statutory or voluntary, is about protecting the public
the response continues. Marvellous, and about time too. So, by investigating the safety record of AltMed practitioners before including them on the list the more dangerous amongst them will be eliminated, right...? Nope, because there is no requirement for assessing safety or efficacy.
The whole response is basically nothing more than a re-hashed version of the government's justification for setting up CNHC in the first place - deliberately avoiding the issue of efficacy and leaving that up to individual choice. How on Earth one is meant to exercise individual choice without any evidence for efficacy is beyond me, it really is.
Fudge, evasion, obfuscation - any more words spring to mind...? The entire OfQuack scenario is a shining example of how pandering to a minority interest group is more important to the government than the principles of scientific enquiry and evidence-based medicine. We must not let this lie - I can only suggest alerting as many media outlets as possible to this farcical situation to put more pressure on the government to relent.
badscienceblogs is an aggregation of the best writing about science and its abuses, distortions, absurdities and corruption. Also, its humour and colourful characters. We write about how science is portrayed in the media, how it is used and abused by commercial interests and how it is hijacked and impersonated by fraudsters and the deluded.
