SGU Episode 266

This episode's icon on the Episode List has been changed to reflect its renewed need for completion. This episode was in the middle of being transcribed by Jason koziol (talk) (as of 7 Dec 2014).

This episode needs: transcription, proofreading, time stamps, formatting, links, 'Today I Learned' list, categories, segment redirects. Please help out by contributing!

How to Contribute

SGU Episode 266
August 19th 2010
(brief caption for the episode icon)
SGU 265                      SGU 267
Skeptical Rogues
S: Steven Novella
B: Bob Novella
R: Rebecca Watson
J: Jay Novella
E: Evan Bernstein
Guest
BH: Bruce Hood
Quote of the Week
'You know that chemistry has an impact on your daily life, but the extent of that impact can be mind-boggling. Consider just the beginning of a typical day from a chemical point of view. Molecules align in the liquid crystal display of your clock, electrons flow through its circuitry to create a rousing sound, and you throw off a thermal insulator of manufactured polymer. You jump in the shower, to emulsify fatty substances on your skin and hair with chemically treated water and formulated detergents. You adorn yourself in an array of processed chemicals - pleasant-smelling pigmented materials suspended in cosmetic gels, dyed polymeric fibers, synthetic footware, and metal-alloyed jewelry. Today, breakfast is a bowl of nutrient-enriched, spoilage-retarded cereal and milk, a piece of fertilizer-grown, pesticide-treated fruit, and a cup of a hot, aqueous solution of neurally stimulating alkaloid. Ready to leave, you collect some books - processed cellulose and plastic, electrically printed with light-and-oxygen-resistant inks - hop in your hydrocarbon-fuelled metal-vinyl-ceramic vehicle, electrically ignite a synchronized series of controlled, gaseous explosions, and you're off to class!'
Martin S. Silberberg
Links
Download Podcast
Show Notes
Forum Discussion

Introduction

You're listening to the Skeptics' Guide to the Universe, your escape to reality.

News Items ()

Banning Wi-Fi ()

• http://www.theness.com/neurologicablog/?p=2215

Psychic Finds Wrong Body ()

• http://www.smh.com.au/nsw/psychic-searching-for-kiesha-discovers-womans-torso-20100812-120mf.html?autostart=1

Kurzweil and Brain Complexity ()

• http://scienceblogs.com/pharyngula/2010/08/ray_kurzweil_does_not_understa.php

Magnetars and Black Holes ()

• http://news.yahoo.com/s/afp/spaceastronomystars

Who's That Noisy ()

• Answer to last week - spiney lobster

Interview with Bruce Hood (31:06)

• Author of SuperSense

S: We're sitting here at TAM 8 with Bruce Hood, author of "Super Sense", Bruce, welcome back to the Skeptic's Guide.

Bruce Hood: Hi.

S: And, I have to say I watched your talk today and, I love the material by the way, I love the talk. The kind of stuff you deal with really is, in my opinion, at the absolute core of skepticism. Which is the knowledge about how our brains function, how they filter information, and deal with the world around us. So, give us a little flavor of your talk today and tell us what are those things that you've learned in your career that really...that you feel are most relevant to what we do as skeptics.

BH: Okay so, really the talk was trying to draw people's attention to the basic function of a brain, which is to interpret the world and make sense of it, and to build models if you like. Allows you to make predictions, figure out why things are the way they are. It's like a causal inference mechanism. And, it's usually pretty good. It's done us well for all these millions of years. But it has a few built in, uh, flaws. And, sometimes it makes errors, and those errors, I think, could underpin a lot of supernatural beliefs.

S: Mm-hm.

BH: The assumption that there are hidden forces or dimensions, or things operating which can't be explained by science.

S: Mm-hm.

BH: Okay? I think one of the critical points I was making in the demonstrations throughout the talk was showing how people shouldn't even trust their own senses. Because, you know the phrase, "seeing is believing"? Well, I hopefully demonstrated today that that's not the case.

S: Right.

B: Believing is seeing in many cases.

BH: Indeed. Yeah, so that's an example where your models of the world really color the way that you interpret the world. The late Richard Gregory was a great friend of mine he said this 50 years ago that, you need these models of the world to interpret it. And that of course, sort of, constrains the sorts of things that you pay attention to.

S: Mm-hm.

BH: So believing very much you're seeing its the way that you go out and you sample information...

S: Yeah.

BH: ...to fit. And, part of that process occasionally produces these explanations...

S: Mm-hm.

BH: ...which don't really hold up under the scrutiny of evidence.

S: Right. Now you said one word during your talk that caught my attention which I thought was for me a core concept. You didn't focus on it but I knew what you were saying and you said that the...our perception of the world is a “constructive” process.

BH: Mm-hm, mm-hm.

S: That's a deceptively deep little concept you threw in there in the middle of your talk it's not something that we passively...

BH: Yeah

S: ...are perceiving, we're constructing it with tons of assumptions.

BH: Yeah

S: Can you elaborate that a little bit?

BH: You don't have any privileged, direct access to reality. Your brain is always extrapolating on the basis of information it's receiving, and then it's constructing that into a framework. To try and make the best fitting model to what you think you're seeing.

S: Mm-hm.

BH: And so one of the very simple visual illusions I talked about are these ones where you think you see a geometric shape which is basically an illusory subjective contour. Now the interesting thing about that it's a very simple demonstration everyone sees the illusory shape but what they may not appreciate is that if you go into the brain we can find cells which are firing as if that object really was there.

S: Mm-hm.

BH: So it doesn't make the distinction between the fact of reality and the illusion because the brain, if it's come up with that solution, it says, well, there really should be a shape there, so fire as if it really is there. So that was the basic point, that all of our phenomenological experience is really extrapolated, is really constructed...

S: Mm-hm.

BH: ...from the information. And of course your models that you apply to interpret information will allow you to imagine all sorts of things, so...

S: Mm-hm.

BH: When I said someone thinks they've seen a ghost, at the neuronal level it's really indistinguishable.

S: Right.

B: Yeah, the problem is a lot of people think that...they equate the eyes with a movie camera, or...

BH: Yeah

B: ...the brain with a hard drive, filling up with information that it stores that doesn't change over time ...

BH: Exactly

B: ...and all that and they can't...a lot of people just don't get past that. And they can't relate to the idea that we're constructing what we see. They think it's a window, but it's not it's a window that, you know, that we change and manipulate and...

BH: Right

B: ... deal with.

S: Yeah, I think if there's like...often if there's one thing I try to get across to non-skeptics is extrapolating from the optical illusion.

BH: Mm

S: People...Everyone knows what an optical illusion is and it's cool, it's fun, but they don't learn the lesson from that. It's like your whole brain operates that way.

BH: Yes.

S: Everything you think and remember and... It's all constructed in the same flawed way that your visual...

BH: Mm-hm

S: ...images are and they're subject to the same kind of illusions.

BH: Absolutely, I mean if you can demonstrate that at the very basic simple level of the system that these flaws are there, then you can imagine that when you're dealing with even more complex, sort of, representations then, yeah, the scope for errors is much more obvious.

S: Mm-hm.

BH: So, yeah that's the whole point...

S: Right

BH: ...that the whole brain is designed to try and interpret and build models.

S: Exactly. Now I think last time you were on the show we focused a lot on the notion of essence.

BH: Mm

S: That we assume that things have an essence, and that goes a long way to giving us our sense that there is...a lot of our supernatural beliefs flow from that. I don't know that we talked about a related concept, and you did allude to it earlier, just now which was agency, so something else that we assume is not only that things have an essence, but there are agents operating in the world and...

BH: Yeah

S: I try to understand the way our brains treat the concept of agency, so help me out, tell me…

BH: Yeah

S: … if you can summarize your understanding of that, where we are with that.

BH: Yeah, so, it would appear to be a system which emerges very early. We know this from the work from Paul Bloom's lab, and Karen Wynn. They do work with very young babies, and...

S: Mm-hm.

BH: …Val Kumar in particular is the lady who really has been doing this work. And they've shown these simple, geometric, little videos of objects moving around the screen, and what...we see them as adults, we see them as being purposeful. They seem to have goals...

S: Mm-hm.

BH: ...you know, even though they’re just kind of random movements. And um, with some of their sequences they look as if they’re, you know, playing out some sort of scenario. We’re giving them a rich interpretation, so we’re seeing them as agents, as having purposes and intents. So agency is really this default...

S: Mm-hm.

BH: ...that we seem to slip into when we’re trying to give a causal explanation for why things are the way they are...

S: Mm-hm.

BH: ...You know if a plate falls off the table, it had to be caused by something. So agency is again a kind of default way of interpreting the presence of something, which is causing it.

S: Right. But it’s also my understanding that we do...our brains will, do make a hard distinction between things that we think are agents and things that we think are not agents. We sort of...

BH: Mm

S: ...we know that a rock is not an agent so we categorize it differently in our brains...

BH: That’s right.

S: ...but that division is not between real agents and non-agents, or things that are alive and that are not alive, it’s things that act like agents and that don’t act like agents. But that’s another way in which we’re constructing based upon lots of assumptions and we get it wrong a lot of times.

BH: Yeah, so Dan Dennett made this point, he called it “intentionality” default. And basically... so this is when you kind of treat your computer as being vindictive...

S: Right.

BH: ...when it crashes on you, or your car is being malevolent because it breaks down on the way to...and he’s argued that we adopt this position, as a kind of convenient way of interacting with things which clearly aren’t agents. We kind of know this at one level, but at another level if we treat it as if did have purpose and goals and intentions it allows us to kind of interact with it...

S: Mm-hm.

BH: ...in a meaningful way. That may be the case, but you know, I certainly know that people seem to lose all rationality when machinery breaks around them and it...

S: Right.

E: (laughs)

BH: ...does seem as if it was deliberate. And we, you know (laughs), it just seems as if...

E: Guilty as charged, here, yeah.

BH: Michael Shermer gave a really great story yesterday. I don’t know if you caught this, but he was on the lift shaft, and he was using his iPhone, and this lady was exiting the lift, and he gestured to her to leave the lift before him, and the iPhone slipped out of his hand, and it fell into the gap between the lift shaft and the door…

(laughter)

BH: ...and he watched as it raffled down and then disappeared down the shaft.

(laughter)

BH: And he stood there with his mouth open watching that, and it was very difficult not to see that as a vindictive piece of nons… He didn’t see…

(laughter)

BH: Yeah, it’s like this thing just escaped.

S: Right, right.

BH: And that’s just our tendency to see things as being purposeful, doing things.

B: Wow.

S: Do you hold with those who say that this tendency to seek agency is all...leads to things like conspiracy thinking and even religious beliefs about there being a God, for example?

BH: Oh sure, I mean yeah, I mean it can operate in any sphere where you’re trying to apply some causal mechanism, some causal… why do things happen, well someone did it. Someone was responsible. Trouble with that of course is you get into an infinite regress of causes...

S: Mm-hm.

BH: ...you know because, it’s very difficult to even conceive random events. The brain can’t conceive randomness. If I asked you to press on your keyboard ones and zeros and try and create a random pattern, very soon, you’d just fall into a sequence. If I take coffee beans and I throw them on the table, you can’t see them as random, you already, automatically organize them into some pattern. And I think that’s the same with sequences of events. You see them as being a chain of agency.

S: Mm-hm. Right. And conspiracy thinking as well? I mean...

BH: Exactly.

S: ...that’s something we talk about a lot, and it seems like there’s this inherent sense of the invisible hand operating...

BH: Yeah

S: ...behind events.

BH: Yeah. The notion that it might just be a kind of coincidence is something that we just don’t readily accept. Coincidence...

S: Mm-hm.

BH: ...we’re not really good at our statistical reasoning. The brain was never really designed to do that. We’re not Bayesians, we can’t do probability analysis.

B: It’s not intuitive at all.

BH: It’s not intuitive. And that’s why statistics is really difficult for people to accept.

E: Yeah. We suck at probability.

BH: Yeah. Probability, you know there’s all these beautiful examples of illusions of probability, and people just never get it.

S: This is a little off what you typically talk about, at least as far as I’m aware, but I’m interested in what you’re thinking is about evolutionary psychology. So do you involve yourself at all in asking that deeper question about why our brains evolved to be the way they are? Or you think it just not an answerable question? Or not interesting?

BH: Well I think the problem about evolutionary psychology is it’s often disregarded as a “just so” story.

S: Mm-hm.

BH: Because it’s very difficult to look back into the mists of early civilization, or early man to figure out why we have evolved our behaviors and our thought patterns. But, you know I believe the mind is a product of the brain, and the brain is a physical system, a biological system, which evolved under selective pressure. So ultimately I would have to contend that a lot of it is constrained by evolutionary pressure. The difference of course is when culture comes in, and then, you know, the degrees of freedom, to give an engineering term, become huge.

S: Mm-hm.

BH: You can’t really, you know, figure out exactly, what the causal...

S: Right.

BH: ...chain of events was which led to our predispositions to think or behave in certain ways. So I suppose what I’m saying is that clearly… I think that evolutionary psychology must be true to some extent, but to apply it as an explanatory framework to make sense of modern day behaviors is difficult. And it leads to a lot of simplistic notions, naivete, you know, men being more aggressive and wanting to have sex with more women, these are typical things which are...

S: Yeah.

BH: ...said to... obviously have an evolutionary adaptation. But again that’s really hard to...

S: Mm-hm.

BH: ...say in a scientific sort of way.

S: Yeah, so you kind of have to assume a hyper-adaptationalist position which is not tenable in order to…

BH: Exactly, yeah.

S: be an evolutionary psychologist, so...‘cause culture and, just randomness...behavior’s meant to be so diverse and adaptive…

BH: Yeah

S: that you can’t say A led to B led to C.

BH: We weren’t around at the time that the various gene was selected, and so we just have to kind of make a after-the-fact kind of analysis. And that can be, obviously, driven by your own expectations and models of what you think was happening, but we don’t know for a certainty.

S: Right.

BH: So evolutionary psychology I think is useful, because it gets you to kind of think about if there’s something there why would it, you know, what possibly could’ve done, but then you definitely need to have other lines of evidence...

S: Mm-hm.

BH: ...maybe it’s genetic, or maybe it’s something to do with anthropology or...you’d have to have more than one line of evidence, rather than an argument based on an evolutionary perspective. That’s my opinion.

S: Mm-hm.

E: It’s complex.

BH: It’s complex, and it’s after the fact.

S: Can I ask what your experience has been as an academic with the degree to which you’ve been popularizing your research in science?

BH: Yeah, I’ve reached a sort of crossroads. Well, I think I’ve already set down the path actually now, it’s no longer a crossroads, I’ve been doing this now for two years. And um, I think that I’m transforming somewhat from your mainstream kind of academic to someone who is increasingly spending more time talking to the general public and, I used to have some real reservations about that, because for many, many years it was felt that that was somehow not being a real academic to do this. But I think the landscape has changed somewhat and I’ve got to keep reminding myself that, certainly in the UK, I’m a public servant. I’m paid for by the taxes. And, you know I have a duty to, you know I’m paid for by other people’s tax money so, I feel I’ve got a duty to try and communicate information which I feel is of relevance to them. And clearly there are situations where there’s not enough communication happening. And science is under threat as well. I don’t know what it’s like in this country but certainly in the UK at the moment we’re facing terrible cuts. And so I feel there’s a real role now for people who are willing to step into the limelight, who are willing to talk, and to give opinions, so long as they don’t go too far beyond their areas of expertise. But just to try and open up those channels of communication, maybe encourage some youngsters listening in that, you know these are cool things. Science is cool....

S: Mm-hm.

BH: And we need to get more, kind of, pop stars of science. We’ve seen it in every other realm, in athletics, and music. But why not science? You know, it can be absolutely absorbing and fascinating. So, there are some great people out there doing it and I think that we should just encourage it. So I’m much more comfortable with my position now....

S: Mm-hm.

BH: ...I still have the luxury of engaging in real research, and I do that, and I would hate to lose that entirely. But that’s becoming less of a characteristic of what my day job is.

S: How do you find that your colleagues and institution respond to that?

BH: Well surprisingly they’re very positive towards it. Well not surprising. It’s just that fact that university system in the UK is changing somewhat. We’re moving more towards the American system. So college fees are going to start increasing and I think that we now have to compete with each other. To get the best students, to raise our profiles, to become more corporate, if you like.

S: Mm-hm.

BH: And that requires a degree of marketing. That requires academics getting out there, speaking, telling the kids about what we’re doing, getting the foreign students to come visit.

S: Right.

BH: These are all changes to the system. We’ve lost the nice cozy, insular, kind of ivory tower image that was so common in the UK for many decades. We’re now being forced by the change in economic circumstances to become more accountable, to become more corporate, and so, what I do promotes the university.

S: Mm-hm. Yeah I think the culture’s still a little different in the United States. I think there isn’t as much recognition of the need to popularize science or to communicate...

BH: Right.

S: ...with the public or engage on a lot of issues. So, maybe it’s ironic, but I think there may be more of an ivory tower attitude over here.

BH: Yes, well of course, the US, you’re very familiar with paying large college fees, and...

S: Mm-hm.

BH: ...you’ve always had a system of, you know, setting up the college fund when the kid’s born, and mum, grandparents feed the money into it. This idea of paying for your education has been in your culture for many decades.

S: Mm-hm.

BH: But, of course in the UK, this has just recently come in, because we always had a kind of social system which allowed for higher education. And what happened is that they’ve just increased the numbers of students going to university without any additional funding. So this has now put a lot of pressure on the system to try and teach more students for less money, and we’ve now reached an impasse, where in fact we now charge for our fees, and they’ve been moderate amounts about five thousand dollars a year. But all the signs and indications show that that’s going to increase.

S: Mm-hm.

BH: So um...and this is what people are finding very difficult to accept, because they’ve had it for so many decades...

S: Right.

BH: ...where they don’t pay for education. But you know, I think that a college education, a university education as we say, opens up so many doors, gives you better job opportunities, better salaries, and therefore it has to be paid for. I would prefer that we did have a social system which allowed everybody to go, but we’ve tried that and it seems to be failing very badly. The univ...the government is just not giving us the support....

S: Mm-hm.

E: Well it’s not that they’re not paying for it, they are paying for it through taxes.

BH: Taxes.

E: Value… VAT Taxes and these sort of things.

BH: That’s true. That is true. It’s just that that doesn’t immediately feed back to the university systems, it goes into the economy.

E: Yes. Right. Heh.

BH: I think the expenditure on science in the UK is something like 0.04% of the GDP, which is pretty pathetic.

S: Right.

E: Are there like lobby groups or something? That get together and try to get larger percentages?

BH: No, is the simple answer to that. We do have some individuals who are trying to draw the public’s attention to it. Brian Cox, for example is a very popular, young physicist, very successful. And he’s being very vocal about this. Especially with the cancellation of many departments… we’re losing chemistry departments right across British universities. ‘Cause they’re too expensive to run. But we’ve just had a change in government and, I don’t know if your listeners are aware, but we have a huge deficit in our budget, and so they’re operating draconian kind of cuts. A quarter, twenty-five percent of cuts right across the board from public sectors, so that means huge pressure on us to try and find other sources of money, so it’s difficult.

S: Mm-hm. Well we’re certainly running huge deficits over here but, so far they’re not cutting anything, they’re just, sort of…

BH: No no, it’s interesting…

S:...spending more money.

BH: I think what you guys are doing right because you’re stimulating it and by… because basically, economies grow out of innovations...

S: Yeah.

BH: ...and I think that you can’t cut off your life-blood....

S: Right.

BH: ...because the long term consequences of not supporting higher education is that you create this huge gap. Because who are you going to fill it with if you don’t have the youngsters being trained up with degrees and that. So it’s really important not to kill off your life-blood.

S: Yeah, it’s the difference between investing and spending.

BH: Exactly.

S: Right, and higher education’s an investment.

BH: I think so.

S: Yeah, especially in… I do think that in this country, there’s been a recognition of so-called STEM education, which is the Science, Technology, Engineering. And I think, it seems that that came out of the cold war.

BH: Yeah

S: And continues to a lesser degree even ‘til today, otherwise the more threatened we feel the more we sort of go back to, oh we gotta get...be competing in science in education.

BH: Well wars are very good for stimulating technology.

S: Yeah

E: That’s true. That is true they are.

S: Yeah it’s true.

E: Space race…

BH: But don’t get me wrong I’m not saying let’s go to war again.

S: Right.

E: No, no, no.

S: No, it’s just a historical fact.

BH: Yeah, it focuses the attention of the politicians, you know.

S: Mm-hm.

BH: But unfortunately, they’re not really that sympathetic to science otherwise. In our country, very few of our politicians have a science background.

S: Mm-hm.

BH: So they don’t respond to it.

E: Same here.

BH: Yeah.

E: Same here.

S: Speaking of which, so what kind of science vs. pseudoscience conflicts are common over in the UK? You’ve traveled back and forth between the UK and the US enough. Do you have a sense of like, what the similarities and differences are?

BH: Well obviously in your country religion is one of the big controversies and the extent of the religious right...

S: Yeah.

BH: ...the power they wield. We have a bit of a problem in the UK, but nowhere near as much, and that’s simply because we don’t have as many extreme religious people in control. Although, they do seem to be on the increase again, so...You have to be, kind of… I’m not going to pass comment on them, but you know, it is not such an issue in this countr... in the UK. Where we have problems are basically issues on alternative therapies.

S: Mm-hm.

BH: Homeopathy is something which gets up a lot of people’s noses. I actually controversially don’t feel so, you know, upset by it, which really annoys my fellow skeptics.

S: Right.

BH: They think that we shouldn’t tolerate anything which is basically peddling water as a cure. But I happen to have a, you know, belief in the placebo effect, and so I think we have to really question...and I’m not saying that there’s a simple answer here, by the way. Whether or not we should allow people to pay for water if they think it makes them get better, and they’re not a drain on public money.

S: Mm-hm.

BH: I can see a good argument for that actually, if they’re not sort of cluttering up the diagnostic…

B: (laughs)

BH: ...expense bills, because you know, otherwise they want to be sent off for scans, and they want to send off and have every other thing done. So I actually, I’m, you know, if people are happy to pay for that, that’s fine.

E: But is that science though? I mean, are we...how does that fit in?

BH: Well, um, the placebo effect is very real.

E: Well, yes.

S: But it depends on what you’re talking about though.

BH: Mm.

S: It’s interesting that you say that because Ben Goldacre has a very similar opinion on it.

BH: Indeed

S: I don’t know if you’re familiar with that. And I don’t know if that’s because you’re both from the UK, or if its just that you know each other.

BH: No, Ben and I, we were, no Ben and I do actually agree on this.

S: Yeah

BH: And actually so does...Richard Wiseman has said something very similar as well. And that’s actually, a lot of people have got very upset by that because the 10-23 campaign...

S: Yeah

BH:...has been very successful and, it seemed very likely that public support for the homeopathic hospices… there are five of them in the UK…

S: Yeah

BH: ...is going to be cut. And that sounds like a great success. But that actually, in terms of pounds, is four million pounds for the entire program.

S: Yeah

BH: A series of investigations for neurological conditions, fMRI scanning, all that, pales in comparison…

S: Yeah

BH: ...to the costs, so, I think that, and I have to be careful here, because I know the cases...

S: Mm-hm.

BH: ...and they’re very distressing cases where people have deliberately gone to seek out alternative therapy and not engaged in conventional therapy, and especially with kids.

S: Right.

BH: So we have cases around the world where people have died.

S: Right.

BH: Because of their belief in homeopathy. And so I’m not saying that I’m an apologist for it, I’m just a realist in terms of maybe there is scope for people who want to do that, so long as they’re not denying access to conventional medicine, so...

S: Mm-hm.

BH: ...it’s a difficult area, I suppose.

S: Yeah I think where I’d disagree with… I mean I’ve heard Ben Goldacre articulate the issues.

BH: Yeah

S: I’m not aware of… I’ve never had this conversation with Richard Wiseman.

BH: Mm.

S: But I think Ben overestimates the effect of the placebo effect.

BH: Really.

S: It’s been, I mean I’ve written about it I’ve reviewed the literature...

BH: Mm

S: ...on the placebo effect and it’s pretty clear actually that there isn’t really much of a placebo effect.

BH: Really? Wow.

S: Yeah, it’s really limited to subjective complaints.

BH: Right, of course, yeah.

S: Yeah, so, but if you ask the question is there any measurable biological effect that can be attributed to placebo effects, the answer’s a pretty clear no.

BH: Okay.

S: So, you have to put that into context. The other argument that my colleagues and I make is that, well, whatever psychological benefit or non-specific benefit you get from placebo effects, which are essentially non-specific therapeutic effects, you get them from real treatments too....

BH: Yeah

S: And, so it’s not like homeopathy or whatever can provide something that getting some minimalist but rational and science-based treatment can also deliver.

BH: Right

S: And then there’s the harm of homeopathy, which, even if you buy the notion that I think 99% of the stuff that’s sold that’s homeopathy is completely inert...

BH: Mm

S: ...and therefore, there’s no direct harm, the indirect harm is kind of hard to quantify.

BH: Yeah, I agree.

S: And so I’m not so complacent about saying there isn’t much of an indirect harm from legitimizing and peddling really abject nonsense as if it were medicine.

BH: But this is the beauty of skepticism.

S: Yeah.

BH: The point is if we’re not dogmatic...

S: Mm-hm.

BH: ...and we can take apart these arguments and consider all the factors which are feeding into it...

S: Mm-hm.

BH: Seems to me that what you’re telling me about the size of the effect of placebo. I’m not an expert in it...

S: Right.

BH: ...but I think as skeptics we’re allowed to sit down and say okay, let’s evaluate the evidence.

S: Yeah, absolutely.

BH: Let’s look at the budgets, let’s do the analysis. And I think that Phil Plait made an issue yesterday about, skepticism should try and be a little bit, not more tolerant, but just kind of stop being so dogma-...or categorical, that there’s a right and wrong…

S: Mm-hm.

BH: ...to every issue. Because, very rarely is that the case.

S: Right.

BH: And so, maybe what I’m saying is that let’s look at all the costs and benefits of that. The issue about homeopathy is whether it is effective, well, everyone knows it’s water, I mean…

S: Yeah, it’s not effective. That, we could agree on that.

BH: We can all agree on that. It’s the other issue, about whether or not allowing people to pay for water...

S: Yeah.

BH: ...is either morally right, ethically right...these are the complex issues.

S: Absolutely, and they’re definitely issues that we don’t take for granted.

BH: Mm

S: And that’s probably one of the most frequent questions I get as a skeptical physician is, well if this treatment is benign and comes with a placebo effect and makes people feel better…

E: What’s the harm.

S: Not only what’s the harm, but isn’t there some benefit to that. And that’s a very important question.

BH: Mm

S: There’s many sub-questions in there like how can we optimize...

BH: Yeah

S: ...the beneficial aspects of placebo effects within the framework of not lying to patients.

BH: Yeah, so well that of course is, the hippocratic oath is...

S: Yeah

BH: ...has to be maintained, and you’re absolutely right.

S: So, I acknowledge all the complexities, I do think it’s a great conversation to have, but I’ll just say that we’ve been having that conversation...

BH: Mm-hm

S: ...and I like to think that we have developed nuanced opinion…

BH: Yeah

S: ...about it, but...

BH: Yeah

S: I’ve recently become aware of the fact that there’s sort of a different sort of...

BH: Mm

S: ...opinion developing among my UK colleagues, which interests me...

BH: Yeah, yeah

S: ...which is why I wanted to…

BH: Well let’s...

S: you know, explore a little bit.

BH: Let’s consider some future scenarios.

S: Yeah

BH: Let’s say okay, so we ban homeopathy, or let’s say we cut funding for it.

S: Yeah, yeah, which is the more, yeah...

BH: That’s more likely.

S: Banning it’s...

BH: Banning it is never going to work. (laughs)

S: Right. It’s like prohibition.

BH: Yeah. We know that the same people who seek out a lot of this are generally chronic patients, you know.

S: Mm-hm.

BH: This is usually why they’ve...quite often it’s testimony hearing from someone else, but very often it’s people who’ve not responded. We then have to say well what replaces it, because I think that some people are inclined towards this way of thinking.

S: Right.

BH: And so, in many ways water is just water, but then when they start getting into all the other stuff then there’s...

S: Yeah.

BH: ...I mean for example Chinese alternative therapies.

S: Yeah.

BH: That’s really worrisome, ‘cause a lot of these…

S: Yeah. Oh there’s definitely a lot more worse things.

BH: Yeah, absolutely, so…

S: And, I do… whenever people start to say that, well, you know, there’s this huge population of people with chronic symptoms.

BH: Mm

S: And, this notion that if we service their chronic complaints with benign, inexpensive and simple treatments that make them feel better, this puts a tremendous relief on the system.

BH: Mm

S: Because we can’t send them off for MRI’s and complicated workups…

BH: Yeah, thats, yeah.

S: I understand that but that’s, that was the “barefoot doctor” campaign that Mao-Tse Tung underwent.

BH: Okay.

S: We can’t afford to give scientific medicine to a billion people so we’re going to have this...

BH: Yeah

S: ...sort of, army of barefoot doctors who are going to give them the traditional stuff that we know doesn’t work, but who cares it’s cheap and they can do it and...

BH: Yeah

S: It kinda rubs me a little bit the wrong way but I understand the dilemma there that, and I do think this is exactly the problem that America is having, is that we have the technology, to, and the science, to provide...

BH: Yeah

S: ...more healthcare than we can afford. So I think this is a very important that needs to be addressed. I’m not willing to say let’s just give them sugar pills and make them go away so we don’t have to pay for them. I’m not saying that was your position, but I’m saying that is kind of...

BH: Mm

S: ...sort of, where it can lead to. I think rather, we need to figure out as a profession, how to efficiently deal with these people within a more reasonable science-based and ethical framework. And maybe there are lots of lessons to be learned from these alternative practitioners who have found a way to sort of optimize the more what I call “touchy-feely” aspects...

BH: Yeah.

S: ...of medicine. Right? So maybe we don’t need physicians doing the million-dollar workup on everybody who has these chronic complaints, and maybe we can have allied professionals, like nurse practitioners or whatever that are able to approach these problems in a way that is more minimalist and...

BH: Mm-hm

S: Again there’s a lot of complexities here. I think though, that we get off on a very ultimately destructive tangent if we say that these non-scientific modalities have a useful role to play directly in dealing with that issue. But I don’t have the ultimate solution either cause I understand that it’s...that we’re in the process of going bankrupt paying for the medicine that we have the technology to deliver. We’re victims of our own success. Now what do we do...

BH: Yeah

S: ...You know. It’s tough.

BH: Indeed, indeed.

B: I don’t have a solution, but I admire the problem.

S: (laughs) Right.

(laughter)

BH: But at least we can talk about it, and that’s...

S: Yeah.

E: Oh yeah, absolutely. Absolutely.

S: Absolutely. Thank you so much, Bruce, for joining us.

BH: You’re very welcome.

E: Thank you, Bruce.

BH: Cheers, bye.

Science or Fiction ()

Item #1: A new analysis confirms that the so-called mitochondrial eve lived about 200,000 years ago. Item #2: New research indicates that for adults internet access at home is significantly associated with a decreased probability of being involved in a romantic relationship. Item #3: New images of the Moon's surface indicate that the Moon is shrinking - by about 100 meters in the recent past.

Quote of the Week ()

'You know that chemistry has an impact on your daily life, but the extent of that impact can be mind-boggling. Consider just the beginning of a typical day from a chemical point of view. Molecules align in the liquid crystal display of your clock, electrons flow through its circuitry to create a rousing sound, and you throw off a thermal insulator of manufactured polymer. You jump in the shower, to emulsify fatty substances on your skin and hair with chemically treated water and formulated detergents. You adorn yourself in an array of processed chemicals - pleasant-smelling pigmented materials suspended in cosmetic gels, dyed polymeric fibers, synthetic footware, and metal-alloyed jewelry. Today, breakfast is a bowl of nutrient-enriched, spoilage-retarded cereal and milk, a piece of fertilizer-grown, pesticide-treated fruit, and a cup of a hot, aqueous solution of neurally stimulating alkaloid. Ready to leave, you collect some books - processed cellulose and plastic, electrically printed with light-and-oxygen-resistant inks - hop in your hydrocarbon-fuelled metal-vinyl-ceramic vehicle, electrically ignite a synchronized series of controlled, gaseous explosions, and you're off to class!' Martin S. Silberberg

S: The Skeptics' Guide to the Universe is produced by the New England Skeptical Society in association with the James Randi Educational Foundation and skepchick.org. For more information on this and other episodes, please visit our website at www.theskepticsguide.org. For questions, suggestions, and other feedback, please use the "Contact Us" form on the website, or send an email to info@theskepticsguide.org. If you enjoyed this episode, then please help us spread the word by voting for us on Digg, or leaving us a review on iTunes. You can find links to these sites and others through our homepage. 'Theorem' is produced by Kineto, and is used with permission.

References