Thursday 23 April 2009

Bad Bad Science.

Ben Goldacre's Bad Science site is excellent in a great many ways. His columns are undoubtedly the best thing in The Guardian, possibly ever. He does a brilliant job of ripping apart the dodgy and often dangerous pseudoscientific claims of charlatans. He, like, totally analyses the heck out of those guys. And most of the commenters on his blog are quite astoundingly knowledgable about a whole bunch of scientific fields. It's probably the only blog on the Web where it is always worth reading the whole comment thread of every post. Go science!

And yet, there's a problem.

Firstly, Ben sounds like the kind of man I'd like to have as a GP myself. He happily admits to being a geek who trawls through as much medical literature as he can get his hands on, analyses the results of studies, etc. This is evidence-based medicine, and he understands it. And he devotes a lot of time to trying to understand why it is that patients go to see quack doctors instead of proper scientific ones, and his answer is never "Because they're thick!" But the point I have never seen him address is that a major contributing factor to people losing faith in conventional medicine is that most GPs are not like him. As practised by your average GP, conventional medicine is based on assuming all your patients are morons and hypochondriacs, failing to read their notes, and not bothering to keep up with scientific discoveries when there are perfectly good baseless prejudices to use instead.

After all the crap that happened to Vic two years ago, our local surgery made her one of their highest-priority patients and told her that she should always call if she had any chest pains. Two of the GPs have since retired and one of the new ones clearly can't be arsed reading her notes, has misdiagnosed her, has given her a test which the hospital later told us was pointless, and told her when she had serious breathing problems that she was just trying to avoid going to work. There's a big heap of evidence in his office — Vic's notes — and his medicine is not based on it.

I'm a migraine sufferer. Long after the invention of Sumatriptan-based drugs, doctors would still tell me to avoid eating cheese and chocolate (an old wive's tale) and stop wasting precious NHS resources when they had real patients to see.

In short, there is, in practice, a big difference between conventional medicine and evidence-based medicine.

The other problem with Bad Science is caused by Ben's writing for The Guardian. For all their scientific knowledge, his commenters are mostly Guardian-readers, and they tend to be a tad intolerant of dissenting political opinions.

For instance, if you can be bothered reading it, here is an excellent example: in a piece about screening for Down's Syndrome, Ben wrote that it's wrong to speak out against aborting babies because they've got Down's because that makes the decision all the more harrowing for the parents. Now, Ben's main criticism of the stories circulating at the time was that their statistics were wrong and the claims they were making were therefore false. But he concluded with this:

If I terminate a Down syndrome pregnancy, is that proof that society is not a warm caring place, and that I am not a warm caring person? For many parents the decision to terminate will be a difficult and upsetting one, especially later in life, and stories like this make a pretty challenging backdrop for making it. This would have been true even if their figures had been correct


While I have plenty of sympathy for parents in that situation, this isn't science; it's an attempt to stop a debate via emotional blackmail. Even if the claims are true, we shouldn't make them because... well, because they make it more difficult to support the Left's pro-abortion agenda. Quite what that's got to do with science is never explained; it is assumed.

Then some genuine disabled people turned up in the comments and proceeded to argue that they had a teensy bit of a problem with the prevailing attitude that having a child like them was some sort of disaster to be avoided if at all possible. This seems to me like such an obvious point that it's quite amazing how many evidence-obsessed scientists simply couldn't get their damned heads around it. Brainduck — a blogger previously praise by Goldacre for her excellent science work — put it best:

I find this pretty ironic in the light of what Ben’s previously written about me ...
It is not a Bad Thing that I was born. The birth of more people like me should not be something that society tries to prevent.

... I never want to be in a position where I’m told I’m irresponsible for having children like me / my brother.

Genetic *testing* is NOT treatment. Killing people isn’t the same thing as treating them, and I don’t understand how the two can so often be confused. Genetic screening is looking at two embryos, and deciding that the one more like me deserves less of a chance at life than the one less like me. Why the hell should people NOT be made to feel guilty about that? Systematically wiping out everyone who thinks like me is wrong, and I should be free to say it’s wrong.

... If you choose to have a baby at all, you don’t get a guarantee that they will be ‘perfect’. They could have the greatest genotype ever, and be affected by birth hypoxia or a car crash or whatever and need 24-hour care for the rest of their lives because of that, and you’d just have to deal with it. If you can’t, don’t have children at all. Deciding that loving your child is conditional on it having the right chromosomes is wrong.

My brother is affected to the point that he’s not managed several attempts to live independently, get a degree or job. I’ll probably have to look after him when our parents aren’t able. So what? This isn’t a ‘tragedy’, it’s just life.

....

This isn’t being discussed, it’s just being allowed to happen under a banner of ‘individual choice’ without any thought for the wider social impacts, and often as not without much if any input from the people most directly affected by it. Yep, selective abortion / embryo destruction is an uncomfortable topic, and people don’t like you discussing it. Ben has managed to call the mother of someone with Down syndrome ’scumbaggy’ for saying that her child is as worthy of life as anyone else. If you say that selectively wiping out people with disabilities is wrong, you’ll be told you are being ‘judgemental’ and shouldn’t make people feel ‘guilty’. But this effectively shuts down a wider discussion of the issues. I’m not about to start waving placards outside clinics. That’s not what the DSA were doing. Why shouldn’t they be allowed to say that actually, life with Down syndrome can be good?


It is instructive to read the way that comments thread went. I turned up and made the apparently controversial points that killing your disabled adult child makes you a bad person and that telling your kids that parents who kill their kids aren't necessarily bad falls short of ideal parenting. For this, I was accused of all sorts of things, including, inevitably, finally, trolling. The commenter who calls himself The Nameless was quite thoroughly obnoxious, behaving in a way that would get him banned from quite a lot of sites out there, but it never occurred to anyone to accuse him of trolling because he clearly believed in the standard Guardian-readers' orthodoxy. Me, I stayed civil, and was pretty much screamed at for my trouble. I invite anyone who can be arsed to read the comments there and let me know if you think I've mischaracterised the conversation.

What was interesting about it for me was that I entered the debate without a particularly strong opinion on the subject of pre-natal screening, and those who absolutely unequivocally support it persuaded me very quickly and effectively that it's wrong.

And we have another example today. This week, Ben Goldacre has written about the story that The Daily Mail has a different editorial stance to The Irish Daily Mail. Apparently, this is shocking and amazing for some reason. The shocking amazing story was noticed by a guy called Martin who blogs over at The Lay Scientist. He's another Guardian-reader, and clearly under the impression that he's a scientist who believes in evidence and rationality.

Now, Bad Science people have been shocked by this type of story before. Despite the fact that an hour spent browsing The Guardian's website will reveal so much disagreement that you'll start to think that every left-winger forms their own separate faction of one, its readers express amazement whenever exactly the same phenomenon can be observed in any other media organisation. I don't get it. And so I made this point at Martin's blog:

People only find this sort of thing suprising because of their insistence on thinking of [insert organisation here] as monolithic. The Daily Mail is made up of a large number of journalists, and, like any other group of people, they disagree with each other about all sorts of things. Ben Goldacre has now linked here, and seems to be similarly baffled by the phenomenon, despite the fact that he himself has had a big fight with his own paper, taking them to task at great length for the crap they put on their front page. The Mail are no more baffling than The Guardian in this respect — less so, in fact, as we're talking about The Irish Mail and The British Mail, two different papers. Why on Earth wouldn't some Irish journalists disagree with some British journalists, just because they're working under the same brand name?


This prompted what I mistakenly thought was a debate. It certainly looked like one: each side raised further points to try and back up their side of the argument. But I was wrong. Should have remembered that, when arguing with a left-winger, you either convert to their cause as quickly as possible or You Are A Bad Person. Here's Martin's eventual response:

"This story is uninteresting! It should be banned! I'm going to come back every few days to repeat again how uninteresting I find this story!111!!! You're all stupid!!!11!"

*yawn*


To which, here's mine:

OK.

I just commented earlier that I find this interesting.

I don't know what you think I think should be banned.

I haven't shouted at you.

And I thought I was just debating an issue with you here. Do you get upset when people who agree with you visit your blog every few days? I think I just got the wrong end of the stick when you responded to my points as if you were actually interested in discussing the issue or something, and so I stupidly responded in kind. If you really just want anyone who disagrees with you to fuck off, you could save yourself a lot of time by stating that in your blog's header. You know, "Comments from non-sycophants unwelcome." Something like that.

Far too much of this amongst the Bad Science crowd, to be honest. For all that everyone likes to claim that it's evidence that's important, anyone who fails to toe the Guardian's political line on that site tends to just get invective hurled at them. Which is a great shame, as you're driving away a lot of people who agree with you on the scientific points.

Finally, at least I'm civil.

Go on, say "*yawn*" again. That'll prove that you're right and I'm wrong, using evidence. Yay science.


'Course, most people, unlike me, wouldn't bother. Most people would get shouted at by the site's owner and sod off, never to return. Not necessarily a problem if you're just running a fun club for your friends, but the science blogs are supposed to be persuasive. You know, like science.

Seriously, what is wrong with these people? They all claim that they want to advance the public understanding of science. That's a noble goal, and one I back to the hilt. But aren't they aware that some members of the public are interested in science yet don't agree with their politics, and some even read [gasp!] papers that The Guardian looks down upon? Doesn't it occur to them that routinely shouting at all such people that they're idiots won't persuade them to join the cause?

Or is the cause really just an excuse to run yet another self-congratulatory clique?


Update:

Brainduck has pointed out two mistakes in this post. Firstly, she's a woman of the female persuasion. Something about her chosen alias made me think "male" — quite wrongly, as it turns out. And secondly, I implied that Ben Goldacre was a GP himself, because I was once informed — I forget by whom, but, again, wrongly — that he was. I have amended a small handful of words in this post to reflect reality.

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