European Skeptics Congress: With Alt-Med’s Rising Popularity, Health Issues High on Agenda
Skeptics worldwide have many common issues: the increasing acceptance of so-called “alternative” medicine (often called alt-med in Europe), the popularity of pseudoscientific beliefs like astrology and life after death, and the lack of public understanding of science. But each country’s skeptics also have issues peculiar to that country. Germany has its Earth Rays, the U.S. has Therapeutic Touch, and the United Kingdom has its seemingly never-ending affair with spiritualism. At the September 2003 European Skeptics Congress, in London, these national variations were much on display, with speakers from all over Europe and the United States.
In 1985, when the last London CSICOP conference took place, it was still possible for the British skeptics to regard America with some superiority in these matters. Alien abductions, for example, was a mad belief Britons were far too sophisticated to embrace. Or creationism: clearly one of those backward American obsessions borne of our country’s religious exuberance. Americans, the argument goes, are gullible and credulous, embracing any new fad that comes along-sort of the way U.S. Northeasterners think of Californians.
In 2003, though, alien abductees appeared regularly on British daytime talk shows, and creationism is on the rise. Just as in America, corporate funding is playing a greater part in academic research, and the level of science education among the general public is dropping. Where the U.S. may be concerned with the millions who have no health insurance, in Europe access to alt-med is often portrayed as a matter of consumer choice and egalitarianism. Why should only the rich and famous be able to afford homeopathy? Few public figures in Europe are as vigorous in opposing questionable health claims as the late British journalist John Diamond, who concluded during his four-and-a-half-year death of cancer that there was no such thing as alternative therapies. “There are only,” he wrote in the British magazine The Skeptic, “therapies that work and therapies that don't.”
It is because of these trends that more than a full day’s worth of the conference was devoted to health issues.
Edzard Ernst, who kicked off the first day with a survey of alt-med research, put it only slightly differently: “In God we trust; all others must have data.” Kimball C. Atwood, who spoke the next day, disagreed with Ernst-not about Ernst’s contention that the evidence is poor quality but about the value of doing that research in the first place. Atwood believes we should be looking more closely at what he calls “prior probability.” If a particular treatment violates everything we know about a scientific field, and the evidence is of poor quality that has not improved over a long period of time, then trials, he thinks, are pointless. Some of his examples, however, seemed uncomfortably dismissive. If all the positive research on a particular treatment comes from a single country, does that mean we should discount it? Atwood held that yes, we should.
One of Atwood’s key criteria for alt-med (that the data should be getting better over time as we learn to produce the right conditions and if they don't there likely is no reality there) resonated with presentations by Ray Hyman and Robert Morris, each of whom surveyed decades of the heartbreak of psi in his own way. After a century of psychical research, we seem no nearer to finding proof.
The most startling presentation was Dylan Evans’s discussion of the placebo effect, based on his 2003 book The Belief Effect. This is a phenomenon I first read about in a New Yorker article by the medical writer Berton Roueché when I was about thirteen. Is nothing sacred?
Panned in Nature, the next week The Belief Effect was chosen as book of the month by the Royal Society of Medicine. Surveying a lot of results from experimental studies in pain units, meta-analyses, and other projects, Evans was only able to find evidence for the placebo effect in reducing pain, nausea (sometimes), swelling, stomach ulcers, depression (not as effective), and anxiety (some evidence). Conditions for which he believes there is no good evidence include cancer, schizophrenia, and most medical conditions. The jury is out, he said, on Parkinson’s, asthma, and heart disease. The alarming bit of his research, however, was the discovery that virtually all the GPs he asked in a telephone survey said they would not be surprised to learn that the placebo effect could cure cancer. These days, it is very common for GPs in Europe to believe in or recommend alt-med, and scientific rationalism seems to be deserting many parts of the medical profession.
That is one reason Willem Betz, professor of family medicine at the University of Brussels, and a key member of the Belgian skeptics group, has relentlessly battled efforts to exempt alt-med from effectiveness and safety controls within the European Union. His presentation covered much of this effort. One important selling point for alt-med in Europe is consumer choice: alt-med is popular. Betz points out that consumer surveys bolstering this claim are easy to construct if you phrase the questions correctly. Betz himself would have to answer “yes” to a question that asked if he had ever used homeopathy; the fact that it was thirty years ago would not be registered.
Even so, it’s clear that psychology does play an important role in many illnesses. Leslie Walker, professor of rehabilitation at the University of Hull, discussed clinical trials looking at the value of psychological approaches to the care and management of cancer patients. At the very least, he thinks, it’s worth considering how we can prevent or at least ameliorate the anxiety and depression that many cancer patients experience. So far, relaxation and imagery show no signs of improving the clinical or pathological response to chemotherapy. However, the size of the tumor and the amount of mood disturbance at the beginning of treatment did act as predictors of the patient’s response: both are bad news.
Michael Heap, the conference organizer on behalf of Britain’s Association for Skeptical Enquiry (ASKE), deliberately made an effort to include some less obvious topics and more controversial points of view. Australian psychologist Dorothy Rowe, for example, talked about whether there is a physical basis for mental illness. Few seemed to agree with her conclusions or approach, just as few agreed with Tom Stafford, who argued that creationism should be taught in British schools as a way of teaching children how to evaluate and critique bad science.
Other less standard skeptical fare included several entertaining discussions of alternative history, both human and linguistic. Lee Keener, of the University of Northern British Columbia, investigated Egyptian pseudohistory as a way of testing what kind of contribution an amateur can make to science. Michael Brass analyzed the claims of Michael Cremo, author of Forbidden Archeology. And, probably the most fun, Mark Newbrook detailed his online encounters with linguistics nuts. One interesting facet is the Sommer Institute of Linguistics, whose mission is to translate the Bible into all human languages. Newbrook notes that these creationists are doing valuable work on analyzing languages, writing dictionaries, and even devising writing systems in some cases. The good linguistic work they do, he points out, can be put to use translating atheist or skeptical tracts into those languages.
Probably the most heartening thing about the conference, if you've been following European skepticism since the late 1980s, is that there’s now so much of it. Many of the skeptical groups were founded in the late 1980s; they certainly didn't appear at the last London conference. The biggest difference about this conference, in fact, was the diverse national origins of the speakers and attendees. The first day’s session, for example, had speakers from Germany, Belgium, Australia, and Britain (although, sadly, still almost no women).
Even so, as Richard Wiseman said on the final day, the problem for skeptics is that while we're trying to produce careful, replicable analysis the world is changing around us. People have little time to read and their attention must be caught instantly or they move on. The tools we have for using the Internet make it extremely easy to shut out viewpoints that we disagree with, admitting only information and viewpoints that reinforce our pre-existing beliefs. At the 1985 conference Karl Sabbagh called this the “ratchet effect,” still a very good way to think about it.
Wiseman is probably an example of what skeptical organizations need to become to adapt to this new world. Instead, he said, of being reactive, showing in a shirt and tie as the necessary tag to dispute whatever the dubious claim is, we should be making our own news and finding creative ways to involve people in the fun of skepticism. Both he and Chris French, who surveyed the work his Anomalous Psychology unit is doing at Goldsmith’s College, are making significant contributions along these lines. If skepticism is to be seen as more than a negative attitude, we need to make it the star of the show.