A few days ago, a group called the Friends of Science in Medicine wrote to the Vice Chancellors of Australian universities, speaking out against the teaching of complementary and alternative medicine in the curriculum. This group consists of more than 400 Australian professors, academics, researchers and scientists who work in biomedicine. I’m one of them – a very junior one.
The strength of the reactions has been fascinating. In the last 48 hours alone, I’ve been a fascist, an elitist, arrogant, narrow-minded, a shill for sociopathic corporate interests, viciously protective of my orthodoxy and a generally morally reprehensible crusader for the intellectual interests of old, white men.
I wonder how I have the time, to be honest. However, in the middle of all the noise and mutual disdain between both sides of the alternative medicine divide, what I think is the central point is being lost. And that central point is this: Magic is an insufficient basis for university teaching.
Yes, magic. “Supernatural, mysterious or unknown forces or powers.” The very same.
It is a fact that some degree-granting institutions currently offer courses which teach therapies based, fully or partially, on magic.
It is not a fact that scientists are unreasonably wedded to their existing ideas, or closed-minded. Science, as anyone who works in it will tell you, is viciously self-critical. The self-critical process takes much longer than we’d like but eventually theories improve as they manage to explain more simply, comprehensively or elegantly the phenomena we see.
It is not the fact that we believe anything that is “natural” is inferior to something “artificial”. It has been more than a century since this distinction has even really existed. On the contrary, existing molecules in plants are a major focus of modern drug discovery.
The issue here is fundamental difference between the way evidence-based and alternative medicine understand the world.
Homeopathy is a good example. Homeopaths believe that water “remembers” an imprint of molecules that used to be in it if they are shaken together. These imprints grow over time, in such a way that the potency of the solution goes up as the amount of active ingredient goes down. These imprints are what make homeopathic solvents potent.
As far as we’re aware, this violates the accepted physical laws of the universe. Modern chemists and physicists agree that this theory badly jars with what they think it is possible for matter to do. All of the attempts to prove the existence of this process have turned out to be methodological errors or outright fraud.
The mechanism, therefore, is regarded as hugely implausible. To the best of our knowledge – and our knowledge in an area like this is very, very good – this is magic in the most literal sense.
Strangely enough, a lot of proponents of homeopathy consider this to be a minor point. They use homeopathic remedies and they observe changes in people, sometimes profound changes. They see homeopathic pracitioners comforting the afflicted. Therefore, they “know” it works. On this basis, the mechanism becomes irrelevant.
This is sufficient to prove your good intentions. It is also sufficient to stop the discipline from being regulated into illegality (as homeopathic solutions are made of nothing but water, it is very unlikely they can directly hurt anyone – unless they harm the sick by keeping them from accessing medical treatment).
The question is not whether people should be allowed to be interested in, study, purchase or advocate for these methods – we would all be in a enormous amount of trouble as a society if they weren’t.
The question is the individual components of that mechanism – the molecules, cells, nerves, processes and pathways – which are the engine room of what happens to bodies when we treat them. We think this mechanism is central. We want to help people too, but we don’t make any progress on how that should be done without mechanisms. And to make progress, we need testable predictions, formed from those mechanisms.
As a consequence, the statement “this experiment worked, therefore this therapy helps people” is not scientific.
If we investigate an alternative medicine and find that the results are increased “wellness”, or “comfort”, or “less distress”, that’s quite pleasant. The problem is where we conclude that as X has been demonstrated to “work”, the investigation of X was scientific. It isn’t.
The statement “this experiment worked, therefore this magic is the best explanation for it” actually IS scientific. It’s just unlikely in the same way that the existence of chocolate eggs on Easter morning is evidence for a magical rabbit. It is good evidence only for the existence of chocolate, not how it got there.
The last link in this chain, of course, is the link between the scientific method and universities. This is a fairly obvious connection. Universities were built and are still maintained to create knowledge by inference – asking questions from what we already think is true. When a potential employer asks whether or not you’ve “got a degree”, this process of critical thinking is what they hope you’ve learned.
When we use inference to understand the physical universe, that’s science. And science is antithetical to magic. Science isn’t interested in outcomes divorced from what made them, because there’s nothing we can do with them. Science does not exist to provide what people want. Science offers us progressively clearer approximations of what is.
One of the worst arguments I’ve encountered so far is that university courses which encompass alternative medicine are “giving people what they want”, as if somehow market forces were more important than facts, and universities existed to tell people what they wanted to know.
Quite the contrary. We are in the business of unvarnished, difficult truths, irrespective of what people might hope is the case or want from us.
And the case so far is this: 100 per cent of all rabbits have been observed to be in magician’s sleeves. Not one, so far, has managed to apparate out of the hat.