Why skepticism about science and medicine?

(cross-posted from scimedskeptic.wordpress.com)

My skepticism is not about science and medicine as sources or repositories of objective knowledge and understanding. Skepticism is demanded by the fact that what society learns about science and medicine is mediated by human beings. That brings in a host of reasons for skepticism: human fallibility, individual and institutional self-interest, conflicts of interest, sources of bias and prejudice.

I have never come across a better discussion of the realities about science and its role in society than Richard Lewontin’s words in his book, Biology as Ideology (Anansi Press 1991, HarperPerennial 1992; based on 1990 Massey Lectures, Canadian Broadcasting Corporation):

“Science is a social institution about which there is a great deal of misunderstanding, even among those who are part of it. . . [It is] completely integrated into and influenced by the structure of all our other social institutions. The problems that science deals with, the ideas that it uses in investigating those problems, even the so-called scientific results that come out of scientific investigation, are all deeply influenced by predispositions that derive from the society in which we live. Scientists do not begin life as scientists, after all, but as social beings immersed in a family, a state, a productive structure, and they view nature through a lens that has been molded by their social experience.
. . . science is molded by society because it is a human productive activity that takes time and money, and so is guided by and directed by those forces in the world that have control over money and time. Science uses commodities and is part of the process of commodity production. Science uses money. People earn their living by science, and as a consequence the dominant social and economic forces in society determine to a large extent what science does and how it. does it. More than that, those forces have the power to appropriate from science ideas that are particularly suited to the maintenance and continued prosperity of the social structures of which they are a part. So other social institutions have an input into science both in what is done and how it is thought about, and they take from science concepts and ideas that then support their institutions and make them seem legitimate and natural. . . .
Science serves two functions. First, it provides us with new ways of manipulating the material world . . . . [Second] is the function of explanation” (pp. 3-4). And (p. 5) explaining how the world works also serves as legitimation.

Needed skepticism takes into account that every statement disseminated about science or medicine serves in some way the purpose(s), the agenda(s), of the source or sources of that statement.

So the first thing to ask about any assertion about science or medicine is, why is this statement being made by this particular source?

Statements by pharmaceutical companies, most particularly their advertisements, should never be believed, because, as innumerable observers and investigators have documented, the profit motive has outweighed any concern for the harm that unsafe medications cause even as there is no evidence for definite potential benefit. The best way to decide on whether or not to prescribe or use a drug is by comparing NNT and NNH, the odds on getting benefit compared to the odds of being harmed; but NNT and NNH are never reported by drug companies. For example, there is no evidence whatsoever that HPV vaccination decreases the risk of any cancer; all that has been observed is that the vaccines may decrease genital warts. On the other hand, many individuals have suffered grievous harm from “side” effects of these vaccines (see Holland 2018 in the bibliography cited just below, and the documentary, Sacrificial Virgins. TV ads by Merck, for example in August 2020 on MSNBC, cite the Centers for Disease Control & Prevention as recommending the vaccine not only for girls but also for boys.

For fully documented discussions of the pervasive misdeeds of drug companies, consult the books listed in my periodically updated bibliography, What’s Wrong with Present-Day Medicine.
I recommend particularly Angell 2004, Goldacre 2013, Gøtzsche 2013, Healy 2012, Moynihan, & Cassels 2005. Greene 2007 is a very important but little-cited book describing how numbers and surrogate markers have come to dominate medical practice, to the great harm of patients.

Official reports may be less obviously deceitful than drug company advertisements, but they are no more trustworthy, as argued in detail and with examples in “Official reports are not scientific publications”, chapter 3 in my Dogmatism in Science and Medicine: How Dominant Theories Monopolize Research and Stifle the Search for Truth (McFarland 2012):
“reports from official institutions and organizations . . . are productions by bureaucracies . . . . The actual authors of these reports are technical writers whose duties are just like those of press secretaries, advertising writers, and other public-relations personnel: to put on the actual evidence and conclusions the best possible spin to reinforce the bureaucracy’s viewpoint and emphasize the importance of the bureaucracy’s activities.
Most important: The Executive Summaries, Forewords, Prefaces, and the like may tell a very different story than does the actual evidence in the bulk of the reports. It seems that few if any pundits actually read the whole of such documents. The long public record offers sad evidence that most journalists certainly do not look beyond these summaries into the meat of the reports, given that the media disseminate uncritically so many of the self-serving alarums in those Executive Summaries” (p. 213).

So too with press releases from academic institutions.

As for statements direct from academic and professional experts, recall that, as Lewontin pointed out, “people earn their living by science”. Whenever someone regarded as an expert or authority makes public statements, an important purpose is to enhance the status, prestige, career, profitability, of who is making the statement. This is not to suggest that such statements are made with deliberate dishonesty; but the need to preserve status, as well as the usual illusion that what one believes is actually true, ensures that such statements will be dogmatically one-sided assertions, not judicious assessments of the objective state of knowledge.

Retired academic experts like myself no longer suffer conflicts of interest at a personal or institutional-loyalty level. When we venture critiques of drug companies, official institutions, colleges and universities, and even individual “experts” or former colleagues, we will be usually saying what we genuinely believe to be unvarnished truth. Nevertheless, despite the lack of major obvious conflicts of interest, one should have more grounds than that for believing what we have to say. We may still have an unacknowledged agenda, for instance a desire still to do something useful even as our careers are formally over. Beyond that, of course, like any other human beings, we may simply be wrong, no matter that we ourselves are quite sure that we are right. Freedom from frank, obvious conflicts of interest does not bring with it some superhuman capacity for objectivity let alone omniscience.

In short:
Believe any assertion about science or medicine, from any source, at your peril.
If the matter is of any importance to you, you had best do some investigating of evidence and facts, and comparison of diverse interpretations.

Elsevier strikes again: Predator or merely parasite?

According to the doubtfully reliable Wikipedia, “Elsevier B.V. . . . is an academic publishing company that publishes medical and scientific literature. It is a part of the Reed Elsevier group” which is “an Anglo-Dutch multinational publishing and information company co-headquartered in London, United Kingdom and Amsterdam, Netherlands. It operates in the science, medical, legal, risk, marketing, financial, and business sectors”.

Actually, Elsevier is strictly in the business of making money, not of providing information, and its activities have included MISinforming or DISinforming, as illustrated by these actions:

⇒ Elsevier put out a number of medical-company advertisements masquerading as professional medical journals — “Elsevier published 6 fake journals”; “Merck published fake journal”.

⇒ Elsevier took over and soon destroyed Medical Hypotheses, after having withdrawn an article that corrected a published error: It was claimed that there had been 300,00 AIDS deaths per year in South Africa, whereas the official count was reported by Statistics South Africa as about 15,000 — “Censored by Elsevier”; “Public Health Service of Italy accepts work of Ruggiero et al.”; Chapter 3 in Dogmatism in Science and Medicine: How Dominant Theories Monopolize Research and Stifle the Search for Truth (McFarland 2012).

⇒ Now Elsevier is in the process of doing its destructive work on the Medical Journal of Australia: “Editor of Medical Journal of Australia fired after criticizing decision to outsource to Elsevier”.

The decision-makers at the company that controls the Medical Journal of Australia do not understand — as the Journal’s now-fired editor does —that the such “technical” matters as the procedures by which articles are submitted, the “infrastructure”, is inseparable from editorial matters. It determines how the Journal presents itself to prospective authors.
My own experience of publishing in an Elsevier journal can best be described as intense frustration at unnecessary complications: creating accounts, navigating ambiguous web pages, filling out numerous forms, putting up with inept computerese — all these only because Elsevier is so anxious to make profits, charging exorbitantly for reprints and requiring authors to pledge not to make copies of their own work available freely to others. Elsevier, not the author of an article, takes the copyright to articles in the journals it publishes. It does not forbid authors from sharing PREprints with the rest of the scientific community, but “Preprints should not be added to or enhanced in any way in order to appear more like, or to substitute for, the final versions of articles”, so that prospective readers will need to access articles via libraries that subscribe — at exorbitant rates — to Elsevier publications, or via reprints supplied to authors at outlandishly exorbitant charges: the article I published runs to 5 pages, and reprints would have cost me $220 for 100 (minimum order), decreasing per copy to $400 for 400 — for the economy version without covers; the deluxe off-prints with covers would have cost $430 for the minimum 100 (but less per copy for more, e.g. “only” $925 for 400). As everyone knows, once something has been printed, there is negligible marginal cost in running off any number of extra copies.

⇒ The exorbitant charges that bring Elsevier extraordinary profit margin led mathematicians to organize a boycott of Elsevier journals: “Why are we boycotting Elsevier?”; “Mathematicians organize boycott of a publisher”; “Scientists sign petition to boycott academic publisher Elsevier”; “Why Elsevier?”;  “The Elsevier boycott one year on”.
In 2010, on revenues of ~$3.2 billion, Elsevier’s profit was 36% (“Why scientists are boycotting a publisher”, Boston Globe, February 2012). Such a profit margin will make jealous even the racketeering Rx-drug industry (Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare by Peter C. Gøtzsche).

⇒ The possibility of cheap online publishing has brought an explosion of hundreds if not thousands of “journals” that librarian Jeffrey Beall has described as “predatory” since they offer nothing but opportunity for anyone to get published in “academic journals” if they can pay for it.
Beall’s survey of predatory publishers lists 693 in 2015, up from 18 in 2011, 23 in 2012, 225 in 2013, and 477 in 2014.
Is Elsevier not also predatory in the same way? It too offers authors online “open access” publishing for supposed more and quicker exposure, for a price: “Fees range between $500 and $5,000 US Dollars depending on the journal”.
And Elsevier too is responsible for the explosive growth in numbers of journals. In 1991, Elsevier took over the prestigious British journal THE LANCET. But prestige alone evidently doesn’t bring in enough money, so Elsevier has traded on The Lancet brand to proliferate publications: The Lancet Oncology since 2000, The Lancet Infectious Diseases since 2001, The Lancet Neurology since 2002; in 2013 were added The Lancet Diabetes & Endocrinology, The Lancet Global Health, and The Lancet Respiratory Medicine; in 2014, The Lancet HIV.

More reviews of DOGMATISM book

Two substantial reviews offering much room for further thought have just been published of Dogmatism in Science and Medicine: How Dominant Theories Monopolize Research and Stifle the Search for Truth:

Journal of Scientific Exploration, 28 (2014) 142-48, by Donald J. DeGracia
Dogmatism in Science and Medicine (DSM) by Henry H. Bauer is about the corruption of modern science. For practicing scientists it is a disturbing book to read. Medicine is bitter, yet we put up with it to get better. DSM is bitter medicine intended to improve the health of science.
. . . .
Dr. Bauer does a professional, competent, and important job bringing the corruption of modern science into the light. The criticisms offered above do not detract from the fundamental correctness of the picture DSM paints, but instead underscore its seriousness, and the need to further refine the picture. To scoff at DSM or to think it is off-base is merely to reveal that the scoffer is woefully uninformed about the transformations that have occurred in science over the past decades. If one is a practicing scientist, or a concerned citizen of good will, one ignores this book at one’s own peril.

Journal of Scientific Exploration, 28 (2014) 149-52, by Brian Josephson
At the end of this fascinating book, Bauer asks the question: Can 21st century science become trustworthy again? He suggests that change must come from outside the existing institutions, which merely serve to perpetuate knowledge monopolies, but first the need for change must become generally recognized . Possibilities discussed include a Science Court; independent, publicly funded institutions that can assess scientific claims of public importance; and designated funds for non-mainstream research. Something of this nature is clearly needed.

 

 

 

What’s wrong with HIV/AIDS — and with ideologically determined “science”

Donald Miller, cardiac surgeon and now Emeritus Professor of Surgery at the University of Washington (Seattle) has written an excellent critique of HIV=AIDS theory:

Fallacies in Modern Medicine: HIV/AIDS  (15 May 2014)

The venue, Lew Rockwell’s website, might be described as right-leaning libertarian: it advertises itself as “anti-state — anti-war — pro-market”. That HIV/AIDS dissidence can find an outlet virtually only in right-leaning places illustrates the sorry state of political-ideological division that shows no signs of ameliorating.
The same situation bedevils public discourse about “global warming” or “climate change”. Conservative-leaning media and groups and individuals seem almost always to be “denialists” on HIV/AIDS and global warming, whereas progressive-leaning media and groups and individuals seem almost always to regard HIV=AIDS and human-caused “climate change” as established fact, even as the plain evidence demonstrates that they are not established facts; see “A politically liberal global-warming skeptic?”  and “The Case against HIV”  (or for book-length treatment, Dogmatism in Science and Medicine).

These circumstances add to the characteristic loneliness of any position that lies between two extreme beliefs. My own sociopolitical leanings fit much better with MSNBC than with Fox News, but I can’t watch MSNBC without cringing whenever global warming or HIV/AIDS is mentioned, as individuals who have no familiarity with the actual evidence rant against us “denialists”.
I’ve also never stopped thinking of myself as science-trained, and have never lost my wonder and awe, that human beings have managed to gain so much evidence-based, science-mediated understanding of the natural world. So I cringe also when “scientific experts” hold forth about “the established fact” of HIV=AIDS or human-caused global warming. Or when President Obama declaims with full conviction about the necessity of combating climate change following indoctrination by his doctrinaire Science Advisor. Scientists (and “experts” generally) who abuse their expertise to propagandize their own beliefs instead of purveying summaries of the range of professional opinion are traitors to their profession.

The global news is replete with descriptions of warring groups of human beings killing one another over apparently irresolvable divisions of ethnicity or religion or political ideology, when it is so obvious to outsiders that all sides would benefit from compromises grounded in available evidence of what makes for sustainable, peaceful, human living.
It’s a great sadness that in the most advanced societies, in which science and technology have gained the most ground, such major issues as HIV/AIDS and global warming have become faiths that distort the facts just as egregiously as traditional religions so often have done.

Race, HIV, media pundits

People carrying black-African genes test “HIV-positive” at far greater rates than do people without that genetic ancestry. HIV/AIDS theory “explains” that by postulating greater rates of careless “not-safe-sex” promiscuity and infected-needle-sharing drug injection. Thereby HIV/AIDS theory postulates significant genetic determination of behavior, which in other contexts is dismissed as pseudo-science.

Moreover, actual observations and studies have repeatedly shown that the facts vitiate that proposed “explanation”: Africans and African-Americans indulge in risky behavior at lower rates than do white Americans (pp. 77-9 in The Origin, Persistence and Failings of HIV/AIDS Theory).
The conclusion is inescapable: HIV/AIDS theory is radically wrong about how “HIV-positive” is transmitted.

But that inescapable conclusion continues to escape mainstream practitioners and researchers and such media pundits as Donald G. McNeil Jr. of the New York Times (Poor Black and Hispanic men are the face of H.I.V.):

“The AIDS epidemic in America is rapidly becoming concentrated among poor, young black and Hispanic men who have sex with men”
NO. There’s nothing recent or rapid about it. The racial disparities have always been there (Chapters 5 & 6 in The Origin, Persistence and Failings of HIV/AIDS Theory).
Furthermore, it is black WOMEN who are most affected compared to others, 20 times more likely to be “HIV-positive” than white women, whereas for males the ratio is (“only”) 7.

“Nationally, 25 percent of new infections are in black and Hispanic men, and in New York City it is 45 percent”
Yes, of course, because it’s blackness that contributes overwhelmingly to testing “HIV-positive”. Hispanics in New York are primarily of black Caribbean-African stock, whereas West-Coast Hispanics are largely non-black, of Latin-American stock. Therefore national-average rates of “HIV-positive” among Hispanics are lower than East-Coast Hispanic rates of “HIV-positive” (pp. 57-8, 71-2 in The Origin, Persistence and Failings of HIV/AIDS Theory).

“Nationally, when only men under 25 infected through gay sex are counted, 80 percent are black or Hispanic — even though they engage in less high-risk behavior than their white peers” [emphasis added]; “a male-male sex act for a young black American is eight times as likely to end in H.I.V. infection as it is for his white peers. That is true even though, on average, black youths in the study took fewer risks than their white peers: they had fewer partners, engaged in fewer acts of sex while drunk or high, and used condoms more often”.
So McNeil is even aware of this conundrum which falsifies the central axiom of HIV/AIDS theory, namely, that HIV is transmitted as a result of risky behavior. Yet he does not follow this statement of fact with any explanation of this paradox which contradicts and falsifies mainstream views.
Instead, McNeil passes on without comment the usual meaningless weasel-words about some unspecified “intervention”:
“Critics say little is being done to save this group, and none of it with any great urgency. ‘There wasn’t even an ad campaign aimed at young black men until last year — what’s that about?’. Phill Wilson, president of the Black AIDS Institute in Los Angeles, said there were ‘no models out there right now for reaching these men’”.
What conceivable use could any models be, when it’s acknowledged that these supposedly at-high-risk people already practice less risky behavior than the no-high-risk white folk?
Still, of course there’s no harm in asking for more money even in absence of any clue what to do with it:
“With more resources, we could make bigger strides”.

What the mainstream says about the high rates of black “HIV-positives” is pitifully, woefully inadequate; it misses the whole point. It suggests that although their behavior is less risky, black folk have “other risk factors. Lacking health insurance, they were less likely to have seen doctors regularly and more likely to have syphilis, which creates a path for H.I.V.”
But it’s yet another counterfactual canard that syphilis and other STDs make it more likely that someone will “contract” “HIV”, i.e. become “HIV-positive”: there is simply no correlation between incidence of STDs and of “HIV” (pp. 31-5, 109 in The Origin, Persistence and Failings of HIV/AIDS Theory).
As to insurance, what is the evidence that having health insurance makes for lower rates of being or becoming “HIV-positive”? This is simply hand-waving bullshit* emitted because no sensible explanation can be offered.
As to seeing doctors regularly, what is the evidence that seeing doctors regularly makes for lower rates of being or becoming “HIV-positive”? Quite the opposite, in fact: The largely white gay men who first contracted “AIDS” had mostly been seeing doctors very often because of their constant need for treatment after suffering all sorts of illnesses. Dr. Joseph Sonnabend, with a practice of largely gay clients in New York in the 1970s, had in fact warned his regular customers that if they did not change their lifestyle something drastic and awful would befall them.

And then, “Other risk factors include depression and fatalism” — What, pray, is the mechanism by which those conditions produce “HIV-positive”? Among people who are acknowledged to behave less riskily than those who are not at high risk of becoming “HIV-positive”?

Another popular non-explanation is that blacks become “HIV-positive” more often because “HIV-positive” is so much more common in the black community: It’s more common because it’s more common.

I cannot imagine a higher degree of hypocrisy, intellectual vapidity, sheer unwillingness to draw obvious conclusions from undisputed facts, than is demonstrated without fail and without end by mainstream researchers, doctors, and pundits when confronted with the plain fact that blackness makes for being “HIV-positive”.

Not that this perverse behavior is much different from behaving as though testing “HIV-positive” proved infection by “HIV” when standard authorities have long stated quite forthrightly that there is no gold standard “HIV” test, no test capable of demonstrating actual infection by “HIV”, and that the rates of false positives are inevitably high (Stanley H. Weiss & Elliot P. Cowan, “Laboratory detection of human retroviral infection”, chapter 8 in Gary P. Wormser (ed.), AIDS and Other Manifestations of HIV Infection, 2004 (4th ed.).

No technical expertise is needed to recognize the sheer unadulterated nonsense of talking about “risk factors” when the known end-result is less risky behavior. How can any number of purported risk factors be alleged to heighten risk when the facts show that the risk is lower of the only behavior that supposedly transmits “HIV”?

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* Words uttered without regard to their truth — Harry Frankfurt, On Bullshit, Princeton University Press, 2005.