In 2020 BC those who believed the earth was flat suffered from ignorance. In 2020 AD, those who believe the earth is flat suffer from motivated ignorance.

What’s the difference?

According to philosopher Daniel Williams:

Motivated ignorance involves a form of ignorance that is driven … by an active aversion to possessing [knowledge]…

It’s not simply a matter of being unaware of relevant information — as most individuals in 2020 BC were unaware of the evidence demonstrating that the earth is round.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]For denialists, motivated ignorance is both self-serving and psychologically comforting.[/perfectpullquote]

[F]or ignorance to be “active” in this way it must satisfy two conditions: “(1) the individual is aware that the information is available, and (2) the individual has free access to the information or would avoid the information even if access were free.”

… When one lacks this awareness, one’s ignorance is … merely “inadvertent”… [I]ndividuals exhibiting active information avoidance would still remain ignorant even if the acquisitional costs pertaining to a body of knowledge were eliminated.

It’s the ongoing effort to prevent learning relevant information maintained by flat-earthers in 2020 who could easily acquire the background knowledge and reasoning skills to recognize that the earth is round.

Science denialists in 2020 — climate denialists, vaccine denialists, COVID denialists — embrace motivated ignorance. It’s not simply that they are unaware of the relevant information needed to reach scientifically accurate conclusions. It’s that they refuse to let themselves be exposed to the relevant information needed to reach scientifically accurate conclusions.

In that effort they are aided immeasurably by social media and mainstream outlets like Fox News. These entities allow users to deliberately recuse themselves from reality by creating cocoons of ignorance where potentially disturbing knowledge is barred.

Motivated ignorance is often socially rewarding because certain forms of denialism enable membership in a social group:

…[C]ertain beliefs function as badges of group membership, enabling us to signal our membership of and loyalty to desirable coalitions.

Although we tend to think of people who are ignorant as also being irrational, Williams argues that motivated ignorance can be entirely rational.

…[P]erhaps the most influential case study of motivated ignorance within contemporary philosophy involves situations in which members of elite or dominant demographic groups wilfully avoid facts about the lives of oppressed or marginal groups and the nature of society more generally. This ignorance is widely thought to be strategically self‐serving, enabling members of such privileged groups to preserve psychologically comforting illusions and avoid accountability…

Similarly, for those who base their identity on denialist beliefs, avoiding scientific information that challenges those beliefs is both self-serving and psychologically comforting. That’s why social media is so popular. It is an opiate for those whose self-image depends on motivated ignorance. Participants can relax and enjoy because they can be sure they will never be psychologically challenged in any way.

That doesn’t mean that those who engage in motivated ignorance are consciously aware of what they are doing. They are often in denial about their desperate need for psychological reassurance, but that does not make them any less needy.

So what’s the problem with motivated ignorance?

One of the most socially consequential forms of ignorance today is the ignorance among voters in contemporary democracies of facts and matters of scientific consensus that are relevant to political decision‐making… [T]here is now extensive data revealing extremely high levels of ignorance of basic matters of empirical fact around which there is strong scientific and expert consensus.

It isn’t a matter of lack of interest in political decisions. Science denialists are often highly motivated to engage in political activism.

As with religious and ideological communities more generally, dissent from group dogmas and sacred propositions can issue in harmful forms of group ostracism, even when such heresies are best supported by the available evidence. Further, it is often painful to abandon deeply held political opinions and commitments, even when such abandonment is best licensed by an impartial evaluation of the facts. Drawing attention to such costs can help to explain how individuals exposed to a deluge of political information can remain both misinformed and yet passionately committed to such misinformation …

In such cases, motivated ignorance is a form of willfully protective cognition. But while individuals may benefit, society as a whole is egregiously harmed.

…[I]f a large number of people in a democracy conform the way in which they seek out, ignore and process information to the goal of protecting their coalitional identity rather than achieving knowledge, the resultant ignorance will then likely play an important role in political decision‐making… [T]he basic dynamic will apply whenever the acquisition of knowledge is heretical and thus socially punished on the grounds that unjustified beliefs function as signals of coalitional membership and belonging…

This has important implications for how we respond to motivated ignorance:

An intuitive view is that the answer to socially pernicious forms of ignorance is to provide people with more information, perhaps combined with an appeal to their reason. This is unlikely to help when ignorance is motivated.

These problems will not be solved with more empirical knowledge, but with better understanding of the seductive allure of motivated ignorance.

Science denialists don’t understand science.

It’s not that they are ignorant of scientific facts although they are. The real problem is that they don’t understand the scientific method.

This is the scientific method (adapted from All In One High School):

It involves making an observation, offering a hypothesis, conducting an experiment, collecting and analyzing data and communicating the findings.

In the case of COVID-19, both scientists and denialists observed the emergence of a new viral illness, but they diverged on the hypotheses that they advanced.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Real scientists revise their claims based on the outcome of their predictions but blowhards and fools do not.[/perfectpullquote]

Scientists, led by Tony Fauci hypothesized that COVID cases and deaths would initially increase dramatically, taper off during the summer months and then return even more dramatically in the fall.

Denialists, led by Donald Trump hypothesized that the number of COVID cases would be small, and that COVID would dwindle and disappear.

Both conducted the same “experiment,” simply waiting to see what would happen.

Tony Fauci’s hypothesis was borne out by what actually happened — multiple, ever growing waves of COVID cases and deaths.

Trump got the exact same data that Fauci got. The data showed Trump’s hypothesis was repeatedly proven to be false. COVID cases didn’t dwindle and they didn’t disappear.

Up to that point, both Fauci and Trump had stuck to the scientific method. They made the same observation, advanced hypotheses and collected and analyzed the exact same data.

It’s what they did next that made the difference. Fauci’s predictions were affirmed when case and death rates grew as predicted. He communicated those findings.

In contrast, Trump’s hypothesis was NOT confirmed by what happened. Indeed the dramatically rising number of COVID cases and deaths are the exact OPPOSITE of what he predicted. If he were following the principles of the scientific method, Trump would be forced to revise his hypothesis. Instead he doubled down.

Why don’t COVID denialists see this? They can’t see it because they don’t understand the scientific method.

This is the denialist version of the scientific method:

Denialists suppose that science involves exploring random claims and deciding whom to believe based on emotion (intuition). That’s why they actually think they’re “educating” themselves by reading random Facebook pages and watching random YouTube videos. They really think they are doing their “research.” They imagine science is merely adjudicating between the claims of experts and those who disagree with them.

They have fallen prey to the logical fallacy, ‘argument from authority.’ They assume that science proceeds by determining which authorities to follow. They imagine they are “empowered” by adopting appealing claims from alternative “authorities” (quacks and charlatans) and not following the “sheeple” who simply believe acknowledged experts.

That’s why they drop into The Skeptical OB Facebook page to “educate” the rest of us by sharing outdated and incorrect citations. That’s why they offer links to other Facebook pages and YouTube videos. If science were really a beauty contest between competing claims those links might be persuasive. But science is NOT a contest of competing authorities. It is predicated on making predictions and then seeing what happens.

It isn’t a matter of whether you like Tony Fauci more or Donald Trump more. It isn’t a matter of whether you are find Tony Fauci’s claims more appealing than Donald Trump’s claims. The key to determining who is a better COVID scientist is how their PREDICTIONS hold up in the face of actual data. Tony Fauci’s predictions came true. Donald Trump’s did not. But that’s not what makes Fauci a far better scientist than Trump. It’s that real scientists revise their claims based on the outcome of their predictions but blowhards and fools do not.

Injuries and deaths resulting from COVID denialism are soaring. One reason is that there are no penalties for denialists. We ought to change that by applying 3rd party laws — requiring large financial payouts — to COVID denialists.

How? We can adapt existing 3rd party drunk driving laws.

Injuries and accidents resulting from drunk driving are a serious problem in this county, and many states extend liability for drunk driving injuries and fatalities to the persons or bars who provide the alcohol used in the hours preceding a crash. This 3rd party liability is known as social host liability laws (when the supplier is a host) or dramshop liability laws (when the supplier is a bar). These laws recognize that the person or business that facilitated the drunk driving bears responsibility for the outcome.

I propose using similar laws to hold COVID denialists — politicians, quacks, social media influencers — responsible for COVID infections and deaths under the theory that the person or business who denies the existence, the easy transmissibility or the deadliness of COVID-19 bears responsibility for the morbidity and mortality that results.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]By levying substantial fines, we could dramatically reduce COVID infections and deaths.[/perfectpullquote]

According to Mothers Against Drunk Driving, dramshop and social liability laws:

• Reduce alcohol-related crashes
• Increase publicity of the impacts of over-serving
• Decrease excessive and illegal consumption
• Does not decrease personal responsibility

Note that these laws do not imply that the bar caused the drunk driving accident, merely that by selling alcohol to someone obviously drunk the bar facilitated the accident. They do not discount the role of the person who chose to drive drunk; but they recognize that 3rd parties who facilitate drunk driving have a responsibility to prevent reasonably foreseeable consequences.

Obviously, the analogy between drunk driving and COVID denialism is imperfect, but the similarities are striking nonetheless:

• COVID denialists (like social hosts and bars) do not cause deaths directly.
• COVID denialists (like social hosts and bars) don’t intend that deaths occur.
• It is entirely possible that the injuries or deaths might have occurred anyway even if the COVID denialists (like social hosts and bars) were not involved.
• COVID denialists (like social hosts and bars in drunk driving) facilitate the behavior that leads to the infections and deaths.

The theory that undergirds 3rd party liability alcohol laws is straightforward. By holding bars and hosts responsible for the results of providing alcohol, it gives them a stake in the outcome. Before serving a drink to an intoxicated person, the bar or host must weigh the possibility of paying money or going to jail if serving alcohol leads to injuries or deaths.

Similarly, the theory that undergirds 3rd party liability laws for COVID denialists is also straightforward. By holding COVID denialists — politicians, quacks, social media influencers — responsible for the results of denialism, it gives them a stake in the outcome. Before encouraging denialism or promoting the refusal to take recommended health precautions the denialist must weigh the possibility of paying a substantial amount of money if infection or death results.

The anticipated advantages?

• Reduce COVID infections and deaths
• Increase mask wearing and other health precautions
• Increase publicity of the health impact of COVID denialism
• Does not decrease personal responsibility

Currently, because they bear no responsibility, there is no downside for COVID denialists like politicians, quacks and social media influencers. By levying large fines, I suspect we could dramatically reduce the number of politicians, quacks and social media influencers who promote denialism. More importantly, we could dramatically reduce the number of preventable COVID infections and deaths.

To stay healthy you need to eat right and exercise. Those who don’t can end up obese and sick.

To stay informed about science you need to read “right” and exercise your critical faculties. Those who don’t often end up intellectually flabby and sick.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Science denialists — be they COVID denialists, vaccine denialists or climate denialists — are intellectually flabby and sick.[/perfectpullquote]

Science denialists — be they COVID denialists, vaccine denialists or climate denialists — are intellectually flabby and sick.

Why? Because they subsist on a steady diet of scientific “junk food,” a diet that is exceedingly satisfying but very unhealthy.

How can they get back into shape?

The first step is to get people to improve their information diet. If you’re eating nothing but candy or toxic food you are going to get sick. If you can improve your … diet to include things that you like but also other things that might be challenging to you then you are going to have a much better understanding of life…

Right wing media creator Matthew Sheffield is talking about political information, but the same principle applies to science information.

For denialists, the science content they love best — Facebook, websites, YouTube — is intellectual junk food. Who wouldn’t adore a steady diet of fatty, sugary, salty processed snacks? But imagine that was all you ate. You would have trouble maintaining a healthy weight and might have difficulty fending off chronic illnesses like adult onset diabetes or heart disease.

To stay healthy, you need to eat a balanced diet that includes foods like fiber and vegetables you may not like. Those foods are healthy food. To stay intellectually healthy you need to read a balanced diet of sources including scientific sources that offer scientific information about COVID, vaccines or global warming that you may not like. Those sources are healthy sources.

Imagine what would happen if you decided that vegetables and fiber were “fake foods” and junk food was the only real food. Do you think believing — even believing fervently — that a diet of only junk food was healthy for you would keep you at a healthy weight? Do you think proclaiming loudly to yourself and other junk food lovers that you are the only ones who see past the lies of dieticians and public health officials would keep you from getting the chronic diseases associated with overweight and obesity? No and no.

Why? Because there is a reality independent of what you think. In reality a steady diet of junk food is not healthy no matter who might tell you it is and no matter how fervently you might insist that junk food is the only “real” food.

Science is like that, too. There is a scientific reality independent of what you think. In reality COVID is a widespread, deadly disease. In reality vaccines are safe and effective. In reality anthropogenic climate change is happening. And if you made a good faith effort to read and understand the scientific consensus you’d know that.

We can take the analogy to a healthy diet even further. Diet — even the healthiest diet — can only do so much. Exercise is also needed. Science information, even the best information for laypeople, tells you what to think. Exercising your mind teaches you how to think.

Instead of simply reading mainstream sources that tell you that COVID is both real and deadly, read books and articles on the scientific method so you can understand how scientists know what they know. Instead of simply dipping in to websites that tell you that vaccines are safe and effective, learn some basic statistics so you will understand how to interpret the existing data. Instead of watching YouTube videos that declare that anthropogenic climate change is happening, watch YouTube videos that detail the climate history of the past 100,000 years so you can understand why what is happening today differs so dramatically from all that has gone before.

How can you stay physically healthy? Eat a balanced diet that includes foods you may not like and exercise regularly. Neither guarantees that you will be healthy, but both together give you the best chance of remaining healthy.

How can you stay intellectually healthy in regard to science. Read a balanced diet of sources including those you don’t like. Exercise regularly by increasing your store of knowledge about basic science, statistics and public health. Neither guarantees that what you learn from scientists and public health officials will always be correct, but together they give you the best chance of becoming truly knowledgeable.

One of the greatest ironies of the alt-right is how conservatives have eagerly embraced previously despised attributes of liberals. After years of decrying political correctness, micro-aggressions and trigger warnings, we now have a group of people — COVID denialists — who think they are special snowflakes.

What’s a special snowflake?

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]When confronted with the “micro-aggression” of being required to wear a mask, they are “triggered” and react with narcissistic rage.[/perfectpullquote]

According to Urban Dictionary:

A malady … wherein the afflicted will demand special treatment, conduct themselves with a ludicrous, unfounded sense of entitlement, and generally make the lives of everyone around them that much more miserable.

The danger of this disease is that the sufferers rarely, if ever, know that they have contracted it, and continue about their merry way under the assumption that EVERYONE ELSE is the problem.

This condition, if left untreated, can radically alter the carrier’s demeanor, to include any of the following: a complete devolution to child-like behavior, temper tantrums, and/or fits of narcissistic rage.

Sound familiar?

In Florida, a shopper was recorded shoving a Walmart employee. In New Jersey, a man was charged with making terroristic threats when he allegedly became combative after being asked to leave a store. In Texas, a woman started flinging groceries from her cart after reportedly refusing to keep her mask on.

In California, two locations of a taco shop had to close after customers kept berating employees over the restaurant’s new mask policy.

It’s hard to imagine anything more child-like and narcissistic then the temper tantrums of COVID snowflakes who refuse to wear masks to prevent the spread of COVID-19. They assume they are entitled to ignore public health directives and transmit deadly diseases to others. In their immaturity and self-absorption, they actually pretend that everyone else is the problem. And when confronted with the “micro-aggression” of being required to wear a mask in stores or restaurants, they are “triggered” and react with narcissistic rage.

The actions of COVID snowflakes, which are inexplicable to most mature adults make perfect sense when viewed from the prism of the snowflakes’ heightened sense of both self-regard and grievance.

COVID snowflakes are everything they professes to despise about the “libs”: exquisitely sensitive to slights, self-absorbed and fragile.

Hi, folks! Jack Daniels here, spokesperson for CPRDD, the Committee to Promote Responsible Drunk Driving.

I’m sure you’ve seen newspaper accounts of horrific crashes that happened after someone drove drunk, but I’m here to tell you that just because a person died or killed someone else while driving drunk, does NOT mean that drunk driving led to those deaths.

Surprised? I’ll bet you are. But that’s because you’ve been subjected to the blandishments of Big Medicine working tirelessly to marginalize the role of alcohol in treating medical ailments. For hundreds of years surgery, from amputations to tumor removals, was performed with alcohol as the only anesthetic. Then along came doctors who could not tolerate the economic competition and marginalized medicinal use of alcohol just to protect their own incomes.

How do we know that drunk driving is a safe and responsible choice? There are many reasons, but before I list them, I want to give thanks to Ima Frawde, CPM (certified professional mask denialist) and her colleagues who have come up with these fabulous arguments; I’ve merely adapted them for drunk driving.

1. Sober drivers die, too.

If you listen to those shills from Big Medicine, you’d think that no one sober ever dies in a car accident. Sure some drunk drivers are killed or kill others, but that hardly means that driving sober can guarantee that you will live. Ice is a major cause of car accidents; fog is another, but no one tries to demonize ice or fog the way that they demonize drunk driving.

2. Over 99% of drunk drivers will make it home without killing themselves or others.

Sure, you see reports of spectacular drunk driving accidents blaring from newspapers and TV, but those are the rare cases. As the many, many people who have successfully driven drunk can tell you, most drunk drivers will arrive home safely.

3. Even when they crash, the death rate for drunk drivers and the people they hit is low.

To hear Big Medicine tell it, everyone who drives drunk will end up dead, but since that’s obviously untrue, drunk driving must be safe!

4. The people killed by drunk drivers often have pre-existing conditions.

We’ve all heard about people hit by a drunk driver who survived the initial accident but then died in the hospital of a heart attack or a complication of the surgery designed to save them. We can’t blame drunk drivers for their deaths! We must blame their underlying fragile health

5. God is my co-pilot

Nothing happens that God does not intend should happen. If He wants a drunk driver to arrive home safely, it will happen. If the drunk driver dies or kills someone that surely means that God intended those deaths.

6. Freedom!!!

Who is the government or Big Medicine to tell me that I can’t care for myself in the way that I think is best? Making sober driving mandatory is the first step toward world domination by jack booted thugs who will implant us all with data chips to control our minds.

There you have it, folks. These are just six of many reasons why drunk driving is safe. The next time you’re thinking about drinking and driving, remember, if those arguments are good enough to promote mask refusal, they’re good enough to promote anything.

Carl has done his research and believes stop signs don’t work. That doesn’t give Carl the “right” to ignore stop signs.

Masks are like stop signs.

The theory behind stop signs is that if you stop before entering an intersection, there’s less chance of being hit by another driver traveling through the intersection. If stop signs work, then every time you stop, you avoid a potential accident.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]There is no “freedom” to give others a deadly illness just as there is no “freedom” to ignore stop signs.[/perfectpullquote]

But suppose Carl doesn’t believe that stop signs work; or perhaps Carl believes that there are too many stop signs. Carl has done his research and made his own decision. Carl points out that he’s not blind. It is entirely possible to tell when another car is coming and stop only then. If the intersection is clear and Carl doesn’t believe that stop signs work, isn’t it his right to refuse to stop?

Isn’t the decision to stop at a stop sign a matter of personal freedom?

And if Carl is wrong and he’s T-boned at an intersection, what’s the problem if he’s willing to accept the responsibility?

It doesn’t take deep thinking to recognize that stop signs work best when everyone stops at them. Indeed, they work in large part because everyone stops at them.

Sure, if there’s great visibility at an intersection you can avoid other cars because you can see them coming. If Carl is barreling through the intersection, you can wait however long it takes for him to get through the intersection before you move into it.

But what if visibility is poor and you can only see cars that are very close to the intersection? In that case, simply stopping at the stop sign before entering the intersection is not enough to protect you. You could be T-boned by Carl because you didn’t see him coming, and he was too far away to see you entering the intersection in time to stop. In other words, you could be injured or killed even though you stopped at the stop sign.

How can that happen if stop signs work? Doesn’t the mere fact that accidents like these can and do happen prove that stop signs don’t work?

No and no.

Stop signs do protect people who heed them even when others do not. But stop signs work best when everyone heeds them. Even if only one person ignores a stop sign, multiple people can be killed. Indeed, it happens nearly every day when people ignore stop signs because they are drunk or they are in a rush.

Masks are like stop signs. They work to protect those who wear them, just as stopping at a stop sign protects those who do. But they work best when everyone wears them, just as stop signs work best when everyone can be counted on to stop.

But what about Carl who has done his research and concludes that the fact that stop signs don’t always protect people means that they don’t work? Does he have the right to refuse to stop because he believes that stop signs are ineffective or harmful? I suspect that most people, even the most ardent libertarians, believe that Carl’s rights don’t cover refusing to stop at stop signs.

Why not? Because stopping at stop signs is a public good and the burden of stopping even if Carl does’t want to do so — and even if Carl believes it doesn’t benefit him to do so — is outweighed by the tremendous harm that is prevented.

Masks are like that, too. The extensive rights enjoyed by people in a free society don’t extend to an ethical right to refuse masking. Some things — like stop signs and masks — work best when everyone does them. Masking to prevent COVID is a public good that prevents tremendous harm to others. Refusing to wear a mask is immoral.

There is no “freedom” to give others a deadly illness just as there is no “freedom” to ignore stop signs.

Dear Mr. Zuckerberg,

It must be extremely difficult to run Facebook, a multi-billion dollar business spread around the globe. A lot of things are automated — for obvious reasons —and therefore subject to unforeseen error. That’s why I suspect you never intended for Facebook to become an instrument to censor science communicators. But sadly, that’s what has happened.

Facebook allows the anti-science mob to shut down the pages of doctors and scientists who dare to provide accurate information about the COVID-19 pandemic, just as it has been allowing the mob to shut down pages of doctors and scientists who dare to provide accurate information about a myriad of scientific issues. How? By automating the complaint process, Facebook lets the mob “vote” against scientific information it doesn’t like.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]There should be a special category of Facebook page for science communicators requiring a higher level of complaint vetting.[/perfectpullquote]

For example, in April 2019 I was banned from Facebook for 24 hours for daring to note a scientific fact: I was banned for calling into question the naturalistic fallacy by pointing out that while unmedicated vaginal birth and breastfeeding are natural, so is rape.

Entire books have been devoted to this issue, including A Natural History of Rape: Biological Bases of Sexual Coercion. Predictably, some people were upset, reasoning — wrongly — that if rape is natural, it must follow that rape is excusable. Ironically, they were demonstrating the point I had set out to prove: that natural childbirth advocates and lactivists have become blind to the real meaning of the word “natural.”

The mob reported my post for using the word ‘rape’ and the post was removed and I was banned from Facebook for 24 hours. In other words, Mr. Zuckerberg, you let the mob censor me, a science communicator, because I offended their unscientific sensibilities.

Now I’ve been banned for 7 days for daring to promote masking during the ongoing COVID-19 pandemic. I wrote a post suggesting — tongue in cheek — A Modest Proposal: No COVID Coverage For Anti-Maskers:

How can we combat health conspiracies among anti-maskers, people who don’t understand or don’t believe scientific evidence? I suggest a simple expedient; insurance companies should refuse to pay for COVID-19 infections and complications of those who refuse to follow public health recommendations on masks and social distancing.

The post reached tens of thousands of people and generated nearly 2,000 comments, most of them from hysterical anti-maskers. When their “arguments” and insults failed to convince me that masks are unnecessary, they “voted” their dissatisfaction by reporting the post to Facebook.

Mr. Zuckerberg, for the life of me I can’t understand what community standards the post has violated. Perhaps you have more insight into my supposed malfeasance, but it doesn’t matter. The mob has convinced Facebook to punish me and — because I had a previous (inappropriate) punishment on my record — I have been banned for 7 days. Of course I appealed, but I have heard nothing.

Fortunately, I have a co-administrator who can still post but I’m calling on that person sparingly to avoid that person being banned.

So here’s my question, Mr. Zuckerberg: why do you allow the mob to censor science communicators on Facebook?

Is it, as I hope, unintentional? Is it an unintended consequence of being forced to rely so heavily on automation? If so, I have a proposal that I hope you will consider:

Could you create a special — verified — category of Facebook page for science communicators that would trigger a higher level of complaint vetting? Once you verified the professional qualifications of the doctor, scientist or science journalist, those pages would no longer be subject to banning on the basis of the volume of complaints but would require human scrutiny before posts were removed or writers censored. This would effectively disempower the mob and free science communicators from their wrath.

I recognize that would involve more work, and therefore less profit. So why would you do it? I hope you would do it to keep the world safe for science. Do you want your children to grow up in a world where doctors, scientists and science communicators can be easily muzzled by an angry mob that despises them? Or do you want them to grow up in a world where science and education are venerated?

It’s your choice, Mr. Zuckerberg. Please do the right thing and accord science — and science communicators — the respect they deserve.

Contemporary midwives and their advocates suffer from a lack of imagination. They view childbirth in Manichean terms, pitting the so-called midwifery model against the so-called biomedical model. It’s a false duality.

There is a framework for maternity care that rises above both. It’s a framework that should govern the provision of all childbirth care. I call it the choice-centered model of childbirth.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Choice-centered childbirth puts control back to where it belongs: with mothers themselves.[/perfectpullquote]

How did we arrive at a false duality?

Modern obstetrics has been spectacularly successful. Science based childbirth has led to an extraordinary drop (over 90%) in both perinatal and maternal mortality in only 100 years.

Indeed, as Dr. Atul Gawande has noted:

Nothing else in medicine has saved lives on the scale that obstetrics has.

Moreover, modern obstetrics has made childbirth more easily endurable. Epidural anesthesia has freed women from pain so excruciating that the ancients could only imagine it as a punishment from God.

In response to their loss of market share to science-based childbirth, midwives have spent the past 40 years promoting grievance-based childbirth.

Grievance-based childbirth starts from the assumption that midwives “own” childbirth and doctors have stolen it from them. It postulates — laughably — that doctors medicalized childbirth for their own benefit and ignores the fact that obstetricians have made childbirth safer in three generations than midwives managed in thousands of generations.

Grievance-based obstetrics insists – preposterously and with no evidence — that childbirth prior to modern obstetrics was a peak spiritual experience for women and that doctors have stolen that imaginary experience away from them.

Of course, midwives don’t refer to it as grievance-based childbirth; they wouldn’t attract many customers by accurately portraying their attempt to claw back market share. They call it “natural” childbirth even though the only thing natural about it is midwives’ lack of life-saving skills.

The false duality of natural childbirth vs. biomedical childbirth results from a fundamental misunderstanding of the locus of control in childbirth. Midwives imagine that childbirth should be governed by their preferences as opposed to by the preferences of obstetricians. Choice-centered childbirth puts control back to where it belongs: with mothers themselves.

In choice-centered childbirth, all choices are valid.

– The choice to forgo interventions is valid as is the choice to opt for maximal interventions.
– The choice to experience the pain of childbirth is valid as is the choice of an epidural.
– The choice to wait for labor to begin on its own is valid as is the choice for induction.
– The choice to avoid a C-section is valid as is the choice to have one by maternal request.
– The choice to room-in is valid as is the choice to send a baby to the nursery.
– The choice to breastfeed is valid as is the choice to formula feed or combine both.

As a result, childbirth education would involve presenting the complete menu of existing choices, not just the ones of which midwives approve.

In others words, midwives and natural childbirth advocates would be forced to respect women’s choices instead of trying to manipulate them. How radical!

A new study shows — yet again — that breastfeeding has NO benefit for cognitive development.

Let’s start with the money quote from Associations between breastfeeding and cognitive function in children from early childhood to school age: a prospective birth cohort study published yesterday in the International Breastfeeding Journal:

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Any observed benefit of breastfeeding on cognitive development DISAPPEARS when corrected for maternal IQ.[/perfectpullquote]

Breastfeeding should not be interpreted to have medical benefits for cognitive development.

The key point in the study is that any observed benefit of breastfeeding on cognitive development DISAPPEARS when corrected for maternal IQ.

The authors started with the following premise:

Despite evidences of breastfeeding for preventing acute physical illnesses in infants, the evidence for the association between breastfeeding and long-term cognitive development is not yet convincing.

How did they test the premise?

The data of nationwide representative sample of 1752 children born between 2008 and 2009 in Korea were prospectively assessed from the fetal period to examine the benefits of breastfeeding and cognitive development. Breastfeeding duration was prospectively assessed by parents. The Korean Ages and Stages Questionnaire and the Korean version of Denver II were used to assess early development annually from 5.5 to 26.2 months of age. Language development at 3 years of age was assessed with Receptive and Expressive Vocabulary Tests. Cognitive function at 8 years of age was assessed using multifactorial intelligence test.

What did they find?

The following chart shows the comparison of cognitive scores on a variety of tests at various ages based on the duration of breastfeeding. Statistically significant differences appear in bolded type. (Full size chart here.)

At the far right of the chart is the crude comparison between children who were ever breastfed and children who were never breastfed. Only 2 of the 9 cognitive tests showed statistically significant differences. The rest showed no difference.

But even those few statistically significant differences DISAPPEARED when adjusted for children’s sex, age, gestational age, birth weight, parental educational level, and household income level (circled results).

In other words, any observed differences in IQ were the result of factors OTHER than breastfeeding.

The authors conclude:

… Many previous studies support the finding that there are positive associations between breastfeeding and cognitive development. However, the mean difference (effect size) in cognitive development due to breastfeeding was only 3.44 points (about one-third of a standard deviation), which is reduced again by the adjustment for maternal IQ. Considering these findings comprehensively, breastfeeding is not considered a critical factor in the cognitive development of children. Other studies have also reported that the observed advantage of breastfeeding on IQ score is actually due to genetic and socioenvironmental factors. When the results are adjusted for covariates such as maternal IQ, the effect of breastfeeding on cognitive function was insignificant. Thus, breastfeeding should not be interpreted to have medical benefits for cognitive development…

This should not be news to anyone who has followed breastfeeding research in for the past decade.

In 2014 the study, Is Breast Truly Best? Estimating the Effects of Breastfeeding on Long-term Child Health and Wellbeing in the United States Using Sibling Comparisons was published by Colen and Ramey.

The authors looked at the impact of breastfeeding on 11 different variables (including several measurements of cognitive development) in three different groups. There were difference between breastfed and bottle fed children in 10 of the 11 measured variables when looking at children overall. Those differences persisted when comparing families in which all the children were breastfed to families where all the children were bottlefed. But when the authors looked within families, there was no significant difference between breastfed and bottle fed children.

Looking within families takes ethnic, cultural and socio-economic factors out of the picture. When you do that, you find NO difference (including NO cognitive difference) between breastfed and bottlefed children.

In other words breastfeeding is a proxy for other factors that impact cognitive development. Since women who breastfeed are more likely to have higher IQ, higher educational achievement and higher socio-economic status, their children end up with higher IQ. It’s NOT the breastfeeding that causes the increased IQ, it’s the maternal advantages that lead to the resulting enhanced cognitive development.

What does this mean?

While every mother should be able to breastfeed for as long she wants to do so, there is NO reason to feel guilty if you don’t want to breastfeed or don’t want to breastfeed for long.

Hold the guilt! The benefit of breastfeeding on cognitive development has been overstated. It is time to correct our advice to mothers to reflect the real benefits of breastfeeding, not imagined benefits that don’t exist.