Hi, there, it’s Ima Frawde, Tooth-wife and I’m here to educate you about Spiritual Tooth-wifery.

I trained as a dental hygienist but that doesn’t sound particularly impressive — especially when compared to dentists who have initials like DMD and DDS after their names — so my friends and I created our own credential, the RTW (registered tooth-wife). The RTW signifies that we are experts in normal teeth. It’s an awesome credential because you don’t need any education or training, just the desire to hoodwink unsuspecting clients and the $450 fee.

But I digress.

Tooth-wives are sick and tired of dentists infringing on our turf by medicalizing teeth. Teeth are perfectly designed by nature, but you’d never know that if you fall for the dentocratic model of tooth care promoted by dentists. Between filling cavities, extracting teeth and drilling root canals dentists have encouraged people to fear the state of their teeth.

In contrast, tooth-wives promote the holistic tooth-wifery model of care. We trust teeth! That’s why tooth-wives should serve as gatekeepers to dental care. You’re only allowed to see a dentist if we approve … and we rarely approve.

Dentists criticize tooth-wives for demonizing interventions, but that’s simply untrue. We vigorously promote home tooth-brushing, home flossing and we recommend and provide professional tooth cleaning every 6 months. These are spiritual practices that empower individuals to take control of their own tooth care.

We do reject dentocratic practices like X-rays; we trust intuition instead. Dental X-rays could be wrong whereas intuition about the state of your teeth is always right. If you don’t feel like you have a cavity then there’s no need to check.

And if your intuition tells you that you need an intervention like a root canal, we can transfer your care to a dentist, but ONLY if we agree that you need one. After all, we are experts in normal teeth and we know that many sources of mouth pain — even excruciating mouth pain — are simply variations of normal.

We are also available to accompany you to the dentist’s office (for a fee) where we encourage you to reject recommended treatments if at all possible. However, if you do opt to undergo dentocratic interventions we will stay with you, hold your hand and prevent you from getting Novocaine. Tooth pain is natural and abolishing it with chemicals numbs you to the spiritual power of taking responsibility for your own pain. Our motto: “no tooth pain, no joy!”

Don’t think you can stand the pain of a root canal without anesthesia? Try hypno-toothing! For the low, low price of $800 we offer courses of multiple sessions to teach you to hypnotize yourself into ignoring the pain. But before you do anything else, you must purchase your own copy of Spiritual Tooth-wifery. It’s filled with stories of women who were empowered by employing tooth-wives and taking control of their own tooth care.

Educate yourself! Trust teeth! If you do you’ll never again fall for the dentocratic model of care and you’ll demand holistic tooth-wifery care for all the years until your teeth naturally fall out.

Three words provoke horror in natural childbirth advocates: maternal request Cesarean!

How dare women choose to bypass the excruciating pain and terror of hours of labor and vaginal birth?

How dare women do everything possible to protect the health and brain function of their children?

How dare women take control of their own bodies to protect against future incontinence?

These prospects appall most midwives and natural childbirth advocates, hence the outsize attention paid to maternal request C-sections despite the fact that they represent less than 1% of births.

But a new study shows — yet again — that C-sections are safer for babies.

Determinants and outcomes of cesarean delivery on maternal request (CDMR): A population-based study in Ontario, Canada was published in May 2020.

Of 668,468 women, 0.7% (4,821) planned CDMR and 85.6% (569,212) planned vaginal deliveries… Older age, higher education, IVF, anxiety, nulliparity, Caucasian race and maternal level IIc hospital deliveries were associated with CDMR.

What did they find?

Women who planned CDMR had fewer adverse outcomes than women who planned vaginal deliveries (aRR:0.59 [95% CI 0.52–0.67]). The WAOS [Weighted Adverse Outcome Score] was lower for planned CDMR than planned vaginal delivery (2.6 v 3.6)…

Conclusions
CDMR rates have not increased in Ontario over the last 5 years. Planned CDMR is associated with decreased risk of short-term adverse outcomes, compared to planned vaginal delivery…

Why would C-sections be safer for babies? Because birth (vaginal birth in particular) puts them at risk for all sorts of injuries.

The paper Neonatal Morbidity and Mortality After Elective Cesarean Delivery by Signore and Klebanoff appeared in the June 2006 special issue of Clinics in Perinatology focussing on the epidemiology and neonatal effects of C-section.

The authors conducted a decision analysis:

…modeling the probability of perinatal death among a hypothetical cohort of 2,000,000 women who had uncomplicated pregnancies at 39 weeks, half of whom underwent ECD and half managed expectantly. After taking multiple chance probabilities into account, the model estimated that although neonatal deaths were increased among women delivered by elective cesarean, overall perinatal mortality was increased among women managed expectantly, because of the ongoing risk for fetal death in pregnancies that continue beyond 39 weeks.

They found that C-sections were dramatically safer for babies:

In other words, if 1 million women underwent C-section at 39 weeks instead of waiting for onset of labor and attempting vaginal delivery, 692 more babies would be saved, 517 cases of intracranial hemorrhage and 377 brachial plexus injuries would be prevented. In exchange, there would be 8476 additional cases of short term respiratory problems and 5536 neonatal lacerations.

But wait! Midwives and natural childbirth advocates insist that C-sections increase the risk of maternal death. To support that claim they present papers that show that maternal death rates for C-sections are higher than for vaginal birth. Sure, just like people who spend time in ICUs have higher death rates than those who do not. The individuals in the former group are sicker than those in the later group. They don’t die because of the C-sections; they die in spite of them for the same reasons that they had the C-section in the first place: pre-existing medical conditions and severe complications of pregnancy.

That doesn’t mean that C-section is a trivial procedure. It is major surgery with all the risks that major surgery poses to anyone. Though the Ontario paper does not show it, vaginal birth is probably safer for mothers in the short term, though it does dramatically increase the risk of future pelvic organ prolapse and urinary incontinence in the long term.

The balancing of risk to the baby and risk to the mother is best done by the mother herself. If a woman can elect to have a homebirth, then surely she has a moral right to elect to bypass labor and have a C-section. C-sections are undoubtedly safer for babies and offer mothers both short and long term advantages. Mothers — not midwives or natural childbirth advocates — are best equipped to weight the risks and benefits for themselves.

Here’s a recent comment from The Skeptical OB Facebook page:

I love how this page tries so desperately to falsely reassure obese people that it’s ok to be obese and there will be no long term complications to your health. It’s mental snake oil and people are eating this page up.

It’s similar to many comments over the last few day. The morally conceited apparently can’t tell the difference between health and moralizing about health.

The comments were precipitated by a series of posts and memes that called attention to the harms of health moralism.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Their devotion to the “health” of others allows the morally conceited to feel morally superior.[/perfectpullquote]

I noted that thin people feel superior to those who are overweight; that appeals to health involve moral assumptions, as well as power and privilege; and that we are hypocrites: demeaning those who risk their health by being overweight while venerating those who risk their health (and brain function) by playing pro football.

I didn’t think the argument was particularly sophisticated but clearly I was wrong. Many people confused my opposition to health moralism with opposition to health. Nothing could be further from the truth.

What’s the difference between health and health moralism? Health is a state of being; health moralism is a method of controlling others. I’m entirely in favor of people being healthy but I strongly oppose efforts to control personal behavior under the guise of promoting health.

Why? Because health moralism is astoundingly arrogant and often harmful TO health.

Consider this excoriation of preventive care by David Sackett, MD a pioneer of evidence based medicine. It’s really an excoriation of health moralism.

First, it is aggressively assertive, pursuing symptomless individuals and telling them what they must do to remain healthy. Occasionally invoking the force of law …, it prescribes and proscribes for both individual patients and the general citizenry of every age and stage.

Second, preventive medicine is presumptuous, confident that the interventions it espouses will, on average, do more good than harm to those who accept and adhere to them.

Finally, preventive medicine is overbearing, attacking those who question the value of its recommendations.

The moral panic over the “obesity epidemic” is a classic example.

Of course morbid obesity is a serious health problem with potentially deadly consequences. However, simply being overweight is not only safe, but actually appears to be protective compared to “ideal” weight. That’s what the scientific evidence shows.

Despite that:

– Health moralism pursues healthy individuals and tells them they are ill or will soon be ill.

But the truth is that you can be overweight and healthy.

You’d never know that from the disgust toward the overweight.

– Health moralism assumes that any problem experienced by an overweight person is due to weight.

But you can be overweight and ill and your illness is not caused or even affected by overweight.

You’d never know that from the harms that overweight people experience when trying to get care for health problems. They are often told that their problems are due to weight when they are completely unrelated.

– And, as the comments on my Facebook page demonstrate, health moralism is incredibly defensive, attacking anyone who questions their effort to judge and control the behavior of others.

You can recognize that overweight is a risk factor for — NOT an inevitable prelude to — illness without condemning those who are overweight.

But you’d never know that from morally conceited fatphobes who feel entitled to rage against any effort to treat overweight people honestly and with respect.

Do you tell yourself you and your friends are the only ones who see the lies?

Do you mock those who believe in expertise or follow the mainstream media?

Do you deride as “sheeple” those who respect authority?

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Have you failed to notice you are being led over a cliff?[/perfectpullquote]

The joke’s on you!

You are a denialemming … so busy reassuring yourself of your insight and independence that you have utterly failed to notice you are docilely being led over a cliff.

If it weren’t so tragic it would be hilarious! You have become everything you claim to despise: gullible, biddable, tractable. Why? Because you have failed to see the big picture.

The big picture is not, as you have been told, that educated elites are misleading you. The big picture — which you could see if only you had a modicum of intelligence and awareness — is that no one attempts to subvert trust in authority figures unless planning to supplant it with their own authority for their OWN benefit, NOT your benefit.

But what about the conspiracies, the elite efforts to fool you about vaccines, climate change, COVID and the presidential election? Those are figments of your imagination. There IS a conspiracy, though, but it’s a conspiracy to manipulate denialemmings like YOU. You haven’t protected yourself from THAT conspiracy; you haven’t even merely fallen for it; you have happily jumped over the cliff to your own destruction.

COVID is the paradigmatic example.

COVID has always been deadly, easily transmissible but impeded by simple public health measures like masks. Yet Trump lied about it and you — gullible fool that you are — believed him. You took power away from doctors and scientists and handed it to Republican politicians.

The result? Millions were sickened and hundreds of thousands died while denialemmings pretended otherwise. Refusing a mask didn’t mark you as “free”; it branded you as easily manipulated and mind bogglingly stupid.

Climate change is similar. The planet is warming rapidly due to human beings and the deleterious results are already being felt. Yet Big Business and the politicians in their pay lie about it and you — gullible fool that you are — believe them. You take power over your life and health away from scientists who care about you and give it to business and politicians who care only about themselves. Denying climate change doesn’t mark you as clever; it brands you as easily manipulated and pathetically naive.

Make no mistake: COVID denial, climate denial and election denial ARE conspiracies about power and money. But they’re not about the power and money of experts but rather the power and money of politicians, quacks and charlatans.

Sadly, denialemmings like you haven’t got a clue. You are so busy laughing at the “sheeple” that you have failed to notice that you are being manipulated right over a cliff.

The most common mistakes of science denialists are mistakes of logic. They assume that what “makes sense” to them is automatically true. Thomas Kida, a professor at the UMass Isenberg School of Management, explains why this assumption is unjustified in his book Don’t Believe Everything You Think: The 6 Basic Mistakes We Make in Thinking.

The 6 mistakes are:

Mistake #1: We prefer stories to statistics. Stories are easy to understand; statistics are hard. The problem is that particular stories which may not be representative while statistics, which are merely the aggregation of thousands or millions of stories, offer a realistic assessment of what typically happens. Antivaxxers’ striking reliance on anecdotes shows how alternative health advocates embrace this mistake.

Mistake #2: We seek to confirm our opinions, not challenge them. Homebirth advocacy is a perfect example of this mistake. To my knowledge, there is not a single homebirth advocacy website or publication that contains accurate information about homebirth. Nonetheless, homebirth advocates actually think that they have done “research” simply because they read the opinions of others who agree with them. In contrast, they generally make no effort to read websites and publications by those who offer information that does not support predetermined conclusions.

Mistake #3: Lay people often do not understand chance and coincidence. Most people have no idea of incidence of various risks. They grossly overestimate the chances of rare events and grossly underestimate the chances of common events. Antivaxxers vastly overestimate the chances of injury from a vaccine, while simultaneously dramatically underestimating the chance of death from from the disease it is designed to prevent (a risk often more than a thousand times higher).

Mistake #4: Our personal perceptions about what is happening are often wrong. Unfortunately, the level of confidence in our perceptions is often entirely unjustified.

Mistake #5: We tend to oversimplify our thinking. Oversimplification is easy; reality is hard. While some simplification is necessary, particularly for lay people when first learning about complicated concepts, we must always keep in mind that simplification introduces distortions. Simplification is the merely the first step in thinking about complicated issues. It does not lead us to correct conclusions.

Mistake #6: Our memories are often inaccurate. This has actually been studied quite extensively. People tend to alter their memories to create a “narrative” that makes sense to them. Reality is not a narrative, however.

These mistakes are a vestige of the thinking processes that served us well in the hundreds of thousands of years of evolution in the wild. Statistics did not exist, so stories were the best way that we had to understand the world around us. Our perceptions were all we had available to us, and oversimplification is almost always the first step to understanding. In other words, there was a time when reasoning from what “makes sense” was the only thing that we had. Now those methods have been superceded by other, more accurate methods, but some people are still stuck in the past.

The typical science denialist does not know about or does not understand the new, more accurate methods for evaluating the world around us. Denialists believe what they think because they literally do not know better.

My email and Facebook messages are filled with the same question over and over again:

Are the new COVID vaccines safe for use in pregnancy?

I don’t know … and the truth is that no one knows.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]The truth is that no one knows.[/perfectpullquote]

Yet the American College of Obstetrician Gynecologists (ACOG) is recommending the vaccine for pregnant persons.

They have issued the following guidance:

ACOG recommends that COVID-19 vaccines should not be withheld from pregnant individuals who meet criteria for vaccination based on ACIP-recommended priority groups.

My personal view is that ACOG has been too quick in issuing recommendations. They risk their credibility — and in a climate of active vaccine skepticism in the US — the credibility of all vaccine recommendations by getting out ahead of the data.

I’m not sure why they felt the need to make any recommendation at this time. The latest information in their own journal suggests a more cautious approach.

According to Coronavirus Disease 2019 (COVID-19) Vaccines and Pregnancy; What Obstetricians Need to Know:

Because pregnant persons were excluded from the initial phase 3 clinical trials of COVID-19 vaccines, limited data are available on their efficacy and safety during pregnancy. After developmental and reproductive toxicology studies are completed, some companies are expected to conduct clinical trials in pregnant persons. Until then, pregnant persons and their obstetricians will need to use available data to weigh the benefits and risks of COVID-19 vaccines.

There are a myriad of factors to be considered:

• Data from animal studies (once developmental and reproductive toxicology studies become available)
• Lack of data on pregnancies during vaccine clinical trials
• Risks of vaccine reactogenicity, including fever; treatment with antipyretic medications (eg, acetaminophen) might reduce this risk
• Timing of planned vaccination during pregnancy
• Extensive evidence for safety of other vaccines during pregnancy
• Risk of COVID-19 complications due to pregnancy (increased risk to pregnant person of severe disease and death)
• Risk of COVID-19 complications due to underlying conditions (eg, diabetes, obesity, heart disease)
• Risk of COVID-19 to fetus or newborn (intrauterine transmission is rare, but preterm birth appears to be increased)
• Risk of exposure to SARS-CoV-2 and potential for mitigation with working from home, wearing masks, and physical distance

This is a uniquely difficult situation for three reasons: we don’t fully understand the disease in non-pregnant people; we don’t know whether the disease impacts the embryo or fetus; we have no experience at all with this new type of mRNA vaccine since there has never been another one like it.

Make no mistake: at the moment there is no evidence that the new vaccines are harmful to pregnant persons or their unborn babies.

The odds are high that the vaccine is safe and offers real, important protections during pregnancy. But good odds are no substitute for scientific data, and in my judgment, professional organizations should not make recommendations in the absence of data.

What does that mean for you if you are offered one of the new COVID vaccines during pregnancy?

It means — in my view — that the decision to accept or forgo the vaccine should be based on your specific circumstances, not based on a blanket recommendation.

Keep in mind that this is both a rare and a temporary situation. It’s a rare situation because the disease is relatively new, the vaccine was developed very quickly and we don’t have much data on the short and long term risks of either.

It’s temporary because going forward we will be gathering massive amounts of data on the disease, the vaccine and the impacts of both on pregnancy.

A year from now we will have a much better idea of whether pregnant people should take the vaccine. Until then, I believe we should honestly tell the public that we don’t know.

Over the past four years it has become increasingly clear that many Americans are suffering from the sickness of science denial. It’s a dangerous infection that profoundly weakens the body politic, is transmitted through the air(waves), and mutates easily, making it difficult to control.

As with any illness it helps to recognize the symptoms so you protect yourself.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]When someone displays see one or more of these symptoms, run in the opposite direction.[/perfectpullquote]

There are six cardinal symptoms of science denialism:

1. The secret knowledge symptom: When someone implies they are sharing secret science knowledge with you, ignore them. There is no such thing as secret science knowledge. In an age where there are literally thousands of competing scientific journals, tremendous pressure on researchers to publish papers, and instantaneous dissemination of results on the Internet, nothing about science could possibly be secret.

2. The giant conspiracy symptom: In the entire history of modern science, there has NEVER been a conspiracy to hide lifesaving information among professionals. Sure, an individual company may hide information in order to get a jump on competitors, or to deny harmful effects of their products, but there can never be a large conspiracy because every aspect of science is filled with competitors. Vast conspiracies, encompassing doctors, scientists and public health officials exist only in the minds of denialists.

3. The flattery symptom: Purveyors of science denialism invariably try to flatter those they seek to infect by implying that the potential victims are uncommonly smart, insightful and wary. They portray non-believers as “sheeple” who are content to accept authority figures rather than think for themselves. But a real scientists does not need to flatter you and would not waste the time to do so. He or she knows what is true and what isn’t and shares that information whether it makes you happy or is the last thing you want to hear.

4. The toxin symptom: I’ve written before that toxins are the new evil humors. Toxins serve the same explanatory purpose as evil humours did in the Middle Ages. They are invisible, but all around us. They constantly threaten people, often people who unaware of their very existence. They are no longer viewed as evil in themselves, but it is axiomatic that they are released into our environment by “evil” corporations. There’s just one problem. “Toxins” are a figment of the imagination, in the exact same way that evil humours and miasmas were figments of the imagination.

5. The “brilliant heretic” symptom: The typical science denialist often has no training in the relevant branch of science. No problem. A pervasive theme in science denialism is the notion of the brilliant heretic. Believers argue that science is transformed by brilliant heretics whose fabulous theories are initially rejected, but ultimately accepted as the new orthodoxy.

The conceit rests on the notion that revolutionary scientific ideas are dreamed up by mavericks, but nothing could be further from the truth. Revolutionary scientific ideas are not dreamed up; they are the inevitable result of massive data collection. Galileo did not dream up the idea of a sun-centered solar system. He collected data with his new telescope, data never before available, and the sun-centered solar system was the only theory consistent with the data he had collected.

6. The “quantum” symptom: Science denialists love to baffle followers with bullshit, hence the invocation of esoteric scientific theories that they don’t understand. Quantum mechanics and chaos theory are two incredibly abstruse scientific disciplines, heavy on advanced math. If you don’t have a degree in either one, you aren’t qualified to pontificate on them.

There is a saying in science that “extraordinary claims require extraordinary evidence.” Denialists’ claims are typically extraordinary, but denialists don’t offer evidence. Instead they display some or all of the six symptoms in an attempt to trick you into buying what they are selling, and they are invariably selling something. When someone displays one or more of these symptoms, you can be virtually certain that you are in the presence of full blown science denial. To avoid being infected don’t walk — run — in the opposite direction.

Hi, folks, Ima Frawde here. I spend every working day denying the safety and effectiveness of vaccines, denying the reality of climate change and denying the deadliness of the COVID pandemic.

How do I relax?

I’m a football fan! I spend all my free time watching football, following my team on social media and reading about my team on fan websites.

My team is going to win the Super Bowl!

How do I know? Because football is just like science denial.

1. Our quarterback, the captain of our team, says we’re going to win the Super Bowl.

Just like with science denial, I always trust the claims of our leader.

2. Our fans say we’re going to win.

Just like with science denial, it always helps to associate exclusively with others who already agree with you.

3. I’ve watched extensive film of our team winning and compared it to extensive film of other teams losing.

As in science denial, you must cherry pick the data.

4. I’ve seen our team play mini-golf against other teams and they always win.

If you only watched the YouTube videos of our team winning at mini-golf you’d be equally impressed, too.

5. We won every game in the first half of the season.

Sure sportscasters often declared that our opponents won, but as I tell my fellow science denialists you can’t believe the mainstream media.

6. We also won every game in the second half of the season.

Yes the refs declared that we lost those games, but just as everyone knows scientists are paid to say whatever government or industry wants them to say, everyone knows refs are paid by the NFL to say which team won regardless of what really happened.

7. We had an undefeated season!

Like science denialists, true fans never change their minds based on actual evidence.

Wait, what? The only way you can tell which team is best is by having them play other teams and accepting the outcome of the contests?

Surely you’re joking.

As a professional science denialist I can assure you that would never work!

Science denialists believe the opposite of scientists.

Science shows that vaccines are safe and effective; anti-vaxxers believe they’re neither.
Science shows that the earth’s climate is changing as a result of human activity; climate denialists either claim it isn’t changing or the change is not the result of humans.
Science shows COVID-19 is a coronavirus that causes serious illness; denialists either deny its existence or its severity.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Determining scientific truth requires being willing to change conclusions based on new evidence.[/perfectpullquote]

How we do we know what is true?

It’s NOT, as many denialists think, by deciding WHO to believe. You can’t determine scientific truth merely by deciding that Donald Trump knows more science than Dr. Tony Fauci.

It’s NOT even, as other denialist think, by deciding WHAT to believe. You can’t determine scientific truth by deciding that YouTube videos present a more compelling case for a particular belief than scientific papers.

Rather, scientific truth is determined by HOW to believe.

Science is a process.

As the authors explain in Enquiry and Normative Deviance; The Role of Fake News in Science Denialism:

Science denialism doesn’t merely involve a rejection of a scientific theory — otherwise scientists themselves would count as science deniers given that they would reject theories on the basis of their explanatorily inadequacy. Rather, science denialism deeply challenges the practice [of] impartially testing research methods, theories, and evidential sources with the aim of improving the accuracy of scientific theories.

That’s because science isn’t about specific beliefs; it’s about evidence and how we use it. Simply put, science requires two things:

First, determining scientific truth requires following all available evidence to logical conclusions.

That’s why science denialists hold beliefs that are inevitably false:

Instead of attempting to find ALL available evidence, denialists use only evidence that is offered to them by other denialists.

Instead of assessing ALL evidence, denialists assess only some, carefully cherry-picked pieces of data.

Instead of incorporating the MOST sophisticated scientific evidence (by reading and understanding scientific papers) denialists rely overwhelmingly on the LEAST sophisticated forms of data that can be easily transmitted in bite sized amounts by web pages and YouTube videos.

Second, and even more importantly, determining scientific truth requires changing conclusions based on new evidence.

What does that mean in practice?

It means acknowledging the LIMITATIONS of the existing data.

Scientific papers usually contain a section near the end that explicitly acknowledges that the existing data might have led to erroneous conclusions perhaps because not enough data was collected or because the data was inadvertently collected from a non-representative sample.

It means interrogating your own conclusions for ALTERNATIVE explanations.

In the same section of the scientific paper acknowledging the limitations of the existing data, there is usually a few sentences or a paragraph entertaining alternative explanations for the existing data and making a case for why those alternative explanations are not supported by the data.

It means acknowledging that the conclusion may change and SHOULD change if future data contradicts it.

Lay people often point to changes in scientific belief as if they reflect a weakness of science. But the willingness to follow additional evidence to a new (even an opposite conclusion) is the great STRENGTH of science.

It means testing to see if you are wrong by considering, reading and attending scientific meetings with those who disagree.

Scientific truth can only be found in contentious communities that deeply engage those with whom they disagree. Denialism, in contrast, takes place in supportive communities (information silos) that drastically limit the data available, misrepresent those who disagree and never, ever directly engage with them publicly.

In other words, the ONLY way you can tell whether a scientific claim is true is by having it compete with other claims on a level playing field and being willing to accept the outcome if it loses.

Science encourages that kind of competition. Denialism fears it.

Science denialists have a deeply fraught relationship with scientific evidence. On the one hand, even the most outlandish forms of denialism attempt to invoke the imprimatur of science. Claims range from the simple (“studies show …”) to the elaborate (lists of scientific citations of papers that appear to support the claims being advanced, but actually do not). On the other hand, when scientific evidence undermines their claims, denialists suddenly discover that scientific evidence is not “applicable” to their claims or is “not enough” or produced by scientists with ostensible financial conflicts of interest.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Denialists use science only when it supports their pre-determined conclusions. [/perfectpullquote]

As Professor Rory Coker explains:

Pseudoscience appeals to the truth-criteria of scientific methodology while simultaneously denying their validity. Thus, a procedurally invalid experiment which seems to show that astrology works is advanced as “proof” that astrology is correct, while thousands of procedurally sound experiments that show it does not work are ignored…

Something similar plays out in every type of science denialism. Consider anti-vaccine advocacy. On the one hand, antivaxxers brandish scientific papers that show deleterious effects of various vaccine components like thimerosol or aluminum. Leaving aside for the moment that the papers are typically not directly relevant (involving related but different chemicals, involving massive amounts as compared to the minuscule amounts present in vaccines), these are real scientific papers containing valid scientific evidence.

But, unfortunately for anti-vaxxers, there are tens of thousands of scientific papers that demonstrate the safety and efficacy of vaccines. In contrast to the scientific papers that they like, this mass of scientific research, is not accepted on its face. When trying to persuade the unsophisticated, scientific evidence is explicitly rejected (“vaccine preventable diseases were decreasing BEFORE vaccines were invented”). If the audience is more sophisticated, a more subtle approach is required. In that case, specific poorly done papers are critiqued, never mind that they aren’t particularly representative of the literature as a whole.

This double standard is deftly summarized by Edzard Ernst MD, PhD, FMedSci, FSB, FRCP, FRCPEd in a brief editorial in the journal he edits, Focus on Alternative and Complementary Therapies (FACT). Prof. Ernst is the bete noire of “alternative” health. His credentials are impeccable. He was the first Professor of Complementary Medicine in the UK. Born and trained in Germany, he began his career at a homeopathic hospital. His belief in “alternative” health was so complete, he set out to show that its various remedies are both safe and effective.

But what he found apparently shook him to the core. His 700 published papers represent a lifetime of research that led him to conclude that only 5% of “alternative” medicine is backed by scientific evidence. The other 95% has either not been studied or has been definitely shown to be ineffective, unsafe, or both. Not surprisingly, Dr. Ernst is now viewed as “the scourge of alternative health.”

Dr. Ernst begins by reviewing the relationship between “alternative” health and evidence based medicine:

I have said it so often that I hesitate to say it again: the concepts of EBM are not a threat but an unprecedented opportunity for CAM [Complementary and Alternative Medicine]. EBM does not focus on mechanisms of action or basic sciences … It merely asks, ‘does it work?’ This open-minded approach is therefore uniquely suited for testing the value of CAM …

Alas:

What I have seen happening recently is almost the opposite. If the results do not fit the preconceived ideas of CAM proponents, the findings tend to be dismissed. In such instances CAM enthusiasts tend to declare the studies in question to be fatally flawed. If trial after trial is negative, the old argument re-emerges … Scientific rationality, they argue, is for testing washing machines and guns but ‘for understanding what passes between humans… [it] is not adequate’…

In other words, there is a double standard:

Rigorous proof, it seems, is the standard for conventional health care, and study designs that cannot possibly generate a negative result are being promoted as the standard that CAM enthusiasts would like to see applied to CAM. Observational data might then masquerade as proof of effectiveness, while unbiased studies are deemed to be not applicable to CAM.

… Scientific testing of CAM is acceptable, perhaps even desirable … but the results have to be positive. If they are not, then the level of scientific rigor is swiftly lowered until finally – BINGO – a (false)-positive result is being generated. Science has thus become a tool not for testing (its true purpose) but for proving that one’s preconceived ideas were correct.

That double standard is integral to science denialism.

Rigorous proof is the benchmark in science. It is not the benchmark in denialism. Scientific research is desirable, but the results have to confirm denialism. If they don’t, the level of scientific rigor is swiftly lowered until finally the desired (but false) result is achieved. Denialists use science only when it supports their pre-determined conclusions.

That’s a double standard.