Science denial, Dunning Kruger and the Tuteur Corollary

00A1BF6C-2246-46A4-B444-D109C816FFAB

I spend my days wrangling with science denialists on the Skeptical OB Facebook page. I don’t really argue with them since a doctor can no more argue science with a denialist than a mathematician can argue calculus with a four year old. Neither denialists nor four year olds know enough to come to grips with the actual subject.

Most four year olds would be quick to agree that they don’t understand calculus, but most denialists aren’t nearly so self aware. As victims of the Dunning Kruger effect, they actually think they know what they are talking about.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]The Tuteur Corollary: If they don’t understand it, it must be a plot to harm them.[/perfectpullquote]

The Dunning Kruger effect explains why those who know the least about a particular topic — science, for example — actually believe they know the most. They simply don’t know what they don’t know. According to Dr. Dunning:

What’s curious is that, in many cases, incompetence does not leave people disoriented, perplexed, or cautious. Instead, the incompetent are often blessed with an inappropriate confidence, buoyed by something that feels to them like knowledge.

It seems to me that there is a corollary to Dunning Kruger — I’m going to call it the Tuteur Corollary — that applies to science denialists:

Those who lack relevant knowledge look at what they don’t understand and imagine it must be a plot to harm them.

I’ve noticed that when bad things happen to people, they can be roughly sorted into two groups: those who look at the untoward event they don’t understand and ask, “How did this happen?” and those who look at the exact same event and ask, “Who did this to me?” In other words, those with a modicum of knowledge want to understand — and assume they will be able to understand — what happened; in contrast, those who lack basic relevant knowledge (and often basic logic as well) assume that if they don’t understand something bad, it must be because someone, generally a corporation or government entity, is trying to harm them.

Anti-vaxxers are the perfect example.

Those who don’t understand basic immunology obviously don’t understand how vaccines work. Dunning Kruger leads them to conclude that vaccines don’t work; the Tuteur Corollary impels them to explain the world-wide consensus of immunologists, pediatricians and epidemiologists on the efficacy of vaccines as a world-wide plot to boost the fortunes of Big Pharma.

Those who don’t understand basic statistics obviously don’t understand that the recent apparent increase in the incidence of autism can be attributed to better diagnosis and expanded classification. Dunning Kruger leads them to insist that autism is an epidemic; the Tuteur Corollary leads them to conclude that corporations, with the blessing of government, are deliberately causing autism.

Those who don’t understand basic chemistry obviously don’t understand that a chemical that is dangerous in its elemental form, like mercury, is not dangerous when a component of a chemical compound, thimerosal. Never mind that there are many examples in every day life: elemental sodium is exposive; sodium chloride (table salt) is beloved as a seasoning for food. That’s Dunning Kruger. The Tuteur Corollary is responsible for the nonsensical belief that Big Pharma once added an expensive chemical to its vaccine preparations for no therapeutic reason and intended to poison children.

Those who don’t understand the scientific method obviously don’t understand that a single scientific citation (or even a dozen) that they’ve never read is not an argument against vaccination, especially when compared with the literally tens of thousands of papers that demonstrate the safety and efficacy of vaccines. Dunning Kruger leads them to assume that they are more educated about vaccines that those with PhDs in immunology. The Tuteur Corollary forces them to conclude that the entire scientific, medical and public health communities are deliberately ignoring all the fascinating data on whale.to and NaturalNews that seems so compelling to them.

Dunning Kruger explains why those who know the least are most likely to fall prey to anti-vax charlatans. The Tuteur Corollary explains why they abandon common sense to conclude that a random quack is more dedicated to curing their cancer than their own oncologists, that people peddling worthless miracle cures are less interested in profit than doctors, and that the vaccine conspiracy is so massive and so dastardly that doctors, pharma execs and public health officials are willing to inject their own children with vaccines in order to maintain the deception.

Dunning Kruger also explains why those who know the least are most likely to fall prey to COVID denialist politicians. The Tuteur Corollary explains why they abandon common sense to conclude that a politician like Donald Trump is more dedicated to preventing COVID than a scientist like Tony Fauci. It explains why denialists imagine simple public health measures like mask wearing to be a nefarious plot to deprive them of their “freedom.” It explains why denialists twist themselves into pretzels trying to argue that the hundreds of thousands of EXCESS American deaths in 2020 were all people who died of other causes.

The bottom line when it comes to science denial is that large groups of Americans now rest their self worth on the twin delusions that their own ignorance is “knowledge” and that whatever they don’t understand must be a plot to harm them.

Who’s responsible when an anti-masker gets COVID?

Word Responsibility Handwritten With Black Marker

Imagine this scenario: A woman, after reviewing the evidence from both sides, after carefully considering the increased risks, and after deciding that she is willing to accept the responsibility for the outcome, decides to … smoke cigarettes.

This situation happens all the time. Indeed, a substantial portion of the population smokes cigarettes. In 2021, everyone knows that cigarette smoking increases the risk of lung cancer, emphysema and other diseases. However, most smokers will accurately point out that not everyone who smokes gets a smoking related illness, that smoking provides both pleasure and concrete benefits such as relaxation and increased concentration, and that adults are entitled to make their own healthcare choices. In addition, there are scientists who assert, and who have testified under oath, that the harms from smoking have been dramatically exaggerated.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Anti-maskers intend to take exactly the same responsibility for their health that smokers intend: none.[/perfectpullquote]

So if a woman claims to have made a knowledgeable decision to smoke cigarettes, and is aware of the potential consequences, does that mean that she is “taking responsibility” for her health?

In one very real sense, it does, since she is the one who will suffer if any harmful effects ultimately occur. She is the one who will gasp for breath with emphysema, she is the one who will endure treatment for cancer and who may die a painful death from it. However, it most other ways, she has no intention of “taking responsibility” for her health.

First, most women who elect to smoke cigarettes have some measure of denial about what is can happen. They tend to grossly underestimate the risks of getting a serious illness; they tend to be unaware of a variety of less common illnesses caused by smoking (bladder cancer, peripheral vascular disease); and they tend to drmatically underestimate the impact that emphysema, lung cancer and other diseases will have on their life as a whole. So while they may be technically “educated” about the risks, they are not acting with a clear eyed assessment of those risks.

Second, smokers have no intention of managing any complications alone. If they get emphysema or cancer, they will expect and demand state of the art treatment for those diseases. They caused their own disease, but they will expect and demand that others do everything possible to cure or at least ameliorate it. Moreover, they have absolutely no intention of paying for their decision. They bought insurance for just this eventuality. As far as they are concerned, other, healthier people can pay for their illness with higher premiums overall.

In a very real sense, they don’t plan on taking ANY responsibility for their health. They plan on other people doing all the work, and paying most of the money to rescue them if their choices were wrong. The bottom line is that women who “take responsibility” for smoking are generally in denial, grossly underestimate the risks of serious harm, have no intention of fixing their own medical problems, and have no intention of paying the bulk of the cost from those problems.

COVID denial is very similar. Most anti-maskers have no clue as to the real risks of COVID. Second, most anti-maskers are in denial about the fact that serious complications and even death can occur among low risk people, including young people and those without pre-existing health conditions. Third, anti-maskers expect and demand state of the art medical care to rescue them from their decision to forgo a mask. Fourth, anti-maskers have absolutely no intention of paying the bulk of the costs that may result from their choice, ranging from a long stay in the ICU to months of rehabilitation thereafter.

In other words, all the talk about anti-maskers taking responsibility for their own health is just talk. In the ways that count, anti-maskers expect everyone else to do all the work, take all the responsibility and shoulder the bulk of the expense for their choice. Anti-maskers intend to take exactly the same responsibility for their health that smokers intend: no responsibility at all.

Forcing pregnant people who request a C-section to see a psychiatrist is obstetric violence

57EB52B0-FC9A-4C9E-AE74-8BD456BFAE07

It’s one of the oldest tricks in the misogynist playbook: declare that any woman who tells inconvenient truths is mentally ill. Physicians of the 19th and early 20th Century even had a name for the purported mental illness: hysteria.

That’s why it is the bitterest irony that Australian midwives have declared that women who request C-sections should be seen by psychiatrists.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]The only thing more disrespectful than telling pregnant people how to give birth is declaring them mentally ill because of their choices.[/perfectpullquote]

Aussie docs slam mental health screening of C-section women:

Australian obstetricians have vowed to fight any move to send pregnant women booked for a C-section to a psychiatrist, as the extreme move to slash caesarean rates …

However, the Australian College of Midwives supports efforts to reduce unnecessary C-sections and believes women should have access to a psychiatrist to discuss their de-cision …

Apparently, Australian midwives believe that women who request C-sections are “hysterical” and require mental health evaluation.

In the paper The Race of Hysteria: “Overcivilization” and the “Savage” Woman in Late Nineteenth-Century Obstetrics and Gynecology, Laura Briggs explains how the mental health diagnoses were weaponized to control women:

Hysteria, we learned from feminist historical scholarship in the 1970s, was never just a disease. It was also the way nineteenth century U.S. and European cultures made sense of women’s changing roles. Industrialization and urbanization wrought one set of changes, while the women’s rights movement brought another. Together, these included higher education for women, their increasing participation in a (rapidly changing) public sphere, paid employment, and declining fertility. These cultural changes were accompanied by a virtual epidemic of “nervous weakness” largely among women, causing feminist historians to begin asking whether the diagnostic category of hysteria was simply a way of keeping women in the home…

To punish women who refused to be enslaved by their biology, misogynist physicians declared these women’s choices to be symptoms of mental illness.

Similarly, to punish pregnant people who refused to be enslaved by their biology, misogynist midwives declare these people’s choice of C-section to be symptoms of mental illness, requiring evaluation by mental health professionals. This how radical midwifery ideology makes sense of women’s effort for greater bodily autonomy in choosing how they will give birth. As in the case of hysteria, it tells us more about the prejudices of those making the diagnosis than the health of the pregnant people being diagnosed.

Moreover, requiring women who choose C-section to see a psychiatrist isn’t merely misogynistic; it is obstetric violence.

Obstetric violence is defined as:

…[T]he appropriation of women’s body and reproductive processes by health personnel, which is expressed by a dehumanizing treatment, an abuse of medicalization and pathologization of natural processes, resulting in a loss of autonomy and ability to decide freely about their bodies and sexuality, negatively impacting their quality of life.

It is supremely disrespectful to tell pregnant people how they ought to give birth and ignoring what they might want (pain relief, interventions, maternal request C-section) in labor. Telling a woman she must undergo a vaginal birth simply because it is natural is no different from telling a woman she must continue an unwanted pregnancy because that is natural. It results in a loss of autonomy, ability to decide freely about their bodies and sexuality, negatively impacting their quality of life.

The only thing more disrespectful is to label them as mentally ill and force them to be evaluated by a psychiatrist. Not only does that compound the loss of a pregnant person’s autonomy, it is an abuse of the mental health system. As in a totalitarian state, it turns the mental health system into an expression of state power. Second, it reduces access for people who actually have mental illness to the mental health services they need by diverting those services to ideological ends.

It is fundamentally unethical — and probably also illegal — to force pregnant people into psychiatric evaluation that they do not want and do not need in an effort to deprive them of autonomy to choose a C-section.

And it is a particularly egregious form of obstetric violence.

Why do denialists delude themselves?

BD9DAD92-69C7-43AD-BB21-4AAFD9BA57EF

Why do people believe things that even the most cursory exploration would reveal to be untrue?

Why do people fervently embrace vaccine denialism, climate denialism and even election denialism?

It’s only partly because they find these delusional beliefs comforting. The real reason is because belief in fantastical delusions has become a form of identity signaling, advertising membership in a particular social group.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Denialism is a form of social identity signaling.[/perfectpullquote]

That’s the theory outlined by John S. Wilkins in the 2016 paper Why do believers believe silly things? Costly signaling and the function of denialism.

He starts with the example of a member of the “Exclusive Brethren”:

… I would try to talk to him about his beliefs, but he simply refused to engage. The Exclusive Brethren have withdrawn from all conversation with the secular world (which, in their view, includes all other Christians) except for business. I wondered at how a clearly intelligent person could believe what he believed, and then it hit me: he couldn’t speak to outsiders, because they just looked at him with their jaw open and shaking their head. His beliefs isolated him from those outside his community, and therefore, by implication, strengthened his involvement within the community…

The more delusional the belief, the more aggressively believers hold it:

Think of this as a kind of investment: one spends a long period developing one’s beliefs and social connections. If you are challenged in your beliefs, you put at risk your social networks with those who use the silly beliefs you hold as a test of inclusion, and therefore risk your social connections…

The key point is this:

… [I]t is not the content or topic of the beliefs that matters, but the fact that in order to hold them and assert them, you have isolated yourself from the external community as a show of faith. To abandon them simply because they are false would cost too much. And so you face up to the cognitive dissonance and rationalize your beliefs and the facts that challenge them.

It’s impossible to reason denialists out of their bizarre beliefs because they didn’t reason themselves into them. They swallowed them whole from the arbiters of the social group to which they want desperately to belong.

That explains why group members constantly signal their allegiance to shared delusions. But why believe something delusional — like claiming vaccines don’t work, climate change isn’t real, or the recent Presidential election was stolen — in the first place?

Because the more delusional the lie, the more powerful the resulting in-group identity. That’s especially true if it is personally harmful to maintain belief in the delusion. For example, COVID denialism literally sickens and kills believers by convincing them to forgo protective public health measures.

COVID denialism is the ultimate social signal because it is a “power lie.”

In her book Surviving Autocracy, journalist Masha Gessen explains the “power lie”:

The purpose of the power lie isn’t to get you to believe something that’s untrue, as is the case with ordinary lies. The goal of a power lie is to demonstrate extraordinary power over others by insisting that denying what you know to be true is proof of political fealty.

COVID denialism is a power lie because it forces people to deny the danger of sickness and death as proof of political fealty to Donald Trump.

That’s how South Dakota came to be the epicenter of a massive, deadly COVID outbreak. A motorcycle rally in Sturgis became not merely a motorcycle rally, but an opportunity for identity signaling. Hundreds of thousands showed up, demonstrating the tremendous power of the lie.

The result was exactly what public health authorities predicted.

Albert Aguirre was amped as he and a buddy skimmed across the South Dakota plains, heading to join 460,000 bikers for a motorcycle rally shaping up to be a Woodstock of unmasked, uninhibited coronavirus defiance.

“Sit tight Sturgis,” Mr. Aguirre, 40, posted on Facebook on Aug. 7 as he snapped a photo of the sun sifting through the clouds. “We’re almost there!”

Less than a month later, Aguirre was struggling to breathe and a few days after that he was dead.

The lie is so powerful that there have been reports of COVID deniers desperately trying to maintain their denial even as they are DYING of the disease. They recognize they are very sick; they seek help at hospitals; but they insist literally to their dying breath that they must have some other disease. Even unto death they feared both cognitive dissonance and exclusion from their chosen social group more than they feared death.

That’s why head on efforts to educate denialists out of their denial are doomed to failure. Since denialism has nothing to do with facts it will not be changed by facts. Maintaining delusional beliefs is a form of identity signaling, not a form of intellectual independence. Denialists aren’t cognitively brave; they’re socially weak, dependent on their group for approval and desperate to signal continuing membership.

Scientists create first vaccines against stupidity

Syringe and vials filled with vaccine. Isolated on pure white.

It’s been a dream for so long, but scientists have finally created the first vaccines against human stupidity. Early tests show that they are more than 90% effective at selectively extending the life and promoting the health of intellectual elites. They have the added advantage of also protecting those who are smart enough to follow the scientific advice of those elites.

We call the new injections COVID vaccines.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Though scientists set out to create a vaccine against COVID, they also created an indirect vaccine against stupidity.[/perfectpullquote]

They are an entirely new form of vaccine in that they work indirectly against stupidity. A conventional vaccine against stupidity would protect people from being infected by stupid conspiracy theories. They could watch as much Fox News and join as many anti-vax websites without gullibly believing the crap that they spew. In contrast, these new vaccines work by protecting only those who are already scientifically literate, extending their lives and promoting their health by dramatically reducing the incidence of COVID in vaccinated populations.

How does it work?

Here’s an example:

Yesterday Fox News spokesclown Tucker Carlson had this to say about the new vaccines:

Carlson, who has regularly mocked public health experts and questioned the consensus of the scientific and health communities on measures that can be taken to reduce the spread of the coronavirus, highlighted an Alaska health care worker who had an adverse reaction to the vaccine on Tuesday but who responded quickly to standard treatment…

Carlson [opened] his show with the story of the Alaska worker as an on-screen graphic read, “BAD VACCINE REACTIONS.” The text in Carlson’s banner that appeared in the lower-half of the screen snarked, “THERE WILL BE NO QUESTIONING THE CORONA VACCINE.”

Carlson warned his viewers that they should be skeptical of what he described as a “glitzy” effort to get people vaccinated.

Carlson’s comments make it much less likely that those stupid enough to believe his conspiracy mongering will accept the lifesaving vaccine. In large populations, therefore, the educated are far more likely to get the vaccine and get it early, reducing their chance of death or long term impairment. Over time, the elites (and those who follow them) will get healthier and the stupid will sicken and die in greater proportions.

It’s incredibly ironic when you think about it. Right wing conspira-nuts are hyperventilating about ever more moronic and exorbitantly priced treachery (“vaccines contain microchips!”), but if the government wanted to harm Americans, it wouldn’t have to spend billions of dollars on vaccines. It could simply and cheaply dump poison into the water, the air or food.

Or for even less money it could do what it has already done: refuse to acknowledge the value of public health measures. Hundreds of thousands have died as a result, many dying preventable deaths.

A government that really wanted to harm Americans wouldn’t have to sink billions of dollars into a vaccine or trillions of dollars into injecting everyone with microchips. But apparently when you’re stupid, you ignore the obvious in favor of ever more ridiculous conspiracy theories.

So though scientists set out to create a vaccine against COVID, they also created an indirect vaccine against stupidity … which is fine by me. I want to get the vaccine for myself and my family as soon as we possibly can so we can return to normal life without fear of preventable death from the virus.

At the moment about 300 million Americans are ahead of me in line. If the stupid want to give up their places, I can get vaccinated that much sooner. Thanks for your help, Tucker Carlson!

Antivaxxers will be begging for the new COVID vaccines!

BE38C1AE-5EC6-4734-8FE7-7EBA1885A991

As the new COVID vaccines begin to come to market, there is concern among public health officials that a substantial proportion of the population will refuse the vaccine. I doubt it. In fact, I suspect that it’s just a matter of time before antivaxxers will be begging to get it.

Why? Because they’ll witness it working in a way they are currently unable to see other vaccines work.

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]It’s just a matter of time.[/perfectpullquote]

Nearly all vaccines work in two different ways.

1. Vaccines stimulate the production of antibodies. Antibodies are proteins that recognize specific bacteria or viruses and bind to them, thereby signaling to immune cells that they are targets for swift destruction. Each antibody binds to a specific site on a specific bacteria or virus.

That’s how vaccines lead to antibodies, but that’s NOT how they protect the whole population. Even the best vaccines are not 100% effective, and we can’t vaccinate 100% of the population. For example, babies can’t be vaccinated for specific diseases until they can mount the appropriate antibody response. Immuno-compromised people may not be able to mount an immune response at all.

In a vaccine-naive population, this is the primary way that vaccines provide protection.

2. Widespread vaccination leads to herd immunity, dramatically reducing the chance that an infected person will encounter an unprotected person who is susceptible to the disease.

Consider diphtheria vaccine:

Imagine that little Ainsley comes in close contact with 10 children per day. Now imagine that Ainsley develops diphtheria. Who is likely to catch diphtheria from Ainsley? If 99% of children are vaccinated and the vaccine is 95% effective, the odds are low that any of the 10 children she comes in contract with could get diphtheria. Thus, the outbreak of diphtheria ends with Ainsley (though it may end poor Ainsley’s life).

Now imagine that only 50% of children are vaccinated against diphtheria. That means that half the children are likely to be susceptible, and therefore diphtheria is almost certain to be transmitted. And since the children who catch diphtheria from Ainsley are going to expose additional children who aren’t vaccinated, the disease begins to spread like wild fire.

In other words, in 2020 if Ainsley’s mother doesn’t vaccinate her against diphtheria and she never gets diphtheria, it’s NOT because she was breastfed, eats organic food and has a strong immune system. It’s because herd immunity ensures that she’s never exposed to diphtheria.

This is the primary way that vaccines work in a population that is largely vaccinated.

Why does that matter?

It’s impossible to “see” herd immunity at work. In a population that is largely vaccinated against diphtheria (or any other childhood illness), the incidence of the disease is so low that most people will never see a case in their lifetime. It’s easy for parents to pretend that diphtheria poses no threat to their children and that vaccines are unnecessary. How could their children get diphtheria if it appears that no one has diphtheria?

In contrast, it’s easy to “see” the impact of antibody production in vaccine-naive populations.

Consider polio in the 1950’s. Summer outbreaks led to tens of thousands of cases (most in children) leaving hundreds paralyzed or dead. By some accounts, second only to the atomic bomb it was what most Americans feared most.

Frantic parents were eager to enroll their children in the vaccine trial.

The first large-scale clinical trial of Salk’s vaccine began in 1954 and enrolled more than 1 million participants. It was the first vaccine trial to implement a double-blind, placebo-controlled design …

The scientist leading the vaccine trial, Dr. Thomas Francis, Jr. from the University of Michigan, announced the positive results at a press conference on April 12, 1955. Later that same day, the U.S. government declared Salk’s vaccine safe and effective for use …

The rate of polio among vaccinated children was reduced by nearly 90% compared to those children who had received the placebo. Parents rushed to get their children vaccinated because the benefits of the vaccine were glaringly obvious. It’s very easy to see the impact of an effective vaccine in a vaccine naive-population.

If the new COVID vaccines are similarly effective (and early results suggest that they are), their impact will be even more obvious. In contrast to polio, which at its height sickened tens of thousands of Americans each year, COVID has sickened millions and killed hundreds of thousands in less than a year. The incidence of COVID and COVID deaths will immediately begin to drop dramatically as soon as vaccination starts and it will be obvious that those who received the vaccine are protected and can return to a normal existence.

In other words, it will be clear to even the most obstinate antivaxxer that the COVID vaccines really work. Will there be unanticipated risks to the vaccine? That’s always a possibility, but in a vaccine-naive population like ours the benefits will outweigh all but the most serious risks.

That’s the one silver lining to the vaccine shortage that is going to persist for many months. There isn’t enough to give to everyone so only those who really want it will be able to get it. The benefits of the vaccines will become apparent and antivaxxers will want those benefits, too. It’s just a matter of time.

Breastfeeding ableism

6AFBF4A8-6FD0-4D81-AD55-D7C7C9745043

Recently Chrissy Teigen issued a full throated defense of infant formula.

ok I’m gonna say something and you all are definitely gonna make it a thing but here goes: normalize formula.

[N]ormalize breastfeeding is such a huge, wonderful thing. but I absolutely felt way more shame having to use formula because of lack of milk from depression and whatnot…

As for efforts to increase her supply:

[perfectpullquote align=”right” bordertop=”false” cite=”” link=”” color=”” class=”” size=””]Insufficient breastmilk is a disability; refusing to believe it is ableism.[/perfectpullquote]

[T]he stress of it, combined with the guilt that you cannot do nature’s most natural thing for your own baby is too much. I dunno why this is my crusade now. I just remember the sadness I felt and want you to know you are doing it right if your baby is fed, mama.

The lactivist response has been predictable and predictably ableist — including the belief that breastfeeding is perfect and the assumption that insufficient breastmilk could have and should have been “fixed.”

What do I mean by ableist? Let’s do a little thought experiment. I’m going to share with you a typical lactivist response and as you read it, try substituting a different disability like deafness or paraplegia or autism.

The following quotes come from Lucy Ruddle IBCLC.

Breastfeeding ableism assumes that disability is the result of lack of effort on someone’s part, either the person with the disability or those responsible for his or her care.

We know that around 80% of women wanted to breastfeed but weren’t able to meet their goals. And when we look at why it boils down to lack of proper help… and being offered formula instead.

Are people deaf because of a lack of proper help and being offered lip reading or hearing aids instead?

No, and insufficient breastmilk is not the result of a lack of proper help or the availability of formula.

Breastfeeding ableism like many other forms of ableism is remarkably condescending:

I need to say this very clearly, Chrissy. You did not fail to breastfeed. Lack of good, skilled, early and consistent help, alongside a societal belief that breastmilk is only valid if it’s exclusively fed is to blame. Not you. Not your body. Not breastfeeding.”

Is paraplegia the result of lack of skilled help? No, and neither is insufficient breastmilk.

Is it appropriate to infantilize people with paraplegia by declaring that your body is not to blame, nor is the ability to walk? Of course not.

Breastfeeding ableism like many forms of ableism reeks of pity:

My heart aches for you, and so many like you who are failed every single day. If you ever want to talk through your experiences in what we call a debrief, I would be very happy to hold a safe space for you, judgement free. Sometimes just unpicking all of those swirling angry and painful feelings can help us to find peace with how things turned out.

Is it possible to be more presumptuous than to imagine that a person who is not neurotypical appreciates your heartache or wants to debrief with someone who insists that they could have been “fixed”?

Lucy Ruddle is hardly alone in her ableist beliefs that insufficient breastmilk isn’t a real disability and is the result of lack of support. She’s not alone in her striking condescension nor her assumption that those who are disabled welcome her pity.

She’s parroting the currently popular lactivist philosophy known as “beyond choice.”

As explained by social scientist Suzana Ignjatović in her paper Breastfeeding Divisions in Ethics and Politics of Feminism:

The “beyond formula vs breastfeeding debate” position focuses on constraints to successful breastfeeding, addressing breastfeeding and women’s economic, social, and political status. It is assumed that women are constrained by structural factors and that these factors should be addressed instead. According to Hausman, the constraints include lack of paid maternity leave, lack of support, the sexualization of women’s body …

But “beyond choice” is NOT beyond choice. It presumes that the only correct choice is to breastfeed.

…[This] approach is usually implicitly pro-breastfeeding. Shifting focus to obstacles and support means that women would choose to breastfeed (“all woman will ‘naturally’ adore breastfeeding”), if they get proper support.

It’s just like forms of ableism that assume that people who are deaf or autistic want to be “fixed.” They don’t.

Insufficient breastmilk is a disability, like many other disabilities. It is not the result of lack of effort or lack of support. Those affected do not merit condescension and they certainly don’t benefit from pity. They want — and they deserve — to be accepted on their own terms not the terms of lactation professionals who flatter themselves by imagining they know better.

Science denialism is motivated ignorance

Graphic of orange person burying head in sand

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.

Who is a better COVID scientist, Trump or Fauci?

76F2A33D-7F5A-410E-81A8-04DB0A1D9EAF

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):

5A881A45-05A9-4BA1-9DB9-A7DE3231DC0B

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:

5536E158-4C00-40D3-8010-1990BBD7E75E

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.

Let’s apply 3rd party drunk driving laws to COVID denialists

Liability claim form for a million dollars!

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.

Dr. Amy