Alternative health, Dunning Kruger and the Tuteur Corollary

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I’ve spent the last few days wrangling with anti-vaxxers on the Skeptical OB Facebook page. I wasn’t arguing with them since a doctor can no more argue immunology with anti-vaxxers than a mathematician can argue calculus with a four year old. Neither knows enough to come to grips with the actual subject.

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

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

The Dunning Kruger effect explains why those who know the least about a particular topic — health, 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.

But it seems to me that there is a corollary to Dunning Kruger — I’m going to call it the Tuteur Corollary — that applies to advocates of alternative health in general and anti-vaxxers in particular.

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.

Simply put, the Tuteur Corollary to Dunning Kruger as is this:

Those who lack relevant knowledge look at what they don’t understand and imagine nefarious deeds.

For 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 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 alternative health charlatans. The Tuteur Corollary explains why they abandon common sense to conclude that quacktress Suzanne Somers is more dedicated to curing their cancer than their own oncologists, that people peddling worthless miracle diets and cures and 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.

It’s bad enough that we live in Dunning Kruger nation where variety of very loud “confident idiots” actually think they know more than the experts in their respective fields. What’s worse it that we appear to be living in a nation where such ignorance is enshrined in our values.

As Dr. Dunning explained:

Some of our most stubborn misbeliefs arise … from the very values and philosophies that define who we are as individuals. Each of us possesses certain foundational beliefs — narratives about the self, ideas about the social order—that essentially cannot be violated: To contradict them would call into question our very self-worth.

When it comes to healthcare, large groups of Americans now rest their self worth on the twin delusions that stupidity is knowledge and if you don’t understand it, it must be a plot to harm you.

  • RudyTooty

    So much of this is true of me – or was.

    I kid you not – ONE WEEK into my midwifery apprenticeship, my CPM “Pretend” midwife apprenticeship, I gave a presentation to a group of students on midwifery. My supervising midwife had originally scheduled herself to do it, but since she had acquired a new apprentice midwife, and she was tired that day, she sent me in her place. And she stroked my ego and told me that I knew more about childbirth because I’d now been to 2 or 3 magical births with her, and I could talk about the magic of midwifery care, and becoming a midwife, and how magical natural birth is and blah blah blah blahdie blah blah.

    And I remember that presentation… and how surreal it was. But how I also felt strangely empowered to do this thing because I was told I could. And I could rave about the wonder of birth and how great apprentice-trained midwives are, and share our secret-magical knowledge.

    GAH. I just have to put it all out there.
    It’s creepy what one will believe. It’s creepy how much confidence one can have in their ignorant viewpoints.

    I’m sharing this on the off-chance that someone will come here and recognize his or herself.

    I didn’t know what I didn’t know.
    I thought I was smart and knowledgeable.
    I was stupid and ignorant.

    Extremely ignorant.
    And simultaneously confident.

    ^ That is one effing frightening combination.

    • demodocus

      That is rather terrifying.

    • Amazed

      One week? I am speechless.

  • Rachel May

    Such Anger. Glad you’re not my Doc.

    • demodocus

      I’m glad my doctors agree with her

    • MaineJen

      Anger? I only saw logic. Want to be more specific about this anger you see?

      • momofone

        Logic?! She’s even more glad Dr. Tuteur’s not her doc!

    • Charybdis

      Where’s the anger? Could you describe the anger you are perceiving?
      It reads more like logic with a dash of irony and sarcasm, covered with a veneer of exasperation.

    • Amy Tuteur, MD

      Is that how you handle cognitive dissonance? You pretend that the other person is angry so you don’t have to think about the truth of what they write?

      • The Bofa on the Sofa

        It’s easier than actually addressing the issue.

    • The Bofa on the Sofa

      Then again, what’s wrong with anger? When there are people who make choices that put other people at risk, and willfully defend and promote those beliefs, why SHOULDN’T we be angry?

      I’ll admit it, anti-vaxxers piss me off. They put my kids at risk for disease. They put others’ kids at risk for disease. That sounds like a good reason to be angry.

    • Corblimeybot not logged in

      It is misogynist to try to derail a woman’s argument by labeling her an “angry woman”, rather than engage with what she actually said. You are a misogynist.

    • Sue

      Truly?

      Who wouldn’t be happy about a doctor who is angry about misinformation that harms others, and who works to oppose it. That benefits the community, way beyond individual patients.

    • Sarah

      Bet she’s devastated you’re not her patient.

  • SporkParade

    That would explain why the hardcore anti-vaxxers are all conspiracy theorists, too.

  • Sue

    Two things.

    First, it seems that the US Presidency is being led by a perfect example – the (orange-skinned) guy who thinks that it should be easy to get Middle East agreement. Just because smart people have tried over generations, there’s no reason why a real-estate dealer shouldn’t be able to broker a deal, right?

    Next, a story that has been unfolding in Australia over recent months. Parents of a profoundly disabled 4 yr old child with severe cerebral palsy and intractable seizures have retrospectively decided that he is “vaccine injured” – even though he had his first seizure withih hours of birth, and before any vaccine. They are concurrently saying he was ‘injured’ by his Vit K shot. He also had meconium aspiration with a period of hypoxia.

    This baby apparently had good APGARs at birth, and a normal early MRI, so they say he was “born perfect” and therefore anything that has happened subsequently must be a result of medical malpractice and “toxins” from the VitK.

    Same principle as in this article – if you can’t understand why something happened, assume that somebody did something wrong, or that standard medical therapy must be “toxic”.

    Anyway, progress in the story is that this child, who has a tube into the stomach for feeding, as stopped the PEG feeding formula, and stopped the anti-convulsant medication, and substituted their own “organic, plant-based” PEG feeds, and cannabis oil.

    The child has lost a lot of weight and now is skin-and-bones – and had to be removed from the family and admitted to hospital for re-feeding. The medical system, which this child relies on, had been painted as the “enemy”, and the poor kid is alone in hospital because his parents have caused so much disruption that he had to be taken from them.

    So much unnecessary suffering, all because the parents want to attribute blame.

  • Amazed

    People don’t change. Oh they don’t change. I’ve recently been rereading one of the “rural” stories of a great storyteller of ours, published in 1901. It’s named “A Scourge of God” and depicts a village that suffers an epidemics of something unnamed but deadly. In the peak of summer heats. In addition to a long draught. The source of the epidemics is a pool in front of the vicar’s house that everyone draws water from and the young teacher, after giving a long and hard thought to the matter, says so. Of course, the superstitious old people in the village give him no credence and the vicar keeps preaching that the epidemics is a God’s punishment for sins. And of course, he’s pleased to take the money from all the funeral services. When the young people take the teacher’s side and stand guard at the pool with bludgeons to prevent anyone from drawing water, their fathers side against them because it can’t be the pool. What does the teacher know, after all? I am sure we can all see the likeness.

    At the end, it’s all superstitions. People don’t even know how little they know. They don’t trust science. I can only guess that they don’t trust literature either because it tells us in no uncertain terms how things used to be.

    • Heidi_storage

      Author, please? Sounds interesting.

      • Amazed

        You won’t know the author and I don’t expect you read Bulgarian *grin* but I found a translation of the work here. I hope you enjoy!

        http://mayathehobbit.deviantart.com/art/The-Scourge-of-God-216282661

        • Heidi_storage

          Thanks!

          • Amazed

            Truth be told, Elin Pelin isn’t a favourite author of mine but that has to do more with personal preferences, rather than merits. Here, he’s spot on. Superstition is a powerful thing. It isn’t this dangerous nowadays, with those who refuse to listen to science. They think they have science and faith on their side because people who do things the right way won’t get sick but we know it’s no better than superstition, supported by a grain of knowledge, of course. Just a grain. They think it’s a mountain.

            Oh, and Elin Pelin has another heartbreaking story named At Harvest Time. There, a reaper, a young girl, pretty and in love, dies there, on the field, by a sunstroke. He knew what rural life was here some 150 years ago. But as we know, it was all sun and roses, women popped their babies out on the field and kept harvesting… Alternative healthcare “providers” draw heavily on this narrative when we know reality wasn’t anything like.

          • demodocus

            sunstroke sucks.

          • Amazed

            Well, to be fair, it might suck now. Then, when people regularly died by it, they weren’t alive to feel it suck. But I guess that’s the survival of the fittest and all.

  • Amy

    My favorite big bad scary vaccine component is when they talk about “animal DNA.” Apparently all anti-vaxxers are vegans; if not, they are ingesting “animal DNA” on a regular basis!

    • AndreaRealMPH

      And fetal parts, even though the Catholic Church has encouraged vaccination, correctly guessing that there is little to be done about the few lines that are made from post-abortion fetal cells; and that it’s hugely more productive to protect current pregnant women, fetuses, and little kids by vaccinating.

      • crazy grad mama

        Plus anti-vaxxers always make it sound like pharmacists are grinding up babies to put in vaccines, when the truth is much more mundane.

      • Amy

        Well, that, and the fact that a cell line cultivated from post-abortion fetal cells fifty years ago isn’t exactly the same as grinding up fetal parts and mixing them into the vaccine.

    • crazy grad mama

      Same with anti-GMO people: “GMO food has DNA!” Well yes, so does everything else you eat. (I think there’s a valuable discussion to be had around the role of GMO food in big agriculture, but if you start that debate with “DNA=bad!” I’m going to laugh in your face.)

      • AnnaPDE

        A girl in my class in year 8 actually declared: “I don’t eat anything that contains genes!” She’s learned a bit since then, admittedly, having studied chemistry and done a PhD in it.

    • Sheven

      Human DNA is also animal DNA–most of which we share with other animals. Every cell in their body has animal DNA in it.

      • J.B.

        And we are mammals who are born to breastfeed, but animal DNA is totally different!

        • kilda

          omg, breastmilk contains mammal DNA! Run for your lives!

          • demodocus

            omg, i fed my son girl cooties!

    • Sue

      But…but…it’s INJECTED STRAIGHT INTO THE BLOODSTREAM!!

      • Roadstergal

        “It’s injected into the muscle.”

        “It ends up in the bloodstream!”

        “Just like eating…”

        “IT’S DIFFERENT!”

        • Azuran

          Does that mean that mosquitoes cause ‘the autism’? Because when they sting you, they are injecting INSECT DNA straight into your bloodstream.
          And biting mosquitoes are female, so men are injected with female insect DNA. And isn’t autism more common in men? Think about it!!!!

          • MaineJen

            …Kafka?

    • Roadstergal

      Animal DNA – completely different from human DNA. I mean, not in the chemistry, not in the structure, not in the building blocks, not in the base pairs, not in anything but effectively miniscule variations of the order of certain bits, but it’s so totes different!

      • AnnaPDE

        Let’s not even start with plant DNA. Because didn’t you know that modern wheat is killing us as it has “more complex DNA” than the nice healthy varieties from a few hundred years ago, because of selective breeding?
        (And this BS, as written by someone calling themselves a “nutritionist”, is happily printed in a major Australian news publication.)

  • Cyndi

    Standing ovation.

    • Nick Sanders

      I misread that as “standing ovulation”.

      • MaineJen

        I canceled my standing monthly order for ovulation years ago 🙂

        • demodocus

          >>jealous<<

        • Roadstergal

          We have a crappy local newspaper that’s a lot like ovulation. It comes on a regular basis despite all of our efforts to stop it, we have no use for it, and we have to clean it up every time it shows up.

          Actually, I was able to cancel my ovulation, and I wasn’t able to cancel that damn newspaper. So it’s worse.

          • KeeperOfTheBooks

            I think I just might have cracked a rib laughing. 😀

      • Cyndi

        Nope. Too old for that.

  • Azuran

    To be fair, the entire scientific, medical and public health communities are
    totally deliberately ignoring whale. to and
    NaturalNews, because anyone with half a brain knows they are nothing but a huge pile of crap.

    • namaste863

      Why did I look up whale.to? Why? Can people seriously be that gullible? Pass the brain bleach, please.

      • Anj Fabian

        Sorry. Now you know why it has the reputation it does.

      • KeeperOfTheBooks

        I’ve never heard of it before, and y’know what? I think I’ll remain in blissful, blissful ignorance. 😀

        • MI Dawn

          In this case, ignorance is definitely the right choice. I’ve gone to those sites exactly once and regretted it ever since. Those who frequent them so they can pull items for us to point and laugh have my greatest respect.