I have a very poor ability to adjust to the time-shifts caused by crossing the Atlantic, so on Friday night (about 2am here) as I was shuffling onto the hideous piece of metal that would carry my terrified body back home to London (my fear of flying is the only concession I will make to irrationalism in this article), after a week spent waking up, ravenous, at 3am, I wasn't paying much attention to the CNN broadcast being played full-blast at our heads by the 'helpful' airport authorities (do Americans have a terror of silence in public spaces?). But my colleague in the queue behind me was (paying attention, that is). More bloody denialism, he muttered. Which made me look up at the screen.
What was on the broadcast was an interview with a family who had refused to have their child treated for cancer, because they distrusted the medical opinion of their doctor, and because of 'religious objections'. The broadcaster had found another MD to praise their approach. Just before I got on the plane, I heard their preferred doctor shouting - I've seen patients cured of incurable cancers! Cured!
I checked just now (google really is an amazing engine) and my memory of the snippet I overheard isn't wrong. You can read the full transcript of that edition of (what I now see was) the Larry King show here, if you wish, but I'm not writing this to slag off American television or that poor family (who I see now, having read the full transcript, did in the end (but only after a court order) permit their child's cancer to be treated with conventional medicine).
What really stuck in my mind was the resigned nature of my colleague's muttering. More bloody denialism. It's everywhere, these days, this denialism. It's an offshoot of the pseudo-religions we invent to pass the time. First environmentalism became somewhat cultish, accusing those not willing to sign-up to the theory that The End Of Everything Is Nigh of being, in some sense, heretical. ('The science is settled' - that would be a first, then, in the history of the Universe). Then, I'm afraid, the people who oppose the hypothesis of man-made climate change started their own branch of fundamentalism: it was quite cold this summer, 'therefore' everything the climate-change activists say is wrong.
Both sides wave various bits of scientific research about to 'prove' that their opinion is the One True Faith Theory, and they grow depressingly tribal. I grew sick of reading unpleasant comments about the youngsters at climate camp this summer on rightwing blogs. They were 'hippyish', I read, often. It's bad to be hippyish? Underneath my shirt I still wear a string of wooden beads. And you know, trying to love people and not damage the planet while you're at it doesn't strike me as the worst foundation on which to fashion a life. In fact it strikes me as a pretty bloody good model for living, and one which, if practised more often, would probably make the Earth a nicer place to be. That we keep digging up holes to bury full of rubbish, most of which comes from things we couldn't honestly be said to have needed in the first place, says something unpleasant, something Ballardian in its nihilistic pointlessness, about the way we live now.
The most damaging - from a short-term species-level point of view - form of denialism is the rise of anti-medicalism. I've made that term up, to describe the hysteria generated by newspapers about, for example, vaccines. The press demand that medicines are 100% safe and 100% effective, in 100% of the people who take them. This is, of course, an impossible demand, as just a tiny, tiny bit of reading about pharmacology would make evident to the writers of those articles. Because it is impossible, we seem to be growing into a state where any new medicine is considered to be little short of a poison, invented by evil pharmaceutical organisations, in order to spread terror and illness throughout humanity.
I was particularly disappointed to see the Spectator promoting the views of people whose agenda is to suggest that HIV doesn't usually lead to AIDS. That some people are infected with HIV and have not (yet) developed full-blown AIDS is just a natural consequence of human biological variability. That the healthier the host, the better the prognosis (on average) is, again, not evidence that HIV does not cause AIDS. That medical researchers interviewed by the film-maker were not in 100% agreement says nothing that should worry us (I'd be more worried if the opposite were true). I am not a natural political fan of Ben Goldacre but I certainly agree with the headline of his article on this topic: setting out to spread a false message that HIV doesn't cause AIDS is, indeed, pernicious.
Disclosure: I work in research for a huge pharmaceutical company. In the part of the business where I live, we spend our professional lives attempting to find disease-modifying agents and pharmacological amelioration for patients trapped in the horror of severe psychiatric illness. Now, nobody understands the pathogenesis of schizophrenia: there are various competing theories on the topic and if you asked 18 neuroscientists their views you would likely hear 18 (at least) different proposals. You cannot 'see' schizophrenia under a microscope, any more than you can see HIV by looking at the blood of an infected person. Does this mean we should stop researching the root causes of the disorder, that we should desist attempts to find a pharmacological remedy for it? That we should not develop a medicine to treat it unless it were possible that everyone with schizophrenia would be cured, instantly, with absolutely no side effects? Current antipsychotics are helpful for, in particular, one dimension of the disorder, in a large subgroup of the patient population: but they do not work for everyone and they do not help with the full spectrum of the illness and they do certainly cause some potentially terrible side effects in some patients. Does that mean that doctors who prescribe the current generation of neuroleptics are in some sense engaged in an act of deception?
My answer to all those questions is: no. I don't expect journalists to be experts in every topic they choose to champion, and nor should certain topics be declared as out of order. Free speech is indivisible, etc etc. But actions have consequences. Researching a topic is painful but important. And we must get away from this ridiculous concept, a blight on our national conversation, that science works through the creation of a simple point hypothesis, the rejection of which makes its logical alternative the only truth left to be said on whatever topic is being discussed. Only simple hypotheses can be easily falsified (the earth isn't flat, my cat doesn't drive a car, and no, not all swans are black). Hypotheses about complex environmental systems, or complex biological ones, are not likely to be of a yes/no nature and we get nowhere by pretending otherwise. We properly investigate them by generating evidence of integrity and measuring what such evidence does to their support, measured on the calculus of probabilities. It might be that the evidence provides such little support for an hypothesis (such as the theory that HIV doesn't cause AIDS) that to continue to hold that belief can, in a practical sense, be termed irrational. But the theory that HIV leads to AIDS isn't 'proved', in some once-and-for-all mathematical sense; and that the Spectator can find a film-maker who says that it isn't says nothing of epistemic weight for the counter-theory which his film seeks to promote.
I think artificial dividing lines are always a dead-end, whether practised in politics, in environmentalism or in medicine. It's one of the reasons I've put myself forward for candidate selection, as I wrote on my website. I've always been a fan of evidence-based medicine. What I think we need now is more evidence-based journalism. Then we might get what we really need: evidence-based politics.
