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Criticism By and For the Scientifically Untrained
Dr. Brian D. McLean, DDS
As a general dentist practicing for some thirty-five years, I have,
over the past several years, come to question first the therapies
of medical science that have impacted my own health, then the processes
by which my profession reaches its therapeutic recommendations, and
finally more broadly the way scientific method is utilized within
the healing arts.
I'm angry at what I have found.
As a case in point, let me refer to Dr. Fineberg's statement from
the United States Institute of Medicine (IOM). This statement was
in defense of the IOM's report on the safety of vaccines and their
suspected link to the rise in autism. Of special concern were those
vaccines containing thimerosal, a mercury-laden preservative. Dr.
Finberg concludes his report with the statement, "The Institute
of Medicine and the National Academies have full confidence that the
Immunization Safety Review Committee operated independently, impartially,
and in accordance with the highest scientific standards."
The vaccine safety issue has engendered a great deal of dissent by
folks well qualified to disagree. Dr. Andrew Wakefield is one. US
Congressman Dr. Dave Weldon is another. But I find that following
their arguments requires more technical and scientific expertise than
I possess. Since this and many other medical issues directly impact
our health and continued existence on this planet, it is important
for the less erudite among us to be able to form worthwhile judgments
about scientific debates. I believe we can all do that. You don't
have to be a rocket scientist to figure out that the damn thing blew
up on the launch pad. (Why it blew up is another matter.)
Intrigued by the promise of Dr Fineberg that all was above board,
I proceeded to read the IOM report - (well as much of it as I could
stomach.) I submit that the report is clearly and irredeemably flawed
by its own definitions and stated rules of conduct. One does not need
to be able to weigh the merits of the evidence presented to be able
correctly to label the entire process as worthless.
That is the conclusion I have reached according to the "Bogus
Science Detector" (BS detector for short) that has assembled
itself within my cranium over the last few years. Should any reader
be able to point out flaws in the operation of this device - I have
no doubt that such flaws exist - I would be delighted to hear from
them at firstname.lastname@example.org (That stands for "Offer Him A Piece
Of My Mind.")
Let me first describe the evolution and workings of my BS detector.
If you like it, you can assemble one for yourself, absolutely free,
within your own cranium!
Having thus established a functioning BS detector, we can check out
Dr. Fineberg's committee's report and see if the detector starts to
The scientific knowledge enabling the construction of my BS detector
comes in part from three great thinkers:
1. Thomas Huxley
Thomas Huxley was the progenitor of a whole gang of illustrious Huxley's
who said, well over a hundred years ago,
"The great tragedy of science - a beautiful hypothesis slain
by an ugly fact."
Stripped of the emotional words, tragedy, beautiful, slain, and ugly,
we derive the essential meaning that a hypothesis must explain all
the relevant facts. Add back those emotionally charged words and we
taste Huxley's sarcasm.
Scientists and their financial underwriters seem to love their hypotheses;
anything that might threaten them is necessarily "ugly".
2. Max Planck
Now consider the words of the Nobel Laureate who discovered the fundamental
constant of nature:
"A new scientific truth does not triumph by convincing its
opponents and making them see the light, but rather because its opponents
eventually die and a new generation grows up that is familiar with
Planck did this work in 1900, and his discovery of "Planck's
constant" was the first hint in physics of what later became
quantum mechanics. Plank had no idea. He thought that by inserting
a constant into his equation he was fudging his math to get a right
answer and expected that someone would iron out the kinks in his theory
or replace it with a better one.
Perhaps they will. We can realize two "rules" of science
based on this:
Rule 1. It's OK to be wrong.
Rule 2. Most scientists don't believe Rule 1.
This universal, powerful scientific inertia, as it occurs in the medical
field, must inevitably mean that some (much?) of the "wisdom"
driving the medical advice you receive is outdated or downright wrong.
In fact, it is the duty of medical (and other) scientists, not to
defend a current and revered theory, but to seek to destroy it; not
to ignore data they dislike but actively and aggressively to seek
them out. There is clearly a long history of science, scientists and
those who profit by applying the technology that science inspires
doing less than what we are entitled to expect of them.
3. Karl Popper
Sir Karl Popper received a knighthood for his contributions to philosophy
- particularly with respect to the philosophy of science. He has pointed
out that one can never prove a hypothesis to be true. But one can
readily demonstrate that a hypothesis is false. The fact that one
can amass an enormous amount of evidence in support of a hypothesis
surely must mean one of two things:
(1) The hypothesis is correct in every respect.
(2) It is not, but no one has discovered the flaw(s) - yet.
This means that the only way science can truly advance is by seeking
flaws in its hypotheses. Anyone who can demonstrate such a flaw, anyone
who can produce a fact or piece of evidence, which cannot be explained
by an existing hypothesis, should be welcomed. Why, then, are such
facts regarded as ugly? Perhaps we should ask Dr. Olivieri, for instance,
why she was fired from her research position at Toronto's Sick Children's
Let us therefore build some triggers into our BS detector.
"The great weight of evidence" is interesting, impressive
and often convincing. But doubling the size of the evidence pile does
not make the hypotheses any more "true!" Yet the very phrase
"great weight of evidence" implies that there is a lesser
weight of conflicting evidence. What ever has happened to that little
pile of ugly facts?
The answer that one hopes to find is each and every ugly fact has
been examined for merit or lack of it. Can one demonstrate, error,
fraud or sloppiness of technique? Can others reproduce the evidence?
If not, were the replication experiments conducted fairly and honestly?
Such activity and debate is truly what science should be about.
Of course, if all the conflicting evidence were properly shown to
be invalid, there would be no collection of such data in need of being
"overwhelmed" by "the great body of evidence."
Thus the phrase "the great weight of evidence" in itself
implies an absence or at least a shortfall of such activity. My BS
Detector starts to grumble. Ah, I hear you cry, there is always some
flake with a nutty notion. True. There may not be time or resources
to check out all of them. What about the Ph.D.'s and others who dare
to dissent? Are they flakes too? Why are they so often "dismissed?"
I choose that last word carefully.
At its worst, the "weight/body of evidence" arguments translate
as follows: If a fact and the hypothesis it may engender run contrary
to an "accepted" hypothesis, the former should be ignored
as unworthy of attention. In other words, if it's not in accord with
"the great weight of evidence," it's wrong.
That last restatement of the "weight of evidence" argument
is so absurdly antithetical to the scientific principle that the hypothesis
must account for all the data, no sane scientist would support it.
That, I suppose, is why they couch their arguments in fuzzier terms.
That way they don't have to confront the real meaning of what they
Apart from dismissing those who dare to dissent - (shooting the messenger,
as it were) - science has devised various other filtering mechanisms
to admit only data considered legitimate of consideration. (But as
I understand Popper, any hypothesis is fair game. He prefers the certainty
of eventually being able to disprove a hypothesis to the impossibility
of ever being able to prove one.)
Whatever its merits, the peer review system serves as a strong, anonymous
censorship panel, to which there is no right of appeal. That is truly
a peculiar institution to set up where free exchange of ideas is supposed
to occur. Peter Duesberg, Ph.D., a much-beleaguered opponent of the
HIV-AIDS connection puts it this way:
"The corporate equivalent of academia's 'peer review system'
would be to give General Motors and Ford the authority to review and
veto all innovations by less established carmakers competing for the
How would you feel, for instance, if you were denied any knowledge
of who the Supreme Court Justices were, by what merit they reached
office, or how they ever voted?
Think about it. If pursuit of truth through science were paramount,
one would design a system meant scrupulously to unearth "ugly
facts" and demonstrate their merit or lack thereof. Why would
one entrench anonymity and lack of right of appeal in that system?
Such features, however, would ideally serve the agenda of a body whose
purpose was to defend the status quo.
Even the Cochrane Collaboration can find little evidence to justify
the system. They conclude:
" At present there is little empirical evidence to support
the use of editorial peer-review as a mechanism to ensure quality
of biomedical research, despite its widespread use and costs."
What is the Cochrane Collaboration? This is a body formed to support
clinically the practice of evidence-based medicine. The latter is
an attempt to organize thought processes involved in evaluating scientific
data - truly a worthwhile objective.
One principle of evidence-based medicine is that clinicians should
carefully evaluate whether conclusions in papers they read are supported
by data. Studies nowadays are analyzed with such advanced statistical
methods that it truly requires a statistician to evaluate them. Few
physicians are statisticians and even if they were, few have the time
to evaluate studies in the way required. To the rescue comes the Cochrane
Collaboration, a group of folks with the credentials properly to evaluate
In practice, however, there are many problems.
If I had to pick one, it would be the one exemplified in the August
2003 edition of Journal of the American Medical Association.
Researches in Copenhagen analyzed 167 random-controlled drug studies
from the Cochrane Collaboration. They showed that when apparently
unbiased studies were funded by for-profit organizations it was over
three times more likely that the experimental drug was recommended
as treatment of choice than when funds were supplied by nonprofit
organizations (16% vs. 51%.)
The kicker is the last line in the abstract's conclusion:
"Readers should carefully evaluate whether conclusions
in randomized trials are supported by data."
Since the purpose of the Cochrane Collaboration is to spare clinicians
the necessity of doing precisely that, what good is it?
So when I hear an evocation to "The Great Weight of Evidence"
or reverence for the Peer Review System or Evidence-Based medicine
by BS detector becomes sensitized. Then I read on to see what is done
with such devices. When I discover that they are used as licenses
to dismiss, discard or ignore evidence investigators don't like, my
BS detector clangs so loudly that it becomes difficult to continue
reading. Usually I stop, as I did in the case of the IOM report. It
is possible, even probable, that the report makes some cogent arguments.
But since I know that they are based on incomplete evidence, I could
not put much store by them.
So what, specifically, is wrong with the IOM report? To my BS Detector,
"Published and Unpublished Data
Published reports carry the most weight in the committee's assessment
because their methods and findings are laid out in enough detail to
be assessed. Furthermore, those published works that undergo a rigorous
peer review are subject to comment and criticism by the entire scientific
community. Thus the committee generally cannot rely heavily on unpublished
data in making its scientific assessments (regarding either causality
or biological mechanisms) because they usually lack the commentary
and criticism provided by peer review and must therefore be interpreted
What a lovely "Catch 22." The peer-review system won't publish
conflicting data. Nor is it obliged to say why. Nor is there a right
of appeal to that system. Being unpublished it lacks the criticism
(or support) it might otherwise have garnered.
Lacking exposure to criticism, it must be no good anyway.
No doubt the peer-review system prevents a lot of garbage from getting
into journals. But how many babies are thrown out with the bathwater?
We will never know. The bathing and subsequent dumping were never
"The committee also relies on editorial and peer-review
procedures to ensure the disclosure of potential conflicts of interest
that might be related to sources of funding of the research studies.
The committee does not itself investigate the sources of funding of
the published research reports it reviews, nor do funding sources
influence the committee's interpretation of the evidence."
Gee, that's reassuring. Trust the system when it supports your agenda;
but when that agenda is likely to be disrupted, ignore the principle
of evidence-based medicine that requires one to take into account
how the funding of a study might corrupt its outcome.
"Unpublished data and other reports that have not undergone
peer review do have value, however, and are often considered by the
committee. They might be used, for example, in support of a body of
published, peer-reviewed literature with similar findings. If the
committee concluded that the unpublished data were well described,
had been obtained using sound methodology, and presented very clear
results, the committee could report, with sufficient caveats in the
discussion, how the unpublished data fit with the entire body of published
So as long as the unpublished data is "in support of a body of
peer-reviewed" etc.- (read 'the great weight of evidence') -
the committee will take the trouble to consider it. Nothing could
be a more perverse diversion from true scientific inquiry! Anyone
interested in uncovering the truth, in gaining new knowledge, would
know that amassing more evidence in support of what we think is true,
while interesting, contributes little. Only the "ugly facts"
can show that what they think is true is actually in error. But they
apparently don't want to consider those. To that endů
"Only in extraordinary circumstances, however, could an
unpublished study refute a body of published literature."
So while Dr. Fineberg and his committee dodge and discount evidence
they don't like, although I may be lacking the ability to evaluate
the data in question, my BS detector and I are as confident about
the integrity of their findings as we are about the pronouncements
of any kangaroo court anywhere.
Brian D. McLean graduated from the University of Toronto dental
school in 1969. After a one-year dental internship at the University
of Chicago, he was for two years a part-time instructor at the University
of Toronto dental school, and has practiced general dentistry in
Mississauga, Barrie and Toronto since 1970. He admired the health
professions because they were "science-driven." Alas,
he has discovered over the years that somehow dogma often trumps
scientific method. The belief that fluoride and mercury are safe,
effective and necessary serves to dismiss evidence to the contrary.
He often refers to himself as a "recovering dentist. email@example.com