Tuesday, November 12, 2013

Modern Snake Oil and Contempt for the Ethics and Morality of Scientists and Doctors

I get enraged.  Over and over I hear people say that you can't trust science but should trust some new age truism or conspiracy theory instead.  Why does this make me so angry?  Because I have several close personal friends who are research scientists and medical doctors.  One of my cousins is a medical doctor and research scientist with dozens if not hundreds of published studies credited to his name, a friend of over 30 years is the head of two major medical departments and oversees hundreds of researchers, and yet another friend of nearly 40 years is a scientist working at JPL.  I studied research psychology for several years at Tulane (dropped that second major because it wasn't the type of psychology I was interested in) and have an intimate knowledge of scientific ethics, methods, and motives.  I'm going to limit this discussion to medical research in particular (though the same accusations are levied against aerospace scientists, climate scientists, or even my friends who attended the funerals of Sandy Hook children they knew personally) because one particular blithe and insulting comment keeps coming up in the context of "western" medicine v. "traditional" medicine:  "All doctors are in the pocket of 'Big Pharma.'"

The most common infuriating statement I hear is that "herbal supplements" or "natural cures" are superior to modern medicine.  This belief is based on a series of logical fallacies including anecdotes, appeal to nature, confirmation bias, and arguments from antiquity.  Scientific studies are dismissed because they're "all funded by 'Big Pharma'" which explicitly accuses the tens of millions of research scientists and doctors performing long term studies and collecting billions of data points for analysis of being unethical, corrupt, and untrustworthy.  This opinion is based on the false idea that all or even the majority of peer reviewed studies are underwritten by pharmaceutical companies and that all these studies are manipulated and falsified by those companies.  Again, this is insulting to all these scientists that do the work of conducting the studies, running the experiments, crunching the data, and reaching conclusions.  It ignores that these studies, once complete, are then examined and re-examined by other scientists and doctors, that the data is sifted through by people whose sole goal is finding fault with the study.  Most of the time fault is not found or, when it is, it is because a larger study or experiment has been conducted that shows the original findings were not as significant as the data of the smaller study showed.  There is also a huge confusion in the minds of laymen and media that report on these studies as to what statistically significant means.  For instance, if a study shows that the effect of ginkgo extracts is statistically significant that does not mean that anything has occurred other than a measurable change when compared with placebo.  It does not mean that spending $50/month on ginkgo tablets is justified, it means that in this particular study they found an effect that rose above the baseline noise always found in a statistical study.  Subsequent larger studies can show (and in this case have shown) that the effect is so small as to be insignificant and in the smaller study was a fluke of the population involved.  Science moves forward and self corrects.  Belief is stagnant and entrenched.

As far as "Big Pharma" underwriting studies of their own drugs there is no doubt of this.  They have a LOT of money and they must have these studies for the FDA and international regulatory bodies to approve their use as medicine.  There have even been very rare cases of companies hiding data or cherry picking, the most prominent example that comes to my mind is Viox.  The study results were manipulated unethically so that the product's lethality was concealed.  So how was this fraud discovered?  Through the scientific process.  The process of peer review eventually brought out the truth, the drug was recalled (largest in history), and criminal charges were pursued.  This does not happen in the world of herbal supplements and "natural medicine."  The $60 billion/year herbal supplement industry does not underwrite independent peer reviewed examination of their products because they don't have to and because they're well aware that most of their claims will be disproven.  The herbal/dietary supplement industry spends fortunes on lobbying and have several major politicians in their pockets (most notably Senator Orin Hatch).  The industry wrote and pushed through Congress a bill in 1994 that exempted them from the same oversight as medicines.  The only time the FDA can do anything about their products is if they are found to be contaminated, they actually poison people, or the companies make explicit medical claims (which can be skirted by adding the simple statement "this product is not a medicine").

When you buy an herbal supplement you have no way of knowing that it is what it says on the label, much less knowing how much active ingredient is in the pill, or whether or not that herb has any real effect regardless.  But somehow intelligent people who should know better are willing to trust this unregulated and demonstrably fraudulent industry over the entire scientific medical field, impugning all the scientists and doctors involved as being unethical liars.

[A little side note:  so called "boner pills" that claim to be herbal aphrodisiacs are constantly found to be spiked with Viagra.  As soon as they are found out the company folds, the product is pulled from the shelves, a new company is started by the same players, the same spiked product is repackaged and continues to be sold (usually for prices equivalent to or greater than pure, unadulterated Viagra).  Ancient Chinese secret?]

One last point about Big Pharma v. Big Dietary Supplement:  the largest owners of herbal supplement companies are Big Pharma.  Why would companies like Pfizer buy dozens of "dietary supplement" companies?  Because they can make a ton of money with little or no regulation.  Dietary supplements are an out of control cash cow for these mega-corporations.  Those racks of pills at your local health food store are not being made by a conscientious mom & pop company working diligently next to their little garden, they are the same people that make the pills that line the shelves of your pharmacy.  They know they can stuff dried grass into a pill, sell it as St. John's Wort and there will be no consequences but if they sell a tablet of ibuprofen that is full of sugar they'll face huge fines and criminal liability.  The "Big Pharma" argument is in and of itself moot as "Big Pharma" is running both sides of the equation.

So yes, it makes me furious to hear perfectly intelligent people call my friends and relatives liars and frauds while claiming that proven liars and frauds are more trustworthy and honest.

related sources:


Alan (Evil) Miller said...

From Facebook:
Debbie XXXX - Gonna ask this here, not there....
Sooo... making $ with no regulation is okay for big pharma, because, after all those scientists do need funding, but not the snake oil people who pioneered psychosomatic healing? The libertarian scientist rules?
about an hour ago ·

Alan Miller - Big Pharma (which is a misnomer) is heavily regulated and the industry of herbal/dietary supplements is not. Your first question is based on a fallacy (and you also didn't read my entire piece or you'd know that Big Pharma and Big Dietary Supplement are the same companies). What in the world so called psychosomatic healing has to do with this is beyond me. I did not mention this pseudoscience at all. That part of your question is known as a red herring.

I don't even understand your "libertarian scientist" question. Science is a methodology, not an ideology. Proper science is following a set of rules to reach a conclusion. Individual scientists can fall prey to confirmation bias (expecting a certain result and finding it when it's not there, for instance) or other human failings but science writ large will always self correct. One in a million scientists will commit actual deliberate fraud (as opposed to simply making a mistake) in the course of their careers and their fraud will always be found out as will the simple mistakes. The dietary supplement industry commits fraud 24/7, they have no peer review system in place, no ethical guidelines they adhere to, and their supporters disbelieve their own advocates. Belief is static. Science evolves.

Read the study I link in the body of my piece. Everything about their study is included. The names of the dozen+ scientists involved, the funding sources, the methodology, how the samples were collected, all the data from their analyses and the processes used. The DNA samples of these "herbal dietary supplements" showed massive fraud across the board, and potentially life threatening fraud. If you have kidney disease and take some of these mislabeled products they could kill you. Certain unlisted herbs found in these medicines could cause heart failure when combined with other medicines. Many of the pills contained wheat contrary to the label which could be horrible for someone with an allergy.

I don't say that herbs don't have efficacy, they definitely do. You simply cannot trust that any given pill on the shelf contains what the bottle says or, if it is what it says, what the potency of that substance is.