Monday, November 12, 2007

The Importance of Self-Criticism

It is often said by proponents of alternative therapies and the like that Science is arrogant in thinking it has all the answers, but this is a false argument; science does not claim to have all the answers. Its method is set out in such a way that those working in evidence based science must continually attempt to disprove its firmly held beliefs; it is commonly said that scientific theories can never be proved, merely disproved; and as each theory is disproved we move towards a better understanding of the universe. That is to say that when evidence arises that points out flaws in the current theory, a new theory is required that will account for both the old and the new evidence. This new theory, in time, may well be disproved, and a further theory required.

Ben Goldacre, the author of the Bad Science column, often mentions the top 3 requested research papers from the BMJ's archives to highlight the fact that scientific endeavour is based in a healthy environment of self-criticism. This may be of special interest to those who spam alt.religion.scientology with anti-psych posts!

The top scoring paper was a case-control study which showed that patients had a higher risk of heart attack if they were taking the painkillers rofecoxib (Vioxx), diclofenac, or ibuprofen. Vioxx of course was at the heart of a major scandal. At number 2 was a large meta-analysis of drug company data, which showed no evidence that SSRI antidepressants increase the risk of suicide, but did find weak evidence for an increased risk of deliberate self harm, which is worth keeping an eye on. And in third place was a systematic review which showed an association between suicide attempts and the use of SSRI’s, and highlighted – very critically - some of the inadequacies around the reporting of suicides in clinical trials.

What is perhaps more important than the content of these studies is that the papers are not the result of Scientologists or any other axe-grinding, anti-science group researching the effects of medication. These papers are a result of people working in the rational, logical world of evidence based science. They are seeking out truth by the creation and analysis of data.

The problem that both Scientology and the anti-psych; anti-big Pharma movement has is that it tends to hold up disproofs as evidence of a systemic failure of science, as though the method itself was in some way flawed. Scientology, in its recruitment, warns staff to watch out for people who seem to require evidence for the claims Scientology makes about itself. Anyone who has done any serious research into Narconon or any of the other technologies developed and promotoed by the Church will know that the kind of rigorous, double-blind tested, evidence-based research that is necessary to determine the efficacy of their programmes either does not exist or is woefully misinterpreted for the sake of a sale. Furthermore staff working on such unproven therapies or techniques show no interest in researching or improving them. This is because it is not good Scientology to question the tech. There is no room in Scientology for it to criticise itself, despite the early writings of Hubbard on the subject. Keeping Scientology Working is used to ensure that no-one is able to put the tech to the test.

This is the fundemental hole in the anti-psych spam. It generally involves people working in the field of psychiatry publishing research into their own field. Few of the people quoted by the spammers are making a case against the field of psychiatry as a whole, and it is well worth investigating the background of those who do.

Much of the rest of the anti-psych spam is made up of psychiatrists being disciplined for improper behaviour. Again, all that these posts show is that self-monitoring of psychiatrists is ongoing, and that it gets results; the system works! Posters may want to see the transgressions of the minority of psychiatrists that are struck off or otherwise disciplined as a sign that there is something rotten at the core of psychiatry, but do be aware that you cannot hold that argument without also maintaining the argument that Scientologists who break into government offices, or defraud people, or otherwise harm or rob people also demonstrate something rotten at the core of Scientology.

Whereas one may, and often do, get scientists complaining about the way that research funding is awarded, or that there are flaws in the way pharmaceutical products are developed or marketed, one will not find any Scientologist criticising Scientology. Called on to say something, anything, that is wrong with Scientology might lead to the glib "there aren't enough Scientologists", but little more; not even how slow the Church was to pick up on all that bad tech it's been selling its members for years, right up to the day that the revised texts and courses were made available. That total lack of self-criticism (and intolerance to criticism) is not a sign that Scientology is somehow right and true; it is a symptom of its own failings.