Social Media Sessions: Alt Med is not the Answer
- Admin
- Nov 12, 2022
- 9 min read
This is an exercise in critical thinking and reasoning.
David Gorski is a brilliant doctor and scientist, and a phenomenal communicator and advocate of skepticism and intellectual rigour. However, his post (below) was taken out of context by a commenter who, despite bringing some legitimate concerns to the table about the US healthcare system, uses these points to sympathise with Alternative Medicine. The commenter (John, second image) seems (intentionally or not) to de-legitimise Gorski’s point by moving the goalposts. His argument seems to suggest Gorski is criticising Alt Med without understanding why people turn to it, or that he’s criticising people who turn to it and saying they shouldn’t. I know that he isn’t – having read a lot of Gorski’s writings. I’ll explain further below.
Gorski’s Point
In the post (below), David is responding to a tweet (by ‘B’) which is not talking about the healthcare system. It appears to be coming from a conversation about bodily autonomy/freedom – highjacked as a common gateway argument into pseudoscience used by grifters and Alt-Med proponents. I’d hazard a guess that it came from either the Roe Vs Wade news or as anti-vax rhetoric about COVID vaccines.
As such, Gorski is not addressing the healthcare system. He is simply pointing out the well-established fact that alternative medicine is un/disproven, and often harmful. Therefore, it is not the answer to problems which may exist by extension of the current political/healthcare system, nor is it any part of this particular discussion around bodily autonomy.
He is also making the point that many people will take the term Alternative Medicine as being a legitimate medical enterprise or equal to medicine, which it is not.
It strikes me as out of the blue that ‘B’ (first image) side steps into alt med in this way. It looks like an obvious attempt at an endorsement/gateway for it, using the bodily autonomy angle. Quite a sly (or just ignorant) way to go about promoting snake oil, particularly if they are indeed talking about desperate, pregnant women here – some of which will undoubtedly be the target audience of expensive or potentially harmful herbal sugar pills.
Their comment is essentially the same as "throwing all your money away and forgoing treatment that we know works may not be an option for everyone, but it is an option". Why? Because people are free to do so. Then should we advocate for self harm, deceptive money-grabs, magic beans, based on the fact that people can do what they want? I don't think so, because it is wrong. People being free to do as they please is not justification for me to encourage them to drink bleach, for example. It's deceptive, sly, dishonest, dangerous.
Now to the main commenter I referred to in the introduction, criticising Gorski’s post:
Fallacious Reasoning
John makes points which are not so logically sound as to why Gorski’s post bothers him, which appear to strengthen his argument against Gorski’s post. But for all his not exactly false points, they are mostly red herrings. To be clear, I am not saying John’s concerns or points are all wrong in and of themselves, just that they do not warrant the criticism of Gorski’s post or follow logically from the point of it – and this may serve to diminish Gorski’s very valid and important point.
“Woefully incomplete picture of the realities of US healthcare”
Gorski wasn’t talking about or using US healthcare as an argument to support his point. He wasn’t even talking about the victims of either Alt Med or the healthcare system. The notion that Alt-Med is exempt from valid criticism because the healthcare system isn’t great, is woefully ignorant.
“A medicine you can’t afford is ineffective”
Raises a legitimate point (if we are talking about problems with the US healthcare system). However, the subject is that Alt Med is not legitimate or a solution. Actually (and I know I’m being pedantic), a medicine you can’t afford is still ‘effective’ – it’s just unaffordable, and that is another healthcare system issue. Alt med, whether affordable or not, is still ineffective. It’s also unethical (based on misinformation or lies), and still costs money.
This blurs the line of ‘unaffordable’ and ‘ineffective’ – medicine you can’t afford is ineffective, but to the lay person this can imply that Alt Med is affordable - and can be effective. It conflates the use of the word effective in the context of accessibility, with the use of the word effective in the context of works biologically. This may water down the distinction between proven medicine and Alternative Medicine.
“A medicine that betrays you with side effects (as rare as they may be) is ineffective”
Plenty wrong with this.
The word ‘betrays’ is used pejoratively against what are very effective and safe treatments (such as vaccines, pain killers, antibiotics, antihistamines, countless more). This only serves to undermine legitimate medicine and isn’t even to do with John’s angle – issues with the healthcare system, not medicine.
Side effects don’t take the place of a beneficial effect, they’re just additional. Chemotherapy is an obvious example. Drowsiness with antihistamines. Nausea/headaches with antidepressants or antibiotics. Mild virus symptoms after a vaccine. This is not a ‘betrayal’ – the medicine is still treating something worse if left untreated. So no, medicines with side effects are not ineffective, even if you experience side effects.
Risk Vs Benefit. All medicine is a risk vs benefit analysis, informed by the best quality data. The rarity and relatively mild nature of side effects are outweighed by the benefit of the medicine, and serious or lasting effects are extremely rare compared to the chances of serious or lasting effects of the condition that needs treating. This is misuse of the precautionary principle.
He ignores the fact that the vast majority of Alt Med literally betrays you in that it doesn’t work, proponents betray your trust, and it still takes your money – but for nothing. At least expensive and real medicine works. By contrast, legitimate treatments don’t ‘betray’ you, as the possible side effects are well documented, risk assessed, and listed on the packaging, or communicated to you by a physician.
Additionally, Alt Med carries a much higher risk of side effects with unregulated and varying doses of substances, and next to no expertise in diagnostics or drug interactions. Even Alt Med-related practices such as Chiropractic betray you. Spinal injuries are not uncommon, with nonsense diagnoses and a disregard for plausibility and evidence. This website documents hundreds of thousands of cases of harm done to otherwise treatable patients, through alternative medicine and therapies.
One other way Alt Med betrays you is with false hope – leading to the delay of diagnosis by a doctor and missing crucial time windows to catch serious diseases early enough to prevent. Alt Med practitioners are not trained to a high medical standard such that they would recognise early warning signs. It can kill you in more ways than one.
“The placebo you CAN afford has a better chance of being effective than the medicine you can’t access; especially when you have to pay for the ‘privilege’ of being denied care by a doctor”
Again, there’s a lot to unpack, so I’ll try to hit the main points only.
Firstly, a placebo is commonly misunderstood to have a physical ‘effect’ of sorts. The placebo effect describes not a physiological effect, but variables which may make someone feel or perceive to be better (and wrongly attributed to the placebo pill itself). It is not effective – apart from to psychologically modulate some forms of pain perception.
Therefore, it has zero chance of being effective for most conditions that have a physiological cause – and in fact, if something on the level of a placebo is all that’s needed, then it’s just as well the doctor wouldn’t prescribe something that would have an effect, because you wouldn’t need it. In this case it would be in your best interest not to risk addictive drugs, or risk unnecessary drug interactions or side effects.
A placebo would be a waste of money, unethical (dishonest, and no real effect) and actually more dismissive in that sense. The privilege is that you get to see a doctor in the first place, that you live in a country which has a relatively high standard of expertise and diagnosis available at all, and that you can book in to see one whether you have very low or very high concerns - before you are even sick. To be denied care at this point is either in your best interest and a wise expert opinion, or perhaps an inadequate diagnosis, possibly a system failure. You’re still better off seeing a doctor in the first place; and entitled to requesting a second doctors’ opinion/booking another appointment, after following their first set of advice.
I understand what he is saying, that when hope is thin on the ground and they can’t access the medicine they need, people will clutch at whatever they can. But really, "the placebo you CAN afford" has a better chance of wasting your money – even if it is cheaper. As painstaking as the healthcare system may be to go through, using alt med on the premise of false hope and availability may further delay your action in getting the treatment you may seriously need.
He ends the comment with:
“Fix THOSE problems with the healthcare system and maybe you won’t see as much of this.”
This can be a difficult fallacy to categorise, likely a mix of 2 or 3. His entire comment is a series of misdirection from Gorski's point. It’s most fittingly a red herring fallacy. See also avoiding the issue fallacy.
Red Herring Fallacy:
Avoiding the Issue Fallacy:
You could also loosely say it’s a kind of an ‘Argument from Motives’ fallacy, in which:
“The opposite side of this fallacy is [John] falsely justifying or excusing evil or vicious actions [Alt Med] because of the perpetrator's apparent purity of motives or lack of malice.”
The perpetrator in this case being 'B', or advocates of alternative medicine.
Conclusions
Various issues with the healthcare system absolutely do mean that not everyone can access the medicine they need. But this doesn’t mean that the Alternative Medicine industry isn’t preying on those same vulnerable and desperate people, for profit (100 Billion USD in 2021 – 20 Billion growth since 2020). It doesn’t mean we should seek out a scientifically illiterate, self-proclaimed ‘guru’ or 'life coach' or 'wellness expert' trained at the college of holistic hokum, and drink herbal concoctions, and clutch ‘energy beads’ and pretend ourselves better. This is a toxic practice - the below podcast is a fantastic dive into wellness culture.
It’s a matter of perspective; alt med proponents would frame it as though those who are desperate for something to take (the victims) are being criticised by ‘science’ for turning to alt med, and the blame rests with US healthcare (and science by extension, somehow) - that is the commenter’s perspective in reply to Gorski.
The reality is that Gorski, and science, is actually criticising Alternative Medicine itself, for being the unproven, often disproven, and unregulated predatory industry that it is – exploiting those victims desperate enough to turn to it. It's worth pointing out that Gorski and many other physicians have criticised the healthcare system as well, on separate occasions.
Moreover, he is simply trying to explain what ‘Alternative Medicine’ is, which is something a lot of people don’t realise. The ‘alternative’ medicine that has been proven to work, is just medicine. The Unbiased Science Podcast just did a brilliant job of illustrating this, specifically the subcategory Naturopathy:
I recommend the 2 embedded episodes below for a deep dive on the branch of alternative medicine that is Naturopathy, which illustrates the whole Alt Med industry by extension.
Part 1:
Part 2:
Criticising this nefarious industry is one branch of discussion, relevant to the Gorski post about ‘B’s tweet. In short it was a block on the attempt at slipping Alt Med in through the back door of an otherwise unrelated issue. There’s nothing wrong with Gorski’s comment, and it’s in good faith.
Therefore, for John to introduce the issues of the US healthcare system as a counterargument for the fact that Alternative Medicine is A. nefarious and B. has nothing to do with the conversation around bodily autonomy, sounds very apologist – even if he was just trying to defend those vulnerable enough to use it. Intentionally or not, John’s comment serves as a red herring to alleviate some of the criticism of what is a multi-billion dollar fraudulent and harmful industry, while undermining the scientific voice of reason.
All angles considered, John may indeed only be concerned for all those who the US political and healthcare system has failed. He may have jumped the gun in assuming that Gorski was criticising the victims while ignoring the reasons they turn to Alt Med (while really, he is criticising a very real problem at its own source). John makes the subject of Gorski’s post to be about the victims, while the subject was first about the industry which exploits the victims. These disconnects in discussions can be crucial turning points for some people to themselves fall victim to pseudoscience, as in this case, the expert (Gorski) could now potentially be portrayed by John as victim blaming to people who wouldn’t spot these differences.
Just because the political and healthcare systems are far from perfect, does not mean that we should turn to a demonstrably worse option. It does not mean that we should return to the pre-scientific dark ages or embrace a fraudulent industry. Alternative medicine is not the answer.
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