Tuesday, January 15, 2008

Fair and Balanced Reporting

The real problem with taking on quacks and misinformation in popular media is that if I spent all my time doing it I wouldn't have time to go to class, eat, sleep, or breathe. I've come to expect depressing amounts of credulity from the media. Honestly, I'm less bothered by the idea that reporters aren't doing proper fact-checking (because that's an eternal issue) and more annoyed by the fact that stories like this one legitimize fraud as actual medicine.

Ann Arough at the Little Rock Wellness Center, she listens carefully and mulls over their conversation before suggesting a remedy. Some of the things Arough, a naturopath, might suggest are herbal supplements, diet or lifestyle change, a visit to a medical doctor or with her husband, Mark, who specializes in acupuncture and Chinese medicine. Or she might suggest that they try a homeopathic remedy.

This article follows a lot of similar articles on the subject of questionable medical practices, especially those run by local newspapers desperate for stories. They always contain a certain set of specific elements:

1: Introduce the practice (homeopathy, acupuncture, ear candling, whatever is on sale at Whole Foods this week) with a brief overview of its history.
2: Touching personal story about a patient who used method X and "achieved miraculous results."
3: Quotes from an "alternative" practitioner who supports method X.
4: Short sound bite from a "skeptic" that gets turned into a variation of "X is unconventional...but...some patients say it works, so good for them."

The "skeptic" quotes are what bug me the most. The writers of these articles are trying to give the illusion that they're giving you "both sides" of a "complicated issue" by interviewing or quoting a mainstream medical professional, but what they're really doing is trying to lend an air of legitimacy to their story by getting an implicit endorsement of the s-CAM of the week.

Allopathic doctors, the physicians most people visit, tend not to understand the diluted remedies, says Dr. Stephen Hathcock, a general practice physician at the Center for Integrative Medicine in Little Rock. “I don’t know that anyone understands the science of it and Western medicine doesn’t function in that realm,” he says.

He goes on to say some silly stuff about how "energy medicine is cutting edge" and what have you. No. No no no. There is nothing cutting edge about misunderstanding quantum physics. Biotechnology, immunology, and biochemistry are the fields driving medical advancement. Not poor interpretations of electron entanglement.

I get really tired of reading these because it's like watching a bad horror movie. You know how you want to scream at the screen when the protagonists are doing something so stupid that there's no possible way they aren't doing it on purpose, unless we assume that horror movie characters have never seen a horror movie themselves? I get the same way about these sorts of statements about homeopathy. Maybe you "don't understand the science of homeopathy" because homeopathy is magic. There is nothing vaguely scientific about it unless we're talking shifting from physics and chemistry into the realm of psychology. At that point, it becomes easy to understand how homeopathy, like many CAM treatments, can be effective: Ye olde placeboe effecte.

Of course, as I've said before, patients like placebos. I recall hearing a story about a patient who wanted his doctor to sign a contract saying that his doctor would try to maximize the placebo effect whenever possible, essentially giving the physician license to "fool him" if it would help with his symptoms. The doctor, on totally reasonable ethical grounds, refused. But the story illustrates my point well. Patients don't typically care how they get better; they just want to do it. And if homeopathy, megadoses of vitamins, or acupunture make them feel better, or give them a sense of empowerment regarding their illnesses, they're going to go for it. But they wouldn't have tried those methods in the first place if someone hadn't recommended them, directly or indirectly. And the lack of willingness of many medical professionals to condemn outright CAM for fear of alienating their patients--or worsening their treatment outcomes--creates a nasty ethical quagmire.

Sometimes you get item 5, which is "alternative medicine practitioner really, really wishes they would license practitioners of X in their home state to ensure quality of care."

She and her husband returned home to Arkansas about two years ago, and she intends to lobby for licensure legislation here, which would allow her and others to practice medicine according to her training, and, she says it would create standards that would ultimately protect patients.

Yeah. I'd much rather see a witch doctor with a degree from Harvard than a witch doctor who picked up his trade from correspondence courses online.

I may write the editor of NWAnews. I may not. I have a feeling my words will fall on deaf ears. Personally, I think this represents the ultimate failure of the media; its tendency to portray and even create controversy where there is none. The scientific consensus--which is the only one that matters, when we're talking about science--is that homeopathy is nothing more than a ritualized placebo. Science isn't like politics. You can't put reality to a vote if you don't like it, and there are such things as absolute truths. "Fair and balanced" reporting implies that both sides of a "controversy" have equal weight. In this case, they do not.

Why can't we bury this issue once and for all?

1 comment:

shmoo said...

"Science isn't like politics. You can't put reality to a vote if you don't like it, and there are such things as absolute truths."

I wish more people in the US felt this way.