Friday, 5 November 2010

Freedom of speech: clarification

A few days ago I suggested accountability for those that intentionally spread lies that cause harm to others. In comments marko makes several good points. Nonetheless, they do not apply to what I wanted to say. To avoid any misunderstanding let me clarify. Freedom of speech has nasty side-effects. In an attempt to protect us against them I offered two solutions:

First, limit what people can say. marko offers good arguments as to why this is a problematic approach. That is why I concluded this should not be done. So far, we agree.

Second, make people accountable for the consequences of their right to say whatever they want. Again, some convincing arguments appear to make this route untenable. That is, if you would make this about any influence (film, book, painting) causing others to interpret that as a call to arms.

This is not what I intended, nor said. Just to be sure, I am talking about the willful spread of misinformation, lies, and propaganda with the intention to advance ones ideology while explicitly rejecting contrary evidence. Not infrequently do we see explicit advise to do, or not do, certain things. This ,of course, should be allowed, but if people act on those lies, and this causes harm, the abuse of freedom of speech should result in accountability.

Unsurprisingly the anti-science brigade is mostly inspired by religion. To cite Holy books as origin for unsupported beliefs -refusing to vaccinate, rejecting global warming, opposing evolution, et cetera- is one thing. To go out and tell people not to use condoms because some imaginary friend tells you to is quite another. Aside from the fact that I have not found the exact part where it says "being gay is a sin," "vaccination is evil," "the earth is 6000 years old," "Darwin is wrong," "Galileo is wrong," .......... (you get my drift) once you start evangelising the gospel "science is bad, ideology is good" you are responsible. Especially when you are shown the error of that proposition on numerous occasions: i.e. condoms do protect against STD's, vaccines save lifes, the earth is not flat.

To illustrate my view on accountability: randomly shooting your M16 is allowed. However, if a neighbour gets shot, because you are standing in the middle of the street while doing that, you will be criminally charged. Like bullets, words are dangerous and therefore require responsibility in its user. There can be no misunderstanding, my suggestion applies only to promoting unsupported, and discredited, opinions which are detrimental to our health. If this is still ambiguous to you, look at the following:
  1. Infectious disease promotion movement: vaccines are evil, and germ theory denial, resulting in re-emerging of preventable diseases,
  2. Alt-med works and is harmless: incorrect, since it both delays adequate treatment with therapies that do not work, and has serious side-effects,
  3. HIV-denialists: obstructing prevention and adequate treatment,
  4. Smoking does not cause cancer: after introducing a smoking ban a sharp decline of cancer and coronary-disease, 
  5. Abstinence only prevents pregnancy and STD's: incorrect, it actually causes the opposite, it increases the risk,
  6. Global warming is a hoax: discredited propaganda claiming we do not need to invest in better energypolicy, resulting in increased dangers to our planet, 
  7. Killing in defence of The Truth: murder is always a reliable statement when you are incapable of explaining why ideology trumps reason,  
  8. Shouting fire in a cinema: irresponsible behaviour in general,
  9. War on Drugs: stressing the evils of drugs while ignoring the sociological drama and the risks of alcohol and tobacco,
  10. Muslims want to kill us: as argument why the War of Terror is merely self-defence, and no, they help us, (compare: McCarthyism)
  11. There were WMD's: ignoring evidence to the contrary this caused hundreds of thousands to die, and millions became a refugee, 
  12. Torture is the only way we can win: an age old, and utterly nonsensical, argument which is dissected here,
The above examples are just that: examples. The list goes on and on. In all these cases, time and again, the ideological claim has been proven wrong. To cite an article in the European Journal of Public Health:
    All of these examples have one feature in common. There is an overwhelming consensus on the evidence among scientists yet there are also vocal commentators who reject this consensus, convincing many of the public, and often the media too, that the consensus is not based on ‘sound science’ or denying that there is a consensus by exhibiting individual dissenting voices as the ultimate authorities on the topic in question. Their goal is to convince that there are sufficient grounds to reject the case for taking action to tackle threats to health.
    This is referred to as denialism. The article identifies five characteristics:
    1. The identification of conspiracies. When the overwhelming body of scientific opinion believes that something is true, it is argued that this is not because those scientists have independently studied the evidence and reached the same conclusion. It is because they have engaged in a complex and secretive conspiracy.
    2. Fake experts. These are individuals who purport to be experts in a particular area but whose views are entirely inconsistent with established knowledge.
    3. Selectivity, drawing on isolated papers that challenge the dominant consensus or highlighting the flaws in the weakest papers among those that support it as a means of discrediting the entire field.
    4. Creation of impossible expectations of what research can deliver. For example, those denying the reality of climate change point to the absence of accurate temperature records from before the invention of the thermometer. 
    5. Use of misrepresentation and logical fallacies.
    That is what I object to. Nobody should be allowed to invoke freedom of speech and transform it into the right to disseminate lies. It is in these situations I propose accountability for irresponsible behaviour. The active promotion of (medical) disinformation leads to increased morbidity and mortality, which is evident to every reasonable person willing, and able, to understand the difference between fact and fiction. Claiming to be presenting factual information when it clearly involves refuting established science is not comparable to writing books or making cinema.

    No, I am not advocating a witchhunt. It would still be required to present evidence that harm -i.e. HIV infections, epidemics of infectious diseases, hatecrimes, et cetera- is linked to what was said by denialists. However, if such a causal effect can be proven why should the anti-science movement not be liable in the legal sense?

    Concluding, I am against prohibiting specific views, but would make those that irresponsibly -as in: choosing ideology over reason- promote dangerous behaviour accountable for the resulting harm. Freedom of speech comes at a price!

    Update: The right to lie gives us this.

    Update II: Regarding alternative medicine it is possible to take a more legalistic approach, Brennen McKenzie just started a series on the topic:
    When I write or talk about the scientific evidence against particular alternative medical approaches, I am frequently asked the question, “So, if it doesn’t work, why is it legal?” Believers in CAM ask this to show that there must be something to what they are promoting or, presumably, the government wouldn’t let them sell it. And skeptics raise the question often out of sheer incredulity that anyone would be allowed to make money selling a medical therapy that doesn’t work. It turns out that the answer to this question is a complex, multilayered story involving science, history, politics, religion, and culture.
    What I hope to do in this series of essays is look at some of the major themes involved in the regulation of medical practice, particularly as they relate to alternative medicine. I will begin by touching on some of the general philosophical and legal issues that have defined the debate among the politicians and lawyers responsible for shaping the legal environment in which medicine is practiced.
    Update III: Yet another example of the freedom of misinformation.

    Update IV: Using Bush's card-trick here is the denialism deck of cards.

    Update V: The right to mislead claims yet another victim.

    Monday, 1 November 2010

    Vaccine Unawareness Week

    November has arrived and the infectious-disease-promotion-movement has its "Vaccine Awareness Week." Therefore they are being offered a less Halloween inspired week of science-based information regarding vaccines. Probably they are not interested in a rational debate because the willfully blind ignore information contradicting their ideology. This inoculates them against the current correcting "misinformation week"-week. So, this week supporters of critical thinking attempt to reach the worried and misguided adherents of the anti-science crowd. Articles promoting critical thinking can be suggested at Science-Based Medicine:
    Many of our fellow science bloggers are on board as well. We will use this site at aggregate as many science-based posts about vaccines and public health as we find. If you have or know of any that are not listed, please let us know in the comments and we will add it.
    The first posts are already on-line. Steven Novella deconstructs the propaganda surrounding flu vaccines while Orac revisits a previous post:
    About seven months ago, I encountered a profoundly intellectually dishonest set of graphs done by Obomsawin that were designed to demonstrate that "vaccines didn't save us."
    I note that, not only have the graphs not been changed as far as I can tell, but Dr. Obomsawin is scheduled to give a webinar tomorrow evening (exactly 24 hours from now, actually) entitled Graphic Reality: The Charting of Truth in which he is apparently going to argue the same old nonsense that "vaccines didn't save us."
    Orac notes that he:
    intended for a while to go back and revisit Obomsawin's remaining nonsense. Somehow I just never got around to it. As you may recall, in my original post I didn't deconstruct all of his graphs and how deceptively he used them. Vaccine Awareness Week might be the perfect opportunity to rectify that oversight.
    Please visit the above mentioned aggregate site frequently this week for more. You may also be interested in what immune response is, since this is what vaccines attempt to augment. Some background can be found here.

    Update: Red flag? Mercola will help us fight those scientists. All you need to do is buy something from him.

    Update II: Collecting articles trying to protect us against the infectious-disease-promotion-movement Liz Ditz makes it easy for us to follow these posts.

    Update III: At Science-Based Medicine Harriet Hall adds:
    Physicians, has a feature called AFP Journal Club, where physicians analyze a journal article that either involves a hot topic affecting family physicians or busts a commonly held medical myth. In the September 15, 2010 issue they discussed “Vaccines and autism: a tale of shifting hypotheses,” by Gerber and Offit, published in Clinical Infectious Diseases in 2009.  
    The article presented convincing evidence to debunk 3 myths:
    1. MMR causes autism.
    2. Thimerosal (mercury) causes autism.
    3. Simultaneous administration of multiple vaccines overwhelms and weakens the immune system, triggering autism in a susceptible host.
    Next is Steven Novella who analyses the history of chicken pox and the fairy-tales from the anti-vaccine brigade, and Orac shows another example of crank magnetism.

    Update IV: The current endeavour is noticed in New Zealand by Skeptics in the Pub. Information on Vaccination Safety and Quality is available at the WHO website and EBM-first offers us some valuable links. More on influenza, effectiveness of vaccination and its risks, are discussed by Science-Based Pharmacy. Also, I found an old, but sadly still relevant, article there which was a response to the misinformation spread by those who prefer the return of preventable infectious diseases. As an aside, in Canada there already was a National Immunization Awareness Week earlier this year. Striking is an article written by Dr. Jay L. Wile. In his own words:
    He is best known for the "Exploring Creation with..." series of textbooks written for junior high and high school students who are being educated at home.
    With this background I was pleasantly surprised to read:
    Because people in California are refusing the whooping cough vaccine in large numbers, whooping cough is rearing its ugly head there. Children are needlessly becoming sick and dying, and we have the misinformation spread by anti-vaccine people to thank for it.
    Pretty amazing. Then there is the nice overview "Not Dangerous, and Irresponsible to Opt-out of" by Todd W. Finally, for those wandering the intertubes, here is a guide to evaluate trustworthiness of websites.