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.

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