Sunday, November 24, 2013

The pseudoscience of Deepak Chopra

by Felipe Nogueira

If I had to choose a person as the icon of pseudoscience that would be Deepak Chopra. Everytime I listened to Chopra, he made a lot of misuses of scientific terms - it looks like quantum can't stay out of it - combined with religion/supernatural ideas. When it's possible to extract any meaning from what he is saying, it usually has scientific errors.

Chopra has propagated the notion of "quantum healing" or "quantum medicine". The word quantum came from quantum mechanics, which describes the behavior of matter on microscopic scales. In other words, quantum mechanical effects are significant on very small scales, but on a much bigger scale than the atomic one, quantum effects disappear and we don't notice them. Therefore, there is no such thing as "quantum medicine".  

Recently, the renowned evolutionary biologist Richard Dawkins debated with Deepak Chopra. The debate is on Youtube. It's very impressive how Deepak Chopra cannot properly answer a single question or make a comment about a specific issue, without changing the subject, without using scientific terms out of their contexts. Dawkins mentioned that several times throughout the debate and highlighted one of Chopra's recurrent misuses of the word quantum: 
You have used the phrase "quantum leap" to apply to the origin of language, to the origin of life and jumps in the fossil record. Now, this is a pure metaphorical usage of the term quantum leap. All you are using it for is a change that ocurred in the world for which we have yet no explanation. On the other hand, you have used the word quantum in the proper physicist sense. You talked about digital information going to satellite. In that case, you're talking about quantum theory in the true sense of quantum mechanics. You are bamboozling people, by using quantum in two completely different senses, giving them the impression that there is something about modern physics, something about the spooky aspects of modern physics, to things like the origin of language or the origin of life or breaks in the fossil record. Those three things - the origin of life, origin of language, breaks in the fossil record - are scientific problems to the extent that we don't yet have answer to them, we're still working on them. They have nothing whatsoever to do with quantum in the physicist sense.
Other scientists have criticized Chopra too. Just a few days ago, the evolutionary biologist Jerry Coyne made the following comment about Chopra:
he’s a pseudoscientist, showing all the characteristics of that genre, including the use of meaningless jargon that sounds profound, a refusal to discuss serious criticism of his views, and a deep sense of persecution by “the establishment.”
On a debate at Caltech, psychologist and Skeptic publisher Michael Shermer and neuroscientist Sam Harris debated against Chopra (and writer Jean Houston). Shermer said the following about Chopra's way of speaking:
Stringing together, at a rapid pattern, a bunch of scientific sounded words sprinkled in with some spiritirual New Age words...it doesn't mean anything. 
One of the interesting things about this debate at Caltech is that Chopra asked for a physicist in the audience to speaks out on his support. In the Q&A session, the debate moderator recognized the theoretical physicist Leonard Mlodinow in the audience and invited him to make a question. If Shermer and Harris critics weren't enough for that day, Mlodinow settled the issue down very clearly (video available here):
Would you [Chopra] like to take a short course in quantum mechanics sometime so we can straight out your slightly misuse of quantum notation?*   
Mlodinow was not the only physicist who criticized Chopra. In a Scientific American column, the renowned cosmologist Lawrence Krauss called Chopra one of the worst abusers of quantum mechanics for profit. Krauss puts the following about Chopra:
I have read numerous pieces by him on why quantum mechanics provides rationales for everything from the existence of God to the possibility of changing the past. Nothing I have ever read, however, suggests he has enough understanding of quantum mechanics to pass an undergraduate course I might teach on the subject.     
Chopra's nonsense goes beyond that. He also says that the universe has purpose and consciouness. According to Chopra, even atoms and subatomic particles have consciousness; evolution is driven by consciousness. Of course, saying all those things doesn't make it true and Chopra offers absolutely no evidence for his claims. In the recent debate, Dawkins explained some organisms have purpose, for understood evolutionary reasons, but that doesn't mean the universe itself has a purpose. Some organisms also have consciouness, but this is not true for atoms, photons, electrons and the universe itself, because consciouness originates in the the brain. And evolution gave origin to consciousness, then evolution can't be driven by consciousness.

I think the following contradiction is pretty clear. When a scientist claims there is no evidence for the supernatural (God, after life, souls and ghosts, etc) some religious/spiritual people, Chopra included, say science doesn't have and cannot have all the answers, because science methodology is incomplete. However, that doesn't stop them from using scientific terms. It looks like having religious beliefs and praying for their God aren't enough: they desperately insist that their religion is supported by science, when it's not.

The importance of stretching these things out is because scientific understanding is at stake; Chopra is giving wrong explanations, and people fall, buy and propogate this kind of nonsense ideas. For example, quantum mechanics is, indeed, highly non-intuitive and strange things happen all the time, but they happen, as I said, on microscopic scales. However, a lot of people believe quantum mechanics is assoaciated with religion, supernatural, spirituality, meditation, or mysticism. These people are just wrong**. On a interview about pseudosciences related to quantum mechanics, Krauss is very clear:
quantum mechanics, for better or worse, doesn't bring any more spiritual benefits than gravity does.
Letting false claims, such as those made by Chopra, spread without critics is a disservice to science and failure to recognize the importance of scientific understanding in our society. The "willful obscurantism" Chopra has done is exactly what Dawkins said in the end of the debate: "the enemy of truth and science".

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* The discussion between Shermer, Mlodinow and Chopra didn't end there and they were at Chapman University in another debate. The "clash" between Mlodinow and Chopra gave origin to the book The War of WorldviewsScience vs Spirituality co-authored by both.  When I heard this book is going to come out, I thought it could give a credit to Chopra he didn't deserve, although I presumed Mlodinow would show the confusion Chopra does so often. Indeed, Mlodinow's part of the book is very good and I recommend the book when I want to show someone how a scientist thinks and some contradictions between science and religious (or spiritual) ideas.

** If you are one of these people, you should consider to improve your scientific knowledge. For example, if you want to know a little bit more about quantum mechanics, you can try the excellent explanation by theoretical physicist Sean Carroll available here. Also, try to read the article about quantum pseudoscience by physicist Victor Stenger here.


      
  

Wednesday, October 2, 2013

Lawrence Krauss: "Science is a method for distinguishing fact from fiction"

by Felipe Nogueira

Interview with Lawrence Krauss
Lawrence Krauss is a renowned theoretical physicist and was one of the first to suggest that most of the energy of the universe resides in empty space, an idea which today is called "dark energy". He has participated in several discussions and debates to popularize science and has lectured around the world about his last book A Universe From Nothing: Why There Is Something Rather Than Nothing. As the title suggests, the book explains that our universe may have come from nothing.
A Universe From Nothing

I did an interview with Krauss and it is available on Youtube. In my opinion, Krauss is one of the best science popularizers today; a big advocate of scientific skepticism and education. Through his debates, lectures, and books, I have learned with him for some time: Krauss is one of my educators, even I've never met him in person. So, Krauss is a big motivator in my scientific journey. I want to registrate my happiness to talk with him; I'm honored for doing it, I thank him for the opportunity and attention.  

This is the first of the interview.
Links: second part | video on youtubeversão em português

On your debates, you had mentioned that science is not a thing, it is a process. What’s science all about?
Krauss: Science is a method for distinguish fact from fiction. It’s a method for asking questions systematically and to answer those questions in a way that you can test. Another important thing is that it’s a method based on empirical evidence: one asks questions about the universe, one tests the universe with empirical questions and observations, and then one either confirms or falsifies something. The important thing about science is that you can’t prove something to be true, you can generally prove something only to be false, but, like Sherlock Holmes, you get rid of all the false stuff  and what’s left over is true.

Can you tell me one of the science misconceptions?  I can try to make a point there is a notion that science is a matter of opinion and we should hear all sides of the story.
Yeah, as I often like to say, the great thing about science is that in science one side is usually wrong.  There are open questions, where there is uncertainty and debate. The resolve of debates is not rhetoric or volume, but rather nature. So, if you have an idea and measure it and it simply disagrees with observation, then you throw it out. There is no discussion. There is no need to debate the question whether the earth is round or whether it is flat. There still people who claim the earth is flat. But they are just simply wrong.  As journalist, you don’t have to quote them. Similarly, about evolution: there are some people somehow don’t think evolution happened, but they are wrong. And I have to say the same thing about the fact the human induced clime change is happening; those people who argues against it are simply wrong.

You've made a point recently that the only knowledge that matters is the empirical one. Can you elaborate?
I don’t understand when people say that they can get knowledge by revelation. That just simply leads to delusion. We all, in fact, delude ourselves in a daily basis. We need to be skeptical of ourselves and we need to test things. I can see reflection and maybe even wisdom, but knowledge comes from observation, and testing, and experiment. Anyone who claims to have knowledge otherwise, first of all, can’t demonstrate and, second, is most likely to be wrong.

You’ve made a point that in this process of science we do not learn how the universe works by logic…
The point is that classical logic is based what seems reasonable. But what seems reasonable to us is based on our experience and as we broader our experience what seems reasonable can change. Quantum mechanics is the perfect example. It doesn't seem reasonable for a particle to be able to be in two places at once, but in the quantum mechanical world that what happens. Based on observations, you can do carefully reasoning and logical arguments. But to presume in advance what is logical or to use classical logic one has to be very careful, because the world is not classical.

What you mean by that “the world is not classical”? 
As Richard Dawkins [renowned evolutionary biologist] has said and I like to repeat, we evolved our sense of logic and reasoning to escape lions on the Savanna and Africa; not to understand quantum mechanics.  But, in the very small and in the very large, the universe behaves in a way that seems paradoxical to us.  And it is paradoxical to us because our intuition is based on a small segment of reality and that segment doesn´t apply universally and we have to be very careful to not do so. Science teaches us that our myopic views don't necessarily represent all of reality and we have to be very careful to assume what we think is either natural or sensible is really the case.

People say that science changes all the time and this is a bad thing.
First of all, Science does changes, it´s called progress.  It changes in a very well defined way.  It’s not that we throw out what went before, this is another big misunderstanding of science. What satisfies test and experiment will always survive. Even Newton's Law, which had been supplanted by General Relativity and Quantum Mechanics, on the scale in which they apply, for the motions of cannon balls, baseballs, missiles against Siria, Newton's Law will always apply. So, we may learn new things in the edges of knowledge, in fact we always will, which makes science wonderful, that changes our underlying picture of things, but there's a consistency on our ability to predict and it´s not as we throw out what went before.

What’s your opinion on philosophy?
Philosophy is useful to reflect in the knowledge generate by science.  And all the good philosophers I know they do that, they use rigorous logic and reasoning to reflect on the knowledge and interpret it and ask new questions. So philosophy sometimes is useful for framing questions, but science is what is useful for coming up with answers and for generating that knowledge. I think any philosopher who argues otherwise is overstating the case. And as I say I have many friends who are philosophers and I think we all agree that what philosophy is good for. And it used to be, let´s face it: it used to be indistinguishable from physics back in the days when Natural Philosophy was the case, but they two diverge. And philosophy just simply isn’t the right way to generate knowledge about the world, it’s the way to reflect upon that knowledge.

People use notions that are different in science, like the words “theory” and “nothing”. What is theory for science and why people keep getting it wrong?
Theory in science is the highest level of knowledge, it’s not a hypothesis. Theory, like Newton’s theory of universal gravity or quantum theory, is a mathematical supposition that has been subject to test over and over again. So, when we say evolution is a theory, we are putting it on the highest possible pedestal, not suggesting it’s a random hypothesis.

There is an article that you had written that says string theory is not a theory in the same sense evolution is a theory...
Scientists are human beings and misuse words like anyone else. And now I very pleased to say I convince people like Brian Greene [a string theorist], who is a friend of mine, and he agrees with me now – of course, he doesn´t quote me – that string theory is a not theory, it shouldn´t be called a theory.
There are a lot of theories we don’t have and one clear example is a theory of quantum gravity. We don´t have a theory what happens in the center of the singularity of the black holes, we don´t yet have a theory what happens when t = 0 in the big bang. We have ideas, but we haven’t been able to test them. And some people have argued that complexity is a theory – Complexity Theory – but I’m not convinced that there is really a theoretical underpinning of complexity.

String theory is not a theory because it doesn't make any predictions yet, or because the predictions it makes are not falsifiable at this moment? 
String theory is both. It doesn’t really make any predictions at this point because is still an evolving idea. And every time it makes predictions, they realize they are probably premature, but the predictions it could make are probably beyond the realm of experiment, although smart theorist continue try to think in ways we might be able to test the ideas, like the existence of extra dimensions, for example. There is small possibility that we might be able to test in Large Hadron Collider, but it’s a very small possibility indeed.

What do you mean that the universe have come from nothing on your last book? 
I mean that is plausible, given everything we know and every measure we made about the universe that it could come from nothing: no space, no time, no particles, no radiation. In particular, if you ask, what would be the characteristics of a universe that did come from nothing by the know laws of physics and some reasonable extrapolations of the know laws of physics, it would have the characteristics of our universe.

On your book and lectures, you mention three levels of nothing.    
Yeah, nothing, like theory, is a word that means different things to different people. I as often like to say, the people that don’t like what I say define nothing in a way that only God can create something. But for many people nothingness was the empty void of the Bible, the empty space is nothing. Of course, that is not nothing, we show that. Or that kind of nothing can easily create something. That can be defined as nothing: empty space is a good approximation, but it's really much more complex than our naive pictures. Then, I say the more dramatic version of nothing involves only no particles and no radiation, but no space itself. And that, again, could come into existence by any reasonable theory of quantum gravity. And then the final version of nothing: maybe even the laws that govern how things evolve in our universe themselves are accidental. That’s the ultimate version: no laws, no space, no time, no matter no radiation. Well, maybe that’s not nothing, but it is pretty good nothing to me.



Lawrence Krauss: "The tenets of the world major religions are incompatible with science"

by Felipe Nogueira

Interview with Krauss

Lawrence Krauss is a renowned theoretical physicist and was one of the first to suggest that most of the energy of the universe resides in empty space, an idea which today is called "dark energy". He has participated in several discussions and debates to popularize science and has lectured around the world about his last book A Universe From Nothing: Why There Is Something Rather Than Nothing. As the title suggests, the book explains that our universe may have come from nothing.

This is the second part of the interview that I did with theoretical physicist him. I am honored for doing it and I want to thank him for his time and attention.

Links:  First part | Video on Youtube | Versão em português.

I am fascinated by the idea of quantum computing...
Krauss: Quantum computers are fascinating idea, but the point is quantum computers would allow you to do certain algorithms that classically you cannot do, such as factor large numbers into their prime numbers. Every number has a unique expression in terms of a product of primes. The primes that very large numbers are product of cannot easily be determined. That algorithm is possible in quantum computers. Why we should care? Well, it turns out, people use large numbers and their prime factors as keys for the secure of credit cards and bank accounts. So, if you can factor them easily, then we have to find other ways to secure it. That’s the bad news. The good news, however, is quantum computers can also provide quantum encryption and in a sense allow you to see if someone has been eavesdropping in a message. So, there is plus and minus for using quantum computers. But it´s not clear that we can practically do it. 

The reason we can't do it is because something called quantum decoherence?    
In general, that’s right.  The quantum world is generally invisible for good reasons because the interactions of particles with the environment destroy quantum correlations and it is precisely the quantum correlations you want to exploit to do quantum computing or quantum teleportation or to do anything like that.   

And about science and morality: you say that without science our morals are useless.         
I do. Everyone who claims the morality is based on religion, actually base morality on reason.  As I often say to people, if you did not believe in God you probably would not kill your neighborhood. Although, some people say they would. The point is that science tell us the consequences of our actions. And if we don't know the consequences of our actions, we can't even determine what is right and wrong. And then we use reason, empirical evidence for the consequences of our actions and reason based on it to determine what’s appropriate. Most people operate that way and that’s the laws of the most nations are based on, not on some religious doctrine, but on reason and empirical evidence. As Steven Pinker put it, you can ask: how does God know what is right or wrong? There are two possibilities. One is that he invented them arbitrary, in which case what’s the point of worrying about that? Or two: he bases what is right or wrong on what is reasonable, but if he does, we can just get rid of the middle man and go directly to reason ourselves.  

Do you think there is an objective moral?  
I think there are universal morals in a sense that people are biologically hardwired to think certain things are wrong, like for example a priori most people find that incest repulsive.  But there are biological reasons for that. But I don’t think there are objective morals. I think morality is determined contextually within a context of a framework of a time and certain circumstances. And as I say, in certain circumstances, incest isn’t wrong in my opinion. Let me make it clear: in certain circumstances, it is not obvious that it is wrong or immoral. 

The laws of quantum mechanics are deterministic, but what about the distribution of probabilities?
The underlying equations are secondary differential equations, which are deterministic: you give a initial set of conditions and you can derive unambiguous. The wave function evolves deterministically, so the underlying physics evolves deterministically. It's absolute true that effectively from the point of view of observation or experiment things are probabilistic, but the underlying laws are deterministic.       

What do you think about free will? 
I think free will is an illusion., it is an effective illusion. We live in a world that for all intents and purposes behaves like a world in which we have free will. Essentially it is undistinguishable from a world with free will. The question whether it exists or not is one of those irrelevant question. 

You make it clear that saying that God is explanation for something is a cop-out. 
People mean many different things by God, because God it's not well defined.  Everyone invents their own Gods. When people use the term god it is a very personal term and it means many different things. As I said, its ill-defined, not least because it is a illusion. 

Some people make the case that science and religion are compatible because some scientists believe in God.    
That is ridiculous. There are scientists who can hold mutually contradictory beliefs. And those scientists became atheists when they go into the laboratory and they stop being atheist when they go out of the laboratory. So, if you can ignore everything you believe in one circumstance, it is absolutely compatible. And a vague belief in some order in the universe and purpose it is not incompatible with science; there is no evidence of it, but it is not incompatible. But the tenets of the world major religions are incompatible with science. So, some vague deism is compatible with science, but certainlly not belief in world major religions.

What about the idea that science deals with how questions and religion deals with why questions?
Religion doesn’t deal with anything. But what we mean by why? If you ask why, you presume purpose. So religion presumes purpose and presumes to answering it. But the presumption of purpose is a presumption,. Therefore, unless you establish there is evidence of purpose, you are inventing things and that’s why religion invents things.

Some religious people claim the fine-tuning of the universe count as a point for them.
They don't understand what they are talking about. The old claim that bees were fine tuned to see the colors of flowers means they were designed. But, no. If they couldn't see the colors of flowers, they wouldn't get nectar and they wouldn't be able to reproduce. Our characteristics seem to be such that they are fine-tuned to the universe in which we live. To put in the other way around, suggests the universe is fine-tuned for us. But that can be an accident. We evolve in this universe; if we would evolve in another universe, our characteristics might be different. Secondly, the universe isn’t fine-tuned for life: the universe is quite inhospitable for life and the universe is trying to kill us all the time. Thirdly, there are constants that could be much more natural that would make life even better. All of those arguments are based on a lacking understanding of fine-tuning.

What about The Unbelievers?
We are in the final stages of negotiations of distribution. It will get world wide distribution in 2014. It will be in some theaters in United States in 2013. And may get theatrical distributions in each country. It will certainly get distribution on Amazon, Netflix, and video on demand, and DVD. Whether it gets theatrical distribution, will depend on negotiations with each country, which I'm not a part of it. 

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I would like to thank again Professor Krauss for his time and attention.

Tuesday, October 1, 2013

Paul Offit: "I ask for people to be more skeptical"

Paul Offit is an pediatrician, the Chief of the Division of Infectious Diseases of the Children's Hospital of Philadelphia, and was the co-inventor of the rotavirus vaccine. His last book, Do You Believe in Magic? The Sense and Nonsense of Alternative Medicine, is a critical analysis of alternative medicine. 

This is the second part of the interview I did with Paul Offit, which is available on Youtube. Links: first part | video on Youtube | versão em português.

With more risk of acquiring heart disease and cancer with vitamin E, do you know some hepatologists recommends vitamin E for non-alcoholic steatohepatitis*? 
I'm not familiar with those data, but if there are studies showing that vitamin E in that situation is a value, it's great. But what amazes me about the vitamin E story is that I bought a preparation of vitamin E that said "natural E 1000". If you look on the back label, it said that it had 3330% of the recommend daily allowance. This gel cap it's about the half of the size of almond. Almonds are excellent sources of vitamin E. You would have to eat about 1650 almonds to get what was the amount of vitamin E of that one gel cap. That's not a natural thing to do. And now we know: if you take large doses of vitamin E or betacarotene for prolonged period of time, you increase your risk of cancer and heart disease and potential shorten your life. Those data were clear; there are twenty studies now.

And what are the risks of taking multivitamin supplementation (vitamins supplements in a dose near to the recommend daily allowance)?
There is one study with women that took multivitamins and they did worse than the ones who didn’t take the supplements. But I would like to see this study repeated, before we can say that with confidence. The false assumption of supplementation is that the vitamins taken in a small pill are going to be processed in the same way as the vitamins of vegetables and fruits.

I think it is a preconception to assume that vitamins supplements are safe just because are natural. I don’t know where this confidence come from. What do you think? 
I give credit to the industry, which has been able to sell itself as natural. For example, you have the nutraceutical and dietary supplements industry that sell their supplements as all natural, as it can’t hurt you and it’s being made by old hippies on mountains. This is not true. Pfizer and Hoffman-LaRoche are major players in dietary supplement game. Second, it’s an unregulated industry with no obligation to support its claims and in United States they have enough political influence to keep the FDA away from regulate them.

What about other types of alternative medicine, like acupunture, do you think it's valid for any condition?
Edzard Ernst was the first one to do retractable needle studies that shown if you though that the needle are going under your skin is valuable as the needle actually going under skin. There are studies showing some people can learn to release endorphins with acupressure. I can tell you that there two pediatricians in the Children's Hospital of Philadelphia, who had been trained in acupuncture - it's like to be trained to be a psychic, as far I'm concerned - and want to bring acupuncture to the hospital. I think they want to do that because there are patients demands. Instead of what we should be doing as doctors, which is to help patients going through medical information, instead of setting a professional standard, we become waiters in a hospital. The Hospital of University of Pennsylvania offers reiki master in their oncologic clinic. I don't think that hurts anybody, and maybe some people do benefit from that, but the slippery slope is that it creates this notion that there are healing energies to manipulate.

People need to make a distinct that if a treatment works it doesn't mean it works in the way it claims. 
That's a very good point. Mehmet Oz was asked what he does when his children gets sick. He answered that his wife gives a homeopathic arnica and if the children are still sick, if they don't get better from that, she calls him. Here's the logic of that. Probably 8% of the diseases we see in the emergency department of The Children's Hospital of Philadelphia are self-limited, such as viral infections of nose and throat. So you can make the argument that the homeopathic arnica is not going to heart them and the odds are they have self-limited disease. By giving the homeopathic arnica means they are not getting antibiotics for viral infection, that's good. It means they are not getting a preparation that contains pseudoephedrine, which could be quiet damaging special to young children, and that's good, and they get better. The problem is either he or his wife believe the homeopathic arnica actually made them better. Then, the next possibly awful step is when a child has asthma, you give a homeopathic bronchodilator. Children had been given homeopathic bronchodilators and died, instead of getting real bronchodilators, which would save their lives.

What's the whole point of writting your book Do you believe in magic? 
I guess I have this fanciful notion that if you can explain something clear and compelling and in an interesting manner, you get people to take a step back to think what they are doing. That's all I ask. I ask people to be more skeptical about what they are putting into their bodies. I think you should be skeptical to anything you put on your body, including vaccines.   

People say to me often that is not a good thing to be a skeptic. Do you have problems with that? 
It’s true. When I had surgery on the knee, my surgeon recommended that in my recuperative period I take chondroitin sulfate and glucosamine. But the data say chondroitin sulfate and glucosamine do nothing to promote healing, to decrease inflammation and pain. And there are studies showing that they do nothing for the pain of arthritis. I knew those studies and I couldn’t convince myself that was something I should do. It could be argued that if I thought that was going to relieve my pain and, therefore, I wouldn’t take a non-steroid anti-inflammatory drug. It’s expensive, but was not going to hurt me. But I didn’t share this belief system. In theory, science shouldn’t be a belief system, it’s an evidence-base system and the evidence was not that for it.  

On your last book, you mentioned that we used supernatural explanations to explain disease and now we don't use it anymore, we replace them. Do you think religious or any supernatural idea creates a barrier for scientific understanding?
Yes. When I wrote this book, I got a lot of hate mail from people who I think were angry that I attacked their belief system, I attacked the church of vitamins and supplements. Religion is a belief system, science is an evidence-based system. People make what should be an evidence-based system a belief-system.

Why people don't trust modern medicine? 
I think because it can be frustrating, technological and cold. What alternative medicine offers is something that is warmer; it is built in some sort of spirituality. And the fact that modern medicine is uncertain; there are many things we don't know. I'm sure we will know more in 100 years than we know now. We are constantly generating new information, that's what science is. In science, as you generate more information, you can take a textbook and throw it out without a backward glance. That's good, it’s mutable, it’s changeable; it's always self-correcting. But I think uncertainty is disconcerting, if you get the certainty of Andrew Weil.. If you look his books, he tells you not only how to treat your hepatitis, but he tells how to be a friend, how to raise your children, it's like a bible. Then, I think people are attracted to that.

And what's the whole point of writing your book Do You Believe In Magic? 
I guess I have this fanciful notion that if you can explain something clear and compelling and in an interesting manner, you get people to take a step back to think what they are doing. That's all I ask. I ask people to be more skeptical about what they are putting into their bodies.

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* This is a recommendation from the guideline for the diagnosis and management of non-alcoholic fatty liver disease published by American Association for the Study of Liver Diseases, American College of Gastroenterology and American Gastroenterological Association. This guideline is available here.

I would like to thank Paul Offit for his kidness and attention!

Monday, September 30, 2013

Paul Offit: "Science it's not about being open-minded"

by Felipe Nogueira

Interview with Paul Offit
Paul Offit is an pediatrician, the Chief of the Division of Infectious Diseases of the Children's Hospital of Philadelphia, and was the co-inventor of the rotavirus vaccine. He wrote books about the importance of vaccines, clarifying the risks, which is often misunderstood by people. In example, some people believe that MMR vaccine (against measles, mumps and rubella) causes autism. However, that relationship was already analyzed scientifically and we know it's wrong. 

His last book, Do You Believe in Magic? The Sense and Nonsense of Alternative Medicine, on which he makes a critical analysis of alternative medicine, was published this year.

I did an interview with him and it's available on Youtube. I thank Paul Offit for his time and attention. This is the first part of the interview. 

Links: second part | Youtube | versão em português


Can you pinpoint when the anti-vaccination movement started? 
I think it started with the first vaccine. The smallpox vaccine was developed by Edward Jenner in 1700s. There was violent opposition to the vaccine in the early 1800s and the reason was because that vaccine was mandated. People don't like to be told by the federal government they need to get a vaccine. That happened with the first vaccine and it's true today. If you talk to the professional anti-vaccine people, like National Vaccine Information Center, Moms Against Mercury, Safeminds, Generation Rescue, I think they will say they would stop their anti-vaccine efforts if you simply make vaccines optional.

What exactly is the risk of Guillain-Barré Syndrome with flu-shot? 
You can say with confidence that the swine flu vaccine that was given in 1976 had a risk of Guillain-Barré Syndrome in 1 per 100.000 who were given the vaccine. It is not clear that since then any vaccine causes Guillain-Barré Syndrome. But the limit of detection is 1 per million. CDC and other groups that tried to categorize this always say that we cannot say is more common than 1 per million. The people are left with this vague notion that vaccine might cause Guillain-Barré Syndrome, but since the 1976 swine flu vaccine there is no clear evidence that it has.

If a vaccine causes a problem, usually the disease that the vaccine try to prevent causes the same problem with higher risk for it. Can you elaborated on that?
The best example would be thrombocytopenia, which is lowering the platelets level. Measles vaccine can cause thrombocytopenia. There is a couple of studies and they all have been consistent and reproducible: the measles vaccine causes thrombocytopenia in 1 per 25-30 recipients. A measles virus also does that and it is far more common. When you get a chicken-pox vaccine, from 8 to 12 days after that, you can get a mild chicken-pox rash with 5 blisters, but sometimes can be 30 blisters. But if you get chicken-pox natural infection you can get 300 to 500 blisters.

Knowing that MMR vaccine does not cause autism, how do you think it is dangerous to widespread information not corroborated by science?
I wish I had the answer to that. I think once you scare people, it's hard to unscare them; once you open the Pandora’s box, it's hard to close it. When the question was raised by Andrew Wakefield in 1998 with his publication in the Lancet, that wasn't a study. That was a simply case series: 8 children whom had received the vaccine and developed symptoms of autism within 1 month. There are now 12 studies, looking to large number of people who did or didn't get the vaccine to answer the question "are you at a greater risk of having autism if you receive that vaccine?" The answer has been very reproducible: no. I think people are far more compelled by anecdote than they are by statistics. So, if Jenny McCarthy gets on Oprah and says "I watch my son get this vaccine, I watch his soul leave his eyes" and she cries, that's very compelling. If you have a scientist on the show that says "fair question: could the vaccine cause autism?  Is this a causal effect relationship? Is this just a temporal effect or it is a plausible effect?" You can answer that question. It's a scientific question, it can be answered in a scientific venue and it has been answered in a scientific venue. But how do you compel people with science? And how do you trump the anecdote with science? And the media became critical and they're not great at it.

What about your history with urologists, PSAs and prostate cancer? 
Yeah. I ended up switching urologists, because the urologists that I was seeing continuous to buy into the notion to get repeated PSA levels and repeated the biopsies. There is morbidity associated with that. And my think was to find a urologist who I though was practice medicine that was consistent with evidence that PSAs and biopsies haven't lengthened the lifespan of the american male. PSA and biopsies mean a lot of money for urologists and they make a living of this. It was nice to be able to find a urologist who was willing to practice medicine based on what was the evidence. I just saw a recent New English Journal article which look to people who took finasteride and compare them with people that didn't take finasteride. It found a lower incidence in people who take finasteride of having prostate cancer that was unlikely to kill you, the same type that causes high PSA levels, so called prostatic intraepithelial neoplasia type I and II. It's when you get to third stage [of cancer] that there is a problem. Because the urologists will continue to pursuit continuous PSAs and biopsies, finasteride avoid that, lowering your risk of going through that. In any case, it's a flawed system for all the biopsies and PSAs that were done: it hasn't lengthened the lifespan of the american male. But it's a big money maker for urologists, so I think they are slow to give it up.

What is your opinion about medicine students have been taught in medical schools things that are not scientific?
I think it's criminal. I got an email from a student who was at third year medical school in New York State University. He said he had a lecture from a homeopath that explains the water can remember that there was an active substance in some point of the past. Nonsense. He wrote a letter to dean of the medical school saying he is offended that this man came to teach him in a medical school that should be evidence based, not mystical. The dean wrote him back that he need to be more open minded. Very painful. This has nothing to do with being open-minded, it's all about evidence. Science it's not about being open-minded, it's about forming a hypothesis, establish burdens of proofs and subject those proofs to statistical analysis. Science has nothing to do with politics; it has nothing to do with being open-minded. I would think the dean of New York medical school would know that, but he didn't.

It could be said that the one who is not being open-minded is the dean of medicine, because he is not willing to accept homeopathy does not work. 
But maybe sometimes it does work. I mean, maybe sometimes you take something that you think is going to benefit you and it does benefit you simply because you think it's true. Placebo effect is not trivial, it's a real effect, and it can have a physiological base. I talk about that in the last chapter of my book. People can learn to release neuroendorphines and to regulate the immune system.
  

Sunday, September 29, 2013

Michael Shermer's Moral Arc of Science

by Felipe Nogueira

Michael Shermer is a psychologist, the Founding Publisher of Skeptic Magazine, the Executive Director of Skeptics Society and monthly columnist for Scientific American (his columns have not been published in the Brazilian edition of SciAm for a long time).

Readers of the portuguese version of this blog are aware of Michael Shermer's work, since I had posted my translation to portuguese to some of his articles. As a leader in skeptic movement and his continuous very well done work to promote science, Michael Shermer is, no less, a true inspirer to me. In response to my first email, in which I had explained how weak is the skeptic movement around here in Brazil, he answered that I should create my own Skeptic Society! Unfortunately, I am not that far, at least not yet, but I am really trying to promote skepticism and science over here.

Michael Shermer´s last book is The Believing Brain, in which he explained the psychological drives for beliefs in things such as conspiracy theory, ghosts, and God. Now, he is focusing on his next book, The Moral Arc of Science. He already posted some articles about this topic here and here. Michael´s Moral Arc of Science thesis is that a science of morality is possible, as he puts it:
the survival and flourishing of individuals is a basis for establishing moral and values, and so determining conditions by which humans best flourish ought to be the goal of science of morality.
Michael Shermer is not alone on this. The neurologist Sam Harris had written a book about the subject titled The Moral Landscape: How Science Can Determine Our Values. Sam Harris argument is based on (quoted from the book):
1) questions about values—about meaning, morality, and life’s larger purpose—are really questions about the well-being of conscious creatures.  
2) human well-being entirely depends on events in the world and on states of the human brain. Consequently, there must be scientific truths to be known about it.
It's a controversial issue and they engaged on online discussions: Michael discussed with the philosopher Massimo Pigliucci and Sam Harris with the cosmologist Sean Carroll. Science have been studying sucessfully and determined the impacts of human actions in other issues, such as the risk of tobacco smoking and global warming; I think it can do the same with morality. I not only agree that science can study, it should study, like Shermer and Harris are arguing, and it should start now: the best thing to guide our actions is empirical evidence, which is the realm of science. So, I totally agree with the main thesis of Shermer´s theory about science of morality, but I do not agree with him about every detail he mentioned on his last lecture about the subject, presented on the Northeast Conference on Science and Skepticism 2013

1) Michael defines the Ask-First principle :
To find out an action is right or wrong, ask first.
I think it's good principle in some cases, like adultery, the example Michael gave. He makes clear (and I agree, of course) the principle can't be applied to all cases, like asking to Hitler or Bin Laden if it's right to kill them. But my concern is that the Ask-First Principle is, at least a little, subjective. Consider the case of female genital mutilation. Two different woman had been mutilated and we go there and ask them if the mutilations were wrong. One says yes, like Michael presented, but the other says no, because, even she was in pain, that was God´s plan for her (or whatever the reason). How can we get out of this situation with the Ask-First Principle? We have two identitical situations. And yet we have two different answers. How can we decide now? Are we (the science of morality) going to say female genitalia mutilation is right in the case of the second woman (I think female genitalia mutilation wrong in all cases!)? The best analogy to the point I am trying to make is with medicine. The two women are analogous of two different patients with same diagnosis and the same disease severity. Are we going to prescribe different treatments for these patients? It is possible that the treatment of choice differs from one doctor to another, but, if we want consistence, the same doctor must prescribe the same treatment. And the difference between one doctors´s choice to another doctor´s is only acceptable in the case there is no conclusive evidence of what  is the best treament ; when empirical evidence settles down the issue, all doctors should do the same. Medicine will not say the best available treatment is wrong because a patient does not want to receive that treatment. This is not possible with the ask-first principle: we´re never going to find a empirical evidence of what´s the right answer in the example I gave, because the definition of what is right and what is wrong can be different among different people in the same conditions. We need a better tool, or, at least, we need to define better the cases we would use the Ask-First Principle. 

2) The Ask-First Principle should be applied to the individual, the moral agent that has been acted upon. Why the individual? Michael offers the following explanation:
The individual is the primary moral agent because the individual is the principal target of natural selection and social evolution.
He goes on saying he rejects group selection (it is an interesting question by itself: is there any scientist  - I mean serious scientist, not figures like creationists or Intelligent Designer proponents that call themselves "scientists" - that still supports group selection?). Is the individual the principal target of natural selection? I rather say the gene is the unit target of natural selection, the individual is the vehicle. So, saying the individual is the target of natural selection is not a good justification for the individual as the primary moral agent. The important point here is that I don´t think the science of morality should constraint itself on evolutionary theory. Even if the group or species would be the target of natural selection, how would that change the science of morality? The individual is the primary moral agent, because it´s the individual that suffers, or in Michael´s words, "it is the individual who is most affected by moral and immoral acts." Suffering, well-being is a function of the individual; there is no way we can, i.e, increase well-being in a group without increasing it at least in some individuals of this group.  It's interesting to note that science of morality can have more than one focus: some moral scientists can focus in the individual, studying how to maximize flourishing for particular individuals, and others can focus in a group or society, studying how to maximize flourishing of a group of individuals. Having one does not excludes the other.

3) "If Gay is natural then gays ought Moral Progress: Gay Decriminalization."

I do think it´s very wrong to discriminate people based on race, gender, sexual orientation, weight, height, etc. So,  I agree with gay decriminalization, but it´s not because gay is natural. This remembers me the fallacy that everything natural is good or right, everything unnatural is bad or wrong (appeal to nature/naturalistic fallacy). Some conditions like psycopathy or pedophilia can be classified as natural (at least part of it, since neurogenetics plays a huge influence), but I don´t think psychopaths killers, or pedophiles who abuse children, ought moral progress; I think they should be in jail, even it was "natural" for them to do the attrocities they´ve done. Also, science of morality should recommend changes to our nature, if that leads to more flourishing (less suffering, more happiness, more well-being, more freedom, more liberty, more justice, more prosperity, etc).

In this article, since I agree with Michael´s first premise, I tried to mention things I don´t agree with him in order to add something interesting to this discussion or to Shermer´s new book. In the end, we are not asking too much and can be summarized on his following statement:
All moral systems have shortcomings, so why not add one more arrow to quiver of ethics by adding science?
If I haven´t added anything on the discussion, maybe others have learned something, like I did with this discussion and others within the skepticism and science promoting movement. Also, as I said in the beginning, skepticism and science promoting movement is very weak in Brazil, so hopefully this discussion brings some attention to the importance of science, evidence and scientific thinking to Brazilian people; science is making our lifes better, and can make it even better. This is why Michael and I are employing and promoting science, critical thinking, asking for evidence instead of superstitious thinking, pseudoscience, anti-scientific thinking, and faith: science is the best tool to understand how the world works and our nature is and we want a society based on truth, justice, freedom and prosperity.

Thank you, Michael Shermer!                      

About the blog

by Felipe Nogueira 

As the title of the blog suggests, my objective with it is popularizing science and skepticism. Actually, I already had a blog written in portuguese with the same objective, for brazilian readers. As I often say, science and skepticism promoting here in Brazil is very weak. For example, online articles and books are constantly written by several scientists, like the evolutionary biologists Richard Dawkins and Jerry Coyne, the theoretical physicists Lawrence Krauss and Sean Carroll, the psychologists Steven Pinker and Michael Shermer, and the medical doctors Edzard Ernst and Paul Offit, just to name a few.  But, unfortunately, only a few of this books had been translated to portuguese and english language is still a barrier for brazilian people. 

So, in 2012, I decided to open a blog for brazilian people. I had written few articles myself. But, since several topics had been very well covered by others in online articles, some of my posts are translations, authorized by its autors, keeping all the credits and with the source to the original article. 

At this moment, I have the need to publish some things in english for the following reasons. I had contacted some of this scientists and authors and I plan to contact others, so now they could know what I am doing. Second, part of what I am doing can help promoting science not only in Brazil.

Just to keep things more organized, I created this blog for english texts only. In the other one, I will continue to translate and writing in portuguese.
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My twitter: @felipejacknog