The world is flat! If the Earth was round, the entire population of Australia would simply fall off.  Right? And we would be able to see the curve of the Earth, for goodness sake. Believe your own eyes! It is flat! Flat!

Crazy, I know. But a few people seem to honestly believe this nonsense, as nicely evidenced by the recent “debate” between hip hop artist B.o.B and renowned astrophysicist Neil deGrasse Tyson.

B.o.B believes his eyes. Tyson believes the science. Mic drop.

It is easy to dismiss flat Earth believers as kooks. And that is how, in general, we respond to them. We laugh and shake our heads. But equally absurd flat-Earth-like beliefs (let’s call them FEaBel for short) permeate our society and are too often treated not as kooky, FEaBel-ish and just plain wrong, but as reasonable “alternatives.”

Indeed, these FEaBel beliefs are often openly embraced in our health care system, and even at our publicly funded research universities.  And, for a host of socio-political reasons (pseudoscience correctness?), we seem to tolerate them and give them a ridiculous amount of room to thrive.

Let’s run through a few of my favourite examples of the FEaBel hokum that can be found in and around our health care system.

Reiki.  This is an ancient (hey, just like the belief that the world is flat!) “healing” technique aimed at, to quote the website of the International Association of Reiki Professionals, “the life energy that flows through all living things.” Let’s be crystal clear: if you believe Reiki works beyond the placebo effect, you believe that there is a magical energy force running through our bodies that can be manipulated by a person’s hands.  No touching required.

This is some serious flat-earth level wackiness. It is scientifically absurd. But do Canadian universities and health care systems dismiss the practice in the way Neal deGrasse Tyson dismissed flat-earth beliefs?  Nope. They offer classes, demonstrations and space for practitioners.

Homeopathy.  The idea behind this therapy – that non-existent particles in an ultra-diluted solution can be an effective treatment – has been debunked so many times, by so many entities that it is truly unfathomable that it is still around. This is flat-earth thinking at its most robust.  And yet, Health Canada (and, for that matter, some Canadian universities) seem to treat homeopathy as if it were a legitimate practice. Instead of simply warning consumers to save their money and stay away from these useless and misleading products, Health Canada provides a list of government approved products.

And the provision of homeopathy is a core part of the practice of naturopathic “medicine,” a regulated – and, therefore, government-legitimized – profession in many provinces. The Canadian College of Naturopathic Medicine, which teaches its students the “practical application of homeopathic principles,” explicitly highlights a clinical trial it is leading on the use of homeopathy to treat chronic whiplash. Seriously. This is so FEaBel I’m left wondering if it is actually sophisticated satire.

Detoxing. Specifically, I’m referring to the idea that using a “cleansing” diet or procedure (infrared saunas, colonics, ionic foot baths) is beneficial.  This is all very FEaBel nonsense. And yet the popularity of this science-free concept continues to grow.  A 2011 study conducted by actual naturopaths, found that 92 percent of their naturopathic colleagues reported using “detoxification therapies.”

I could, of course, refer to many, many other common FEaBel health care practices, such as the use of spinal manipulation therapy for the treatment of ADHD, asthma and allergies or the pushing of useless supplements and “natural” remedies to boost the immune system. Unfortunately, the examples are endless.

I am absolutely certain I’ve offended a few individuals with my categorization of the above as FEaBel. Some may feel I am being closed-minded, overly dismissive and/or disrespectful.  But remember, I’m not critiquing anyone’s religion or even a particular world view.  These practices are increasingly presented to us – by practitioners, professional organizations and, cringe, government-created regulatory entities (the Ontario College of Homeopathic Medicine?) – as evidence-based and scientifically valid. As such, it is entirely appropriate to respond by outlining what the science actually says.  Was Neal deGrasse Tyson being disrespectful and closed-minded when he outlined the evidence supporting his it-is-a-globe-dammit perspective on the shape of our planet?

Before I get to how we should respond to all this FEaBel thinking, let me quickly deal with a few of the most common logic-free responses that invariably emerge whenever someone critiques alternative medicine.

Yes, many therapies provided in conventional medicine lack good evidence. But this is not, obviously, a justification for using more therapies that are completely devoid of scientific support. Indeed, lets scrap the terms alternative and conventional and just go with the science-based stuff that works.

Yes, there are many profound conflicts of interest that twist the relevant evidence, such as the ever-present shadow of Big Pharma. But, again, these are not justifications for embracing bunk. They are justifications for better science. And, more importantly, let’s not overlook the fact that there are intense conflicts in the alternative medicine world. There are, for example, personal and professional reasons why alternative medicine “experts” may have a bias when it comes to interpreting the best available science. If, for example, you have spent a significant amount of time and money becoming a Reiki Master (this actually exists) and Reiki doesn’t work, you are out of a job and a personal identity.

Yes, many people feel better after receiving one of the above noted therapies.  I’ve tried some of this stuff. Positive experience. The placebo effect, to note just one relevant factor, can be a powerful force. But there are some serious ethical, legal and health policy challenges with the strategy of ignoring science and creating and legitimizing professions for the sole purpose of inducing the placebo effect.  Is this really a sustainable approach?

So, how should we respond to all this FEaBel pseudoscience?  In addition to simply encouraging the science-informed community to speak out more often and more forcefully, regulators like Health Canada should be more aggressive and, whenever possible, clamp down on misleading claims and false advertising. Indeed, one way to fight pseudoscience is for regulators to be more creative in their application of truth-in-advertising laws.

I also think that the professions’ regulators need to get more involved.  If, for example, naturopathic medicine is really evidence-based, then the provincial colleges should stop naturopaths from providing homeopathy, detoxification therapies, iridology, high dose vitamin injection, and many other FEaBel practices.  If the regulators don’t do this, let’s stop pretending they are science-based and dismantle the legitimizing regulatory frameworks.

Will we see these self-regulated professions take such actions? Unlikely.
That would be like the Flat Earth Society suggesting their members buy a globe. If the Ontario College of Homeopathic Medicine required their members to adhere to science-informed standards, there wouldn’t be any members.

Regardless, as a society we must do something.  There is growing anti-intellectualism and tolerance for pseudoscience, which, as Tyson noted in his flat earth rebuttal with just a smidge of hyperbole, “may be the beginning of the end of our informed democracy.”

But if our tolerance of FEaBel bunk is because of some official “pseudoscience correctness” policy, please, governments and universities, make this policy explicit so it can be properly scrutinized.  If it is because you believe that promoting a placebo response is more valuable than a science-literate citizenry, critical thinking and scientific honesty, then please make this policy explicit too.

Otherwise, let’s treat all the FEaBel health bunk like we treat the belief that the Earth is flat.

Now, can I get another Neal deGrasse Tyson gravity-facilitated mic drop?

Timothy Caulfield
Timothy Caulfield is a Canada Research Chair in Health Law and Policy, a professor in the faculty of law and the school of public health, as well as research director of the Health Law Institute at the University of Alberta.

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