The Yuletide edition of the BMJ carries a lovely article by Jeffrey Aronson, Patent medicines and secret remedies. (BMJ 2009;339:b5415).
I was delighted to be asked to write an editorial about it, In fact it proved quite hard work, because the BMJ thought it improper to be too rude about the royal family, or about the possibility of Knight Starvation among senior medics. The compromise version that appeared in the BMJ is on line (full text link).
The changes were sufficient that it seems worth posting the original version (with links embedded for convenience).
The cuts are a bit ironic, since the whole point of the article is to point out the stifling political correctness that has gripped the BMA, the royal colleges, and the Department of Health when it comes to dealing with evidence-free medicine. It has become commonplace for people to worry about the future of the print media, The fact of the matter is you can often find a quicker. smarter amd blunter response to the news on blogs than you can find in the dead tree media. I doubt that the BMJ is in any danger of course. It has a good reputation for its attitude to improper drug company influence (a perpetual problem for clinical journals) as well as for clinical and science articles. It’s great to see its editor, Fiona Godlee, supporting the national campaign for reform of the libel laws (please sign it yourself).
The fact remains that when it comes to the particular problem of magic medicine, the action has not come from the BMA, the royal colleges, and certainly not from the Department of Health, It has come from what Goldacre called the “intrepid, ragged band of bloggers”. They are the ones who’ve done the investigative journalism, sent complaints and called baloney wherever they saw it. This article was meant to celebrate their collective efforts and to celebrate the fact that those efforts are beginning to percolate upwards to influence the powers that be.
It seems invidious to pick on one example, but if you want an example of beautiful and trenchant writing on one of the topics dealt with here, you’d be better off reading Andrew Lewis’s piece "Meddling Princes, Medical Regulation and Licenses to Kill” than anything in a print journal.
I was a bit disappointed by removal of the comment about the Prince of Wales. In fact I’m not particularly republican compared with many of my friends. The royal family is clearly good for the tourist industry and that’s important. Since Mrs Thatcher (and her successors) destroyed large swathes of manufacturing and put trust in the vapourware produced by dishonest and/or incompetent bankers, it isn’t obvious how the UK can stay afloat. If tourists will pay to see people driving in golden coaches, that’s fine. We need the money. What is absolutely NOT acceptable is for royals to interfere in the democratic political process. That is what the Prince of Wales does incessantly. No doubt he is well-meaning, but that is not sufficient. If I wanted to know the winner of the 2.30 at Newmarket, it might make sense to ask a royal. In medicine it makes no sense at all. But the quality of the advice is irrelevant anyway. The royal web site itself says “As a constitutional monarch, the Sovereign must remain politically neutral.”. Why does she not apply that rule to her son? Time to put him over your knee Ma’am?
Two of the major bits that were cut out are shown in bold, The many other changes are small.
BMJ editorial December 2009
Secret remedies: 100 years on
Time to look again at the efficacy of remedies
Jeffrey Aronson in his article  gives a fascinating insight into how the BMA, BMJ and politicians tried, a century ago, to put an end to the marketing of secret remedies. They didn’t have much success.
The problems had not improved 40 years later when A.J. Clark published his book on patent medicines . It is astounding to see how little has changed since then. He wrote, for example, “On the other hand the quack medicine vendor can pursue his advertising campaigns in the happy assurance that, whatever lies he tells, he need fear nothing from the interference of British law. The law does much to protect the quack medicine vendor because the laws of slander and libel are so severe.”> Clark himself was sued for libel after he’d written in a pamphlet “ ‘Cures’ for consumption, cancer and diabetes may fairly be classed as murderous”. Although he initially tried to fight the case, impending destitution eventually forced him to apologise . If that happened today, the accusation would have been repeated on hundreds of web sites round the world within 24 hours, and the quack would, with luck, lose .
As early as 1927, Clark had written “Today some travesty of physical science appears to be the most popular form of incantation” . That is even more true today. Homeopaths regularly talk utter nonsense about quantum theory  and ‘nutritional therapists’ claim to cure AIDS with vitamin pills or even with downloaded music files. Some of their writing is plain delusional, but much of it is a parody of scientific writing. The style, which Goldacre  calls ‘sciencey’, often looks quite plausible until you start to check the references.
A 100 years on from the BMA’s efforts, we need once again to look at the efficacy of remedies. Indeed the effort is already well under way, but this time it takes a rather different form. The initiative has come largely from an “intrepid, ragged band of bloggers” and some good journalists, helped by many scientific societies, but substantially hindered by the BMA, the Royal Colleges, the Department of Health and a few vice-chancellors. Even NICE and the MHRA have not helped much. The response of the royal colleges to the resurgence in magic medicine that started in the 1970s seems to have been a sort of embarrassment. They pushed the questions under the carpet by setting up committees (often populated with known sympathizers) so as to avoid having to say ‘baloney’. The Department of Health, equally embarrassed, tends to refer the questions to that well-known medical authority, the Prince of Wales (it is his Foundation for Integrated Health that was charged with drafting National Occupational Standards in make-believe subjects like naturopathy .
Two recent examples suffice to illustrate the problems.
The first example is the argument about the desirability of statutory regulation of acupuncture, herbal and traditional Chinese medicine (the Pittilo recommendations) .
Let’s start with a definition, taken from ‘A patients’ guide to magic medicine’ . “Herbal medicine: giving patients an unknown dose of an ill-defined drug, of unknown effectiveness and unknown safety”.
It seems to me to be self-evident that you cannot start to think about a sensible form of regulation unless you first decide whether what you are trying to regulate is nonsense, though this idea does not seem to have penetrated the thinking of the Department of Health or the authors of the Pittilo report. The consultation on statutory regulation has had many submissions  that point out the danger to patients of appearing to give official endorsement of treatments that don’t work. The good news is that there seems to have been a major change of heart at the Royal College of Physicians. Their submission points out with admirable clarity that the statutory regulation of things that don’t work is a danger to patients (though they still have a blank spot about the evidence for acupuncture, partly as a result of the recent uncharacteristically bad assessment of the evidence by NICE ). Things are looking up. Nevertheless, after the public consultation on the report ended on November 16th, the Prince of Wales abused his position to make a well-publicised intervention on behalf of herbalists . Sometimes I think his mother should give him a firm lesson in the meaning of the term ‘constitutional monarchy’, before he destroys it.
The other example concerns the recent ‘evidence check: homeopathy’ conducted by the House of Commons Science and Technology Select Committee (SCITECH). First the definition : “Homeopathy: giving patients medicines that contain no medicine whatsoever”. When homeopathy was dreamt up, at the end of the 18th century, regular physicians were lethal blood-letters, and it’s quite likely that giving nothing saved people from them. By the mid-19th century, discoveries about the real causes of disease had started, but homeopaths remain to this day stuck in their 18th century time warp.
In 1842 Oliver Wendell Holmes said all that needed to be said about medicine-free medicine . It is nothing short of surreal that the UK parliament is still discussing it in 2009. Nevertheless it is worth watching the SCITECH proceedings . The first two sessions are fun, if only for the statement by the Professional Standards Director of Boots that they sell homeopathic pills while being quite aware that they don’t work. I thought that was rather admirable honesty. Peter Fisher, clinical director of the Royal Homeopathic Hospital, went through his familiar cherry-picking of evidence, but at least repeated his condemnation of the sale of sugar pills for the prevention of malaria.
But for pure comedy gold, there is nothing to beat the final session. The health minister, Michael O’Brien, was eventually cajoled into admitting that there was no good evidence that homeopathy worked but defended the idea that the taxpayer should pay for it anyway. It was much harder to understand the position of the chief scientific advisor in the Department of Health, David Harper. He was evasive and ill-informed. Eventually the chairman, Phil Willis, said “No, that is not what I am asking you. You are the Department’s Chief Scientist. Can you give me one specific reference which supports the use of homeopathy in terms of Government policy on health?”. But answer came there none (well, there were words, but they made no sense).
Then at the end of the session Harper said “homeopathic practitioners would argue that the way randomised clinical trials are set up they do not lend themselves necessarily to the evaluation and demonstration of efficacy of homeopathic remedies, so to go down the track of having more randomised clinical trials, for the time being at least, does not seem to be a sensible way forward.” Earlier, Kent Woods (CEO of the MHRA) had said “the underlying theory does not really give rise to many testable hypotheses”. These two eminent people seemed to have been fooled by the limp excuses offered by homeopaths. The hypotheses are testable and homeopathy, because it involves pills, is particularly well suited to being tested by proper RCTs (they have been, and when done properly, they fail). If you want to know how to do it, all you have to do is read Goldacre in the Guardian .
It really isn’t vert complicated. “Imagine going to an NHS hospital for treatment and being sent away with nothing but a bottle of water and some vague promises.” “And no, it’s not a fruitcake fantasy. This is homeopathy and the NHS currently spends around £10million on it.”
That was written by health journalist Jane Symons, in The Sun . A Murdoch tabloid has produced a better account of homeopathy than anything that could be managed by the chief scientific advisor to the Department of Health. And it isn’t often that one can say that.
These examples serve to show that the medical establishment is slowly being dragged, from the bottom up, into realising that matters of truth and falsehood are more important than their knighthoods. It is all very heartening, both for medicine and for democracy itself.
Declaration of interests. I was A.J. Clark chair of pharmacology at UCL, 1985 – 2004.
1. Aronson, JK BMJ 2009;339:b5415
2. Clark, A,J, (1938) Patent Medicines FACT series 14, London. See also Patent medicines in 1938 and now http://www.dcscience.net/?p=257
3. David Clark “Alfred Joseph Clark, A Memoir” (C. & J. Clark Ltd 1985 ISBN 0-9510401-0-3)
4. Lewis, A. (2007) The Gentle Art of Homeopathic Killing
5. A.J. Clark (1927) The historical aspect of quackery, BMJ October 1st 1927
6. Chrastina, D (2007) Quantum theory isn’t that weak, (response to Lionel Milgrom).
7 Goldacre, B. (2008) Bad Science. HarperCollins
13. BBC news 1 December 2009 Prince Charles: ‘Herbal medicine must be regulated’.
14. Oliver Wendell Holmes (1842) Homeopathy and Its Kindred Delusions.
15. House of Commons Science and technology committee. Evidence check: homeopathy. Videos and transcripts available at http://www.viewista.com/s/fywlp2/ez/1
16. Goldacre, B. A Kind of Magic Guardian 16 November 2007.
17. Homeopathy is resources drain says
There is a good account of the third SCITECH session by clinical science consultant, Majikthyse, at The Three Amigos.
16 December 2009.. Recorded an interview for BBC Radio 5 Live. It was supposed to go out early on 17th.
17 December 2009. The editorial is mentioned in Editor’s Choice, by deputy editor Tony Delamothe. I love his way of putting the problem "too many at the top of British medicine seem frozen in the headlights of the complementary medicine bandwagon". He sounds remarkably kind given that I was awarded (by the editor, Fiona Godlee, no less) a sort of booby prize at the BMJ party for having generated a record number of emails during the editing of a single editorial (was it really 24?). Hey ho.
17 December 2009. Daily Telegraph reports on the editorial, under the heading “ ‘Nonsense’ alternative medicines should not be regulated“. Not a bad account for a non-health journalist.
17 December 2009. Good coverage in the excellent US blog, Neurologica, by the superb Steven Novella.’ “Intrepid, Ragged Band of Bloggers” take on CAM‘ provides a chance to compare and contrast the problems in the UK and the USA.’
18 December 2009. Article in The Times by former special advisor, Paul Richards. “The influence of Prince Charles the lobbyist is out of hand. Our deference stops us asking questions.”
“A good starting point might be publication of all correspondence over the past 30 years. Then we will know the extent, and influence, of Prince Charles the lobbyist.”
Comments in the BMJ Quite a lot of comments had appeared by January 8th, though sadly they were mostly from the usual suspects who appear every time one suggests evidence matters. A reply was called for, so I sent this (the version below has links).
After a long delay, this response eventually appeared in the BMJ on January 15 2010.
It’s good to see so many responses, though somewhat alarming to see that several of them seem to expect an editorial to provide a complete review of the literature. I ‘ll be happy to provide references for any assertion that I made.
I also find it a bit odd that some people think that an editorial is not the place to express an opinion robustly. That view seems to me to be a manifestation of the very sort of political correctness that I was deploring. It’s a bit like the case when the then health minister, Lord Hunt, referred to psychic surgery as a “profession” when he should have called it a fraudulent conjuring trick. Anything I write is very mild compared with what Thomas Wakley wrote in the Lancet, a journal which he founded around the time UCL came into existence. For example (I quote)
“[We deplore the] “state of society which allows various sets of mercenary, goose-brained monopolists and charlatans to usurp the highest privileges…. This is the canker-worm which eats into the heart of the medical body.” Wakley, T. The Lancet 1838-9, 1
I don’t think it is worth replying to people who cite Jacques Benveniste or Andrew Wakefield as authorities. Neither is it worth replying to people who raise the straw man argument about wicked pharmaceutical companies (about which I am on record as being as angry as anyone). But I would like to reply directly to some of the more coherent comments.
Sam Lewis and Robert Watson. [comment] Thank you for putting so succinctly what I was trying to say.
Peter Fisher [comment]. I have a lot of sympathy for Peter Fisher. He has attempted to do some good trials of homeopathy (they mostly had negative outcomes). He said he was "very angry" when the non-medical homeopaths were caught out recommending their sugar pills for malaria prevention (not that this as stopped such dangerous claims which are still commonplace). He agreed with me that there was not sufficient scientific basis for BSc degrees in homeopathy. I suppose that it isn’t really surprising that he continues to cherry pick the evidence. As clinical director of the Royal London Homeopathic Hospital and Homeopathic physician to the Queen, just imagine the cognitive dissonance that would result if he were to admit publicly that is all placebo after all. He has come close though. His (negative) trial for homeopathic treatment of rheumatoid arthritis included the words "It seems more important to define if homeopathists can genuinely control patients’ symptoms and less relevant to have concerns about whether this is due to a ‘genuine’ effect or to influencing the placebo response” . [download
the paper]. When it comes to malaria, it matters a lot.
Adrian White [comment] seems to be cross because I cited my own blog. I did that simply because if he follows the links there he will find the evidence. In the case of acupuncture it has been shown time after time that "real" acupuncture does not differ perceptibly from sham. That is true whether the sham consists of retractable needles or real needles in the "wrong" places. A non-blind comparison between acupuncture and no acupuncture usually shows some advantage for the former but it is, on average, too small to be of much clinical significance . I agree that there is no way to be sure that this advantage is purely placebo effect but since it is small and transient it really doesn’t matter much. Nobody has put it more clearly than Barker Bausell in his book, Snake Oil Science 
White also seems to have great faith in peer review. I agree that in real science it is probably the best system we have. But in alternative medicine journals the "peers" are usually other true believers in whatever hocus pocus is being promoted and peer reveiw breaks down altogether.
R. M. Pittilo [comment] I’m glad that Professor Pittilo has replied in person because I did single out his report for particular criticism. I agree that his report said that NHS funding should be available to CAM only where there is evidence of efficacy. That was not my criticism. My point was that in his report, the evidence for efficacy was assessed by representatives of Herbal Medicine, Chinese Medicine and Acupuncture (four from each). Every one of them would have been out of work if they had found their subjects were nonsense and that, no doubt, explains why the assessment was so bad. To be fair, they did admit that the evidence was not all that it might be and recommended (as always) more research I’d like to ask Professor Pittilo how much money should be spent on more research in the light of the fact that over a billion dollars has been spent in the USA on CAM research without producing a single useful treatment. Pittilo says "My own view is that both statutory regulation and the quest for evidence should proceed together" but he seems to neglect the possibility that the quest for evidence might fail. Experience in the USA suggests that is exactly what has, to a large extent, already happened.
I also find it quite absurd that the Pittilo report should recommend, despite a half-hearted admission that the evidence is poor, that entry to these subjects should be via BSc Honours degrees. In any case he is already thwarted in that ambition because universities are closing down degrees in these subjects having realised that the time to run a degree is after, not before, you have some evidence that the subject is not nonsense. I hope that in due course Professor Pittilo may take the same action about the courses in things like homeopathy that are run by the university of which he is vice-chancellor. That could only enhance the academic reputation of Robert Gordon’s University.
George Lewith [comment] You must be aware that the proposed regulatory body, the Health Professions Council, has already broken its own rules about "evidence-based practice" by agreeing to take on, if asked, practitioners of Herbal Medicine, Chinese Medicine and Acupuncture. They have (shamefully) excluded the idea that claims of efficacy would be regulated. In other word they propose to provide exactly the sort of pseudo-regulation which would endanger patients They are accustomed to the idea that regulation is to do only with censoring practitioners who are caught in bed with patients. However meritorious that may be, it is not the main problem with pseudo-medicine, an area in which they have no experience. I’m equally surprised that Lewith should recommend that Chinese evaluation of Traditional Chinese medicine should be included in meta-analyses, in view of the well-known fact that 99% of evaluations from China are positive: “No trial published in China or Russia/USSR found a test treatment to be ineffective” . He must surely realise that medicine in China is a branch of politics. In fact the whole resurgence in Chinese medicine and acupuncture in post-war times has less to do with ancient traditions than with Chinese nationalism, in particular the wish of Mao Tse-Tung to provide the appearance of health care for the masses (though it is reported that he himself preferred Western Medicine).
1. Lord Hunt thinks “psychic surgery” is a “profession”. http://www.dcscience.net/?p=258
2. Fisher, P. Scott, DL. 2001 Rheumatology 40, 1052 – 1055. [pdf file]
3. Madsen et al, BMJ 2009;338:a3115 [pdf file]
4. R, Barker Bausell, Snake Oil Science, Oxford University Press, 2007
5. Vickers, Niraj, Goyal, Harland and Rees (1998, Controlled Clinical Trials, 19, 159-166) “Do Certain Countries Produce Only Positive Results? A Systematic Review of Controlled Trials”. [pdf file]
15 January 2010. During the SciTech hearings, Kent Woods (CEO of the MHRA) made a very feeble attempt to defend the MHRA’s decision to allow misleading labelling of homeopathic products. Now they have published their justification for this claim. It is truly pathetic, as explained by Martin at LayScience: New Evidence Reveals the MHRA’s Farcical Approach to Homeopathy. This mis-labelling cause a great outcry in 2006, as documented in The MHRA breaks its founding principle: it is an intellectual disgrace, and Learned Societies speak out against CAM, and the MHRA.
22 January 2010 Very glad to see that the minister himself has chosen to respond in the BMJ to the editorial
Rt Hon. Mike O’Brien QC MP, Minister of State for Health Services
I am glad that David Colquhoun was entertained by my appearance before the Health Select Committee on Homeopathy. But he is mistaken when he says, “you cannot start to think about a sensible form of regulation unless you first decide whether or not the thing you are trying to regulate is nonsense.”
Regulation is about patient safety. Acupuncture, herbal and traditional Chinese medicine involve piercing the skin and/or the ingestion of potentially harmful substances and present a possible risk to patients.
The Pittilo Report recommends statutory regulation and we have recently held a public consultation on whether this is a sensible way forward.
Further research into the efficacy of therapies such as Homeopathy is unlikely to settle the debate, such is the controversy surrounding the subject. That is why the Department of Health’s policy towards complementary and alternative medicines is neutral.
Whether I personally think Homeopathy is nonsense or not is besides the point. As a Minister, I do not decide the correct treatment for patients. Doctors do that. I do not propose on this occasion to interfere in the doctor-patient relationship.
Here is my response to the minister
I am very glad that the minister himself has replied. I think he is wrong in two ways, one relatively trivial but one very important.
First, he is wrong to refer to homeopathy as controversial. It is not. It is quite the daftest for the common forms of magic medicine and essentially no informed person believes a word of it. Of course, as minister, he is free to ignore scientific advice, just as the Home Secretary did recently. But he should admit that that is what he is doing, and not hide behind the (imagined) controversy.
Second, and far more importantly, he is wrong, dangerously wrong, to say it I was mistaken to claim that “you cannot start to think about a sensible form of regulation unless you first decide whether or not the thing you are trying to regulate is nonsense". According to that view it would make sense to grant statutory regulation to voodoo and astrology. The Pittilo proposals would involve giving honours degrees in nonsense if one took the minister’s view that it doesn’t matter whether the subjects are nonsense or not. Surely he isn’t advocating that?
The minister is also wrong to suppose that regulation, in the form proposed by Pittilo, would do anything to help patient safety. Indeed there is a good case to be made that it would endanger patients (not to mention endangering tigers and bears). The reason for that is that the main danger to patients arises from patients being given “remedies” that don’t work. The proposed regulatory body, the Health Professions Council, has already declared that it is not interested in whether the treatments work or not. That in itself endangers patients. In the case of Traditional Chinese Medicine, there is also a danger to patients from contaminated medicines. The HPC is not competent to deal with that either. It is the job of the MHRA and/or Trading Standards. There are much better methods of ensuring patient safety that those proposed by Pittilo.
In order to see the harm that can result from statutory regulation, it is necessary only to look at the General Chiropractic Council. Attention was focussed on chiropractic when the British Chiropractic Association decided, foolishly, to sue Simon Singh for defamation. That led to close inspection of the strength of the evidence for their claims to benefit conditions like infant colic and asthma. The evidence turned out to be pathetic, and the result was that something like 600 complaints were made to the GCC about the making of false health claims (including two against practices run by the chair of the GCC himself). The processing of these complaints is still in progress, but what is absolutely clear is that the statutory regulatory body, the GCC, had done nothing to discourage these false claims. On the contrary it had perpetrated them itself. No doubt the HPC would be similarly engulfed in complaints if the Pittilo proposals went ahead.
It is one thing to say that the government chooses to pay for things like homeopathy, despite it being known that they are only placebos, because some patients like them. It is quite another thing to endanger patient safety by advocating government endorsement in the form of statutory regulation, of treatments that don’t work.
I would be very happy to meet the minister to discuss the problems involved in ensuring patient safety. He has seen herbalists and other with vested interests. He has been lobbied by the Prince of Wales. Perhaps it is time he listened to the views of scientists too.
Being interested in science communication, I was pleased when the BMJ asked me to review Unscientific America , by Chris Monney and Sheril Kirshenbaum.
The BMJ provides a link that allows you access to the whole review. They have made very few changes from the submitted version, which is reproduced below (with live links in the text. [Download pdf of print version]
I very soon discovered that the book had already caused ructions in the USA, as a result of its advocacy of appeasement of religious groups. In particular there was all out war with P.Z.Myers, whose very popular blog, Pharyngula. documented the battle in detail).
It is an American book through and through, and in the USA the biggest threat to reason comes from the far-right religious fundamentalists who preach young-earth creationism. It is said that 46% of US citizens believe that the earth is less than 10,000 years old. The same far-right religious groups also preach that carrying guns is good, that Iraq was responsible for 9/11, that climate change is a socialist conspiracy and that health care for everyone is a communist plot. And they never hesitate to lie in the promotion of their ‘religious’ views. The US situation is totally different from that in Europe, where religion is all but dead, and young earth creationism is the preserve of a few cranky used-car dealers (and possibly Tony Blair?)
Review of the Week
Trust me, I’m a scientist
David Colquhoun, professor of pharmacology, University College London
Unscientific America sounds like a fascinating topic, not least because the book is a follow-up from Mooney’s The Republican War on Science. It is written entirely from a US perspective (the USA sequenced the genome and invented the internet, apparently unaided). It’s reported that 46 percent of Americans believe that the earth is less than 10,000 years old. That’s certainly cause for alarm and Mooney & Kirshenbaum are certainly alarmed. They think that the public needs to be educated in science. They identify the obvious problems, evolution, climate change and quackery and ask what can be done. The problem is that they propose no good solutions, and some bad ones. Their aims are worthy but sometimes the book reads like an over-long and somewhat condescending whine about why science and scientists are not sufficiently appreciated.
I simply don’t think that it’s true that the public are not interested in science, nor that they can’t understand it at a level that is sufficient to be useful. It’s true that they have been let down badly by some sections of the media. Think particularly of the “great MMR hoax”1. The disastrous fall in vaccination is more attributable to talk show presenters and air-headed celebrities than to lack of interest from the public. People are systematically deceived by anti-vaxers, climate change denialists, vitamin pill salesmen and a horde of crackpot alternative therapists.
There is one problem that Mooney & Kirshenbaum don’t talk about at all, yet it seems to me to be one of the biggest problems in science communication. It isn’t lack of interest by the public, nor even lack of understanding, but lack of trust. The tendency of real science to indulge in hyperbolic self-promotion is one reason for the lack of trust. Sometimes this descends into outright dishonesty2,3. That is a tendency that is promoted by government and funding agencies by their insistence on imposing silly performance measures. The public is quite sensible enough to take with a pinch of salt the almost daily announcements of “cancer cures” that emanate from university press offices.
On the face of it, one should be encouraged that ‘public engagement in science’ is the mode du jour. It isn’t quite that simple though. Only too often, universities regard public engagement as a branch of their own PR machine4. They even instruct you about what tone of voice to use when talking publicly.
One reason why scientists need to talk to people outside the lab is precisely to counteract this tide of nonsense from PR people, who are paid to deceive. The problem for academics is usually time. We already do three jobs, teaching, research and coping with HR bollocks. How can we find time for a fourth job? That’s not easy, especially for the best researchers (those that do research themselves, not just lead a team). Mooney & Kirshenbaum suggest that the solution is to create a “cadre of communication and outreach experts”. I don’t think this would work. They would, by and large, be outsiders, writing uncritical paeans, dictated by big name scientists. A new cadre of PR hangers-on does not sound like a great idea. A better, and very much cheaper, solution would be to provide a course in free blogging software and we’ll do it ourselves.
The two chapters that I looked forward to reading, on religion and on “The bloggers cannot save us”, proved deeply disappointing. The authors are firmly in the camp of what Richard Dawkins called the “Neville Chamberlain school of evolutionists&rdquo.; They maintain “if the goal is to create an America more friendly to science and reason, the combativeness of the New Atheists is strongly counterproductive”. They are particularly critical of P.Z. Myers5, the University of Minnesota developmental biologist who is splendidly clear in his views. Of the communion wafer, he famously said “It’s a frackin’ cracker”. But he, and Dawkins, are right. When it comes to young earth creationists we have a war on our hands, and nowhere more than in the USA. What’s more it’s a winnable war. Mooney & Kirshenbaum are all for appeasement, but appeasement won’t work. It might please the more moderate wings of the church, but they already believe in evolution and are regarded by fundamentalists as being just as big an enemy as Myers and Dawkins. And, one must ask, who has done best at getting a wide public readership? P.Z Myers’ blog, Pharyngula, has up to two million page views a month. Dawkins’ book The God Delusion has sold three million copies. In comparison the bland and often rather condescending corporate science web sites get tiny numbers of hits.
In Europe in general, and the UK in particular, young earth creationists are not the major problem that they are in the USA, despite being supported by Tony Blair6. Perhaps the nearest analogy in Europe is the threat to reason from various sorts of crackpot medicine. The appeasers are widespread. The Royal Colleges and the Department of Health are at the forefront of the Neville Chamberlain approach. But appeasement hasn’t worked there either. What has worked is the revelation that university courses are teaching that “amethysts emit high yin energy”7. Or, in a lecture on herbal approaches for patients with cancer, “Legally, you cannot claim to cure cancer. This is not a problem because: ‘we treat people, not diseases’ “8. This is shocking stuff but it has not been unearthed by the corporate media, but by bloggers.
I think Mooney and Kirshenbaum have it all wrong. They favour corporate communications, which are written by people outside science and which easily become mere PR machines for individuals and institutions. Such blogs are rarely popular and at their worst they threaten the honesty of science. More and more individual scientists have found that they can write their own blog. It costs next to nothing and you can say what you think. A few clicks and the world can read what you have to say. Forget corporate communications. Just do it yourself. It’s fun. And think of the money you’d save for doing science if the PR people were just fired.
(1) Goldacre, B. The media’s MMR hoax. 2008 http://www.badscience.net/2008/08/the-medias-mmr-hoax/
(2) PLoS One. Ghostwriting documents now fully available on PLoS Medicine website. 21-8-2009 http://speakingofmedicine.plos.org/2009/08/21/ghostwriting-documents-now-fully-available-on-plos-medicine-website/
(3) Colquhoun, D. Universities Inc. in the UK. The Corporate Corruption of Higher Education: part 2. 6-12-2007 http://www.dcscience.net/?p=193
(4) Corbyn, Z. Nottingham raises eyebrows over definition of ‘public engagement’. 21-8-2008 http://www.timeshighereducation.co.uk/story.asp?sectioncode=26&storycode=403234
(5) Myers, P. Z. Pharyngula. 2009 http://scienceblogs.com/pharyngula/
(6) Pyke, N. Revealed: Blair’s link to schools that take the Creation literally (Independent 13 June 2004). 13-7-2004 http://www.independent.co.uk/news/uk/politics/revealed-blairs-link-to-schools-that-take-the-creation-literally-732032.html
(7) Colquhoun, D. Westminster University BSc: "amethysts emit high yin energy". 23-4-2008 http://www.dcscience.net/?p=227
(8) Colquhoun, D. Herbal approaches for patients with cancer. 10-8-2009 http://www.dcscience.net/?p=2043
P.Z. Myers has posted about thie book review, on Pharyngula, as Is this book dead yet? There are a lot more comments there than here, though few of them address the question of science communications..
Butterflies and Wheels is generating a lot of hits
Latest: Michael Reiss resigns 16 September 2008: see below
There has been something of a rumpus in the media today when the education secretary of the Royal Society, Michael Reiss, appeared to endorse the teaching of creationism in science classes, The BBC’s report was only too typical.
“Call for creationism in science”
“Creationism should be discussed in school science lessons, rather than excluded, says the director of education at the Royal Society.”
The Guardian’s report, perhaps also not entirely accurate, started with the words
“Creationism and intelligent design should be taught in school science lessons, according to a leading expert in science education.”
After lunch today the email below was sent out to Fellows
|Dear Fellow/Foreign Member
Royal Society’s position on the teaching of creationism in schools
You may have seen in the today’s media coverage of the Royal Society’s position on the teaching of creationism in schools, following a speech by the Society’s Director of Education. Unfortunately, much of the coverage has given a misleading impression of the Society’s policy.
To prevent further confusion, a statement clarifying the Society’s position has been issued today and the text is given below:
“The Royal Society is opposed to creationism being taught as science. Some media reports have misrepresented the views of Professor Michael Reiss, Director of Education at the Society expressed in a speech yesterday.
Professor Reiss has issued the following clarification. “Some of my comments about the teaching of creationism have been misinterpreted as suggesting that creationism should be taught in science classes. Creationism has no scientific basis. However, when young people ask questions about creationism in science classes, teachers need to be able to explain to them why evolution and the Big Bang are scientific theories but they should also take the time to explain how science works and why creationism has no scientific basis.”
In addition, we are working actively to correct the misunderstanding by dealing directly with individual newspapers and broadcast media.
So that seems clear “The Royal Society is opposed to creationism being taught as science.”. So I shan’t have to resign.
You can be sure that proponents of creationism, and its dishonestly disguised version, “intelligent design” will exploit this misunderstanding ruthlessly.
Watch this space for developments.
Perhaps this matter is not so trivial after all. The Guardian report Reiss as saying
“science teachers should not see creationism as a “misconception” but as an alternative “world view” “
The BBC says
“Rather than dismissing creationism as a “misconception”, he says it should be seen as a cultural “world view”. “
Most importantly, Reiss himself said, in a Guardian blog (not the original speech), on September 11th,
“I feel that creationism is best seen by science teachers not as a misconception but as a world view.”
None of those versions sounds at all acceptable to me.
Creationism is a misconception.
The original speech can be heard on a Guardian Play the mp3 file.
It seems to me all to turn on what Reiss means by “showing respect” for ‘alternative world views’, which you believe to be pernicious bunkum. The term ‘alternative world view’ is itself cause for concern. It smacks of alternative medicine. In what sense is a piece of nonsensical bunkum an ‘alternative’ as opposed to being simply bunkum?. I don’t envy teachers who have to deal with young children, who have been brainwashed by religious parents, on matters like this, but older ones should not be encouraged to think that religious nonsense is a proper alternative to sensible thought and observation.
The Observer on Sunday 14 September reports
Creationism call divides Royal Society
Two Nobel prize winners – Sir Harry Kroto and Sir Richard Roberts – have demanded that the Royal Society sack its education director, Professor Michael Reiss. The call, backed by other senior Royal Society fellows, follows Reiss’s controversial claim last week that creationism be taught in schools’ science classes.
Reiss, an ordained Church of England minister, has since alleged he was misquoted. Nevertheless, several Royal Society fellows say his religious views make him an inappropriate choice for the post.
The Reverend Professor Reiss presumably believes the Nicene Creed. That creed seems to make about as much sense as homeopathy (with the same reservation that some of the words have no discernible meaning at all). I’m inclined to agree that it makes no sense to ask someone who believes that stuff to take charge of science education.
Steve Jones, the UCL geneticist, has his say in the Sun
Latest: Michael Reiss resigns
On 16th September, the following statement was made by the Royal Society.
Some of Professor Michael Reiss’s recent comments, on the issue of creationism in schools, while speaking as the Royal Society’s Director of Education, were open to misinterpretation. While it was not his intention, this has led to damage to the Society’s reputation. As a result, Professor Reiss and the Royal Society have agreed that, in the best interests of the Society, he will step down immediately as Director of Education a part time post he held on secondment. He is to return, full time, to his position as Professor of Science Education at the Institute of Education.
The Royal Society’s position is that creationism has no scientific basis and should not be part of the science curriculum. However, if a young person raises creationism in a science class, teachers should be in a position to explain why evolution is a sound scientific theory and why creationism is not, in any way, scientific.
The Royal Society greatly appreciates Professor Reiss’s efforts in furthering the Society’s work in the important field of science education over the past two years. The Society wishes him well for the future.
Sadly, I’m inclined to believe that this is the best solution. Reiss’s soundness on evolution is not in doubt. but there was sufficient ambiguity in his statements that he should perhaps have anticipated the furore that would, and did, ensue.
Now the trivial stuff.
And this hilarious one from CNN
OK this is not very serious (or is it?). A computer game: players of PolarPalin must help a polar bear to navigate its way across Alaska to blow up oil wells, all the while avoiding Palin, the governor of the state, in her campaign tank.
This has been reposted from my old religion and education blog.
Derek Gillard’s excellent "Education in England" site had this beautiful piece. With his permission, I reproduce it here, because it has now vanished from his site. However you can still read also Gillard’s excellent essay “Creationism: bad science, bad religion, bad education”
Marcus Atkins, a classroom assistant at a Cornish secondary school, is taking the school’s governors to an industrial tribunal claiming unfair dismissal. He says the governors have discriminated against him because of his religious beliefs.
Atkins (pictured in class) is a member of the Fraternity of Neptune, a little known religious group which believes that, since life was created in the sea, they must honour the sea god by wearing full diving gear, including heavy metal helmet and lead-lined boots.
Governors at Porthnutnow High School decided to sack the classroom assistant on the basis that the children couldn’t hear what he was saying, that he refused to work in any classroom where children of fishing families were present, and that his lead-lined boots were wearing out the carpet in the school library.”
“Atkins says he has been unfairly treated. ‘The children can hear what I’m saying perfectly well,’ he told a BBC reporter. ‘All they have to do is stick the other end of my breathing tube in their ear and bingo.’ (At least, that’s what the reporter thinks he said).
Asked about the charge that he had refused to teach the children of fishing families, he replied ‘I’ve got to stick to my religious principles. Why can’t the head simply arrange the school’s timetable so that none of these children are in the classes I work with? What’s difficult about that?’
And the library carpet? ‘That’s ridiculous too,’ said Atkins. ‘I’ve refused to go in the library because there are books about trawlers in there, so how can I be wearing out the carpet?’
Atkins doesn’t have much support – hardly surprising given that Porthnutnow is a fishing village. His local MP is backing calls for him to be sacked and one government minister told the Sunday Mirror that the teaching assistant was ‘denying the right of children to a full education’.
Meanwhile, the government is pressing ahead with plans to open hundreds more religious schools, including a handful of academies sponsored by the Fraternity of Neptune. Grand Merman Sir Cyril Driftwood said ‘It’s a wonderful opportunity to teach children Neptunian theology, a subject I feel has been sadly lacking from the National Curriculum for too long.’
This item appeared originally on my old Religion and Education page. It has been moved here because of the discussion that followed my review in the BMJ of Unscientific America and the discussion that followed, on this blog and on P.Z. Myers Pharyngula blog.
Until recently, the idea that the earth was created 6000 years ago was largely restricted to right wing religious fundamentalists in the USA. Now we have a government in the UK which seems to be happy that such “fruit-cake” nonsense should be taught at the taxpayers’ expense.
The following article, Good God Almighty, was commissioned by Punch magazine, which folded before it could be published.
It refers to the fuss that followed the discovery that a state-funded school was being run by extreme ‘young earth’ creationists. If you want to see just how extreme, look at the speech made by Steven Layfield, the head of science at Emmanuel School. The views expressed are so extreme that the speech was actually deleted from the web site of the Christian Institute as soon as the fuss blew up. Luckily, thanks to the Google cache, this did not work and you can still read it at here.
Good God Almighty!
or Jurassic Theology
[This article was commissioned by Punch, but the magazine went out of business before it was published]
OK class, settle down. Here is your quiz. Compare and contrast the following.
(1) ” . . if the Bible really is the Word of God – and the internal evidence is overwhelming – true Science will always agree with it.”
(2)Science teachers should
“Note every occasion when an evolutionary/old-earth paradigm (millions or billions of years) is explicitly mentioned or implied by a text-book, examination question or visitor and courteously point out the fallibility of the statement and, wherever possible, give the alternative (always better) Biblical explanation of the same data”.
[Steven Layfield, Head of Science at Emmanuel School Gateshead, 2000]
(3) “There are those that argue that Science and Christianity can be harmoniously reconciled . . . We cannot subscribe to this view”
[John Burn & Nigel McQuoid; ex-head, and head, of Emmanuel School Gateshead, 2002]
(4) “Then there is science. Science is a God-given activity. Scientists are 5using their God-given minds and God-given creativity to explore and utilise God-given nature. Sadly, biblical literalism brings not only the bible but Christianity itself into disrepute.”
[The Bishop of Oxford. The Rt. Revd. Richard Harries, 2002]
(5) “God created the world and everything in it.” “It is about 6000 years old”
[Kate and Simon, pupils of Emmanuel School, Gateshead, interviewed by Mike Thomson, BBC]
(5) [Jenny Tonge, MP:] “Is the Prime Minister happy to allow the teaching of creationism alongside Darwin’s theory of evolution in state schools?”
[Tony Blair]. First I am very happy.”
“Secondly, I know that the honourable lady is referring to a school in the north-east, and I think that certain reports about what it has been teaching have been somewhat exaggerated”.
The prime minister is right. Something has been exaggerated:
The idea that teachers realise that the scientific method involves not declaring the outcome in advance.
Clearly, the head of science at Emmanuel doesn’t. To proclaim, before looking, that one view (the literal interpretation of the bible) is “always better” might be expected of an itinerant preacher in the deepest bible belt, but that is the view of the man in charge of educating children at a state-funded English school.
It is a view that offends the Bishop of Oxford, and it is contrary to the views expressed by Pope John Paul II. But don’t worry, our leader is “very happy” with it. To give equal time to a simple assertion (that the earth was created 6000 years ago), and to the wealth of hard-won reasons for thinking it to be untrue, is deeply offensive to every scientist who is trying to fumble towards the best approximation to the truth that can be found. Rarely can a couple of teachers and one prime minister have managed to offend so many people, everyone from bishops to professors, at a single sweep.
Of course neither the prime minister nor anybody else knows exactly what Emmanuel School has been teaching (though the reports from the children themselves give us a good idea). The glowing report from OFSTED was actually the result of a “short inspection” which does not look at such details. The school has not been given a full inspection since 1994, before the serious zealots took control. Views such as those in the first two quotations are so obviously relevant to the quality of science teaching that you may well ask how OFSTED managed not to notice that the views of the head of science were at the very extreme edge of fundamentalism.
Consider also the following amazing coincidence. The team of inspectors who found no fault with the unusual science (biblical is always best) teaching at Emmanuel was almost the same as the team that inspected the Huntington School, York. At that school they said that there was not enough teaching of religion (in the narrow sense, as opposed to spiritual values in general). The Huntington head teacher Chris Bridge lodged a complaint against that report, and it was partially upheld by OFSTED.
Does all this mean that extreme fundamentalism has infiltrated OFSTED, or does it simply mean that the inspectors did not do their homework?
The latter is the more charitable interpretation, but the inspectors are not going to get the chance to ‘try harder next time’. Instead Her Majesty’s Chief Inspector, wrote a letter to the chairman of the governors, asking for “clarification”. Unlike most schools, the Emmanuel School does not publish the names of its governors in the school prospectus, and neither OFSTED, nor the Department of Education, knows who they are. OFSTED does give the name of the chairman as “Dr `Peter Vardy” (as does the school if you phone). It turns out that the learned Dr Vardy is one and the same person as Sir Peter Vardy, the man who gave the government two million pounds to pay for the school. Don’t worry about the “Dr” bit though –it is perfectly genuine. The University of Sunderland was generous enough to give him an honorary doctorate in business administration (after he generously gave the University £1 million). The Chief Inspector (by then changed) recieved a suitably emollient letter from Sir Peter, but did no investigation whatsoever. Ofsted gives the firm impression of having born yesterday.
It is hard to appreciate the manic fervour of Mr Layfield’s notorious speech from only two quotations. It used to be on the web site of the Christian Institute (www.Christian.org.uk), and that site is still worth a visit. Mr McQuoid is a major contributor (see quotation no 2), but other bits are well worth reading too, like the vigorous defence of beating children (don’t get me wrong –I know there are lots of sites that deal with that sort of thing, but this is different; it is holy beating).
Mr Layfield’s speech suddenly vanished from this web site shortly after Tania Brannigan (of the Guardian) told us what was going on. Luckily, though, some kind folks thought it was such an outstanding piece of work that should still be available to everyone (just go to http://www.darwinwars.com/lunatic/liars/layfield.html).
Time’s up folks. Put down your pens and now go out and vote.
This item appeared originally on my old Religion and Education page. It has been moved here because of the discussion that followed my review in the BMJ of Unscientific America and the discussion that followed, on this blog and on P.Z. Myers Pharyngula blog. Evan Harris MP and I were up against the head of fundamentist school that had been started by wealthy used-car dealer, Peter Vardy. Being rather daunted by the Oxford Union, I actually wrote down my bit. The order of speaking because Evan Harris had to rush back to the House of Commons to vote against the Iraq war. The rest is history.
Oxford Union talk on ‘faith schools’ and creationism
This debate is meant to be about ‘faith schools’, but I suspect that the differences between the views of my two friends opposite are rather large. Mr Brady will, I presume, advocate schools that teach conventional religious views, and that I take to be the topic under discussion. First let’s get the issue of Mr McQuoid’s view on creation out of the way before coming to the serious matter of the debate. We have to be clear about one thing -there is a spectrum of religious views and Mr McQuoid is at the extreme fruit cake end of that spectrum. A true flat-earther.
An article by John Burn & Nigel McQuoid; (ex-head, and head, of Emmanuel School) stated:
“There are those that argue that Science and Christianity can be harmoniously reconciled . . . We cannot subscribe to this view”
This appeared on the web site of the Christian Institute, and that site is well worth a look. Apart from promoting ‘young-earth creationism’, it has two other obsessions, the evilness of homosexuality and the desirability of corporal punishment of small boys. It is truly bizarre. Well, at least Mr McQuoid’s job is not to teach science, but the head of science in his school, Steven Layfield, said in a speech published on the same web site (in 2000)
“…if the Bible really is the Word of God – and the internal evidence is overwhelming – true Science will always agree with it.”
Science teachers should… “Note every occasion when an evolutionary/old-earth paradigm (millions or billions of years) is explicitly mentioned or implied by a text-book, examination question or visitor and courteously point out the fallibility of the statement and, wherever possible, give the alternative (always better) Biblical explanation of the same data”.
He is free to express that view, but it disqualifies him from teaching science. The speech from which this is quoted, incidentally, disappeared form the web site of christian.org as soon as the row became public -one does wonder why, but don’t worry you can still ready it at the quaintly named site http://www.darwinwars.com/lunatic/liars/layfield.html However offensive it may be that such extremism is subsidised by taxpayers money, however offensive it may be that no full inspection of his school has been carried out since he came to power, and however offensive it may be that the prime minister supported his views, it is an irrelevant issue for the purposes of serious discussion. The pope does not believe that the earth was created 6000 years ago, the Anglican church does not believe that the earth was created 6000 years ago, hardly anyone but Mr. McQuoid thinks that the earth was created 6000 years ago (except in some parts of the south USA). The number of people who have that capacity to deny the obvious will never be more than handful, and to that extent we need not bother any further about them, and we can get on with the real issue of religious schools. As the Bishop of Oxford (The Rt. Revd. Richard Harries) said (2002)
“Then there is science. Science is a God-given activity. Scientists are using their God-given minds and God-given creativity to explore and utilise God-given nature. Sadly, biblical literalism brings not only the bible but Christianity itself into disrepute.”
Now to the real question…
What is wrong with allowing parents to choose a school for their child that teaches the parents’ religious belief? At first sight this sounds quite innocent, apart from the fact that it is the parents’ religious belief, not the child’s. In any case there are not many parents in the country who have religious (well Christian) beliefs. No more than 7.5 % now go to church regularly, and recently, for the first time, the proportion who profess even a nominal attachment to the church fell below half (as did the proportion of parents who have children baptised).
Why, then, are religious schools quite popular? The reason appears to be that they are selective. The rules say that selection must be on religious grounds only, but it simply does not work out like that. It is bad enough that children’s access to education should depend on their parents’ religious views (or, not infrequently, on their parents’ skill at lying about their religious views). But of course, selection of some implies exclusion of others, and, it turns out, not only because of their religion. Religious selection leads inevitably to racial selection too. In Oldham, scene of the recent race riots, the christian schools are almost exclusively white. Selection by wealth occurs too. In Accrington a C of E school has 12.5% of special needs pupils, while its neighbouring non-religious school has 69.8%; eligibility for free school meals is and 5% in the C of E school and 33% in its neighbour (on average the factor is almost 2).
How could such a disgraceful state of affairs come about? I believe that, as so often, a look at history might help, so let’s go back to see how the world looked in 1820.
Apart from 9 years I have spent all my working life at University College London.
The relevance of that will be obvious if we recall that in 1820, there were only two universities in England, Oxford and Cambridge (though 3 in Scotland). Both Oxford and Cambridge restricted entry to members of the Church of England – not only did they exclude Jews, atheists and muslims, but they also excluded many christians -catholics, protestants and dissenters. They would, no doubt, have excluded Mr McQuoid from getting higher education. It was in this context that liberals and dissenters in London founded the University of London, soon to become known as University College London, with the specific aim of admitting good students regardless of their religious beliefs, and with providing them with non-sectarian education in science as well as humanities (there was little science in Oxford and Cambridge at that time). Despite prolonged opposition from Oxford and Cambridge, UCL opened its doors in 1828.
At that time the fiercely conservative Duke of Wellington had just, albeit reluctantly, made the transition from general to prime minister. Even his government passed measures to increase the rights of catholics and dissenters, but his implacable opposition to electoral reform led to his resignation two years later, to be replaced by the Whig administration of Earl Grey.
The country was in ferment and change was rapid -in 1830 the Liverpool-Manchester railway opened and Faraday’s work on electricity was well-developed. But the electoral system was still mediaeval. The ‘rotten borough’ of Old Sarum (an iron age fort and 7 inhabitants) had two MPs while Manchester, already busy with the cotton trade, had none at all. In 1831 three attempts at electoral reform failed in parliament, but Earl Grey had told William IV “it is the spirit of the age which is triumphing and that to resist it is certain destruction”. The next year, in 1832, Lord John Russell (grandfather of Bertrand Russell) successfully got parliament to pass the (first) Reform Act and the modern age of democracy had begun.
The political ferment was paralleled by scientific ferment -people were no longer constrained by dogma and authority and new ideas came into medicine and biology too.
After another 40 years, Oxford and Cambridge caught up, when the Universities Test Act of 1870 eliminated religious criteria for university entrance. After 1870 it became quite unthinkable that a selection for higher education should be dependent on what a person believed, or did not believe in their private lives about religion.
That was 1870. Now it is 2002.. Can you imagine Oxford reintroducing religious selection of undergraduates now? Yet my friends opposite, and the government, are supporting a view of education that started to vanish in 1828 with the foundation of UCL, and finally died in 1870 with the Test Acts. They are trying to set back progress not by 10 or 20 years but by 175 years.
What next? Bring back rotten boroughs?