Does the Government Actually Do Good, or Just Create the Feeling It Does?

The Government response to the House of Commons Science and Technology Committee report on Homeopathy has been published, and is a masterpiece of dodging the issue. Congratulations to the author, Sir Humphrey Appleby.

In short, they refuse to stop NHS funding of homeopathy, preferring to abdicate responsibility to the PCTs; see here:

(Committee conclusion)

By providing homeopathy on the NHS and allowing MHRA licensing of products which subsequently appear on pharmacy shelves, the Government runs the risk of endorsing homeopathy as an efficacious system of medicine. To maintain patient trust, choice and safety, the Government should not endorse the use of placebo treatments, including homeopathy. Homeopathy should not be funded on the NHS and the MHRA should stop licensing homeopathic products. (Paragraph 157)

(Government response)

We note the Committee’s view that allowing for the provision of homeopathy may risk seeming to endorse it, and we will keep the position under review. However, we do not believe that this risk amounts to a risk to patient trust, choice or safety, nor do we believe that the risk is significant enough for the Department to take the unusual step of removing PCTs’ flexibility to make their own decisions. We believe that providing appropriate information for commissioners, clinicians and the public, and ensuring a strong ethical code for clinicians, remain the most effective ways to ensure quality outcomes, patient satisfaction and the appropriate use of NHS funding.

They do say something about placebo. In response to the Committee's observation that:

We would expect the Government to have a proper understanding of the power and complexities of the placebo effect and the ethical issues surrounding its use in a clinical setting; otherwise it cannot hope to make good decisions relating to patients and public health.

...the Government says:

The Government agrees that, when looking at the evidence base for efficacy, it is important to focus on the most scientifically robust studies and evidence. We note, however, that a “proper understanding of the power and complexities of the placebo effect” is difficult to achieve, since we are not aware of any scientific consensus at present on the mechanisms by which placebos have an effect. We note also that it is not for the Department of Health to comment on the ethics of the use of a particular treatment in a particular setting. 

So they've decided that the Government should have no ethical view on placebo use.

The difficulty is obvious. The way is open for any number of placebo effect treatments to be given Government funding; how could they be stopped, if patients are demanding them and saying that they feel better thanks to them?

As Steven Novella points out:

...for any objective outcome, there is no important placebo effect. For outcomes that are subjectively reported by patients, there is a highly variable placebo effect. It is plausible that the expectation of benefit could result in the release of dopamine and endorphins and produce a physiological decrease in pain, for example, in a subset of people, and there is some evidence for this. But this is, at best, a transient symptomatic effect – not therapeutic.

...and:

Such effects are also non-specific – meaning they do not derive from the intervention itself, but from the therapeutic ritual surrounding the intervention. Even treatments that do not work may therefore provide these non-specific benefit. My opinion is that the non-specific benefits of the ritual of treatment should be combined with an actually effective treatment, not magic pretending to be medicine.

Or, if no actual treatment is available, any placebo should be delivered for the minimum cost. That would certainly exclude comparatively complicated treatments such as homeopathy and acupuncture.

The major problem with such Government indecision is the patina of respectability it gives these purveyors of *nothing*; they are free to pretend they are being efficacious, and this adds to the totality of woo in this supposedly civilised society. The more woo we can eliminate the better informed our citizens will be, and the more likely they are to lead healthy lives, in my opinion.

Further, a Government that condones treatments that just make people *feel* better, rather than *actually* better, might be tempted to extend that principle to other policy areas; would they prefer policies that work, or policies that make people think they work?

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Shit hits Fan

Jack of Kent has blogged about an amusing sequence of events on Twitter yesterday, starting when @GillianMcKeith responded impetuously to a Goldacre fan; go there for an amusing tale that casts light on modern manners in the internet age.

The encouraging thing is the way that, in an electronic age, evidence can be uncovered which details someone's potentially nefarious activities - and it's nigh on impossible to cover those tracks.

The worrying thing is the way that, in an electronic age, evidence can be uncovered which details someone's innocent, but private, activities - and it's nigh on impossible to protect one's privacy.

There are various tools available to make one's online presence less traceable, but that becomes moot when one is commenting in person. Incidentally, although it's not clear that Gillian McKeith made the comments on the Twitter account above, it's clear that it has been held out as an official Twitter for her, with links from her official website, and surely a reasonable person must conclude that her organisation is at least responsible. Although, perhaps the website is an elaborate hoax of which she is unaware too!

UPDATE: Ben Goldacre has blogged about it now.

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The Irony is Palpable

As I explained in my last blog, there is a curious strain of atheist or agnostic who, when perusing public discourse on matters of import, decides that the greatest enemies to improved reason and progress in that public discourse is something called a new atheist. It's difficult to define, but you know one when you see one! Meanness and snark is supposedly their defining attribute, according to those atheists who deplore them.

The facts, as we have seen, rather go against this attribute being a defining one, since these atheists, who deplore meanness and snark in public discourse, also employ it. Remarkably, their response to these revelations of meanness and snark by their own sympathisers, is to engage in yet more meanness and snark; here is an example, from Jeremy Stangroom, a respected writer and sociologist.

Remember, to put this into context, new atheists, such as PZ Myers, Jerry Coyne and Ophelia Benson, have had their reputations besmirched by a sock-puppet posing as a scientist claiming that some new atheist acolytes behaved rather boorishly in the faces of a theist or two (the story is a little vague); this was elevated by Chris Mooney at The Intersection into its own blog entry, presumably in support of Mooney's position, that the new atheists are mean and snarky (which isn't really in doubt), and that this is counter-productive to public discourse (which is). Now the story has been shown to be an invention, new atheists are pointing out the hypocrisy of the self-righteous brigade. Apparently, that is not allowed, according to Stangroom:

Basically, there’s this fella called Chris Mooney, and he tortures kittens. Not literal kittens, but metaphorical kittens that have something to do with framing and accommodation and communion wafers. Anyway, torturing kittens is a bad thing, especially if you get paid by the Templeton Foundation to do it, and this really, really, really upsets those righteous defenders of all that is good and true – the New Atheists.

The irony is palpable. The point here is that new atheists don't mind torturing kittens (er, metaphorically), it's that Mooney doesn't like it, and denounces it in others, but still does it himself. It's the hypocrisy that is the problem.

Now the New Atheists go on about Chris Mooney a lot. Imagine Sisyphus being condemned to listen to some facile bit of Vivaldi for the whole of eternity, or maybe Brian Leiter listing all the people he thinks don’t understand Nietzsche, and you’ll get a sense of it.

The irony is palpable. The point here is that Mooney goes on about the new atheists; he wrote a book which included attacks on them. They couldn't have cared less about him otherwise.

The vindictiveness and viciousness of the New Atheist horde in the face of Tom’s misbehaviour is extraordinary.

The irony is palpable. The point here is that the new atheists have been the subject of reputation-tarnishing untrue slurs from a chap who is hiding behind a pseudonym; it takes a great leap of logic to equate that sort of genuine vindictiveness and viciousness with questions seeking to understand the nature of Mooney's investigation of Tom's misbehaviour.

(To which, if I were Jean, I would be tempted to reply Fuck Off.)

The irony is palpable. Yay for less meanness and snark in public discourse!

Anyway, what’s amusing about all this is that it’s exactly the sort of reaction one would expect from certain sorts of religious fundamentalists when confronted with behaviour they consider unconscionable. It’s a demand for justice and retribution born of an absolute certainty of moral righteousness.

The irony is palpable. And posing as a scientist to deliver a self-serving lie is exactly the sort of reaction one can expect from self-righteous atheists posing as morally superior? Yeah, right.

However, the truth is the participants in this witch-hunt are the 21st century, virtual-world, equivalent of a medieval mob baying for the blood their latest victim.

The irony is palpable. And attacking people standing up for reason and evidence against the unreasonable and deluded rather than attacking the unreasonable and deluded is not medieval in the least, is it?

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You Really Aren't Helping

The curious case of the You're Not Helping (YNH) blog (now defunct, so I can't link to it) highlights a particular sort of human irrational behaviour. It starts from a good intention, I think, but is derailed by simple lack of reasoning.

For a recent history of YNH, this post from The Buddha Is Not Serious gives a good breakdown, in more ways than one. You're Not Helping is a blog started by a faitheist; that is, an atheist who sees value in faith or, at least, that some respect for their beliefs is in order. Even more particularly, a faitheist thinks that some atheist behaviour (typically labelled 'new atheist') is driving a wedge between 'moderate' theists and the rest of rational society. Their complaint is obviously not about the arguments put forward by the new atheists - I show in this post how their arguments are in fact the same ones put forward by the old atheists - and the faitheist is an atheist so presumably must concur. No, their complaint is about the tone; they think a better tone will achieve better results, politically, I think.

Tone is important, we know. Russell Blackford writes intelligently about it here. But it's not all-important. Further, it's not evident that one tone is always the right tone to deliver an argument. I like to think I'm quite reasonable when putting forward my point of view, but I dare say some would call me strident, and others would call me soft on the faithful, depending on their own stridency. I don't see that as a problem. I would encourage a variety of tone for the delivery of these arguments.

The faitheist position is that the tone adopted by the new atheists is unhelpful, and therefore they should not use that tone or, failing that, be silent. There are a number of problems with this:

1) There seems to be no evidence presented to support their hypothesis - it's just common sense, they think.

2) They fail to demonstrate that there is a way of delivering the atheist message without falling foul of the 'tone' accusation. Massimo Pigliucci is a leading faitheist, whose philosophical writing I've often admired, but hilariously is accused here of failing in the tone wars himself ("Tone matters. And sarcasm is not science."). Should he tell himself to be quiet?

3) And finally, their commentaries on the new atheists adopt the same snark and sarcasm that they are demanding the new atheists remove from their commentaries on theism - just consider the antics at YNH and The Intersection.

This really is an impossible and incoherent position. I'm not going to tell them to shut up, however (that's their line). No, I'm just going to keep pointing it out, whether they like it or not, and in whatever tone I choose to adopt. That, I think, is my right.

Incidentally, it's ironic here, that YNH complains about being told to shut up, on a site calculated to shut up new atheists:

If you were aiming to shut up and silence an individual trying to express his opinion by digging deep for personal information and not caring what collateral damage you leave along the way in the form of incorrect allegations, you've succeeded.

Well, I certainly don't want YNH to shut up, but there are justifiable reasons for folk wanting to know who an anonymous blogger is who's telling them to how to behave. There's always a suspicion of ulterior motives; it's useful to know where someone is coming from, since it backs up their opinions and gives them some colour. It's not vital to know, but can be helpful. Imagine if YNH was simply a blog set up by churchmen to sow dissent amongst the atheist community? That would be pertinent. Not that that would ever happen, of course.

But this is really a ridiculous diversion from the everyday battle to promote rationalism in the public sphere. Nevertheless, as long as we are wired as we are, some of us will go off on irrational tangents. Here's hoping William at You're Not Helping will see the error of his ways one day.

UPDATE: Gurdur, another prominent accommodationist, clearly spots the problem that YNH exposes; one cannot demand folk behave according to certain rules whilst one flouts the very rules one demands. This first commenter, defending YNH says:

He may have conducted himself badly, but it does not diminish the validity of the message.

Let me just complete that sentence to highlight its asininity:

He may have conducted himself badly, but it does not diminish the validity of the message that one mustn't conduct oneself badly.

Sigh.

FURTHER UPDATE: A full and frank (?) apology has been made for the conduct of YNH by William. I confess it comes over a little too neat for my liking, but others are giving him the benefit of the doubt. It is only teh interwebz, so let's consign it to history and experience.

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Why Public Sex Bans are Wrong

Steve Zara has posted a thought-provoking article, entitled Why Burqa bans are wrong, discussing bans recently introduced by the French government and some other parts of Europe. I confess to being not completely convinced of the ban's rightness or wrongness, although I lean towards it being right. Many good points are made by him and other anti-banners, citing civil liberties, impracticality, discrimination and silliness. I agree with them!

But that's not to say that these points make a ban wrong, just that any ban must be justified. Societies do ban things, so a knee-jerk libertarian response is not appropriate, though there are civil liberty concerns to weigh. Steve also notes that the real problem of wearing the burqa is that it is '...ill-mannered and disrespectful to others in society'. This is a good observation, but not the *most* problematic thing about it, in my opinion, when it is a cultural *imposition*. So I thought I would compare burqa wearing with public sex, after spotting this story about a cargo cult in Papua New Guinea, who decided that sex would deliver more bananas (I don't scour the web for stories about sex cults, and anyone who says I do is a liar!). A few quotes:

The Banana Cult is headed by a man from Yamine village.
The man and his followers have been engaged in illicit public sex for the past four months and have forced other villagers under threat of violence to participate.
(...)
According to Mr Namusa (village elder), the villagers resorted to cult activities, claiming the government had forgotten them. Mr Namusa said the cultists believed that their banana fruit would multiply 10-fold every time they had sex in public.
(...)
Mr Namusa confirmed the cult movement and said young men and women including married couples were walking around naked and having sex in public places
without being ashamed of themselves.

So to paraphrase Steve's first paragraphs:

Doesn't seeing people having sex in public make you feel uneasy? It makes me feel uneasy. It makes very many people feel uneasy, so uneasy that in several places in Europe there are laws against public sex either on the books or being planned. Such laws are dangerous, and unnecessary.
What is the problem with such sex?

I'm sure the analogy doesn't work completely, but, remember; no doubt some of the people indulging in public sex were freely indulging - it's their lifestyle choice. Should we restrict their freedom? On the other hand, many members of the community were cowed by the group dynamic, and some were too young to know any different. Should they be protected?

Don't be silly, one might say, public sex is much more harmful than a mere fashion choice. Perhaps, perhaps not; I just don't know the damage that burqa wearing *actually* causes (nor indeed public sex).

Banning burqa-wearing in public may have the effect of imprisoning women in those cultures. But, likewise, a banana cultist would feel obliged to spend a lot more time shut up inside having sex to ensure their banana deliveries.

There's only a few women who wear the burqa, so it's hardly a widespread problem. But would one allow just a few tens of people having public sex to ensure their banana delivery? I can't see it.

The point is that legislation against practices, such as public sex and public burqa wearing, are not bad per se, and have to be considered on the merits of each case. If the effects of burqa wearing are sufficiently abusive one would *have* to consider introducing such legislation against that abuse.

Now I don't *think* that burqa wearing is as unwelcome as public sex, although I'm not too sure what harm to society *either* brings! As I say, *I just don't know*. But there is, at the very least, a clear case of potential abuse with 'extreme' clothing that should be assessed, to avoid harbouring a community of abused women. And I don't see that a ban, any ban, can be dismissed out of hand, if it could help to lift the abuse.

Mind you, it would be a good test for Harris's science of morality. If all studies showed communities and women *flourishing* wherever the burqa is worn (I doubt very much that would be the case), what should be the scientific response? Perhaps there might be a need to resort to some Rawlsian primary social goods; or acceptance that we shouldn't be so prescriptive about what is good for people.

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Moral Inscrutability

Russell Blackford has written a good blog post summarising the philosophically-minded objections to Sam Harris's is-ought pseudo-dismissal. I'm basically in agreement with Harris, although note the (valid) objections of a number of philos about the meta-ethics - I just don't think they matter *that* much! But Russell makes a good point when he summarises Harris's argument comparing his putative moral science to medical science:

Unfortunately, we are nowhere near to having the sort of general agreement as to the goals of, well, moralising, if you will, that we do with practising medicine or science. So it's no use arguing:

P1. The ultimate goals of medicine and science are contestable
P2. We can practice medicine and science with no terrible difficulty.
C. We can, with no terrible difficulty, practice anything whose ultimate goals are contestable.
Hence, we can, with no terrible difficulty, practice a "science of morality".

The correct conclusion, at "C.", is that we can, with no terrible difficulty, practice some things whose ultimate goals are contestable. As far as this argument goes, whether morality is one of those things is left as an open question. It really depends on just how much debate there is about a practice's ultimate goals, and how this pans out in practice. Unfortunately, the ultimate goals of morality are so controversial, and so disputed at such a deep level, that it's not surprising when much of what goes on in moral philosophy relates to trying to get agreement on the ultimate goals.

I think this is right, at a foundational level. However, Russell agrees that applying ethics is something that can be done:

But Harris doesn't actually need to make an unheralded breakthrough in metaethics to establish his main point about the possibility and desirability of criticising moral systems. If those moral systems are harmful to human wellbeing ... then criticise them for it! I think hammers exist to drive nails and that it's approximately correct to say that moral systems exist to conduce to human wellbeing and, to some extent, the wellbeing of other sentient creatures.

And of course each society establishes a way of living that announces their conception of the best morality - it would be disingenuous to suggest otherwise.

The meta-ethical problems arise, it seems to me, from the inscrutable origins of our morality. Because we have evolved in the environment according to events that are impossible to retrodict, let alone predict, we find it very difficult to determine the cause of every animal's every trait. The morality we have (signs of which appear in other mammals) has been a necessary development for our survival, or is a consequence of another feature that was necessary for our survival. But it's still just a *feeling*, so consequently isn't an *infallible* guide to what is right for us. It's not a bad starting point, but because many think they have nothing else to go on, they trust their 'gut' feeling over all else.

The religious turn morality's *fallibility* (observed empirically) and turn it into *arbitrariness*. To bolster their flagging confidence in 'what is right', they invest a God with good and call it absolute and objective. Much analysis down the years has yet to show that this approach is tenable or, indeed, plausible. One would think that a good-invested God might have an effect substantially different from an evil-invested God, but it's difficult to see how either could result in the universe we have.

The rationalist can accept that we have a sense of what is good without it being absolute, so tempers it with a good dose of reason and evidence; like everything else in life.

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Catholic Post-modernism

A useful post, by Simon Rowney of Cathnews, as an example of the sort of witless rambling that the intertubes facilitates. I'm of the opinion that the more free speech and transparency for ideas in the public sphere the better, and the internet supplies that in spades. So, the theory goes, idiocy will be exposed, and the human project will progress *more* rationally. Hopefully. It's possible, however, that it allows foolishness to be spread as quick if not quicker than before, so the theory may be wrong. Consider this nonsense:

Modern people believe philosophy is a private and personal encounter with truth. Ever since the publication of Descartes' Meditations each person has been forced to answer the fundamental questions alone. This paradox holds true, despite the fact that Science, much like Christianity, is very public and has a definite creed.

I'm not too sure what this means; perhaps he's commenting on the inevitable problem we humans have as prisoners of our own perceptions; certainly Descartes' cogito ergo sum points us in that direction. But one can easily fall into solipsism, which hardly gets the Catholic anywhere. If one isn't solipsistic, then, by definition, one isn't *forced* to answer the fundamental questions alone. No, one has fellow travellers, and tools to help. (And of course, science does not have a *creed* but a methodology.)

Because of this, in the modern world it is considered a grave error to question another person's rationality. By all means we are invited to proclaim truth and critically appraise the validity of arguments. However we cannot, under any circumstances, question another's rationality.

This is so laughable one is attempted to call Poe. What would be the point of not pointing out someone's irrationality? Or is he saying no-one's really irrational?Are we really expected never to question someone's rationality? Where does that leave the courts, who have to decide on the competence of defendants? Are we not expected to call Harold Shipman and Christie mad? This really is the height of stupidity, let alone irrationality. It's clear to me that what the writer is talking about is not modernism, but post-modernism.

Dawkins assumes that all educated people will reach the same conclusions!

No. He's well aware that educated people reach different conclusions. That evidence is all around us. Why is science such an important methodology? Because it acknowledges this truth and counters it.

In the modern world proclaiming public and definite truths has special difficulties. Dawkins and many spokespeople for science are not even aware these difficulties exist. They move forward in blissful ignorance of their fundamental myopia.

On the contrary, in my experience they are well aware of the problems that proclamations of definite truths can be. Truth in science, as opposed to logic for example, is always contingent. In this it stands in stark opposition to the bold absolute assertions of the dogmatically religious.

The Church, on the other hand, is acutely aware of the modern challenge. She is equally aware that personal philosophy can strengthen Faith and create opportunities for evangelization. In large part the Church's view has been the happy result of Cardinal Newman's influence. Through the life and writings of this thoroughly modern man, the Church has come to understand and embrace the extraordinary interplay between a personal philosophy and a public creed.

It's ironic indeed that the Catholics are beatifying Newman, who appears to have been a very devout man whose very nature is denied as natural by his Church, and was buried with his lifelong partner Ambrose St. John. Interesting indeed to consider how the personal and the public 'interplayed' for him. But however pious and wise is a person does not make them right in all matters, and for that reason, personal philosophy is nothing more than a useful contribution to the human project. The root of much evil in the world is to reify one's own personal philosophy and present it as fact. This could be the definition of the religious.

Rowney wants to discredit science through a post-modern dismissal of all rational analysis, which allows him to maintain his foul prejudices (and of course everyone else theirs). So we begin to see a coalition of forces in defence of irrationality, made up of the devout and the credulous, demanding an unthinking *respect* for any crackpot idea. That way, they can get a free pass for their favourite crackpot idea.

Now the danger here is that many people have rather *disreputable* crackpot ideas, which they are keen to impose in the public sphere, to satisfy their own prejudices and benefit themselves. Rowney's argument is the perfect justification for *any* ideology. By his own logic a church set up with a mission statement to eliminate all Roman Catholics could not be condemned as irrational. Well, unlike him, I *would* question the rationality of such people, and would defend everyone's right to question it. More than that, it's vital for the healthy development of our society that we shouldn't stand idly by when we see irrational behaviour, but should condemn it for what it is.

Therefore I question Rowney's rationality, despite not being able to, apparently.

For an example of the irrationality of Catholic dogma, try this.

And a tragic example of the irrationality of another sect here.

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