Do You Believe in Magic? is a debunking of “alternative” or “complementary” medicine by physician Paul Offit. I’ll mention a few of the topics and points that most caught my attention as I read this book.
Alternative medicine is largely unregulated. There’s really no justification for this, and I would think the overwhelming majority of consumers are unaware of it, and assume instead that whatever requirements there are for standard medicines to be safe and effective, the same rules apply to alternative medicines.
There’s no justification, but there is an explanation. The explanation is just the exercise of raw political power by those who make money off alternative medicine, which is ironic, since it is mainstream medicine (“Big Pharma” and the like) that is routinely accused of such political manipulation (sometimes justifiably I’m sure, since, like any corporation, health care corporations act in their own financial self-interest regardless of merit). The laws and (lack of) regulations concerning alternative medicine are generally traceable to campaign contributions and lobbying, and manipulation of public opinion (typically based on framing the issue such that any regulation of alternative medicine constitutes oppressing it and violating consumers’ freedom to choose it).
Offit compares the unregulated nature of alternative medicine and the way its proponents can and do say pretty much anything to increase their sales to the patent medicine scams of over a century ago.
While some alternative treatments have not been properly tested, many have, and they consistently fail such tests. (Or at least the better designed the tests are, the more likely they are to fail them.)
The book includes interesting sketches of such figures as Linus Pauling, Suzanne Somers, and Jenny McCarthy and their screwy—and very popular—causes.
Offit recounts an experiment in which an alternative treatment for autistic children was shown to be no better than a placebo. The sad thing is that after all the participants were fully debriefed and the results explained to them, the overwhelming majority of parents chose to still pursue the (very expensive) alternative treatment that had just been proven to them to be worthless.
The psychological explanation for this points to a big factor that alternative medicine con artists can exploit. That is that people hate to do nothing, no matter how evident it is that no other course of action is any better. People want to feel like they are at least trying to solve a problem, in this case at least trying to help their child. Doing nothing is too passive. You can imagine their thinking: What these people who conducted the experiment are telling me is that the alternative treatment doesn’t work, but there’s always some chance, however small, that they’re wrong, so rather than just give up and do nothing, it’s better to at least give this a try.
Which is not to say that there isn’t a sense in which placebos do in fact “work.” Offit points out that for certain conditions, placebos (including alternative medicine) have better results than doing nothing, so it’s not technically accurate to say, “That doesn’t work; it’s only a placebo.” The question, he says, is really more of an ethical one. Under what circumstances, if any, is it justified to deceive people for their own good by tricking them into thinking you’re giving them something of greater value than a placebo when you’re not. (I’ve read elsewhere, though, that the placebo effect doesn’t go away—just diminishes—when people have it explained to them that they’re being given a placebo. So deception helps but in some cases isn’t necessary.)
In fact, Do You Believe in Magic? closes with a good discussion of how the downside of alternative medicine arguably outweighs the limited benefits that placebos can provide.
Speaking of placebos, it turns out the placebo effect does not require any conscious beliefs about the efficacy of a treatment, or even the capacity to have conscious beliefs at all. Experiments show that rats experience a sort of placebo effect. When they are given a certain medically beneficial substance repeatedly accompanied by something irrelevant with a strong, distinctive test, and then they are subsequently given just the substance with that taste without the medicine, they still derive some benefit. So their bodies still somehow associate the taste with the benefit, and produce some of that benefit in response.
Reading a book like this puts me in the frame of mind where I wish I were back teaching critical thinking. One of the most valuable things people can learn in life is to become aware of how the untrained mind typically reasons, and what the flaws of that are compared to cogent reasoning.
For instance, consider how natural it is to overrate personal experience, and to a lesser extent anecdotal evidence even from other people. If slick salesmen and true believers tout magnets to you as a miracle cure for acne, and you glue magnets all over your face and subsequently there’s at least some diminishing of your acne, you almost certainly will conclude (if you’re not trained in critical thinking) that the magnets cured, or at least improved, your acne. If you are told of some controlled study involving hundreds of participants that concluded that gluing magnets to one’s face has no more effect on acne than a placebo, you’ll dismiss it as irrelevant (and probably some fake thing intended to deceive in order to benefit Big Pharma or the like), because you already know it works through personal experience.
Indeed, not only will you not be aware of the flaw in inferring the effectiveness of the magnets from the lessening of acne on your face, you probably won’t recognize it as an inference at all, since you’ll think that you directly experienced that effectiveness.
Critical thinking can help someone to understand how much weight to put on different kinds of evidence and experiences, what concepts like “placebo effect” or experimental “controls” mean and why they’re important, when appeals to authority are justified and to what degree, etc. In a population of people skilled in critical thinking, the belief in this woo woo stuff would plummet.
I’ve read quite a lot of books (and other writings) in the genre of skepticism and debunking of pseudoscience and such, and I would put Do You Believe in Magic? in the top half. It’s a well-written, valuable, convincing treatment of its subject matter.