Do You Believe in Magic?, by Paul A. Offit

Do You Believe in Magic

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.

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4 thoughts on “Do You Believe in Magic?, by Paul A. Offit

  1. Jason Preater December 24, 2015 / 4:46 am

    Looks worth reading… And what you write is interesting in more general terms. Any suggestions for books about how our beliefs affect our ability to reason?

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    • Philo December 27, 2015 / 2:49 pm

      Three that I can mention off the top of my head that I’ve come across in recent years are Blind Spots by Madeleine L. Van Hecke, Heuristics and Biases by Thomas Gilovich, Dale Griffin, and Daniel Kahneman, and Mistakes Were Made (but not by me) by Carol Tavris and Elliot Aronson.

      There are many excellent books on critical thinking, on pseudoscience, on medical quackery, etc., but I’m thinking of books that address not only poor reasoning and what’s logically flawed about it, but specifically the issue of psychologically why people are prone to such poor reasoning.

      I have to think confirmation bias is the single most important factor. You see this all the time in politics and public discourse in general–comment sections on online articles, for instance. Once people have “picked a side” of some issue (and by the way that initial selection itself is almost never rational but typically based on having their emotions successfully manipulated), then they become diehard advocates for it, clinging to and repeating anything that could be interpreted in its favor, and easily finding ways to discredit anything said on the other side.

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  2. Darryl December 26, 2015 / 11:57 pm

    Offit is a hack for corporate medicine and his loyal allegiance to big allopathic money which he as widely revealed with his false and propagandistic derision of alternative medicine (eg, dietary supplements) in his widely circulated articles and his books.

    Here’s an example of his deceptive mode of operation: he mentioned that supplements cause some 50,000 side effects a year; what he doesn’t disclose is that the overwhelming majority of those are minor. The true data shows supplements generally are much much safer than aspirin or vaccines. Now since he’s a high-paid pawn for the medical industry he won’t tell you that prescription drugs cause HUNDREDS OF THOUSANDS of SERIOUS side effects a year and kill over 100,000 people each year in the US alone.

    Dr. Offit’s erroneous accusations and claims about dietary supplements have long been refuted by the real facts (read this scholarly article if you google “2 Big Lies: No Vitamin Benefits & Supplements Are Very Dangerous”).

    Anti-supplement allegations made by “experts” are primarily meant to mislead the unwitting public. Or “journalists” such as “Philo” who then blindly repeat the official propaganda.

    Gosh, if the corrupt mass media were only to disseminate Offit’s hyperbole, deception and lies as broadly as they do with his “scientific” allopathic propaganda against supplements. The fact that they don’t should tell anyone that they’re about the same thing as Profit-Offit: public deception.

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    • Philo December 27, 2015 / 4:11 pm

      A few quick points in response to this boilerplate diatribe.

      1. I agree that one should be cautious about opinions expressed in favor of the interests of the rich and powerful, since the rich and powerful—by their very nature of being rich and powerful—have the means and the will to influence opinions in their favor. However, in contrast to a case like tobacco, where the doctors and scientists and such who defended positions supportive of the tobacco industry were a tiny minority clearly out of step with the overwhelming majority who followed the scientific method, those who are skeptical of “alternative” medicine are very much in the majority of those with a professional track record of sticking to rationality and the scientific method in reaching their conclusions. It’s not far-fetched that there are individual doctors and scientists who are unduly resistant to evidence that would be contrary to the financial interests of “Big Pharma” or major hospital chains or what have you, but the notion that mainstream science as a whole is so totally under the conspiratorial control of its corporate paymasters as to be suppressing the truth about alternative medicine I don’t find at all credible.

      2. Putting “journalists” in quotation marks is a way of insultingly insinuating that “journalists” in this context really should be replaced with “so-called journalists.” Given that I am a blogger giving his layman’s opinions and reactions to the books he reads, and have never claimed to be anything else including a journalist, I can’t possibly be a “so-called journalist,” thus the insult misses the mark.

      3. Other than ad hominem, the only substantive claim made here is that by pointing out how many side effects supplements cause, the author is dishonestly implying that those are all major side effects. I didn’t read it that way. In my experience, side effects—whether from mainstream medicine or alternative medicine—can range from very mild to very serious, and tend to be minor more often than major. So I assumed the same about what the author said about supplements. If he wanted to claim instead that supplements are unusual in having mostly major side effects he’d have to come right out and say that, not leave it to be inferred.

      Indeed, my experience has been that critics of alternative medicine more often make the opposite point, that one of the few positive things you can say about alternative medicine is that many such alternatives have little or no serious side effects. Traditional homeopathy, for instance, involves basically giving people plain water and telling them that something that was in the water in the past and has been completely removed will somehow help them through some magic process; that has no more side effects than plain water in general does. (That is, unless you want to count as a “side effect” of alternative medicine the fact that many people who make use of it forego mainstream medicine to their detriment.)

      4. Out of curiosity, I Googled the “scholarly” article mentioned. I didn’t find the article itself, but only further references to it on dietary supplement websites and in comment sections in posts very, very similar to this one. (I guess it’s coincidence that multiple objective, concerned citizens happened to want to set Internet readers straight about supplements, in almost identical wording).

      This is typical of those arguing in favor of alternative medicine: Dismiss as biased and self-interested anything that could be beneficial to industries on the side they oppose, but have a complete blind spot about bias when it comes to material that favors industries on the side they support. So evidently if a scientist writes a book or article critical of alternative medicine he or she must be a paid hack nefariously propagandizing for those who profit from mainstream medicine, whereas those who profit from alternative medicine are never biased but can be trusted to say what they say out of a pure love of truth.

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