Having just finished reading an ‘satirical esothriller’ entitled ‘VIER FRAUEN UND EIN SCHARLATAN’ (it’s a good book but it’s in German, I’m afraid), I have been thinking more than usual about charlatans. A charlatan is defined as a person who falsely pretends to know or be something in order to deceive people. In the book, the charlatan character is deliberately exaggerated as a dishonest, immoral crook. I have met such people; in fact, I have met plenty of such people in alternative medicine. But I have to admit that, in my experience, there are other charlatans too; in particular, I am talking of ‘honest’ quacks who pretend to know while also being utterly convinced to know.
Come to think of the categories of charlatans, I think the matter is really quite simple: as far as I can see, in alternative medicine, there are essentially just two types.
This type of charlatan is the one we think of first when we mention the term. He (usually it’s a male) has a range of remarkable features:
- he is dishonest;
- he is entirely rational;
- he knows about evidence and has prepared all the necessary pseudo-arguments to belittle science vis a vis his followers;
- he is only interested in himself;
- he is immoral;
- he wants to make money;
- he employs all the means available to achieve his aims, including PR, advertising, branding, merchandising etc.
- he does not believe in his ‘message’;
- he systematically studies and exploits his target group;
- he does not live by his own rules;
- when he is implicated in harming a patient, he consults his lawyers;
- he is cynical;
- his ‘charisma’, if he has any, is well-studied and extensively rehearsed;
- when challenged, he sues.
This type is very different from the crook and would be deeply shocked by the crook’s behaviour and attitude. She (often it is a female) can be described as follows:
- she is convinced to be profoundly honest;
- she is deluded, often to the point of madness;
- she ignores the evidence totally and argues that science is just one of several ways of knowing;
- she feels altruistic;
- she thinks she is on the moral high ground;
- she is not primarily out to make money and might even offer her services for free;
- she does not seek fame;
- she is religiously convinced of the correctness of her message and wants to save mankind through it;
- her message is for everyone;
- she strictly adheres to her own gospel and thinks that those who don’t are traitors;
- when she is implicated in causing harm, she consults her ueber-guru;
- she abhors cynicism;
- her charisma, if she has any, is real and a powerful tool for convincing followers;
- when challenged, she feels hurt and misunderstood.
As I indicated already, this is a SIMPLE classification. Between the two extremes, there are all shades of grey. In fact, it is a continuous spectrum.
Why should any of this be important?
Charlatans of both types cause immeasurable harm, and it is impossible to decide which type is more dangerous. Our aim must be to prevent or minimise the harm they do. I think, this aim can best be pursued, if we know who we are dealing with. Identifying where precisely on the above scale a particular charlatan or quack is situated, might help in the prevention of harm.