One argument that we hear regularly in the comment sections of this blog and elsewhere goes something like this:
“Why worry about a bit of so-called alternative medicine (SCAM like homeopathy or chiropractic, or Reiki, or Bach flower remedies, or detox, etc.)? Why should it bother us? Why not let everyone use what they want? Why not be a bit more tolerant?”
Tolerance is defined as sympathy or indulgence for beliefs or practices differing from or conflicting with one’s own. It is, of course, a quality that normally should be welcomed, taught, and celebrated. So, why not be more tolerant with enthusiasts of pseudoscientific SCAM?
In my view, there are several reasons.
- Ineffective therapies harm patients. The public tends to believe that SCAM is inherently safe. This is, of course, not true – think of chiropractic, for instance. But some treatments seem entirely harmless. Homeopathy might be a good example; its remedies contain nothing and therefore homeopathy can do no harm. Sadly, this is not true either. If a patient uses homeopathy to treat a serious condition, she is likely to harm herself by not treating that condition effectively. In extreme cases, this course of action can be fatal.
- Ineffective therapies are a waste of resources. It seems obvious that the money spent on something that does not work is money wasted. This is true whether we buy a car that is beyond repair or a SCAM that does not work beyond placebo.
- Pseudoscience makes a mockery of evidence-based medicine. If we are tolerant towards useless SCAM and accept that some people make money on, and mislead the public about SCAM, we basically send out a message that evidence is of secondary importance. This would weaken the trust in evidence-based medicine which, in turn, is bound to render healthcare less effective and stand in the way of progress.
- Pseudoscience undermines rationality and one form of irrationality begets another. Perhaps the biggest danger of tolerating promoters of quackery is that this undermines rational thinking far beyond the realm of healthcare. “Those who can make you believe absurdities can make you commit atrocities,” wrote Voltaire. I fear that he might have been correct.
In my view, tolerance about pseudoscientific, implausible, ineffective, or harmful SCAMs is misplaced. On the contrary, I feel that it is our duty to limit the harm they do to the public, patients, and progress by exposing them for what they are.