About Rationally Speaking


Rationally Speaking is a blog maintained by Prof. Massimo Pigliucci, a philosopher at the City University of New York. The blog reflects the Enlightenment figure Marquis de Condorcet's idea of what a public intellectual (yes, we know, that's such a bad word) ought to be: someone who devotes himself to "the tracking down of prejudices in the hiding places where priests, the schools, the government, and all long-established institutions had gathered and protected them." You're welcome. Please notice that the contents of this blog can be reprinted under the standard Creative Commons license.

Wednesday, June 10, 2009

Deepak Chopra defends Oprah while committing endless logical fallacies

I regularly read the Huffington Post, for the good reason that it often sports intelligent articles written from a progressive standpoint, and because I believe in open access and open contribution to the socio-political discourse (otherwise, I wouldn’t bother writing this blog). Then again, one of the drawbacks of openness is that you get crap together with the good stuff. This isn’t altogether bad, since reading crap is a necessary component of developing one’s own sense of critical thinking, sharpening the baloney detector, so to speak. But crap needs to be responded to, especially when it comes from influential sources. Hence this column on good old Deepak Chopra (he of quantum mysticism fame) defending Oprah Winfrey from the attacks of a “struggling news magazine” (Newsweek) which recently dared criticizing Oprah for endorsing and promoting pseudomedicine — most famously by lending ample tv time to Jenny McCarthy, the former Playboy model who maintains against all evidence that vaccines cause autism.

Ok, Deepak, here we go. Chopra complains that Newsweek adopts “the same tiresome blend of gotcha journalism and selective fact-reporting that fills tabloid coffers,” which is a stunning case of the pot calling the kettle black if you go on and read the remainder of Chopra’s own piece in the Post. Be that as it may, we then find out that “[Oprah’s] intention to improve women's lives on all fronts is so obvious as to be almost above criticism.” Really? I have no reason to doubt Ms. Winfrey’s intentions, but surely Deepak has heard that the road to hell is often paved with good intentions, no? But you see, “the fact that she has celebrity guests who have causes and crusades in the area of health, such as Jenny McCarthy or Suzanne Somers, is not the same as Oprah herself endorsing what they say.” Well, if you actually watch Oprah (which I sometimes do while working out at the gym) she is strongly endorsing McCarthy and Somers, as it is made clear by the continuous nodding and words of encouragement that Winfrey utters every time these quacks are on her show, or by her sometimes vehement dismissal of their critics.

A major argument deployed by Chopra is that “[Oprah] brings up creative solutions to problems that medical science is baffled by, such as the healing response itself and the role of subjectivity in patient response. ... Do subjective changes affect healing? Obviously they do, or we wouldn't have the placebo effect, which comes into play at least 30% of the time in illness.” He then goes on to show proof of what he is saying by citing a study (conducted by mainstream medical researchers, incidentally), showing that “on average, acupuncture patients received twice as much benefit as those on standard treatment [anti-inflammatory drugs or a massage]. The kicker is that some of the patients received fake acupuncture — they were pricked superficially with toothpicks — and received the same relief.”

Now let us stop for a moment and analyze the above. First off, Chopra does not seem to understand the placebo effect. As Harriet Hall explained in a recent issue of eSkeptic, the 30% figure (which is actually 35%) derives from a 1955 study published in the (decidedly non “alternative”) Journal of the American Medical Association, and authored by Henry Beecher (a non-alternative MD). But the figure of 35% refers to the cumulative effect of everything that is not treatment, which includes not just the actual placebo effect, but more importantly a large component deriving from the body’s natural (evolved, not mystical) ability to heal itself. Indeed, a more recent study by Asbjorn Hrobjartsson and Peter Gotzsche published in 2001 in the New England Journal of Medicine properly compared the improvement achieved with no treatment to the improvement due to the placebo effect, and found little measurable effect of the placebo. This doesn’t mean that the placebo effect doesn’t occur, just that it is much more limited than the “30%” figure mentioned by Chopra, who apparently doesn’t bother reading the medical literature before making his spectacularly misinformed pronouncements.

Moreover, a rational person would conclude from the study of “real” and “fake” acupuncture that there is no such thing as real acupuncture! If pricking patients with toothpicks has the same effect as inserting needles, wouldn’t you surmise that the whole thing is in fact the result of placebo and natural healing, no acupuncture required thank you very much?

Chopra criticizes the “medical establishment” for being slow to explore new treatments, and cites the case of American doctors who have finally begun considering lumpectomies in place of the much more drastic mastectomies in cases of breast cancer. I am no fan of the health industry, and particularly of the pharmaceutical industry, especially as they are run in this country. But, please notice that the increase in interest in lumpectomies was the result of rigorous studies published by European researchers in peer reviewed journals. Nothing whatsoever to do with “alternative” medicine, whatever that means.

One more example, which perfectly embodies Chopra’s “logic,” such as it is. The mysticism that he promotes (and handsomely profits from) needs “mystery,” as in things that official science doesn’t understand. Otherwise he couldn’t sell his quackery as an “alternative.” So he cites, predictably, the mind-body connection, as in the following stunning passage: “So let me offer a typical finding that comes from the Centers for Disease Control and Prevention, among other official sources. It concerns the effect of child abuse and other adverse circumstances on later health. Is it ‘soul talk’ to believe that a child raised around parents who abuse substances, who suffer from mental illness, or who outright abuse the child will suffer health risks later in life? According to the CDC study, covering 15,000 HMO members in San Diego between 1995-97, the risk of contracting an autoimmune disease as an adult is increased from 70% to 100% if you happened to be abused as a child or grow up with adverse home conditions. ... This study suggests a human connection rather than a biological one.”

A human rather than biological connection? What does Chopra think human beings are, if not biological organisms? And notice, again, that the source of the study is a perfectly mainstream organization, the federally funded CDC. And no, no scientist in his right mind would dismiss this as crazy ‘soul talk,’ because the idea of a connection between stress and health has been accepted and explored experimentally by biologists in both humans and other animals for decades. Indeed, if you are a dualist (as in “mind-body”) like Chopra you actually have a hard time explaining exactly how is it possible that the mind and the body are thus connected (a much bigger mind, Rene Descartes, tried and miserably failed). But if you are an old-fashioned materialist scientist you actually expect a connection between “mind” and “body” because they are both the results of biological functions.

I’m sorry, Mr. Chopra, but that little “struggling news magazine” actually did something that takes gall these days: they questioned the nonsense sputtered by a celebrity with no medical training whatsoever in the name of protecting the public’s health and welfare. It may be tiresome journalism, but it is the only kind of journalism worth reading.

21 comments:

  1. Nice reply Massimo. I find it fairly easy to pick logical fallacies up when someone is honestly arguing a case, because they interrupt the flow or argument. But I struggle with people like Chopra or peddlers of woo where the argument isn't so logical to begin with. What's your secret?

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  2. Heh. "Nothing whatsoever to do with “alternative” medicine, whatever that means." Well, how do you know that if you don't know what that is?

    It's not that I don't know what you mean, but more that I really don't know what “alternative” medicine is.

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  3. As I understand it, "alternative" medicine means therapies that are not part of mainstream medical practice. Over time, some mainstream medical practices have become discredited and are either completely discontinued or only continue to be practiced outside the mainstream. On the other hand, some "alternative" practices are recognized to be genuinely beneficial and become accepted within mainstream medicine. In both cases, scientific research can be instrumental in effecting a change. Insurers also play an important role. To the extent that they are willing to pay for certain therapies, they confer legitimacy on them.

    Regarding the paper by Hrobjartsson and Gotzsche, note that it is available for free [pdf] from the New England Journal of Medicine. What was unique about this paper was that the authors identified studies where some patients were randomized to receive placebo while others were randomized to no treatment. This permitted an estimate of the actual placebo effect. Few clinical trials have a "no treatment" group, but unfortunately improvements experienced by patients in a placebo group are sometimes labeled as a "placebo effect", when as Massimo has pointed out, they may simply reflect normal healing. A further point: Hrobjartsson and Gotzsche did find "possible small benefits [of placebo] in studies with continuous subjective outcomes and for the treatment of pain".

    What intrigues me is how the idea that the mind has a profound influence on the body has become so broadly accepted based on what seems to me to be pretty thin evidence. In some cases, the idea does seems quite plausible. When people are depressed they tend not to look after themselves, e.g. not eating well, or even harm themselves. But the widespread notion that one's frame of mind can affect the progression of cancer strikes me as farfetched—although I'm not familiar with the evidence about this.

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  4. Brian,

    well, you know, I am about to become officially a philosopher (as in someone whose salary is paid by a philosophy department), so I better be good at spotting logical fallacies... :)

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  5. Massimo, I should've included emoticons so that you knew I was paying you a compliment without trying to sound fan-boyish. But you probably worked that out. ;)

    In any case, it's a skill I'd like to develop. I've found books on formal logic only help if you can get the form of a statement and see if it's valid. It seems that informal logic helps the most in these situations, but being informal, requires much more context and experience to determine if someone's committed a foul or has a right to use an argument in such a way. Recommend any books?

    Congrats. on the position.

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  6. Brian,

    there are several good books out there on critical thinking, most of which include a treatment of logical fallacies (formal and informal).

    The book I will be using for the first philosophy class (Critical Reasoning, at the 200 level) that I'll be teaching this fall is: http://www.amazon.com/Short-Course-Intellectual-Self-Defense/dp/1583227652/ref=sr_1_1?ie=UTF8&s=books&qid=1244754354&sr=8-1

    One of my favorite resources is: http://www.fallacyfiles.org/index.html

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  7. Massimo,

    You got an appointment at the SUNY-Stony Brook Philosophy Department? Or are you moving to another univ.? Will you have a dual appointment or is this a total departmental shift?

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  8. Joseph,

    no, I am leaving Stony Brook. I took a position as the chair of the philosophy department at the City University of New York, Lehman College.

    It's exciting, I get to change career after 27 years of doing evolutionary biology. I figured almost three decades in science followed (hopefully) by two or three decades in philosophy should make for an interesting life...

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  9. I figured almost three decades in science followed (hopefully) by two or three decades in philosophy should make for an interesting life... I'd wager it'd make you have more of an empirical bent than rational. I'm always skeptical of philosopher's who come to science and tell scientists, especially biologists, what essential kinds, ontologies, etc, or what not they're dealing with. I think philosophy should not only quote the science, but should understand the science. I guess my limited understanding of Hume has forever corrupted me....In any case, I approve of a scientist doing philosophy. For what that's worth.

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  10. Congrats on the career-shift! It sounds like you're successfully "following your bliss" as they say.

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  11. Nick Barrowman,

    What I write here's only a conjecture as to how mood could affect healing, and tissue reaction to injury.

    There are mainly two arms of autonomic nervous system (the part of nervous system we're not conscious of) in the body--parasympathetic and sympathetic. The latter dominates during times of stress, and tends to suppress the immune system by production of costicosteroids. Whereas, on the other hand, it makes the gut more perceptive to pain. Inflammation of of any kind also makes the gut more perceptive to pain. Sympathetic system activation keeps the body in a catabolic state, (i.e., breaking down of stored energy) and reduced appetite--which could further the effect of cancer cachexia (severe weight loss seen in cancer). Whereas, parasympathetic system has opposite effects--it promotes the 'healing' state of the body. Also, the immune system (in particular the T cytotoxic lymphocytes which individually target the cancerous cells) functions better with parasympathetic system predominance.

    So basically, it's not a case that we don't have biologically plausible ways in which the 'mood' could affect the outcomes of chronic disorders like cancer. Plus unfortunately, many criteria (therapeutic endpoints and side effects), like pain relief, gastrointestinal discomfort, etc. are subjective, which depend a lot on tolerance threshold at a given time, and thus certainly on 'mood'.

    Massimo, congratulations on your new appointment! You might also want to shed some light on the above aspects.

    Take care.

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  12. Ketan,

    In response to your comment, I did a bit of reading on psychoneuroimmunology.

    I had commented that

    What intrigues me is how the idea that the mind has a profound influence on the body has become so broadly accepted based on what seems to me to be pretty thin evidence.

    I accept that there is a growing body of evidence in psychoneuroimmunology. Most of that evidence, however, is from basic, rather than clinical science.

    My original comment was rather vague. What is a "profound influence"? What is "quite plausible"? What would it mean to say that "one's frame of mind can affect the progression of cancer"?

    My sense, however, is that some intriguing findings in basic science have been extrapolated beyond the evidence. Of course the mind affects the body, but the more relevant questions are under what conditions, and to what extent?

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  13. Hi Nick Barrowman!

    In my previous comment, I was merely conjecturing as to what possible biologic mechanisms could play a role in disease progression. Even if some day, such mechanisms are found to significantly influence the progression, it would be an oversimplification to say that they do so in a PREDICTABLE manner. And more so it'd always remaini difficult to ascertain if the psychological factors could not be arising from the disease process itself. To imply that attempting to alter psychological factor alone could ALTER the disease course (in particular duration of survival) is an absolute travesty of medical science, and of course I won't subscribe to such concepts till proven statistically.

    And I'd also talked of subjective criteria like pain perception, which if used as therapeutic endpoints, instead of objective criteria like survival are bound to be found favorable in 'happier' persons.

    TC.

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  14. Massimo,

    Congrats on your new position! Best of luck in your new second career. The field of evolutionary biology will be poorer now.

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  15. The mysticism that he promotes (and handsomely profits from) needs “mystery,” as in things that official science doesn’t understand. Otherwise he couldn’t sell his quackery as an “alternative.”

    I've got a slight problem with this. It strikes me as an Ad Hominem Tu Quoque fallacy. The fact that he profits from promoting quackery is not a valid argument that what he promotes is quackery or invalidates his implied criticism of Newsweek for filling their coffers by using tabloid techniques.

    Don't get me wrong, I'm not defending this snake-oil salesman, I'm just pointing out what I see as a logical flaw (but great rhetoric) in your post.

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  16. jdhuey,

    thanks, but this would be a logical fallacy if my *entire* argument against Chopra were the fact that he profits from his quackery. I have plenty of independent reasons to buttress my claim, but I still think it is good to call people's attention to his profits (especially considering how he keeps going on about the fact that doctors make money out of their misguided and close-minded practices).

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  17. thanks, but this would be a logical fallacy if my *entire* argument against Chopra...

    Really? Does this fallacy become valid simply because it keeps company with other rock solid arguments?

    (Again, I'm in total agreement with you regarding Chopra. I'm just pursuing a pedantic point.)

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  18. Yes, one common misunderstanding about fallacies is that they invoke arguments that are *never* appropriate. But that is not the case. Take, for instance, the genetic fallacy (considering one's background and character instead of their argument).

    If I were to dismiss someone *solely* on that ground I would be committing a fallacy. But there are plenty of instances where someone's character is part of the problem, or where knowledge of that character helps bringing into focus the full picture.

    Remember that logical fallacies strictly apply to deductive reasoning (if ... assumptions ... then ... conclusions), but in most cases of inductive reasoning different pieces of information become relevant -- as long as our argument is not based entirely on them.

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  19. Ketan wrote:

    In my previous comment, I was merely conjecturing as to what possible biologic mechanisms could play a role in disease progression. Even if some day, such mechanisms are found to significantly influence the progression, it would be an oversimplification to say that they do so in a PREDICTABLE manner. And more so it'd always remain difficult to ascertain if the psychological factors could not be arising from the disease process itself. To imply that attempting to alter psychological factor alone could ALTER the disease course (in particular duration of survival) is an absolute travesty of medical science, and of course I won't subscribe to such concepts till proven statistically.

    Well said!

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