Science-Based Medicine is Having a Little Trouble with Critical Thinking (and Due Diligence)

By Dr Ray Greek

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Before I begin, allow me to once again explain that while I think the writers at Science-Based Medicine are flat wrong regarding their assessment of my position on animal models (or not even wrong as most of the positions that they criticize they attribute to me while these statements and positions are actually mythical or at least not from me), on the whole I agree with Science-Based Medicine and their positions on Evidence-Based Medicine, CAM, vaccines, and so forth. I find it sad that some of the SBM bloggers appear to have little knowledge of critical thinking but even they usually nail down difficult medical topics very effectively. On the whole, Science-Based Medicine offers something of value to society!

On February 3, 2014, David Gorski, MD, PhD wrote a roughly 4600-word essay titled: Animal rights activism: Petitions aren’t science. I encourage everyone to read the entire essay, as there are themes, specifics, and especially tone that I will be unable to reproduce or address.

Dr Gorski’s essay revolves around the fact that a group in the UK is sending him messages regarding a political measure in the UK called an Early Day Motion (EDM), specifically EDM 263 put forth by For Life On Earth (FLOE).

Gorski states:

As a prelude, however, let me point out that I won’t be dealing (much) with the morality of animal research, mainly because I believe that whether or not animal research is morally acceptable is not primarily a scientific question. Science can inform the consideration of the question of animal research, but in the end it’s a moral question. That is not to say that science is irrelevant, because part of the consideration of the moral question of whether and when it is acceptable to use animals in research is the issue of how much value to science animal research brings. How utilitarian you want to be considering this question is something that can be discussed . . . (Emphasis added.)

I agree with this! One might say that this is exactly what I have been addressing over the last few decades.

But here come the straw man arguments. Gorski continues:

but animal rights activists often invoke an extreme negative version of a utilitarian argument in that they try to portray as animal research as not just useless (i.e., providing no useful scientific information), but even as harmful or providing misleading or mistaken scientific conclusions. If that is the case, then it’s a no-brainer that animal research cannot be justified ever because in that case it would cause suffering to animals but provide no benefit in terms of scientific advancements that could lead to improved medical care.

Some of the above is exactly what some nonscientists in the animal rights movement say and I have chastised them for it repeatedly. But some of Gorski’s criticisms appear to be based on false assumptions about the value of animal-based research or are just made up out of whole cloth. Regardless, Gorski continues:

Unfortunately, as I documented six years ago, animal rights activists have a distressing tendency to use truly bad arguments to do everything they can to paint animal research as useless or even harmful to the science of medicine. These arguments tend to fall into one or more of three categories:

Animal research doesn’t teach us anything of value or even misleads us (i.e., it is bad science).

Animal research does not predict human physiology or response to disease, or animals are “just too different from humans to give reliable results” (i.e., it is bad science).

There are better ways of getting the information that do not use animals (i.e., there is better science available than using animals.)

Yep, those are what some animal rightists say. My position however, is and has always been the following.

1. Animal-based research has and can continue to help us learn a lot about the material universe in the form of anatomy and physiology of animals (animals being all members of the Animal Kingdom). This is a tautology IMO.

2. However, animal-based research does not offer predictive value for human responses to perturbations that occur at, or involve, higher levels of organization.

3. But in terms of responses on the gross level of human physiology and anatomy, animals and humans share a lot of properties and a lot of facts regarding humans and animals were or could have been learned using animals. The history is tricky and some claims made by vivisection activists are simply false but their greater claim (if they know the difference)—that such breakthroughs could have been made with animals—is true.

4. There are better ways of getting the information that do not use animals (i.e., there is better science available than using animals.)

5. But in some areas we have no predictive modalities at all—animal or in vitro or in silico. In these areas, we should consider human-based research. But perseverating that “animal-based research is all we have so we must use it” is like saying “sacrificing children for a good corn harvest is all we have so must use it.” Such statements fail both morally and scientifically. In science before we make statements like that we need actual data and numbers—studies that looked at the number of tons produced at the corn harvest when children were sacrificed and when they were not. We need numbers in terms of success rates when animals were used and when they were not. Were the animals necessary or merely sufficient? Are the historical explanations for the development of, say heart surgery, actually consistent with what happened or even what could have happened and again, were the animals used necessary or sufficient. These questions lie within the realm of philosophy of science and the answers shed light on what works and what doesn’t. In my experience, this area of science has been ignored and demeaned to the detriment of society. (But I don’t have any meta-analyses on this.)

On to the main part of the blog.

Gorski writes:

Like the case with many holding dubious scientific beliefs whom many would consider cranks, one favorite tool to promote their agenda is “public debate.” I’ve seen it many times myself. For example, I’ve had HIV denialists and antivaccine activists challenge me to “live” public debates over their favorite topics.

Contrast this with the following from Dr Steven Novella who wrote: “During a live debate we can see how the candidates think and what they know and believe about scientific issues. They can also be pushed on specific points if they give evasive answers.”

Gorski maintains that: “They [cranks and nonscientists] seem to think that science is decided in public debates and view the quite understandable reluctance among scientists like myself and skeptics to engage cranks in such spectacles as ‘cowardice’.” Sadly, Gorski is correct on some of this in at least some cases and Gorski is more or less spot on when he continues stating:

It is not, but cranks continue to labor under the delusion that science is somehow decided in such forums, which are a variant of a sort of argumentum ad populum, in which something is argued to be true because it is popular or, in a debate, an argument is thought to be closer to the truth because it is more popular. Science doesn’t work that way. It is decided on evidence presented at scientific conferences and in peer-reviewed journals, where the real scientific debate plays out until it is temporarily settled and scientists come to a provisional consensus. That provisional consensus, of course, is always subject to change as new observations, data, and experimental results come to light, but it takes observations, data, and experimental results to change the consensus, not “live public debates.”

Popularity does not equal truth! How about that? Gorski misses the boat on some of the above, however. First of all, the above is how “normal science” works. It is not how paradigm shifts occur nor how really big changes in science sometimes occur. Moreover, Gorski creates a straw man in stating: “Such ‘live public debates’ have only one purpose: To sway public opinion to a viewpoint not supported by science, in the process elevating pseudoscience or the unproven to the same plain as the scientific consensus as a scientifically viable “alternative,” no more, no less.” If that were the purpose why would Novella endorse and participate in them? Unless, maybe, those debates, when properly conducted allowed each side to make previously unaddressed points? A proper debate would take a long time but it could also end general public acceptance of a lot of nonsense.

My purpose in debates is to prove that my position is correct. In an effort to do that, I have suggested rules for debates, which I will present momentarily. Such rules eliminate or penalize many things, such as snarky comments that are directed at the opponent and do not inform on the science. I for example, do not write ~5000 word essays filled with vituperative hyperbole, no real content, that contain many examples of the fallacy of equivocation along with other fallacies, and illustrate essentially no critical thinking. But if someone did have that as his modus operandi, a proper debate might present challenges for him and not accepting an invitation to such a debate might result in his being called a coward.

Gorski continues: “The fact is, pseudoscientists, pseudohistorians, and cranks desperately want to debate accepted experts in the field in which they apply their crankery.” Such is not the case for me. I tried the debate thing for over a decade and was very frustrated at the results, in part, for the same reasons that underlie Gorski’s comments and for the following.

1. The audience cannot follow the science and hence has no idea who is spouting nonsense. By audience I mean both nonscientists and scientists whose discipline lies outside the area in contention. For example, do not ask me to be an expert in a debate regarding quantum gravity. I know nothing about it, hence as an “expert” or audience member I would be clueless regarding who was right and who was wrong.

2. There are no referees / experts that both parties agree on and whom can be asked to settle matters of dispute in their area of expertise. There is no effort to find and educate such experts in the form of making sure they have the material that will enable them to understand both sides of the argument and render a judgment. This can be easily remedied by each side providing a small number of articles or position paper for the experts to read and understand prior to the debate. Not all experts would be expected to comment on every point in the debate—just the salient points in his or her area of expertise.

Currently, I don’t do debates as, without the list of debate requirement’s below being fulfilled, I just do not see any reason to leave the lovely weather of southern California, interact with the airline industry, risk encountering pro-vivisection extremists that will threaten and harass me, listen to the campus police say that if there is any kind of disturbance they will Taser me first (regardless of which side started the disturbance, yep, those campus cops know which side their bread is buttered on), and so forth. Flying from one hostile encounter to another when there exists no standard to judge outcome has not worked out well for me and others like me (think evolutionists debating creationists).

Debate Format

I would be happy to participate in a debate that includes the following.

1. The subject of the debate will be: Resolved: Animal models have no predictive value for human response to drugs and disease. (This is our issue despite the purposeful misrepresentations by Dr Gorski and others.) If anyone requests a second debate on the role of animals in basic research, AFMA will be happy to participate but only after the prediction issue has been addressed. AFMA is willing to have the basic research debate first if our opponent stipulates to the fact that animal models offer no predictive value for human response to drugs and disease. Thirdly, AFMA will debate specific historical breakthroughs that the pro-vivisection activists claim as one-shot arguments that prove everything they say is right (for example the Blalock-Taussig procedure was developed and could only have been developed by Blalock experimenting on dogs at Johns Hopkins). AFMA does not really have such historical debates in our mission, because they are immaterial to the prediction problem, but we can do it provided the predictive issue is debated first. And finally, the speaker or speakers on the opposite side must be recognized by the vivisection community as a world renowned expert on the topic being debated. I have debated many times only to hear from the vivisection community that the other guy (who lost) was not really an expert in all this. Funny how he seems to get a lot of his verbiage on animal models published in the scientific literature and endorsed by various science societies.

2. In term of judges and a moderator, the below are necessary:

a. Someone from the media, a university’s law school, business school, medical school, a science department, or any other person agreed upon by both participants will moderate the debate.

b. A panel of judges will be present. They may come from academia or industry. The judges should include experts from the fields of clinical medicine, complexity/chaos theory, philosophy of science, evolutionary biology, clinical research, drug development, the meaning of predictive value, and the differences between applied and basic research. Both debaters must agree on each of the judges.

c. A position paper or papers, complete with references, will be presented to the judges by each participant. The judges are expected to verify that the references state or imply what the presenter was claiming (in each judge’s area of expertise) in order for the paper and concept to be allowed in as evidence. The position paper would then function as the presenter’s official position and the presenter must adhere to the facts in the paper during his portion of the debate. Allusions, by the presenter, to areas outside the topic or his respective position paper would not be allowed in the formal portion of the debate. Any false claims or mistakes discovered in the position papers will be acknowledged by the moderator prior to the debate. This allows the audience to see where the presenters started in terms of their claims and facts.

d. Basic principles of science will also have to be agreed on, as will the basics of critical thinking. Disagreements regarding the principles of critical thinking and science that occurred during the negotiation process must be acknowledged by the moderator prior to the debate. This will encourage all parties to play fair, as their requests will be matter of record.

e. A Q&A from the judges and moderator will follow the debate, after which, or during which, the judges and moderator will comment on the positions of the presenters. The judges are expected to point out errors of logic or errors of fact in their area of expertise as well as remark on whether the presenter proved his position or disproved the opponent’s position.

f. The above guidelines are designed, in part, to ensure that both presenters are adhering to current science and not misrepresenting areas of science that the audience may not be familiar with. (This is similar to the fact checking that happens after presidential debates but allows the fact checking to be done pre-debate, by the judges, and thus affect what is presented.) The position paper will allow the judges to confirm the principles and facts in the paper and rule accordingly on disagreements involving those facts. It will also encourage the presenters to make sure their facts are current. If such a situation creates degenerates into one side not accepting the views of the experts the debate moderator will acknowledge this and explain that such is why one side is not participating in the debate.

g. Moreover, if one side consistently breaking the rules or attempts to Gish Gallop or use examples that the experts have not allowed, his presentation must be in the form of a pre-recorded video.

3. The moderator will inform the audience before the debate begins that there are time limits being imposed on the participants and that interruptions or harassment of the presenters will be met with expulsion from the debate.

4. A clock with a timer function must be clearly visible to the presenters. The moderator will start and stop the clock, enforce the time limits, and stop a presenter who exceeds his time limit unless the opposite side agrees to grant more time.

5. Each participant will be provided a microphone, lectern and access to a projector by the host institution and will be allowed to use audio-visual equipment during the formal presentation as well as the Q&A period. A maximum of two projectors must be available to be used by a presenter. A white board and stand should also be available for each side.

6. Each presenter may hand out printed materials before and after the debate.

7. The debate will last no less than 2 and no more than 3 hours. Each side will initially receive a total of 45 minutes. AFMA will present first, as the pro side of the resolution, and speak for 40 minutes, followed by the other party speaking for 40 minutes. After this each side will be given a 5-minute rebuttal. A break will be then be given, after which the Q&A will occur.

8. Neither side will be allowed to interrupt the other. If one side does interrupt or harass the other, the moderator must award 5 minutes or more for the other side to speak on whatever aspect of the topic he wishes. The added time will be added to the rebuttal time or be available immediately if the interruption is after the formal debate.

Properly moderated and judged debates would be a welcome addition to many controversies in society. On to the remainder of the blog.

As I have repeatedly stated, I have no formal arrangement with FLOE. What they say and what positions they take appear to mimic some of mine but I doubt dead scientists who are lauded by various people today are challenged to prove that the dead have no influence on the websites of the living or that living scientists are constantly asked to correct what their fans say about certain aspects of science. There are a lot of people in the world and some of them like to “help” their heroes get out what they perceive the message to be regardless of whether or not the heroes ever asked for such a thing. The sensible thing to do would be to ask the scientist to clarify his position and then attack that rather than attacking second hand claims. And therein we come to the rub.

Despite publishing numerous books, book articles, and journal articles describing my position (most in PubMed-indexed journals but some in newer, peer-reviewed journals that are not currently eligible for indexing in PubMed) [1-25] no one has actually addressed the position. People like Gorski have offered it for derision among his followers who have belittled it even though they were belittling a straw man, and ignored corrections from the person that actually wrote the article. Now, none of this means I am right. Poor critiquing skills do not mean that what Gorski is critiquing is in fact correct. On the other hand, when people write thousands and thousands of words and never actually address the heart of the position, I am forced to think that maybe there is more going on here than first meets the eye.

Steven Novella, MD, neurologist at Yale stated on the February 1, 2014 podcast The Skeptics’ Guide to the Universe (beginning at 37:28): “Animal models for medical research are still essential. . . . For the foreseeable future medical progress is absolutely dependent upon animal models and doing animal research . . .” I challenged an earlier version of that statement made by Dr Novella when discussing the role of animal models, stating: “Mouse and other animal models are essential to biomedical research. The goal is to find a specific animal model of a human disease and then conduct preliminary research on the animal model in order to determine which research is promising enough to study in humans (Novella, 2013a).”[20]

Hansen and I replied:

Indeed, that is the goal. Implied in this goal is the notion that animal models are, or can be, of predictive value for humans in terms of responses to drugs and disease. However, as we have shown, such a notion is simply without support. Anecdotes offer nothing in terms of PPV and NPV, and correlations that are only revealed retrospectively do not qualify as being of predictive value. Thus the claim that animal models are essential to biomedical research is a case of begging the question. Nevertheless, most defenses of animal models begin just this way. [20]

Our article continues:

. . . Novella continues: “It turns out that the SOD1 mouse is an excellent animal model for SOD1 FALS in humans. This is not surprising considering that it is the same mutation. However, the SOD1 mouse model of ALS is much less predictive for sporadic ALS. Most of the drugs that look promising in the SOD1 model have not shown a significant clinical effect in humans with sporadic ALS (only one drug has actually made it through FDA approval: riluzole)” (Novella, 2013a). Novella, a neurologist who treats ALS, is arguably in a reasonable position to judge the value of an animal model. However, as we should anticipate from the section on evolution, mutations do not result in the same outcomes across species lines. For example, mutations that cause phenylketonuria and Sanfilippo syndrome in humans are normal in macaque monkeys (Gibbs et al., 2007 and Holmes, 2007). As we stated, even strains of the same species vary in their response to seemingly potent perturbations such as knocking out a gene. Combine this with convergent evolution and we see no reason to suspect conservation of gene function across species. Conservation does happen (Greek and Rice, 2012), but there seems to be no standard method for determining it without comparative studies. Thus again we can only establish validity in retrospect. [20]

I suggest you read the entire article on the SOD1 mouse in order to understand Trans-Species Modeling Theory (TSMT) and for examples of how vivisection activists respond to our position. In fairness to them, I do not think they actually understand our position—they have not read it. Commenting on a position that you have not read is not a good thing for anyone, but it is especially poor form for people who are self-professed critical thinkers.

When I was a child in the Deep South, being raised by fundamentalist Christians, we did not understand much of anything about evolution. The language the few scientists spoke that we heard and the phrases they threw at us might as well have been Martian. Not much changed even though I majored in science (it was at a Bible college). But the two things that poor, uneducated Christian creationists can spot a mile away are inconsistency and just flat out avoiding the argument. They may not see that their being unable to answer the evolutionists’ argument is really important, but that’s because they do not have a clue what the evolutionists are saying. Of course they can’t answer them.

But when they see scientist number 1 attacking scientist number 2 tooth and nail and saying the exact same things about scientist number 2’s position that he was saying about creation, AND when scientist number 1 is shown to be WRONG, that is all the creationist needs to completely discount evolution. We heard the same verbiage and the same angry tone from the same guy both about how stupid we creationists were and how stupid his opponent in some science controversy was. But then he lost that argument to scientist number 2. Think anybody in that community ever believed anything scientist number 1 said about creation and evolution ever again?

Discussing animal-based research on podcasts or blogging about it on the Internet is what I call “blogging without consequences.” No matter how wrong you are, no harm will come to you or your reputation. In part because no one will actually read and understand the literature on the topic and even if they do they will probably just bandwagon along as no one wants to be called a crank. Not be a crank, no one wants to be called a crank.

So if your name is Gorski or Novella and you are just damn certain you are right, you should jump on that debate format listed above. Everything to protect you is in place. Top name referees (I can offer some names I guarantee we will all agree on, if you wish) that will judge the merits of the arguments in their areas of expertise, solid rules that eliminate misquoting, avoiding the argument, various fallacies, as well as the Gish Gallop (and more can be added). WOW! Now what’s missing guys?

But if you do the debate and these experts/referees actually come out and agree with me? What then? Hmmmm. Better not risk it.

Photos courtesy http://skepticdenialism.blogspot.com/2011/01/f-u-brian-deer-steven-novella-david.html

References

1. Greek R, Greek J: Evolution and animal models. Comp Med 2002, 52(6):499-500; author reply 500.

2. Greek R, Pound P: Animal studies and HIV research. BMJ 2002, 324(7331):236-237.

3. Greek R: Letter. Dogs, Genes and Drugs. American Scientist 2008, 96(1):4.

4. Shanks N, Greek R: Experimental use of nonhuman primates is not a simple problem. Nature Medicine 2008, 14(10):807-808.

5. Greek J, Shanks N: Thoughts on animal models for human disease and treatment. JAVMA 2009, 235(4):363.

6. Shanks N, Greek R, Greek J: Are animal models predictive for humans? Philos Ethics Humanit Med 2009, 4(1):2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19146696

7. Greek R, Greek J: Is the use of sentient animals in basic research justifiable? Philos Ethics Humanit Med 2010, 5:14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20825676

8. Greek R, Hansen LA, Menache A: An analysis of the Bateson Review of research using nonhuman primates Medicolegal and Bioethics 2011, 1(1):3-22. http://www.dovepress.com/an-analysis-of-the-bateson-review-of-research-using-nonhuman-primates-peer-reviewed-article-MB

9. Greek R, Shanks N: Complex systems, evolution, and animal models. Stud Hist Philos Biol Biomed Sci 2011, 42(4):542-544. http://www.ncbi.nlm.nih.gov/pubmed/22035727

10. Greek R, Shanks N, Rice MJ: The History and Implications of Testing Thalidomide on Animals. The Journal of Philosophy, Science & Law 2011, 11(October 3). http://www6.miami.edu/ethics/jpsl/archives/all/TestingThalidomide.html

11. Greek R: Animal Models and the Development of an HIV Vaccine. J AIDS Clinic Res 2012:S8:001. http://www.omicsonline.org/2155-6113/2155-6113-S8-001.php?aid=5787

12. Greek R: Book Review. Zoobiquity: What Animals Can Teach Us About Health and the Science of Healing. . Animals 2012, 2(4):559-563. http://www.mdpi.com/2076-2615/2/4/559

13. Greek R, Hansen LA: The Development of Deep Brain Stimulation for Movement Disorders. J Clinic Res Bioeth 2012, 3. http://www.omicsonline.org/2155-9627/2155-9627-3-137.php?aid=9962

14. Greek R, Menache A, Rice MJ: Animal models in an age of personalized medicine. Personalized Medicine 2012, 9(1):47-64. http://dx.doi.org/10.2217/pme.11.89

15. Greek R, Pippus A, Hansen LA: The Nuremberg Code subverts human health and safety by requiring animal modeling. BMC Med Ethics 2012, 13(1):16. http://www.ncbi.nlm.nih.gov/pubmed/22769234

16. Greek R, Rice MJ: Animal models and conserved processes. Theoretical Biology and Medical Modelling 2012, 9(40). http://www.tbiomed.com/content/9/1/40/abstract

17. Greek R: Animal Models of Cancer in Light of Evolutionary Biology and Complexity Science. In: The Research and Biology of Cancer. edn. Hong Kong: iConcept Press; 2013.http://www.iconceptpress.com/www/site/papers.webView.php?publicationID=BK030A

18. Greek R: Animal Models in Drug Development. In: New Insights into Toxicity and Drug Testing. edn. Edited by Gowder S. Manhattan: InTech; 2013: 124-152.http://www.intechopen.com/books/new-insights-into-toxicity-and-drug-testing/animal-models-in-drug-development

19. Greek R, Hansen L: The Strengths and Limits of Animal Models as Illustrated by the Discovery and Development of Antibacterials. Biological Systems: Open Access 2013, 2(2):109. doi: 110.4172/BSO.1000109 http://www.omicsgroup.org/journals/BSO/BSO-2-109.php?aid=14441

20. Greek R, Hansen LA: Questions regarding the predictive value of one evolved complex adaptive system for a second: exemplified by the SOD1 mouse Progress in Biophysics and Molecular Biology 2013:http://dx.doi.org/10.1016/j.pbiomolbio.2013.1006.1002. http://www.sciencedirect.com/science/article/pii/S0079610713000539

21. Greek R, Menache A: Systematic Reviews of Animal Models: Methodology versus Epistemology. Int J Med Sci 2013, 10(3):206-221. http://www.medsci.org/v10p0206.htm

22. Hansen La Fau – Greek R: Evolution and animal models. JAMA Neurol 2013, 70(2):271. http://archneur.jamanetwork.com/article.aspx?articleid=1569980

23. Jones RC, Greek R: A Review of the Institute of Medicine’s Analysis of using Chimpanzees in Biomedical Research. Science and engineering ethics 2013. http://www.ncbi.nlm.nih.gov/pubmed/23616243

24. Greek R, Shanks N: FAQs About the Use of Animals in Science: A handbook for the scientifically perplexed. Lanham: University Press of America; 2009.

25. Shanks N, Greek R: Animal Models in Light of Evolution. Boca Raton: Brown Walker; 2009.

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