SKEPTICAL EYE: Scepticism and cynicism are often confused. Indeed, many people see the two positions as synonymous. Mistaking scepticism for cynicism is akin to mistaking apples for oranges or frogs for horses. The two are in fact very, very different.
Scepticism is a central component of the scientific method. It is characterised by a questioning attitude, open-mindedness and an insistence on objective evidence for claims made.
A sceptic is a person who views our knowledge of the world as dynamic and tentative, open to change and modification in response to information gathered.
Within the sceptical community there is an expectation that claims made and views expressed will be challenged and must be defended. This is common practice in science, for example, but is rarely seen in alternative medicine circles. The knowledge base in the latter arena tends to be fixed and unchanging, relying on antiquity and tradition for its evidence base.
Authority, revelation and intuition, while often lauded by alternative practitioners, are regarded by the sceptic as poor sources on which to base one's judgments and are, in general, not to be trusted. With regard to authority, some sources may demand more respect and credibility than others, but should never be accepted too naively.
The most reliable source of knowledge from the sceptic's perspective is the scientific method, with its proven track record and despite its well documented limitations. Science is not assumed to explain everything about the world, nor even to have this potential, but it is viewed as the best means we have at our disposal with which to gain clearer understanding of the universe in which we live.
Sceptics are generally an optimistic bunch, while cynics are steeped in pessimism. The sceptic is constantly engaged in a curious exploration of the world, while the cynic is busy moaning and predicting disaster and human nastiness at every turn.
One might begin to understand at this point, why it is so frustrating for sceptics to be so often branded as cynics. Sceptics and cynics would more accurately be described as natural enemies.
The above comments are prompted by the number of responses I received to my last column which was headed A dose of cynicism. The title was not mine. I was also interested to see the article by Dr Gabriel Stewart in the Health Supplement that was highly critical of that same piece.
In parallel with a broad confusion between cynicism and scepticism it appears that many people, including Dr Stewart, erroneously assume that a critical posture with regard to many of the practices that fall under the umbrella of alternative medicine, implies uncritical support of all practices within the mainstream.
Nothing could be further from the truth.
Since 1997 I have presented a significant number of conference papers that have been critical of many practices within my own area of psychology. Every mainstream conference provides a forum for debate and criticism, and further opportunity for such is available in mainstream journals.
It is only through this process of active critical engagement that progress can occur. In contrast, alternative medicine gatherings and publications show no signs of debate or criticism. All practices are accepted as equally valid with the common, generally unfounded claim, that they have broadly proven positive impact.
Another common characteristic that contrasts with the situation in the mainstream is that many alternative practitioners claim to be multi-qualified: for example, providing aromatherapy, reflexology, reiki and homeopathy. There is usually also a long alphabetical list provided of the conditions they can treat.
Mainstream medicine and the pharmaceutical industry are undoubtedly culpable in many cases of unnecessary suffering and death in society. They have as a consequence been widely and justifiably criticised. It is not, however, the function of this particular column to pursue this path.
My focus in this context is on the alternative medicine movement which, in my view, receives far too little critical attention.
Some of the points raised in Dr Stewart's article bear further comment.
The number of mainstream physicians who routinely use alternative treatments is relatively small. The two main reasons that such practices are appropriately shunned are that they have no acceptable supportive evidence base and that they are based on theories that run counter to how we understand the human body to work. Homeopathy is the most obvious, illustrative example.
Contrary to Dr Stewart's assertion, doctors very rarely lose their licences for incorporating alternative therapies into their practices. This, therefore, does not constitute a significant deterrent to any physician wishing to do so.
When loss of licence does occur it is usually in a situation where the "therapy" is known to be highly dangerous or lethal.
A number of doctors who have been struck off the medical register happily continue to provide alternative treatments with impunity.
His statement that 20 per cent of appendectomies reveal appendices that are perfectly normal, even if true, does not negate my assertion that you cannot wish away an appendicitis. If the removed appendix is normal, it is obviously not inflamed in the first place and more likely indicates a misdiagnosis.
In conclusion, neither science nor medicine are without significant flaws and both have their share of badly behaved practitioners.
All professionals and their relevant controlling bodies must contend with these facts.
They must also challenge and contend with those within their ranks who choose to abandon evidence-based practice and the hard-won scientific foundation upon which their expertise rests and who consequently expose their patients or clients to questionable and potentially dangerous alternative practices.
Perhaps the most important tool we possess in ensuring the best for those whom we serve is a strong, science-based sceptical attitude. The same would significantly benefit the patient when choosing a treatment route.
• Paul O'Donoghue, Irish Skeptics Society.
• www.irishskeptics.net