Pseudoscience in Complementary and Alternative Medicine

DEFINITION: Discussion of key warning signs of pseudoscience in CAM

Overview

Pseudoscience exhibits the superficial appearance of science but lacks its substance. In the case of complementary and alternative medicine (CAM), pseudoscientific procedures appear to play by the rules of science but, in fact, do not. Pseudoscientific procedures rarely possess the crucial safeguards against confirmation bias that characterize the mature sciences. Instead, they exhibit the tendency to seek evidence consistent with hypotheses and to deny, dismiss, and distort evidence that is not. Consequently, pseudoscience leaves itself vulnerable to errors.

The distinction between science and pseudoscience is not absolute or clear-cut; some sciences engage in pseudoscientific practices, and vice versa. Nevertheless, as philosopher of science Mario Bunge and others have observed, numerous indicators, or warning signs, of pseudoscience can be pinpointed. It should be noted that these indicators do not prove the presence of pseudoscience, but the more such indicators accompany a discipline, the more skeptical one should be of that discipline. In particular, there are ten warning signs of pseudoscience, all of which are relevant to certain CAM practices.

Key Warning Signs

Overuse of ad hoc hypotheses. An ad hoc hypothesis is an escape hatch or loophole that allows proponents of claims to discount negative results. Although developed sciences sometimes make use of ad hoc hypotheses, pseudosciences routinely invoke them as ploys to immunize their claims from refutation. For example, a proponent of a new form of meditation found to be ineffective in ten independent studies might maintain that all these investigations were flawed because they were not conducted by the technique’s developer, who is the only person qualified to perform them.

Absence of self-correction. Sciences tend to change over time in response to new data; pseudosciences rarely do. For example, despite extensive scientific data showing that an herbal remedy is ineffective for severe depression, a practitioner might continue to insist that the treatment should be prescribed for this condition.

Focus on confirmation rather than refutation. As philosopher of science Karl Popper observed, science progresses most efficiently when investigators strive to disprove their claims rather than to prove them. In contrast, pseudosciences tend to focus on confirming rather than disconfirming instances. For example, when confronted with evidence that an initial positive finding could not be replicated in five other investigations, a proponent of using acupuncture to treat diabetes might focus exclusively on the positive result and ignore the replication failures.

Reversed burden of proof. In science, the onus of proof lies with the proponent of a claim, not with skeptics. In contrast, pseudosciences tend to place the burden of proof on skeptics rather than on proponents. For example, an advocate of using shark cartilage to treat cancer might insist that critics have not proven conclusively that shark cartilage is ineffective. In science, it is up to the advocate to show that shark cartilage works, not up to the critic to show that it does not.

Evasion of peer review. Sciences rely on a procedure called peer review, in which journal manuscripts reporting original findings are sent to several independent scholars to evaluate the merits of the studies. Many, if not most, manuscripts submitted to premier journals are rejected for publication; others are accepted only after multiple rounds of substantial revision. Although peer review is not a perfect process, it weeds out many errors in researchers’ methodology or conclusions. Some pseudoscientific CAM procedures circumvent the peer review process, thereby bypassing one of the key safeguards of science. For example, many advocates of energy therapies for anxiety disorders have advanced claims that have not been subjected to independent scrutiny by other scholars.

Mantra of holism. Many pseudosciences invoke the mantra of holism—they argue that a claim cannot be tested in isolation and must be tested only in the context of all other claims. Holism is invoked to insulate assertions against refutation. For example, a believer in naturopathy might insist that a study showing that naturopathy is ineffective be dismissed because persons who use naturopathy almost always do so along with other treatments.

Over-reliance on anecdotal evidence. A familiar saying in science is that “the plural of anecdote is not fact.” Anecdotes, which usually take the form of “I know a person who” stories, can be helpful in science, especially when they suggest fruitful hypotheses that can later be tested in rigorous investigations. However, anecdotes rarely justify a definitive claim that a CAM technique works. For example, a practitioner who asserts that homeopathy must be effective because they have witnessed several persons “get better after receiving homeopathic remedies” is operating in a pseudoscientific fashion.

Absence of boundary conditions. Pace University psychologist Terence Hines noted that almost all scientific procedures possess boundary conditions: limitations on when the technique works and when it does not work. In contrast, pseudoscientific treatments frequently lack boundary conditions. Their proponents often maintain that they are effective for virtually every condition and every person. For example, an advocate of chiropractic might contend that this method is effective not only for back problems but also for cancer, multiple sclerosis, diabetes, and schizophrenia.

Use of scientific-sounding language. Many pseudosciences utilize scientific-sounding terms to create an aura of legitimacy. In doing so, however, they often use these terms incorrectly. For example, in explaining how their methods seem to work, they may refer to “quantum fields,” “neural networks,” or “complexity theory,” yet also may strip these terms of much of their accurate meaning.

Absence of connectivity. In science, new ideas tend to build on or connect with earlier ideas. In contrast, many pseudosciences purport to construct entirely new paradigms from whole cloth. For example, the developer of a new magnet therapy might insist that his treatment relies on entirely undiscovered electromagnetic principles.

Finding legitimate sources of CAM. Many pseudoscience and money-making schemes victimize chronically ill individuals. Still, several sources can help individuals determine if CAM methods, supplements, and therapies are legitimate options for natural healing. The United States Food and Drug Administration (FDA) does not evaluate medicinal supplements, but they offer information about herbs and dietary supplements. The National Cancer Institute (NCI) provides information on CAM therapies with relevant research concerning the effectiveness and possible negative interactions. Additionally, illegitimate CAM institutions can be reported to the National Council Against Health Fraud or the United States Federal Trade Commission (FTC).

Conclusion

These ten warning signs of pseudoscience are not exhaustive. Social work researchers Bruce Thyer and Monica Pignotti have identified other features of pseudoscience, including a tendency to make extraordinary claims that go far beyond scientific evidence (such as claims of miracle cures), insistence that a technique is being unfairly suppressed by establishment scientists, and requirements that practitioners of the technique agree to vows of secrecy. In all cases, pseudosciences purport to be something they are not. Therefore, consumers should be wary of CAM procedures that display any of the warning signs presented here.

Pseudoscientific practices in healthcare may or may not be physically harmful in and of themselves, but they can be dangerous in other ways. Followers of CAM pseudoscience may avoid mainstream therapies or treatments and fail to prevent or cure otherwise treatable conditions. Widespread adoption of ineffective methods can have a negative effect on public health, as in the case of parents who refuse to vaccinate their children over pseudoscientific fears that vaccination causes autism. Indoctrination in pseudoscience may also be harmful to the scientific community, as it undermines the viewpoints of legitimate scientists, distracts from scientific progress and the value of the scientific method, and disrupts scientific education. Finally, adhering to pseudoscientific beliefs can be expensive and time-consuming as practitioners often seek to profit from their ideas and may require complex commitments from their followers. Although sometimes pseudoscientific CAM practitioners may honestly believe in the efficacy of their ideas, the field is also a common target for con artists and unscrupulous businesses seeking to exploit consumers' willingness to try and believe in new treatments.

Bibliography

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Lilienfeld, Scott O., Steven J. Lynn, and Jeffrey M. Lohr, eds. Science and Pseudoscience in Clinical Psychology. 2nd ed., Guilford Press, 2015.

Li, Ben, et al. “Integrative Medicine or Infiltrative Pseudoscience?” The Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland, vol. 16, no. 5, 2018, pp. 271-77. doi:10.1016/j.surge.2017.12.002.

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