Musings on CAM, University Education and Falsifiability

…or do Amethysts emit high Yin energy?!!

Roger is tied up this week, so I am filling in, and this story on Complementary and Alternative Medicine (CAM) and university education caught my eye this week.

Some Australian health care researchers have set up an organization (Friends of Science in Medicine ) to discourage universities from offering accreditation for programmes supporting unproven health treatments and therapies. The group is also campaigning for such therapies to be removed from claimable benefits by health funds.

This is quite an interesting issue as it contrasts the principles of Evidence Based Practice (EBP), and publicly funded healthcare with the freedom of public to choose whichever healthcare therapies they wish, and arguments supporting alternative explanatory discourses.

The members of the Friends of Science in Medicine make it clear they are not trying to muzzle CAM practitioners but distinguish teatments that are known to work from those that are unproven.  They argue students should be given the analytic tools to enable them “to separate fact from fantasy” and particularly support Karl Poppers Principal that any hypothesis must be falsifiable.

Popper published the book Logik der Forschung (The Logic of Scientific Discovery) in 1934 in which he argued that the Logical Positivists‘ criterion of verifiability was not suitable for scientific enquiry. He suggested  falsifiability was a practical and more deductively sound alternative to verifiability. Verifiability supposed that only meaningful propositions were scientifically relevant, i.e. those that could be “translated” as reports of direct observation. He argued for testability, and suggested falsifiability was a much better criterion for science than verifiability, because it did not invite the problems inherent in verifying only experienced inductive inferences. For example we can inductively hypothesize “all cats have tails” on the basis of our experiences observing cats and is “verifiable” by observing cats. Nevertheless the problem with verifiability is that it restricts inquiry to only focus on inductive observational phenomenon (as we have to be able to directly experience them). Popper argued for testability, and suggested “falsifiability” was a much better criterion it also allowed statements from the physical sciences that supported phenomena that were not directly observable, and would not have satisfied the strict verification criterion; the law of thermodynamics, for example.

Popper used his principle of falsifiability to separate science from metaphysical non-science. Simply put, his falsifiability principle stated that for any hypothesis to be credible, it must be inherently disprovable before it can become accepted as a scientific hypothesis or theory (also known as naïve falsifiability). For example, the hypothesis that penicillin will kill streptococcus bacteria is easily testable and falsifiable, as a single incidence of the antibiotic failing to do so would make the hypothesis questionable, and it can be easily tested in deductive experiments. This is a scientific hypothesis, and an example of a hypothesis worthy of investigation in Popper’s view. The hypothesis intercessory prayer will speed up healing is not a scientific hypothesis according to Popper, as it is impossible to falsify. There is no empirical way to ascertain if it is false.

From this philosophical perspective a lot of CAM frameworks become problematic as they rely on what we would call unscientific unprovable hypotheses. There are some problems that remain with the principles of falsifiability, however:

1)   Currently unfalsifiable hypotheses could at a later date, (with an identified and empirical theoretical framework, and observational technologies established) become falsifiable and thus become scientific. For example for the ancient Greek’s the notion of the atom was unfalsifiable at the time, but is not so now.

2)   It has also been argued that falsifiability cannot effectively discriminate, and Sokal and Brickmont have noted falsifiability can’t distinguish between astrology and astronomy, as both could be used the basis of falsifiable hypotheses make predictions that are incorrect

3)   The so-called Duhem-Quine thesis (Gillies, 1998) also argues very convincingly that we cannot test a single hypothesis in isolation, and that falsifying one has implications for others.

Overall, we find Popper’s principle of falsifiability is generally accepted as useful in the scientific community, and in EBP in hypothesis formation, although a review of recent research journals will identify it is not extensively used amongst healthcare disciplines. Although a number of philosophers have since criticized his views on inductive reasoning and other aspects of his critical rationalism, it is now generally accepted that scientific induction can lead to worthwhile conclusions that have been established to such a degree that we can comfortably assume they are true. Stephen J. Gould (1941-2002) exemplifies this notion nicely in this quote:

“In science, “fact” can only mean, confirmed to such a degree that it would be perverse to withhold provisional assent. I suppose that apples might start to rise tomorrow, but the possibility does not merit equal time in physics classroom.” (Gould, 1981)

So from the Friends of Medicine perspective the clear division between falsifiable medical scientific work and unfalsifiable CAM work as being not suitable for public funding is not as simple as it first appears. Nevertheless, they do have an excellent point, in that using public money to promote dubious and clearly barking-mad therapeutic practices is not a good idea.

There are some pretty awful examples out there. David Colquhoun published some worrying handouts from CAM university programs here in 2009. These are worth a look, and I particularly liked that Westminster College was teaching that Amethysts emit high Yin energy!

Using scientific principles to establish which subjects should be taught at public universities and which not is a complex endeavor (at the extreme end of this argument arts and theology programmes would all go to start with)! Nevertheless the idea that we should restrict publicly funded university healthcare programmes to those that support EBP has some merit. What do you think? We would love to hear your ideas, particularly those of you living in areas where CAM has a strong public healthcare presence.

Bernie

References

Gillies, D. (1998). The Duhem Thesis and the Quine Thesis. In M. Curd, & J. A. Cover (Eds.), Philosophy of Science: the central issues (pp. 302-319). New York, NY: Norton.

Gould, S. J. (1981). Evolution as fact and theory. Discover Magazine, 254–55.

Popper K. (1934)  Logik der Forschung (The Logic of Scientific Discovery)

Sokal, A. D., & Bricmont, J. (1998). Fashionable nonsense: Postmodern intellectuals’ abuse of science. New York: Picador USA.

Thornton, S. (2009). Karl popper:  The Stanford encyclopedia of philosophy. Retrieved 10/28/2011, 2011, from http://plato.stanford.edu/entries/popper/#ImmLawConTre

3 thoughts on “Musings on CAM, University Education and Falsifiability

  1. I can see why Friends of Medicine want to do this, but it does seem a bit extreme.

  2. Maybe, but the question is should how and should we control what is taught by publicly funded universities? Its one thing to identify dodgy and unsubstantiated theories, and nonsense, but trying to establish clear criteria about what is acceptable to teach becomes very complex!

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