Book Review – Denialism

During my last round of book buying, I found a book amidst the science section with a title that fit perfectly with many of the topics I've written about. It is Denialism: How Irrational Thinking Hinders Scientific Progress, Harms the Planet, and Threatens Our Lives by Michael Specter.

I remembered hearing about it somewhere before so I picked it up. When I got home, I checked out the reviews on Amazon.com and almost decided to return the book. It's not that it has a bad rating (3/5 stars), but many of the top rated reviews said that, while the topic is certainly important, it lacks the rigor to support the danger implicit in the subtitle and worse, failed to get much into why denialism exists and what should be done about it.

But for some reason (probably laziness) I kept it and after finishing my last book, I did my general roll of the dice to determine what I'd read next from my pile and this book ended up being the scientifically selected winner. It's taken me almost 2 months to get through it, but now that I have, I think this book is one of the more important ones in the conversation.

The book starts out with Specter's thoughts on what may be part of the reason for why the rejection of science has become so commonplace. He suggests that it is due to some large failures of science that have caught the public eye. Specifically he cites things like the Challenger disaster, Chernobyl, Three-Mile Island, and Vioxx (the latter being the main focus). As he puts it

Thirty years ago nobody discussed the principal motive behind scientific research: nobody needed to. It was a quest for knowledge. Today, the default assumption is that money matters most of all, and people tend to see science through the prism of commerce.

The rest of the book is spent addressing several of the major forms of denialism.

The first is that of vaccines causing autism. In it, there is a very telling quote from Jay Gordon, Jenny McCarthy's pediatrician.

Let me state very simply, vaccines can cause autism. . . . The proof is not there yet. It will be found

Belief first. Evidence later. This is a hallmark characteristic of denialists.

The entire chapter is laced with success of vaccination efforts and the costs of not vaccinating. Although Specter never comes right out to say it, the message is clear: We cannot let unsubstantiated (or worse, disproven) fears stop us from using methods that we know save far more lives than they even hypothetically cost.

Specter's next target is what he calls the "organic fetish" and the scare over genetically modified foods. This is a topic I haven't gotten much into, but Specter makes many good points in the chapter. All food is genetically modified by hundreds and thousands of years of artificial selection. But by adding genes to add nutritional value as well as growth, we can and have improved the quality and quantity of food we produce. Given that "natural" foods haven't been fortified with extra vitamins, GMOs are in reality much better for us than the organic ones. In addition, they are designed to last longer and need less pesticides which are harmful to both our health and the environment. It's pretty much wins all around, except perhaps for a loss of some flavor.

While a loss of flavor vs a gain of nutrition isn't a huge problem in the US, where we don't have much of a problem getting balanced meals (whether or not we choose to is a different story), other nations don't have that luxury. GM foods would allow for poor nations to produce enough food of sufficient quality to feed their people. But many nations have chosen to ban GMOs because of the fear-mongering of the anti-GM crowd and instead, will let their residents starve. I think this is one of the many points Specter makes that really back up the claim made in his subtitle. When fear trumps progress, people die in the meantime.

The "alt-med" fad was the topic of the next chapter. From homeopathy to nutritional supplements, Specter addressed the effectiveness of each and concluded that few were of any value (of those that he did concede were some vitamins, calcium, and folic acid for pregnant women). And worse, many were outright harmful. One example he cited was that of Ephedra, a drug that "boosts adrenaline, stresses the heart, raises blood pressure, and is associated with an increased risk of heart attack, stroke, anxiety, psychosis, and death." Which is probably why the FDA finally banned it, causing outrage in the alt-med community, because, yet again, "[b]elief outranks effectiveness."

The bigger problem I, and Specter see, is that this nonsensical belief takes funding away from research that has true potential. In no case is this more true than the alt-med one, in which the denialism camp has fought so hard, they've conned the US government into funding a major scientific organization, the National Center for Complementary and Alternative Medicine (NCCAM), to review treatments that have already been demonstrated not to work.

This organization does operate scientifically, doing rigorous tests and coming to valid conclusions, the point is that these reviews shouldn't need to be done in the first place. Instead, we now spend $121 million annually to tell ourselves what we already knew: None of these "medicines" work. Thus far, the NCCAM has not approved a single treatment. Compare this amount with the funding for autism research from the government in a year which is only $118 million. Bunk science gets more funding?!

The last of the body chapters was on the need to recognize geographical background (or race) as an important consideration in medicine and how the taboo of race has largely prevented research into how differences in people of different lineages affects their responses to medicines. Again, the message is clear: while we deny the science, people die.

Specter concludes with a somewhat hopeful note. He discusses the potential of synthetic biology, real Intelligent Design of organisms, to change our manufacturing processes and potentially assist in everything from energy production, to cleaning up the atmosphere, to creating medicines. It's a rather utopian ideal, but the message is clear for anyone that's been paying attention; this could be our future. Are we going to let fear take it away?

Overall, I think the book was extremely well written. My worst criticism is that it didn't go far enough. Many of the points could have been spelled out even more instead of letting readers draw the conclusions that the material points them to. After all, the people that most desperately need to read such a book, can't seem to draw intelligent conclusions for themselves. Without this, the book is little more than preaching to the choir, but I think this stems from another major point that Specter didn't address, which is the root cause of denialism.

While I agree that fear is a major component of it, I think there's another component that was completely overlooked which is that of the general level of scientific ignorance in the world. But such points weren't really the topic of the book. After all, the subtitle was "How irrational thinking hinders scientific progress", not "Why is there irrational thinking". Ultimately, I think the latter is a far thornier topic and there's no single answer. Rather, there are many, only one of which Specter touched on. I'd love to see another book on that latter topic though. I think this, along with such a book on the "why", as well as some other books illustrating other harms of pseudoscience could easily be bundled together to make one of the most important arguments for rational thinking today.

So while others may criticize this book for its incompleteness, I think it's fine. It fulfilled the goals set out by its subtitle. There definitely need to be more, but that's the job of other books.