Scientism and Pseudoscience: A Philosophical Commentary

I have built a reputation for being a critic of scientism, which my dictionary defines as “excessive belief in the power of scientific knowledge and techniques.” Indeed, I am putting together a new volume on the topic for Chicago Press, which will be co-edited with my long time partner in crime, Maarten Boudry (a couple of years ago we put out an analogous collection on pseudoscience, a topic that I actually see as in some sense the mirror image of scientism). The contributors include colleagues who participated to a workshop I co-organized with Maarten at CUNY’s Graduate Center back in 2014.

But “scientism” can also be a label that defenders of pseudoscientific notions use to dismiss good science they don’t like, from evolutionary biology to atmospheric physics. So a paper I recently published in the Journal of Bioethical Inquiry takes on this alternative aspect of scientism, chastising a number of authors who rejected a very sound critical paper on the ethics of homeopathic “treatments.”

What happened was that back in 2012 the journal Bioethics published a commentary by K. Smith entitled “Against homeopathy—a utilitarian perspective.” In it, the author mounted an ethical challenge to homeopathic practice, framed in utilitarian terms, as the title obviously suggests (though a similar critique, I think, could be mounted also on both deontological and virtue ethical grounds).

Smith presented a systematic argument that began with an explanation of the theoretical implausibility of homeopathy and, in particular, of the two fundamental principles of the practice — the “law of similars” and the “law of infinitesimals.” He then engaged the empirical literature on homeopathy, finding it woefully insufficient to establish any of the claims on which the approach is based.

Smith also very carefully examined the possible benefits of homeopathy, including non-invasiveness and cost-effectiveness; its holistic approach; the possibility, range, and strength of placebo effects; and its fostering of patients’ autonomy regarding healthcare decisions. He concluded that “the benefits of homeopathy are rather minimal.”

Next, Smith went on to equally systematically analyze the possible disutilities of homeopathy: the risk of failing to seek conventional healthcare; the waste of resources that results from supporting homeopathic practice (since it is known not to work, outside of placebos); the problem raised by unwarranted credence, i.e., the credibility that homeopathy gains when it is endorsed by medical practitioners or healthcare agencies; the simultaneous weakening of support for evidence-based medicine and the weakening of support for types of “alternative” therapies that actually do work (e.g., some forms of meditation, massage, etc.). His conclusions were that “investment in homeopathy by public healthcare providers is unethical as it entails a waste of resources … the effect [of such investment] is important and amounts to a serious net disutility.”

I would have honestly thought all of the above to be a rather uncontroversial no-brainer. But, of course, I was wrong.

Bioethics published four responses to Smith’s paper (together with Smith’s counter-response), and that’s where things got interesting, and the s-word began to be carelessly thrown around. Let me give you some of the highlights:

One of the respondents, R. Moskowitz, began with the strange assertion that “if homeopathy is based on a mystery, that does not prove it to be a fake,” a type of “reasoning” that could just as well be used (and in fact has been used!) to defend the practice of astrology. He then went on, boldly and strangely, to turn the criticism that homeopathy works by placebo and via the natural self-healing of the human body into a positive: “can a higher compliment be paid to a medicine than that its action cannot be distinguished from a gentle, spontaneous, and long-lasting cure requiring no further treatment?” Well, if a medicine does not do anything beyond the spontaneous healing of the body, is it still medicine? And why do we charge patients for it?

A second critic, I. Sebastian, brought up a fallacious argument from authority, citing Nobel Prize winner Luc Montagnier’s (a virologist) support for homeopathy as somehow relevant to the discussion, in lieu of actual evidence originating from properly controlled, large, and well-statistically analyzed experiments. She characterized “allopathic” medicine as based on a deductive-nomothetic model (thus displaying only a superficial understanding of the philosophy of science), claiming that that is not the “model” adopted by homeopathy, for which somehow uncontrolled and anecdotal evidence is supposed to be sufficient. She then went on to accuse Smith of thinking that Mahatma Gandhi was unethical (because he was a proponent of homeopathy), which is an example of a colossal non sequitur (as well as yet another recourse to irrelevant authorities — Gandhi was not a medical researcher). Finally, and without any irony whatsoever, she concluded: “If Dr. Smith’s argument were simply an exercise in ivory tower philosophizing, it would be of little concern — but knowing that the health and in fact the lives of others may be affected by such thinking is very disturbing.” Indeed.

The third critic of Smith was one P. Bellavite, who rather idiosyncratically, preferred to focus only on a defense of the homeopathic principle of similitude — the idea that diseases causing certain symptoms are to be cured by the ministration of substances that produce similar effects on the body. He engaged in a manifest example of mumbo jumbo, i.e., talk that appears to be technical but in fact says nothing of substance whatsoever. His mention of “reorganizing regulation systems” and of “neuro-immuno-endocrine homeodynamics” was an artful mix of vacuities and obfuscatory language, as Smith clearly saw in his rebuttal.

Finally, let me turn to L. Milgrom and K. Chatfield, the authors who explicitly invoked scientism in the context of the exchange we are analyzing. To begin with, their response was self-contradictory: on the one hand, they wished to defend homeopathy on the ground of scientific evidence; on the other hand, they accused Smith of being scientistic precisely because he demanded such scientific evidence. It is either one or the other; they cannot have it both ways. Nonsensically, Milgrom and Chatfield complained that Smith avoided utilitarian scrutiny of conventional medicine, which of course not only was not the scope of the original article, but also would help homeopathy not at all.

We then come to the crux of the issue with the following extended quote:

“More perplexing is Dr Smith’s claim that homeopathy could weaken support for science-based medicine. Such fear is rooted not in science but in scientism, i.e. the unscientific belief that compared to other forms of knowledge, science is the absolute and only justifiable access to truth. Taken to the extreme, scientism defaults to Internet-fueled inquisitorial intolerance which, supported by certain academics, sections of the media, and (usually anonymous) blog sites, systematically vilifies anything considered ‘unscientific,’ e.g. the campaign to undemocratically rid Britain’s NHS of its homeopathy/CAM facilities. Fortunately, not all share such fundamentalist views, especially at the frontline.”

And here is my counter-commentary from the paper, in full:

To begin with, notice that Smith has never claimed that science is the “only justifiable access to truth,” much less that scientific knowledge is “absolute,” claims that truly would qualify as scientistic. He has simply treated medical research as a science, from which it follows that any claim about the medical efficacy or lack thereof of any treatment ought to be substantiated with the best scientific evidence available. I don’t know about you, but I quite like the medical advice I receive to be science-based. Notice also the semi-paranoid reference to undemocratic conspiracies to undermine homeopathy. As Smith himself explained in his rebuttal, public information campaigns about the lack of substantive evidence in favor of a particular practice, and calls for it not to be funded with taxpayers’ money, are — on the contrary — eminently democratic. Finally, also notice the use of the pejorative term “fundamentalism,” accompanied in the paper by a reference to an article by Holmes et al. where the word “fascism” is repeatedly used when writing about demands for scientific approaches to medical research. This sort of highly emotive talk — accompanied by precious little substantive evidence to back up one’s extraordinary claims — is one of the hallmarks of pseudoscience and in this case also represents an egregious, ideologically motivated misuse of the term “scientism.”

So, as you can see, my criticism of real instances of scientism does not preclude me from seeing clearly when the term is simply used as an excuse for lazy thinking and patently pseudoscientific “theorizing.”