Michael Foley, a Senior Lecturer in Public health dentistry at The University of Queensland has an interesting article in The Conversation* – ‘Holistic’ dentistry: more poppycock than panacea?
He declares that “all dentists should be practicing holistic medicine.” After all, the World health Organisation’s definition of health (“a complete state of physical, mental and social well-being, and not merely the absence of disease or infirmity”) “sits very well with the concept of holistic dentistry”
But, as Foley says, dentists “should all be practising evidence-based dentistry, too.”
And there is the problem. A perfectly legitimate term has been hijacked in an effort to misinform possible clients. An internet search shows most Australian holistic dentists also endorse and encourage alternative therapies like:
“homeopathy, naturopathy, Bach flower essences, acupuncture, traditional Chinese medicine, chiropractic, ayurvedic medicine, osteopathy, kinesiology, crystals, aromatherapy, reiki, vibrational healing, Buteyko and esoteric chakra-puncture.”
As he says, despite his belief that “Most holistic dental practices will provide a wonderfully caring and nurturing environment for patients .. . . a patient-dentist relationship must also be based on trust and professionalism.”
The placebo effect is not enough and reliance on it could even be dangerous.
But alternative health practices like this do have a market – and for some people their appeal lies with their distrust of science.
Distrust of science and the power of consensus
Sander van der Linden and Stephan Lewandowsky discuss this distrust and how to combat it in a recent scientific American article – How to Combat Distrust of Science.
They centre their argument around the issue of climate science, but I think they are also relevant to alternative health and the distrust of health experts common in our society.
On the one hand they attribute difference in the acceptance of science to the way that people interpret the same information very differently.
“As psychologists, we are more than familiar with the finding that our brains selectively attend to, process and recall information. One consequence of this is “confirmation bias,” a strong tendency to automatically favor information that supports our prior expectations. When we consider issues that we feel strongly about (e.g., global warming), confirmation bias reaches a new height: it transitions into “motivated reasoning.” Motivated reasoning is the additional tendency to defensively reject information that contradicts deeply held worldviews and opinions. One example of this is the “motivated rejection of science”; if you are personally convinced that global warming is a hoax, you are likely to reject any scientific information to the contrary – regardless of its accuracy.”
A message for science communicators
That is an argument which could suggest that science communicators are “just blowing in the wind.”
On the other hand the authors argue that “expert consensus” can counter this.
“Our research shows that highlighting how many experts agree on a controversial issue has a far-reaching psychological influence. In particular, it has the surprising ability to “neutralize” polarizing worldviews and can lead to greater science acceptance.”
In their work they found that if people had been exposed to background material containing the message “97% of climate scientists have concluded that human-caused climate change is happening” they actually increased their estimate of scientific support for human-caused climate change by about 13% (and 20% in some cases). In later work they found a causal link between highlighting expert consensus and increased science acceptance.
This suggests to me that many people may take up an essentially anti-science stance because they are just unaware of the facts of consensus, or are under the illusion that scientific dissent is greater than the objective facts show.
I see that as a positive message. We often concentrate on the anti-science position of ideologically motivated people and forget that the majority are probably misinformed – both about the science and the degree of expert consensus. It is this majority, rather than the ideologically motivated science distrusters, who science communicators need to target.
Are we biologically wired to accept consensus?
The authors suggest there are good biological reasons for the positive effect of consensus information and the negative effect of dissent information on the acceptance of science.
“One feature that clearly distinguishes “consensus” from other types of information is its normative nature. That is, consensus is a powerful descriptive social fact: it tells us about the number of people who agree on important issues (i.e., the norm within a community). Humans evolved living in social groups and much psychological researchhas shown that people are particularly receptive to social information. Indeed, consensus decision-making is widespread in human and non-human animals. Because decision-strategies that require widespread agreement lie at the very basis of the evolution of human cooperation, people may be biologically wired to pay attention to consensus-data.”
That is also sensible:
” Imagine reading a road sign that informs you that 97% of engineers have concluded that the bridge in front of you is unsafe to cross. You would likely base your decision to cross or avoid that bridge on the expert consensus, irrespective of your personal convictions. Few people would get out of their car and spend the rest of the afternoon personally assessing the structural condition of the bridge (even if you were an expert).”
” it makes perfect sense for people to use expert consensus as a decision-heuristic to guide their beliefs and behavior. Society has evolved to a point where we routinely defer to others for advice—from our family doctors to car mechanics; we rely on experts to keep our lives safe and productive. Most of us are constrained by limited time and resources and reliance on consensus efficiently reduces the cost of individual learning.”
The message, then, is:
“A recent study showed that people are more likely to cling onto their personal ideologies in the absence of “facts.” This suggests that in order to increase acceptance of science, we need more “facts.” We agree but suggest that this is particularly true for an underleveraged but psychologically powerful type of fact — expert consensus.”
The “merchants of doubt”
The ideologically and commercially motivated opponents of science recognise this – hence their attempts to sow doubt on the scientific consensus.
They will promote the message that there is no consensus. Or that the very fact of a consensus is somehow a “proof” the science is wrong because scientific understanding will change in the future (the Galileo gambit – see The Galileo fallacy and denigration of scientific consensus).
They will promote the message that the experts are frauds (eg Climategate) “shills” – in the pay of political or economic forces – Big Pharma, the fertiliser industry in the case of fluoridation, etc. Ironic, really, because these very anti-science propagandists are often themselves supported and/or financed by energy companies (in the case of climate change deniers) and “natural”/alternative health big business in the case of anti-fluoridation and anti-vaccination activists
So, perhaps another task for science communicators. propaganda claiming scientific fraud, unethical scientific funding, etc., needs to be countered. But also the public needs to be made aware of the commercial and ideological motivations of those who attempt to misrepresent the science and the expert consensus.
* The conversation has some excellent articles. But Christopher Pyne in his article Government funding for The Conversation website to be axed, reveals that government funding for it is to be stopped.