The ugly truth about critics of “the ugly truth” in science

It’s an interesting issue. Do we sometimes get too defensive about established science? In our efforts to counter the propaganda of the naysayers do we paint an over-optimistic picture of scientific knowledge? Do we sometimes neglect to make a critical analysis of accepted science while at the same time demanding this of the claims made by anti-science critics?

Tracey Brown, director of Sense About Science

Important questions – and don’t tell me they haven’t sometimes caused you to have some uncertainty when defending scientific knowledge from detractors. Of course, you are not alone in this. Tracey Brown, Director of Sense in Science, tackled the subject head on in the annual Sense About Science lecture last week.

The ugly truth

This was the title of her lecture. Perhaps it is a timely warning. We should not be defensive about scientific knowledge – or the policy decisions that rely on that knowledge. We should always be open-minded and critical. And we should always be realistic about the evidence. We should be ready to present and argue for the science – warts and all. Not hiding limitations and uncertainties.

She made these points – and claimed that some of our social policies are based on insufficient information. Or that we sometimes exaggerate the amount and quality of information we have to support these policies. That is the “ugly truth” she highlighted in her lecture.

Unfortunately though, her lecture was a practical example of another “ugly truth” – simple declarations are not enough. One’s criticisms of accepted knowledge are not necessarily correct or justified just because one is being critical. There is still the responsibility to base one’s criticism on facts – and to properly research the area before making critical claims. She based her criticism of at least one social health policy, community water fluoridation, on inadequate knowledge – claims from anti-fluoride campaigners she uncritically accepted.

Falling victim to fluoridation misinformation

Readers can download a podcast of Tracey Brown’s lecture here. I will update this post with a video link when it is available. She discussed fluoridation from 15 – 19 minutes.

Tracey claimed that community water fluoridation (CWF) has very little empirical justification. She gave two reasons:

1. The social health policy is based only on the original research which is over 70 years old and does not measure up to current scientific standards.
2. Data shows that the oral health of both fluoridated and unfluoridated countries has improved over recent decades and this has more to do with the use fluoridated toothpaste and improved health care than CWF.

These are, of course, two claims made again and again by anti-fluoride propagandists and campaigners. She could have taken her critique directly from one of Paul Connett’s political submissions to councils considering fluoridation. If she did so, she was irresponsible as there are plenty of experts who could have provided information of far better quality.

I contacted Sense About Science and found out that Tracey used the following papers to “formulate” her comment on fluoride.

Peckham, S. (2012). Slaying sacred cows: is it time to pull the plug on water fluoridation? Critical Public Health, 22(2), 159–177.

Cheng, K. K., Chalmers, I., & Sheldon, T. a. (2007). Adding fluoride to water supplies. BMJ (Clinical Research Ed.), 335(7622), 699–702.

So, let’s consider Tracey’s claims about CWF

1. The first claim is just silly. Of course, decision makers use the information available at the time – 70 years ago they used the information that was available then. But fluoridation decisions have been made again and again  over the years and it is perfectly natural that decision makers will use the current information for those decisions.The efficacy and safety of CWF have been investigated many times since it was first introduced. Science does not stop after a single study. If Brown had made a simple literature search she would have realised that (see Water fluoridation effective – new study for just one recent example – there are many others).  Or, given that none of us have the time and expertise to be well informed about a wide variety of subjects, she could have consulted somebody with up-to-date knowledge and expertise on the subject. She certainly should not have relied solely on the very one-sided papers by Peckham (a well-known UK anti-fluoride activist) and Cheng et al.
2. From the audio Brown appeared to use this graphic (below – left image) from Cheng et al., (2007) which is very similar to the one promoted by the anti-fluoride propagandist organisation Fluoride Action  Network. I have discussed this graphic in several articles and in my debate with Paul Connett (download the pdf) It is based on extremely limited WHO data (hence the straight lines), makes comparisons which ignore the multiple factors influencing oral health, and ignores the within-country data which show the efficacy of CWF (such as  for Ireland in my second figure).

Left: Graphic used by Cheng et al (2007). Right: Same WHO data for Ireland with fluoridated and unfluoridated areas represented

The ugly truth about Brown’s lecture

Unfortunately, the “ugly truth” Tracey Brown demonstrated was that even scientists, and supporters of science, can be fooled by the claims of anti-science campaigners if they are too lazy to do their own checking. Perhaps she also demonstrated that even scientists, and pro-science people, can suffer from confirmation bias – just like anyone else. They can sometimes adopt a partisan position which restricts them to considering only the misinformation and distortions peddled by anti-science campaigners.

But it does highlight a dilemma for people like Tracey Brown who might feel they have a “whistle-blower” mission to insist that science, or its practitioners, pull up their collective socks. (I hasten to add it is a “mission” I  support – as I support “whistle-blowers” in general).

The dilemma is that we, as individuals, can not be experts in everything. We are not capable, individually, of making a well-informed critical and objective judgement on all the issues we may have to face in  preparing a lecture like Tracey’s. We have to be careful about relying on our own biases or poorly informed memories. We have to recognise our limitations and not be afraid to consult experts for clarification, updating knowledge or even just getting one’s head around complex issues.

The debunking of many of the claims made by scientific naysayers is often like shooting fish in a barrel. It may not require much checking or even serious engagement with the subject. But it is irresponsible to transfer that lazy approach to serious consideration of real science or the social policies informed by that science.

It is especially irresponsible when speaking as the head of a respected organisation and where listeners may feel justified in seeing the claims as expert and to be trusted. Again we face the fact that as listeners none of us can critically judge a speaker’s claims on all the subjects covered.

Destroying credibility

In this example, I have sufficient knowledge about the science behind CWF to judge this aspect of Tracey’s lecture and see she was mistaken. But what about the other subjects she covered? For example, she claimed that current health advice on cholesterol relies on inadequate research and could be wrong. Do I take her word for it? I certainly don’t feel I should – if she is wrong about CWF she may be just as mistaken about cholesterol.

That also makes me wonder if the Sense About Science organisation is as credible in its pronouncements as I used to think it was.

See also:
Annual Lecture 2015 · Sense about Science
Can you handle the truth? Some ugly facts in science and sensibility – an article by Tracey brown introducing her lecture.

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