Andrew Weil

To debate or not to debate, that is the question.
Whether it is nobler in the mind to suffer
The slings and arrows of outrageous quackery
Or to take arms against a sea of quackademia,
And, by opposing end them.

Hamlet, Act III, Scene 1, paraphrased badly.

 

The question of whether it is worthwhile to debate cranks, quacks, and advocates of pseudoscience has long been a contentious issue in the skeptic community. Those of you who’ve been reading my posts for a while know that I’ve always come down on the side that it is not a good idea One thing I’ve learned in my more than a decade of blogging, both here and at my not-so-super-secret other blog, is that advocates of pseudoscience love public debates. Indeed, whenever you see a skeptic agree to a public debate with an advocate of pseudoscience, it’s a damned sure bet that it wasn’t the skeptic who proposed it. I suppose it’s possible that there have been such instances that I’m unaware of, but I do know of a lot of instances where it was the other way around. I’ve even witnessed one myself, when our fearless founder Steve Novella debated antivaccine quack Julian Whitaker about vaccine safety at FreedomFest in Las Vegas while we were at TAM three years ago. Steve mopped the floor with Dr. Whitaker so dramatically that it almost changed my mind about the value of debates with quacks because, witnessing the debate, I saw that the arguments Dr. Whitaker marshaled were such hackneyed antivaccine talking points that I knew I could also have demolished them. Still, in the end, no minds were likely to be changed, and the question of vaccine safety was clearly being used as a tool to oppose school vaccine mandates or, as antivaccinationists like to call them deceptively, “forced vaccination.” Whether vaccines are safe and effective or not is a separate question from whether the government should mandate certain vaccines as a precondition for attending school or being in day care.

Over the years, I myself have been “challenged” to similar debates myself. Perhaps the most bizarre example occurred when someone claiming to represent HIV/AIDS denialist Christine Maggiore contacted me claiming that she wanted to arrange a debate between us. Maggiore, unfortunately, died a mere two years later of—you guessed it—AIDS-related complications. Although occasionally the ego gratification of being asked to participate in such events vied with my longstanding belief that debating cranks doesn’t sway anyone, sharing the stage with a real scientist does unduly elevate the crank in the eyes of the public. Besides, whatever the seeming outcome of the debate, you can count on the crank to declare victory and his believers to agree. In any event, science isn’t decided by the metrics used to judge who “wins” a public debate, which rely more on rhetoric and cleverness rather than science to decide the outcome. Finally, such debates are not without risks. Although Julian Whitaker, for example, was terrible at it, other cranks are adept at the Gish Gallop, and an unprepared skeptic or scientist can be made to appear clueless in front of a crowd that is almost always packed with supporters of the crank, not the skeptic.

Just last week, there was another “debate” challenge that led me to question my resolve not to debate cranks. It came from a most unexpected source.

In which I am challenged to a public debate

About a week ago, I checked my email and was surprised to find a message from John Jackson, who identified himself as the Executive Director of the Adolph Coors Foundation, the charitable arm of the Coors family:

I am writing to invite your participation in a debate on integrative medicine which will be held Sunday evening, March 20, 2016, at the Hyatt Regency in Denver. The debate will be the keynote event of our Pioneers in Health conference. Your debate partner will be Dr. Andrew Weil, who has confirmed participation. We expect excellent attendance of 700-800, possibly more. At least a portion of the audience will include those attending Dr. Weil’s annual Nutrition and Health Conference which begins the following morning. We also expect our conference cosponsor, Americans for Prosperity Foundation (AFPF), to attract attendees through their outreach efforts. AFPF is a grassroots organization that has virtually nothing to do with any kind of medicine, conventional or integrative. AFPF’s interest is promoting innovations in the delivery of health care (more health care choice) which will be the focus of a panel earlier in the day.

The debate topic: “Fad or the Future: Will Integrative Medicine Play a Growing Role in the Future of Health Care?”

I have read numerous articles you have authored on the SBM website and feel your thoughtful and well-reasoned posts (on a whole host of issues) offer an excellent counterpoint to Dr. Weil. Our ground rules for debate are simple: We insist on respect and politeness for differing points of view. Respectful, open and free debate has become somewhat of a rarity in our highly polarized society. However, we feel it is still possible to have smart people discuss important issues in a way that informs and enlightens.

If you are willing to join us, we plan the following debate format: You both make opening statements, you both respond to each other’s opening statements, you ask each other questions, you both answer questions from the moderator and the audience and, finally, you both will be given equal time to offer closing statements. Our foundation will select the moderator which will be a neutral journalist and/or business leader. FYI, audience participation will be limited to questions submitted via a mobile app, not by microphone.

In the interest of full disclosure, our foundation funds several institutions which are studying various “alternative” practices, including the recent study of the use of electro-acupuncture for hypertension. We have also funded a project involving Dr. Weil and the University of Arizona. You can read more about our interest in integrative medicine and who we fund at www.coorsfoundation.org. We are not going to be offended if you say something critical about our focus or if you offer suggestions on ways we can improve it.

Of course, if you agree to participate, we would cover your travel, meals and lodging expenses and are willing to negotiate a reasonable honoraria.

If you would like to discuss this further by phone, please feel free to give me a call. I can be reached in Denver at 303-[REDACTED].

Thank you, Dr. Gorski. I look forward to your response.

John Jackson
Adolph Coors Foundation
Denver

I found this offer extremely tempting, but, I must confess, for the wrong reason. As most of you know, Andrew Weil is a big cheese in the world of “integrating” alternative medicine quackery with real medicine. He’s nationally and internationally regarded as a pioneering expert in “complementary and alternative medicine” (CAM). Indeed, arguably no human being has done more in his lifetime and career to seemingly legitimize the specialty of “integrative medicine.” He’s even started an integrative medicine residency and managed to spearhead a board certification in integrative medicine, although the latter does not use the usual accrediting organization used by most other established medical specialties. Interestingly, many CAM practitioners were not pleased by Weil’s original proposal because the board certification is only available to physicians.

Yes, I’m a bit ashamed to admit that it was primarily the ego massage that Mr. Jackson’s offer provided that led to my waffling, which continued over the course of a few days. I ignored (for the moment) the red flags present in the very invitation, including the fact that the audience would almost certainly be packed with Weil supporters arriving early to attend Weil’s conference the next day and, also as disturbing, the involvement of Americans for Prosperity Foundation, which is a right-wing foundation funded by the billionaire Koch brothers.

During that time, I e-mailed a bunch of my fellow SBM contributors and a few others for opinions and received conflicting advice. One camp was divided into the “Do it!” mode; the other telling me it would be a bad idea. Oddly enough, the first camp was definitely larger than the second. What I also learned was that Mr. Johnson had asked Edzard Ernst first, who had declined. If my ego was stoked before by being chosen to be invited to debate the foremost practitioner of quackademic medicine in the world, then being a second choice after Edzard Ernst, rather than deflating my ego at being second choice, puffed it up even more, given my admiration for Prof. Ernst. Ernst also blogged about it in a post he entitled Standing up for science? Yes, but not at any cost!, in which he declined the public debate and offered to conduct a written debate on his blog. It’s similar to what I proposed when an antivaccine group challenged us to have two of us debate two antivaccinationists publicly. The antivaccine group declined. Likewise, Mr. Jackson declined Prof. Ernst’s offer as well, given that he never wrote back.

My personal response, after having waffled for a while, requested unedited video as a minimal precondition, discussed live streaming the event briefly by email, and failed to find time during business hours to telephone Mr. Jackson for two days, was similar. After overcoming my ego gratification and conflicting advice weighted heavily towards doing something that I didn’t believe in and didn’t think to be a good tactic, I finally emailed Mr. Jackson and stated that I would not debate Dr. Weil in the format proposed. I said that I would be happy to give a standalone talk, but I would not debate. Three days later, I, too, have not heard back from Mr. Jackson. So I have something else in common with Ernst!

Ernst’s post concluded with two questions that I will address in the remainder of this post:

  • Should we stand up for science wherever we can, or is the price occasionally simply too high?
  • What are these mysterious links between alternative medicine in the US and the far right?

“All truth comes from public debate”: A quack manifesto

In addressing Prof. Ernst’s first question with respect to whether we as supporters of science should accept offers to debate pseudoscientists like Andrew Weil, let me discuss briefly why it might be that cranks, quacks, and pseudoscientists find live public debates so attractive. Indeed, I’ve referred to a seemingly near-inviolable belief among pseudoscience promoters that “all truth comes from live public debate.” It’s a belief that I even tried to express using rudimentary Latin as omne verum est a forensem principle. (Latin sounds so much more cool for this, but I have no idea whether this is the best translation—or even grammatically correct; maybe Latin scholars out there can suggest better.) For instance, antivaccine guru Andrew Wakefield challenged Dr. David Salisbury to a “live public debate” about whether the MMR vaccine causes autism or not. (Hint to Wakefield: It doesn’t.) Other examples regular readers might remember through the years include the aforementioned Julian Whitaker debating Steve Novella; Michael Shermer’s “debate” with Deepak Chopra; and antivaccine propagandist David Kirby debating author Arthur Allen. To reiterate, I don’t “debate” cranks, at least not live on stage in such artificial events, because such events (1) make it appear that there is an actual scientific debate when there is not and (2) give the crank the freedom to Gish Gallop to his or her heart’s content.

There’s actually a third reason. The call for a “live public debate” is also an intentional strategy.

A couple of years ago, when I was in the thick of trying to refute the cancer cure claims of Stanislaw Burzynski (who, by the way, is scheduled on November 19 to go to court against the Texas Medical Board, which is trying to do something long overdue and strip him of his medical license), I noticed a series of Tweets (now gone) from Burzynski supporters challenging occasional SBM blogger Peter Lipson and/or “The Skeptics™” to a live debate:

Elsewhere, on a public pro-Burzynski group called the Burzynski Facebook Patient Group, a man named Randy Hinton also called out Peter Lipson on a now-closed Burzynski patient Facebook group:

The only way to ever successfully deal with a growing number of medical mafia internet propaganda minister’s [sic] trying to smear and undermind [sic] Stanislaw Burzynski is to do exactly what I have tried to do for the last 24 hour’s [sic]. Call these maggot’s [sic] out and publically dare them to debate the topic of ANP verses chemotherapy in front of a large live audience with no restriction’s [sic] or sensoring [sic] of information or statement’s [sic]. Multiple attempt’s [sic] yesterday to get Peter Lipson who wrote that pile of crap in Forbes to agree to this got virtually no response. The same will [sic] true of the other pharmawhores doing the same thing all across the country right now. These INTERNET KEYBORAD [sic] GOBLIN’S [sic] will never agree to it because they cann’not [sic] CONTROL the conversation the way they do on their blog’s [sic]. CALL THEM OUT TO A PUBLIC DEBATE AT EVERY TURN.

Later in the comments after his post, Mr. Hinton says:

I have got money that say’s [sic] they run from a live debate like scared rabbit’s [sic]. I have told Eric he need’s [sic] to CALL THEM OUT!!!

Mr. Hinton was obviously referring to Eric Merola, Stanislaw Burzynski’s propagandist, who has in the past unwisely characterized a skeptical blogger near and dear to my heart as a white supremacist and someone too busy eating puppies to bother to read the scientific literature about Burzynski.

These two Burzynski supporters demonstrate what I’m talking about. They seem to think that science is decided in public debates and view the quite proper reluctance among scientists like myself and skeptics to engage cranks in such spectacles as “cowardice.” It is not, but cranks continue to labor under the delusion that science is somehow decided in such forums, which are a variant of a sort of argumentum ad populum, in which something is argued to be true because it is popular or, in a debate, an argument is thought to be closer to the truth because it is more popular. Science doesn’t work that way. It is decided on evidence presented at scientific conferences and in peer-reviewed journals, where the real scientific debate plays out until it is temporarily settled and scientists come to a provisional consensus. That provisional consensus, of course, is always subject to change as new observations, data, and experimental results come to light, but it takes observations, data, and experimental results to change the consensus, not “live public debates.” Such “live public debates” are meant for one thing and one thing only: To sway public opinion to a viewpoint not supported by science, in the process elevating pseudoscience or the unproven to the same plane as the scientific consensus as a scientifically viable “alternative.” It’s also a no-lose proposition most of the time. If the scientist declines, the pseudoscientist can cry, “Coward!” If he accepts, no matter what the outcome, few, if any, minds are changed and the pseudoscientist has been seen on stage with a real scientist.

Does that rule apply here, though? After all, most likely it was not Andrew Weil who was pushing for this debate, although he obviously must have agreed to it first, as he is still listed as being featured on the site, as is the debate. Also, although Andrew Weil and Edzard Ernst can be viewed as being roughly of the same stature within their respective sides of the quackademic/science-based medicine divide, pivoting to invite me clearly involved a massive drop-off in stature for Weil’s opponent. Although I might be somewhat well-known in the skeptical and medical blogosphere, I’m no equivalent to Weil in the world of woo, which is why I’m surprised they didn’t approach, for example, Steve Novella first after Prof. Ernst declined their offer, especially since he’s done debates like this before and I have not. On the other hand, maybe that’s the reason. Steve is a known quantity and that quantity is known to be quite good at these debates.

One thing that is true, however, is that the Adolph Coors Foundation is well known for promoting integrative medicine. Mr. Jackson said as much himself in his email, and the Coors Foundation website touts its projects with the Center for Integrative Medicine at the University of Arizona (run, of course, by Andrew Weil), the Susan Samueli Center for Integrative Medicine at UC Irvine, and the Myrna Brind Center for Integrative Medicine at Jefferson Hospital. For instance, the project at UA promises:

The health insurance industry, and its practice of not reimbursing doctors who prescribe CAM-type treatments, creates a massive bottleneck that prevents promising integrative treatments from entering the medical mainstream. The Adolph Coors Foundation has awarded a gift to the Center for Integrative Medicine at the University of Arizona to support a three-year study of the effect of integrative medicine on health care and health costs.

Specifically, the study will generate a statistically relevant comparison of the health and cost outcomes of two populations of Maricopa County, Arizona, employees … one whose primary care is delivered using an integrative model and the other whose primary care is delivered using a traditional conventional care model. The outcomes generated by this study will be shared with a broad range of medical and health professionals, insurance companies, academics, business leaders and policymakers.

In other words, the Coors Foundation is funding a study at Weil’s Center to “prove” that integrative medicine produces better outcomes and thus persuade the health insurance industry to pay for quackery. Interestingly, this study, the Integrative Medicine PrimAry Care Trial (IMPACT, ClinicalTrials.gov identifier NCT01785485) was started in 2013, and its record hasn’t been updated since then. Enrollment was supposed to have been completed in October 2015, but the record as of 2013 indicates that not a single patient has yet been accrued. Its protocol was published in April 2014 and looks to be measuring so many outcomes that it’s virtually certain that one of them will be positive. So what’s going on with this study? Who knows? There’s not even much about it on the University of Arizona website. It’s a lot harder to find out online what’s going on with a study funded by a private entity than it is for a federally-funded study.

The Samueli Center project involves using electroacupuncture (which, of course, isn’t really acupuncture) to treat hypertension, while the Brind Center project is looking at high dose N-Acetyl-Cysteine as a treatment for breast and prostate cancer. So, yes, the Coors Foundation is deep into funding quackademic medicine and thus has a definite interest in promoting the acceptance of “integrative medicine.”

Although I highly doubt Mr. Jackson had any ulterior motives in trying to organize this debate, he does run a foundation that promotes political policies the Coors family supports. So he likely thinks more in political rather than scientific terms. In politics, a debate is how politicians try to persuade; in science, not so much. It’s also possible that he just thought it would be an entertaining way to discuss integrative medicine. Entertaining it might have been, but public debates of this sort, with their emphasis on rhetoric over substance and the ease with which one can Gish Gallop, are rarely particularly informative. They can serve as entertainment. They can serve as propaganda. Most often they serve as both. But they are seldom a good way to effectively communicate science over pseudoscience, medicine over quackery.

Strange bedfellows: Integrative medicine, Andrew Weil, and the American right

Prof. Ernst appeared quite surprised to learn of the right wing proclivities of the Coors Foundation and the Americans for Prosperity Foundation, apparently because he associated alternative medicine more with the political left. He shouldn’t have been. I’ve pointed out many times over the years at all my blogging locales how the idea that alternative medicine is mainly the purview of hippy dippy leftists and refugees from the 1960s counterculture like Andrew Weil is largely a myth. Sure, there are a lot of alt-med mavens like that, and, yes, the most influential member of the integrative medicine movement is the aforementioned Andrew Weil. However, there is also a lesser known but very powerful component to the alt-med movement on the right. A lot of the reason for this is financial. The supplement industry in the US is concentrated in Utah, and it’s no surprise that its lapdogs in Congress (such as Senator Orrin Hatch and Representative Jason Chaffetz) are pretty much all Republican. More importantly, the conspiratorial bent of alt-med believers meshes well with that of a significant segment of the far right.

Indeed, if you look at the “health freedom” movement (which includes many supporters of alternative medicine and, in particular supplements), you will find that it is very libertarian/conservative-leaning, mainly because to this movement the FDA (whose mission is to make sure medicines marketed in the US are safe and effective) and state medical boards (whose mission is to license and regulate the practice of medicine) are the enemy. After all, the FDA and the FTC prevent quacks from using whatever unproven medicines they want and making whatever health claims they want about those medicines, and state medical boards, when not too busy sanctioning physicians with substance abuse problems, do sometimes try to take medical licenses away from quacks, as difficult as that all too often turns out to be. So the anti-government bent of quacks and their supporters meshes well with the antiregulatory tendencies of the right wing.

Thus, unlike the case with Prof. Ernst, it was not much of a surprise to me to discover that the Coors Foundation and the Americans for Prosperity (AFP) Foundation are co-sponsoring an event featuring Andrew Weil. AFP was founded by the billionaire Koch brothers and, although the AFP and AFP Foundation are separate entities, they are “joined at the hip,” so to speak and frequently work in parallel. In any case, the AFP Foundation is anything but a “grassroots organization” (as it was described by Mr. Jackson). Rather, AFP and the AFP Foundation are the tools through which the Koch brothers exercise much of their political influence and AFP was intimately linked to the rise of the Tea Party. Indeed, the two worked together since the very inception of the Tea Party in 2009. It has even been alleged that front groups with ties to the tobacco industry and Koch brothers planned the creation of the Tea Party a decade before its emergence. Whatever you think of the Tea Party, there is little doubt that AFP is a very conservative/libertarian organization. Among other conservative causes, AFP has vociferously opposed the Affordable Care Act and been a major force spreading anti-science misinformation about anthropogenic global climate change. Funding and promoting anti-science is what AFP and the AFP Foundation do; so I’m not too surprised that the AFP Foundation would be involved in funding a conference like the one I was invited to.

But what about the Coors Foundation? I knew much less about it when I was first contacted, but what I’ve learned about it suggests it’s problematic as well, for many of the same reasons. For example:

In the early 1970s Coors required prospective employees to submit to a lie-detector test in which the company asked if the respondent was a homosexual (prompting Harvey Milk to organize a boycott of Coors beer). Throughout the 1970s and ’80s, the Coors family used generous donations from the Adolph Coors Foundation to launch right-wing groups like the Moral Majority, the Heritage Foundation and the Free Congress Foundation–which coined the term “the homosexual agenda” in publications like Gays, AIDS and You. Meanwhile, the company busted unions (leading to an AFL-CIO boycott), and individual family members like William Coors made racist speeches to black audiences claiming “one of the best things that they [slave traders] did for you was to drag your ancestors over here in chains” (this statement led to a boycott by numerous minority groups).

As a result of protests, the Coors Foundation in 1993 restricted its philanthropy to Colorado and formed the Castle Rock Foundation, which continued to fund far right groups and causes. In 2011, Castle Rock was absorbed back into the Coors Foundation. In any case, one group the Coors Foundation funded, the Heritage Foundation, is well-known for denying anthropogenic climate change and opposing efforts to mitigate it. These days, the Coors Foundation’s priorities sound relatively benign on the surface compared to its past activities (although one notes that some of its priorities are identical to the mission of the Castle Rock Foundation). Be that as it may, the Coors Foundation is clearly very conservative in its orientation and it’s taken on as one of its major focuses the promotion of the “integration” of quackery with medicine.

Integrative medicine, it’s not just for hippy-dippy lefties any more—if it ever was in the first place. It’s now made for some very strange bedfellows.

Aftermath: Ego and money lose to science

As I close, I must admit that I’m left wondering whether I made the right decision or not. I’d be lying if I didn’t admit that it could well have been very cool to be (hopefully) the hero defending science against Andrew Weil, the way that Bill Nye defended evolution against Ken Ham at the Creation Museum in Kentucky. But then I consider again my longstanding belief that public debates are not a good strategy to defend science, coupled with a cold, hard assessment of the cost-benefit ratio. To my mind, the cost in terms of preparation and the associations drawn to me by doing an event linked to groups like the Americans For Prosperity Foundation and the Coors Foundation were just not worth the (at most) modest potential benefit of a win (assuming I could even “win”) for science-based medicine. I briefly toyed with the idea of asking for the same honorarium that they were paying Dr. Weil (which is no doubt significant, likely way more than I’ve ever been paid before to give a talk) as a means of seeing just how Mr. Jackson wanted this debate to take place, but such is not my way and I quickly dropped that idea.

The bottom line is that no amount of money I could reasonable expect, even if the Coors Foundation agreed to pay me as much as they are paying Weil, or ego gratification derived from being on the same stage with the godfather of “integrative medicine” would be worth the effort and risk of doing a debate like this one. Far more importantly, there was no way I could see such a debate being more than a wash or, at best, a modest “win” for science-based medicine with the risk of its being a big loss. In the end, I made my decision, and I’m OK with it. Others might make a different one.

 

 

Posted by David Gorski

Dr. Gorski's full information can be found here, along with information for patients. David H. Gorski, MD, PhD, FACS is a surgical oncologist at the Barbara Ann Karmanos Cancer Institute specializing in breast cancer surgery, where he also serves as the American College of Surgeons Committee on Cancer Liaison Physician as well as an Associate Professor of Surgery and member of the faculty of the Graduate Program in Cancer Biology at Wayne State University. If you are a potential patient and found this page through a Google search, please check out Dr. Gorski's biographical information, disclaimers regarding his writings, and notice to patients here.

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