Saturday, August 25, 2007

Am I too rational for my own good?

In the second episode of Richard Dawkins' new show, The Enemies of Reason, (which you can watch below) Dr. Dawkins takes on "alternative medicine", and pays special attention to homeopathy. In case anyone reading (if anyone is reading) is not familiar with this particular flavor of bullshit, homeopathy is a form of alternative medicine in which substances -- and it truly makes no difference what they are -- are diluted to the point that "in order to get one molecule of the active substance, you'd have to imbibe all of the atoms in the solar system."

Dawkins correctly notes that the only possible use for homeopathic "medicine" -- which, amounts to so much water, exactly as pure as that used for dilution -- is as an expensive placebo. The placebo effect is well-documented and supported by scientific evidence. The psychological effect of believing that a treatment will work causes the body's self-healing mechanisms to function more effectively. In short it only works if you believe it will work. I don't believe that ignorance is bliss, but it's undeniable that under certain circumstances, it can be healthy.

I also considered this some time ago, a few years before I realized that the god that I had heard about all my life could not possibly exist. Before this realization came the realization that prayer could not possibly be efficacious. An all-knowing and unchanging god with an all-encompassing plan would necessarily have decided whether or not to do something long before it is requested, before the birth of the requester, and indeed, before the dawn of time itself. It could not be possible to sway the will of such a being, therefore prayer is useless. My pastor did not know how to respond to this conclusion, except to subtly scold me for thinking that way. Pastors are not, after all, paid to think. My mother, the theologian, told me that the purpose of prayer is not to change God, but to change yourself, which I immediately recognized as the placebo effect.

Of course, knowing the nature of a placebo negates its effect, which at first made me reluctant to share this knowledge. It was a moral dilemma: on one hand, telling someone that prayer is a placebo would make it as useless to them as it was to me, but on the other hand, keeping someone uninformed is always a disservice. This, to me, is perhaps the most important moral question, and it took several years for me to come to the conclusion that sharing the truth with someone is always the moral thing to do, no matter how unwelcome it may be. Each person has a right to their own beliefs, but that includes the right to base those beliefs on the best information available. By giving a person incomplete or false information, you deny them the right to believe what is true, and I can thing of no worse affront. This is why it is considered unethical in scientific medicine to prescribe placebos except in cases such as clinical trials where patients may be in the test group or the control, and thus know that they may receive placebos, and agree to be temporarily uninformed so that the placebo effect can be tested.

For doctors, it would be unethical to do any more than allow a patient to believe that a placebo will be efficacious, whereas religionists and practitioners of "alternative" medicine are free free to employ lies, dogma, and obfuscation to sell their snake oil. Deceiving anyone, yourself included, is harmful, and individuals only have the right to choose that type of harm for themselves. I prefer to rely on my body's own defenses whenever it is reasonable to do so, but I also avoid these types of self-deception that could enhance those defenses, so it is likely that I would be at least marginally more healthy if I were less rational. Perhaps I am too rational for my own good.

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