Bill Maher has been getting a lot of heat lately and seems to be getting a bit defensive. He was particularly stung by Michael Shermer’s open letter in which Dr. Shermer thought it necessary to give Maher a basic lesson in germ theory.

Unfortunately, Maher has responded not by thoughtfully engaging his critics, but with a rambling defensive diatribe in which he simultaneously protests the criticism pointed his way while repeating and amplifying the pseudoscientific nonsense that garnered criticism in the first place.

Maher presents what we call a target rich environment for skepticism, so I don’t think I will be able to address every point, but I will hit the highlights.

Listeners of the SGU podcast are familiar with our “name that logical fallacy” segment. In his second paragraphs Maher offers up enough fallacies to supply this segment for a month. Take a crack at it yourselves:

I agree with my critics who say there are far more qualified people than me — its just that mainstream media rarely interviews doctors and scientists who present an alternative point of view. There is a movement to stop people from asking any questions about vaccines — they’re a miracle, that’s it, debate over. I don’t think its that simple, and neither do millions of other people. The British Medical Journal from August 25 says half the doctors and medical workers in the U.K. are not taking the flu shot — are they all crazy too? Sixty-five percent of French people don’t want it. Maybe its not as simple as the medical establishment wants to paint it.

Maher is willing to admit that he is not an expert, but then he follows this statement with a long post in which he feels free to express his views on vaccines and medicine in general. He should have just stopped after that first sentence. He seems to be saying – I am not an expert, so don’t hold me accountable for anything I say, but I am going to say it anyway.

He then follows with a common claim for Maher – that the mainstream media (apparently he does not consider himself part of the mainstream media) rarely interviews experts with an alternate point of view. This is a bold assertion that strikes me as utter hogwash. I admit perception here is subjective, but it seems to me that the mainstream media gives disproportionate attention to fringe experts and minority opinions.

Look at Oprah, Larry King, just about every talk show and morning show, and Maher himself – the mainstream media loves the fringe. At best we get token skepticism. Who is Maher kidding? But everyone wants to portray themselves as the embattled minority.

Maher goes beyond that and borrows a page right out of the creationist playbook when he writes: “There is a movement to stop people from asking any questions about vaccines — they’re a miracle, that’s it, debate over.” Right – just like we want to dogmatically stop debate about Darwin, and the 9/11 truth movement, and the hollow earth – and every other crackpot claim out there.

Maher confuses concern over the quality of reporting and information with a desire to inhibit free speech. Calling nonsense what it is does NOT equal attempting to silence it. When we call Maher on his pseudoscientific rubbish, this is not some big mainstream conspiracy to shut down debate.

Also – his attitude assumes that there is a legitimate debate to be had – just like the creationists in all their whining about “teach the controversy” assume a controversy where there is none (not a scientific controversy, anyway).

There is no mainstream controversy over vaccines, not because of dogma but because the science is very solidly in one direction – vaccines are safe and effective. Repeating long-debunked misinformation does not create a genuine controversy.

It strikes many of us in the skeptical community that Maher is a picture of self-contradiction in this position. He criticizes 9/11 truthers and creationists, but then commits the identical logical fallacies in attacking vaccines and modern medicine.

Maher finishes off that paragraph with an argument from authority combined with an argument from popularity. Right – and (depending upon which highly unreliable poll you want to listen to) a majority of Americans doubt evolution, and a third of the public thinks Bush had something to do with 9/11.

This is also a bit of a self-fulfilling prophesy – the anti-vaccine movement scaremongers about vaccines, and then points out that there is a lot of fear of vaccines in the public, so there must be something there.

Along these lines, he gives us some more apologetics:

I’m just trying to represent an under-reported medical point of view in this country, I’m not telling a specific pregnant lady what to do. In addition, my audience is bright, they wouldn’t refuse a flu shot because they heard me talk about it, but if they looked into the subject a little more, how is that a bad thing?

This is the same kind of lame excuse for intellectual sloppiness that Oprah gave – hey, my audience is smart enough not to listen to me. I’m just putting this out there, asking questions – what, do you want a fascist state that doesn’t allow people to ask questions?

The “I’m just asking questions” gambit is a particularly disingenuous one. I wonder what Maher thinks when Fox pulls this stunt.

The point Maher keeps missing is that he is making claims that have been debunked – they are not based on a fair reading of the science, and his logic is strained at best.

But let’s get to some specifics. He writes:

The point I am representing is: Is getting frequent vaccinations for any and all viruses consequence-free?

Nice straw man. I can see Maher wants to hit as many logical fallacies in one post as possible. Maybe he thinks it’s like shooting the moon in hearts – if you get them all, you win.

Who is recommending “frequent” vaccinations, or vaccines for “any and all virsues?” There are thousands of viruses out there, and vaccines for just a few. I wouldn’t mind a few more – HIV would be nice. And who is saying that vaccinations are “consequence free” – and what does that mean, exactly?

Scientists are careful to point out that vaccines are not risk free. They have side effects, and even rare serious adverse effects – like all medical interventions. They even go out of their way to report and catalogue all the side effects – that’s a standard part of science-based medicine.

If that’s your question, Maher, then the answer is no, but irrelevant. (A significant sign of intellectual sloppiness or naivete is not being able to ask the right question, or even cogent questions.)

The right question is – what is the risk-benefit ratio of vaccines? We have mountains of data on this question, and the answer is – there is significant benefit in excess of risk. So much so that vaccines are one of the best medical interventions invented by scientific medicine. Really – it doesn’t get much better than vaccines for benefit in excess of risk. But we won’t stop monitoring them, or asking the right questions anyway.

I can’t resist pointing out a bit of irony in his post. He writes:

But apparently it’s (Twitter) taken very seriously, because there was Scott Pelley on 60 Minutes asking the Secretary of Health and Human Services what she thought about the fact that “Bill Maher told his viewers anyone who gets a flu shot is an idiot.” Well, not quite. It was twittered, which I guess doesn’t make a huge difference, but as 60 Minutes is the last bastion of TV journalism, accuracy is appreciated.

So Maher is dinging 60 Minutes for an inconsequential factual error – viewers vs twitter followers. But then Maher writes:

Is it worth it to get vaccines for every bug that goes around? Injecting something into my bloodstream?

and

I would think vaccines containing many different dicey substances shot directly into the bloodstream have a slightly greater chance of secondary effects than a piece of fabric lying across your waist.

Maher has been corrected before on the fact that vaccines are intra-muscular injections – they are not injected “directly into the bloodstream.” And what “dicey substances” are we talking about, exactly? I guess it’s OK for Maher to play it loose with the facts as long as it is for the purpose of fear-mongering about an effective medical intervention.

While there is much to criticize in Maher’s style, his substance is worse. He writes:

What I’ve been saying is that Western medicine ignores too much the fact that the terrain in which bacteria can thrive is crucial and often controllable, which shouldn’t even be controversial.

One more style point though – “Western” medicine is a euphemism for “scientific” medicine and is only used by those with an anti-science agenda. It is meant to imply that science is not universal, but culturally Western.

Which part should not be controversial – that “the terrain” is important or that scientific medicine ignores this fact? What evidence does Maher have that modern medicine ignores the immune system? I believe there is an entire medical specialty dedicated to the immune system (several, actually). Infectious Disease specialists routinely consider the host in assessing the best course of action to take in preventing and treating infections.

But Maher wants to pretend he lives in a cartoon world where doctors treat everything simple-mindedly with drugs and surgery, and don’t consider the patient as a whole. It really is an annoyingly childish view of modern medicine – about as accurate as a creationist’s view of evolutionary biology. It is a product of propaganda from those hostile to science-based medicine. It also is profoundly arrogant – a product of the casual assumption of moral and intellectual superiority. Maher apparently has no problem assuming he has a more thoughtful approach to medicine than the entire medical profession.

On this point he also writes:

“…and if your immune system is already compromised by, for example, eating a typical American diet, then a flu shot can make sense.”

He is assuming that the American diet compromises the immune system. I would like to see a reference or twelve to support that claim. The American diet is far from optimal, but the evidence overwhelmingly shows its defects are in excess, not insufficiency. Americans are not malnourished, and their immune systems (in general, of course) are fine.

Maher has the true-belief that infections can be treated and prevented solely by “boosting” the immune system with diet and nutrition. This, however, is a fantasy of the supplement industry.

The fact is, perfectly healthy people can succumb to a bad infection. Maher also ignores the fact that the best way to protect those who are not perfectly healthy, or do have compromised immune systems, is through herd immunity – for healthy people to get vaccinated to prevent the spread of disease.

After some reluctant acknowledgment that vaccines maybe are not all bad, Maher writes:

But maybe the immune system doesn’t like being tricked so many times. Maybe we should be studying that instead of shouting down debate.

What? The “being tricked” thing was a metaphor Shermer used to explain vaccines a bit to Maher. The immune system responds to vaccines the same way it responds to getting exposed to viruses or bacteria from other sources – getting a cold, or just getting exposed even without mounting an infection. I sure hope my immune system “likes” responding over and over again to immunological challenge, because it is going to have to do just that on a daily basis for the rest of my life.

Maher perpetuates the anti-vaccine fiction that the immune system response to a vaccine is fundamentally different than the response to any infection or exposure to a germ. It’s not.

There is so much more nonsense in this post – it is so dense with logical fallacies and misinformation, that I just can’t hit it all. He goes on to conflate issues about overuse of antibiotics with vaccines. Yes, Maher – we are talking about the overuse of antibiotics. It is being studied to death, and we are trying to balance our duty to save individual patients with the long term effectiveness of our antibiotics.

Maher then states that the “experts” he looks to on this issue are Barbara Loe Fisher, Dr. Russell Blaylock, and Dr. Jay Gordon – anti-vaccine cranks all. That’s Maher’s problem – he might as well take an evolution lesson from Casey Luskin, Michael Behe, and Dr. Egnor.

In the end I think that might resolve part of the paradox that is Bill Maher. He demonstrates that someone who is generally intelligent, able to form rational opinions on many issues, and has been successful in a competitive profession, is also able to climb inside a bubble of pseudoscience on a particular issue.

It is easy for anyone to be overwhelmed by an organized campaign of misinformation. I know very bright people who were blown away by Loose Change when they first saw it. I know otherwise intelligent people who just cannot handle the systematic lies and distortions of the creationists – they don’t have the background and the volumes of information it would take to tackle each false claim and logical fallacy.

The same is true of the alternative medicine and anti-vaccine movement – they have a highly developed package of propaganda, misinformation, and subtle distortions – wrapped in a feel-good and empowering philosophy, that can easily overwhelm even an intelligent person.

But Maher has now stepped into this controversy, even though he apparently doesn’t like it. I guess he only likes getting praise from his audience, and is chaffing under the harsh criticism some of his view have engendered (and I don’t mean from his ideological opponents – something we all enjoy).

Also – like it or not – he is a public personality and his views affect the public. If he is going to tackle medical issues, he needs to do a far better job of exposing himself openly to the “other ” side, by which I mean science-based medicine. He cannot hide behind the “I’m just a silly comedian, no ones takes me seriously, I’m just asking questions” gambit.

He should seriously consider the possibility that he is about as well informed on vaccines and other medical issues as creationists are on evolution. He should not dismiss his critics (while he is criticizing others for being dismissive) and he should take very seriously the fact that he is at odds with the scientific and skeptical community.

Otherwise the criticism will continue – not to shut him up, but to do damage control. Maher is contributing to the public misunderstanding of science in perhaps the most important area – medicine. That is very serious, and he needs to start taking it seriously.

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Note: Orac has a go at Maher also.