Many of the popular science bloggers are decidedly skeptical in their outlook, choosing to promote critical thinking in addition to factual knowledge about their field of expertise. This is a good thing, and I certainly count myself among them. Many of those bloggers embrace the word “skeptic,” meaning scientific skepticism – the rigorous application of logic and evidence to all claims, with a healthy appreciation for the myriad mechanisms of self-deception to which humans are vulnerable.

One of the primary goals of blogging about science and skepticism is to engage the public and other professionals in discussions of important science issues of the day. We welcome criticism, as long as it engages with the logic and evidence.

Increasingly, however, I see those who find themselves at the pointy end of our skeptical jabs responding with what amounts to ad hominem attacks (focusing on us personally rather than our arguments). They have attacked us personally, impugned our motives, accused us of fictitious conflicts of interest, questioned the appropriateness of spending time writing to the public, and have tried very hard to characterize us as closed-minded cynics. Sometimes the attacks are so childish they are beneath recognition or response. But often the attacks are more subtle and sophisticated – but they represent the ad hominem logical fallacy none-the-less.

One such attack was recently brought to my attention – A Burgeoning Klatch of Science Skeptics by SB. Leavitt, MA, PhD at the Pain-Topics.org website. In the commentary section of the article, which begins after describing mainly David Gorski and myself and our efforts at science-based medicine, Leavitt contrasts our skeptical position with what he calls “healthy skepticism.” Then he writes:

Along with that, however, we have acknowledged that it is far easier to criticize science — asking tough questions, pointing out flaws or weaknesses — than it is to do good science. Therefore, we were somewhat dismayed by the writings and posturing of the self-proclaimed community of professional skeptics.

It is always easier to criticize than to do – but that is a really cheap shot. It is a not-so-subtle way of saying “shut up,” – often a theme of those bristling at skepticism. Most of us who are physicians and skeptics have full time careers teaching, practicing, and/or as researchers. We also spend some of our time trying to educate the public about the process of science as it relates to medicine, counter the misinformation in the media, and engage in the important discussions of the day that involve our profession.

Further, criticism is a very important part of the scientific process. It is the very heart of peer review and how the community of science functions. Yet those who do not like to be criticized will often make the “it’s easy to criticize” gambit, rather than address the substance of the criticism.

He continues:

For example, their diatribes against CAM and integrative therapies — which actually can be vital modalities for effective pain management — seem guided more by emotional arguments than a systematic study of all available evidence. Hence, when Novella writes (as noted above), “The default mode of human psychology is to think with our emotions, then deftly rationalize our decisions. As a result there do not appear to be any practical limits to human gullibility,” we wonder if he also is describing how a credulous community of skeptics approach their subjects of scorn.

That’s pretty harsh. At least he follows up with some specific examples of how he thinks we have made emotional assertions without systematic study. Wait – no he doesn’t. He doesn’t give a single example; he simply makes the bold assertion (combined with the bold and unsupported assertion that CAM modalities can be effective in pain management). I would welcome an actual example – then we could discuss the merits based upon the published evidence. I will also let the reader decide for themselves how emotional Leavitt himself is being in his commentary.

This is the “dismissing skeptics as dismissive” gambit – which is ironically dismissive. Fortunately, we have thousands of pages of published material online that document our approach to the topics of our discussion. We spend a great deal of time systematically reviewing the evidence, examining individual studies in great detail, and putting all the evidence into a scientific context. Leavitt’s claim that we do not systematically review the evidence is demonstrably false. If you disagree with our analysis, then stop complaining and show us some evidence and analysis of your own.

Actually, Leavitt does do that (while not addressing skeptics directly), and when he turns his attention to CAM modalities we definitely see where he is coming from. I chose to look at just one of his prior articles on a CAM modality – the use of homeopathy for rheumatoid arthritis. He begins his commentary on the issue thus:

Homeopathy is a therapeutic modality practiced worldwide, it is very popular among some patients, and it has withstood the test of time. Still, few therapies have attracted more controversy and debate. While not going so far as to call homeopathy a hoax, scientists claim that homeopathic remedies are so highly dilute that specific therapeutic effects are biologically implausible. Yet, some observational studies have suggested that patients with certain ailments do improve after consulting a homeopath.

He employs the argument from popularity followed by the argument from antiquity followed by apparent puzzlement over why homeopathy is controversial. This is followed by the acknowledgment that “scientists claim” that homeopathy is biologically implausible, which he then immediately takes away by citing “observational studies” (i.e low quality studies) that show consulting a homeopath works.

Homeopathy is not just biologically implausible – if homeopathy worked, that would require rewriting some physics and chemistry as well. Homeopathy is beyond implausible. It is as close to impossible as we can get in science. This is not being dismissive – it’s the result of a carefully argued scientific analysis of the claims. Leavitt treats the question of whether or not homeopathy works as an open question. I guess he thinks he is being open-minded, which makes skeptics dismissive. He also retreats to the position that more research is needed (no it isn’t), and, well, at least the homeopathic consultation works through placebo effects.

Getting back to the current commentary, Leavitt writes (more dispassion):

Elsewhere in their blogs there are tediously verbose and wearisome debates in print about whether “science-based medicine” or “evidence-based medicine” is the more correct approach. As a further example, skeptics argue that the “placebo effect” should more properly be described as a “placebo response.” While words do make a difference, and there may be nuggets of substance in some of the rhetoric, much of it seems to be an intellectual exercise for the entertainment of their fellow skeptics — and, perhaps, the gullible public.

I am sorry Leavitt thinks that the distinction between SBM and EBM is too tedious to warrant his attention. For those with a similarly short attention span – the essence is this: science-based medicine restores scientific plausibility back to its proper role in determining whether or not a medical modality is likely to be effective. EBM focuses on clinical evidence, while giving too little weight to basic science. Further, we favor a Bayesian analysis of data over reliance on the p-value, because a Bayesian analysis actually asks the question we are interested in – how likely is the claim given the data.

I admit I was actually surprised by this comment. Elsewhere Leavitt at least pretends he is being serious about science. I have news for Leavitt – science is often tedious. Attention to detail and rigorous discussion are often wearisome. The details matter. If he finds our popular writings on SBM tedious, how can he make his way through a technical paper? Or perhaps he is just employing the kind of dismissive rhetoric he accuses us of using.

He continues:

The lesson in all this is that our understanding of “healthy skepticism,” as advocated in these Pain-Topics UPDATES, may have an objective of “stopping the B.S.,” but it is not necessarily bent on “spoiling anyone’s fun.” And, it is not a close-minded approach that encourages contempt prior to adequate investigation.

Ahh – the “closed-minded” gambit. I knew it was coming. Those who are insufficiently skeptical of bad science and bad arguments often play the “closed-minded” card. “Keeping an open mind,” is often used to dismiss detailed skepticism. I challenge Leavitt to give an actual example of our displaying contempt prior to investigation. Our criticism comes as part of detailed examination – that’s what we do.

The problem with Leavitt appears to be that he fails to show proper contempt after scientific analysis and study shows a modality to be little more than pure pseudoscience (homeopathy being a prime example). It is also illuminating that his comments are virtually identical to those we receive from UFO enthusiasts, conspiracy theorists, and proponents of ESP. They all want to shut up the skeptics, and play the same tired cards over and over again.

Fortunately the skeptical community now has a vast record online of our general approach and style of argument – please read and judge for yourselves.

To Leavitt I will just reinforce one point – critical analysis is not being dismissive; calling those with whom you disagree closed-minded is.