Nine Evidence-Based Guidelines

I read with interest Gary Bakker’s article promoting evidence-based guidelines for a “good life” (November/December 2019). Yet I was left pondering the nature of the evidence proposed to support the nine suggestions.

In his introduction, Dr. Bakker promotes the use of randomized controlled trials (RCTs). A key feature of RCTs is, of course, randomization, and it is unclear if Dr. Bakker’s evidence is based on him having randomly assigned his clients to one of several possible treatments that have been proposed for their conditions. There are also questions about outcomes measured: one might reasonably be skeptical of an RCT taking as an outcome a self-declaration, “This helped me.”

While we should all embrace evidence-based thinking, we must be careful about the nature of the evidence we accept.

Prof. Bruce Dunham
Department of Statistics
University of British Columbia
Vancouver, B.C.
Canada

I certainly have no quarrel with the nine bits of advice Gary M. Bakker hands out for how to live a good life. They seem quite sensible, practical, and humane.

But I do quibble with the characterization that they are somehow nobler or more rigorous than various self-help books or collections of bromides, also all based on the personal experience of the authors rather than the gold standard that Bakker himself holds up: “randomized controlled trials (RCTs).”

The fact that Bakker has put in forty years paying careful attention to feedback from his own patients as to what they found effective is hardly more convincing than the thousands of testimonials from patients who have “benefitted” from homeopathy, reiki, or megadoses of vitamin C. They comprise anecdotes, not data.

What were his nine rubrics compared to? What was the control group for each? What were the alternative approaches?

Richard S. Russell
Madison, Wisconsin

Gary Bakker replies:

The interventions I have trialed have been derived from an immense amount of controlled research—RCTs and other designs—by thousands of researchers from around the world over the past forty years that support the theories and approaches/techniques I described in the article. I did not cite this tremendous volume of research in my essay. It is not a systematic review or meta-analysis of RCTs published in a specialist peer-reviewed journal. It is a summary article for the general public drawing on my decades of reading just such reviews. Readers could perhaps partially check my credentials by reading one of my properly referenced, peer-reviewed articles (e.g., on the technique of thought-stopping), but what they will find is a densely referenced, tight, complex, fully empirically justified, extensive argument supporting one tiny useful conclusion. This is hardly of interest to a general reader. Much better to let me spend a lifetime looking these up, bringing them together, even trying them out to see whether they are at least implementable, and then summarizing them as practical “guidelines.”

Witch Hunting

The Commentary “Witch Hunting Requires an International Response” by Leo Igwe (November/December 2019) was quite interesting, and the situation obviously requires action.

However, Mr. Igwe’s appeal to the United Nations for action is a losing proposition. Such a referral to the UN would probably entail the Human Rights Council. At least two of the offending countries mentioned in the article are members of the Council: Burkina Faso and Nigeria. Among other questionable members are China, Democratic Republic of Congo, Egypt, Pakistan, and Saudi Arabia. Perhaps worst of all is the recent election of Venezuela.

Any solution to the “witch hunting” problem will have to come from somewhere other than the United Nations.

Robert S. Kennedy Jr.
Boise, Idaho

Leo Igwe replies:

The writer makes a very cogent observation, that given the current constitution of the Human Rights Council, the resolution of the witch hunting problem lies outside the UN. However, the evidence before us at the moment suggests the contrary because several member states heavily supported a draft resolution that was sent to the UN meeting in September. Incidentally, it was Brazil that blocked the process of adoption due to concerns over the rights of pagans and the practice of paganism in that country. Those sponsoring the resolution are making necessary consultations and hope to resubmit a revised copy for adoption when UN member states reconvene in March. 

Quackery at WHO

Your article “Quackery at WHO” had a disturbing line that sounded familiar: “That political and economic considerations play a more important role in WHO than medical evidence-based science remains difficult to comprehend and accept.”

I’d just finished reading a Cornell Alliance for Science web article titled “Europe Still Burns Witches—If They’re Named Monsanto,” outlining the campaign by European anti-GMO factions (and a block of crooked American lawyers) to punish Monsanto by having an obscure WHO offshoot declare Roundup a “Class IIA” carcinogen (along with drinking hot beverages over 65 degrees C and being a hairdresser). The article dates to late 2017, and recent lawsuits proclaim their success.

Cresson Kearny
Albuquerque, New Mexico

Science Fiction Can Inspire Science

In “Percival Lowell and the Canals of Mars, Part II” (November/December 2019), the authors rightly advocate better education in the sciences, but their dismay that without such education “the average person is likely to start thinking about Vulcans or Captain Kirk whenever the word planet is mentioned” may be doing science fiction a disservice. No doubt there are astronomers and cosmologists working today who grew up watching the series that gave us the name of the first space shuttle and posited a future where a United Federation of Planets sent their version of the Enterprise on a voyage of peaceful exploration. Imaginative speculation about life on other planets has produced some ideas—such as the Martian canals—that turned out to be completely wrong, but it has also produced fantasies that have entertained and inspired in ways that are perfectly compatible with an interest and enthusiasm for science.

Martin Stubbs
London, United Kingdom

Climate and Religious Views

In Kendrick Frazier’s report “Hot Month, Hot Year, Hot Planet” (November/December 2019), his summary of Dan Kahan’s observation (p. 13) that “group identities are powerful cohesive forces … and those allegiances determine how we respond” may be crucial. A significant proportion of climate change deniers appear to have fundamentalist religious views. As the evidence for climate change becomes overwhelming, we should expect that these believers will be encouraged and led by their religious leaders to switch from denial of climate change to the belief that climate change is real and has been brought about deliberately by their preferred invisible super being to send some message to humans. We should watch out for that and be prepared to expose the contradiction.

Don Martin
Toronto, Ontario
Canada

Chiropractic Placebo

Re: Harriet Hall’s column “Wither Chiropractic?” (November/December 2010). The “benefits” of chiropractic (and acupuncture) are mostly subjective, making them difficult to substantiate. One exception is “improved hearing,” which is easily debunked by an audiogram. These so-called benefits are the perfect examples of the placebo effect. And because chiropractic can be costly and sometimes harmful, physical therapy is the much better choice.

J. Richard Gaskill, MD
Los Gatos, California

Hate Crimes Up?

Brian Regal begins his article “Everything Means Something in Viking” (November/December 2019) by saying, “The growing racist, white supremacist, alt-right movement has taken on an incongruous aspect.” I’m wondering what data Regal is using to support his claim that racism and white supremacists are on the rise.

A quick search of the FBI Uniform Crime Report shows there were fifty-five fewer hate crimes in 2018 than in 2017.

Mark Smith
via email

Brian Regal replies:

The New York Times reported on November 12, 2019, that personal attacks motivated by bias or prejudice reached a sixteen-year high in 2018, according to the FBI’s annual report issued that same day. The FBI report is at https://ucr.fbi.gov/hate-crime/2018/hate-crime.

More on Psi’s Claims

I agree with everything the authors of “Why Parapsychological Claims Cannot Be True” say in their original SI article and in their reply to the letter writers (November/December 2019). But here’s an additional complication that influences people’s response to such an article: We humans cannot help feeling that there’s something in our being that goes beyond physical explanation. That feeling, however you characterize it (consciousness, soul, etc.), persists in many people who are otherwise perfectly comfortable with current scientific explanations of “outside” phenomena that use words such as cannot and impossible. Hence the continuing flow of publications supporting both types of explanation. I just did a Google search on “alternative explanation for consciousness,” and after the Wikipedia hit, these two titles showed up in succession: “Science Can‘t Totally Explain Consciousness, and It Never Will …” and “Scientists Closing in on Theory of Consciousness.”

Arleigh Hartkopf
via email

Thank you for publishing my concerns (Letters, November/December 2019) about Reber and Alcock’s “Why Parapsychological Claims Cannot Be True” (July/August 2019). The authors’ comments in reply, “McCann’s point about the coordinated light from a parabolic mirror violating the ISL is based on a theoretical model. No such mirror has been built, and it is unlikely that it can be,” necessitate rebuttal. Einstein used theoretical thought experiments to express his concerns over aspects of the Copenhagen interpretation of quantum mechanics. Thus, theoretical opposition of concepts has significant historical precedent. More damaging to the authors’ argument is the fact that thousands, if not millions, of such mirrors have been built. They are called searchlights. The intensity of the beam from a searchlight does not satisfy the ISL, otherwise they would have been useless in tracking enemy planes in World War II. In short, the authors’ assumption of the validity of the ISL is not justified.

Roger McCann
Brevard, North Carolina

Arthur Reber and James Alcock reply to McCann:

Mea culpa: We should have given more thought in our response to McCann’s initial comments. In our article, we stated, “In telepathy, the distance between the two linked persons is never reported to be a factor, a claim that violates the principle that signal strength falls off with the square of the distance traveled.” McCann correctly pointed out that the inverse square law does not apply to a coordinated light source producing parallel rays. And although it is true that a perfectly coordinated, or “collimated,” light beam cannot actually be produced because of diffraction, we agree that searchlights (and lasers) approach the theoretical ideal.

However, McCann’s point about coordinated light beams has no relevance here, because not even parapsychologists suggest that our brains focus or collimate telepathic communications to specific human targets. Instead, parapsychologists insist that telepathic signals can reach a target person anywhere in the world, even though his or her location is unknown to the sender.

For the Record

In “Another Scandal for Parapsychology” (November/December 2019) the phrase “p below the 0.5 level” should be “p below the 0.05 level.”