People who bash conspiracy theorists or pseudoscience believers often ascribe those beliefs to some general science illiteracy. A frequent conclusion of this analysis is that if those people cracked open a textbook or paid attention during their biology classes, they would have known that doctors know all the best methods to treat them, you just have to trust the process, not listen to the charlatans; that vaccines and drugs in general are safe and you must be stupid to think otherwise.
This view presents this cartoonishly binary division — intelligent science enthusiasts (you can’t say “believers”, because some so-called rationalists will get offended that “you don’t have to believe in science, because it’s all proven facts”) vs ignorant masses who would benefit from reading a book.
The problem is that this is not how science works in the real world. It is, in fact, something you have to take on faith to an extent. No one, especially not a layperson will be able to completely verify each primary source of a scientific text or even a pop-sci book they read. Unless you are able out to carry out all the cornerstone experiments to replicate their results, verify methodology of each primary source, check them for fraud — as it also exists in academia, and it may go long unnoticed even by the people in the field — unless you are able to do all that, you cannot claim that there are no elements of belief in science.
For science to actually find its way to the general public, it needs to be sufficiently processed by professionals first. X number of papers on phenomenon Y, all filled with hermetic jargon, have to be scrutinized, reviewed, conclusions have to be drawn (often varying, if not outright contradictory) by scientists affiliated with certain institutions who lend them credibility. A general narrative needs to be worked out in this process, a narrative that can be later presented to the public, preferably in a simplified form.
So, this kind of superficial analysis presents an image of the world where science works in a political vacuum. It ignores that for science to be accessible and believable by the general public trust in institutions has to be high. Based on my own observations, the usual conspiracy theorist (at least in the field of medicine) pipeline looks as follows:
healthy person -> minor medical intervention causing severe health problems, often paired with lack of informed consent and no prior warnings -> health problems being unacknowledged/unaddressed by medical professionals, no systemic support given, ruined life -> major sense of injustice -> disbelief in institutions (medical, governmental, other) -> science disbelief
I would say that that after the health-problems step this pipeline somewhat forks into either institution and/or science disbelief, depending on your set of prior beliefs. In my case, science disbelief or conspiracy beliefs never came, because I don’t feel conspiracies are required to explain the neglect, abuse and suffering I and thousands of others have experienced. A far simpler explanation is the existence of generally useful science method, but working in the context of a global capitalism putting profit over people. In this environment, if something does not bring enough profits, or if there is not enough backlash and pressure, it is not studied. There is no clandestine pact to poison as many people as possible, but rather people are harmed, because any serious adverse events are rare enough to be simply dismissed, as — random figure — 0.01% of people getting permanently disabled will have no significant impact in the grand scheme of the economy of a country. There are no “humans” in this setting, as they are simply treated as casualties of doing business.1
Even if one says we are talking about drugs that cannot be banned, as they are too useful, it is hard to argue that there is A LOT of middle ground between releasing generally useless safety warnings — and doing absolutely nothing apart from this — and an outright ban. Some examples would be: efforts to educate physicians, moving the drugs into controlled substance category to limit their use and not rely on good will of prescribers, restricting their use to referral centres and hospitals. No regulatory agency, however, is naive enough to rely on good will when we are talking about thousands or millions of healthcare agents. They know safety warnings with no further action do not work. They are mainly a PR stunt, as they have no significant impact on prescription rates.2 This allows regulatory agencies such as FDA and EMA to keep their client i.e. pharmaceutical companies happy, as the drug sales do not suffer.
The point is that people buy into snake’s oil not because of “being stupid”, not knowing to follow doctors recommendations and reading too much shit on the internet. Multiple systemic failures have to occur, and human tragedies have to be met with blatant indifference to radicalize someone to that extent.
I recently remembered one rather aged professor, at the university I used to study, recommend HPV vaccination to his female students. Perfectly fine recommendation, given its efficacy in reducing rates of cervical cancer. One of the students, however, was concerned about some cases of adverse events in Sweden she heard about, and proceeded to ask him about that.
To give some brief context, there are rare, but reported in multiple papers, disabling adverse events of HPV vaccines (that probably extend to most vaccines), such as POTS, CRPS, CFS, possibly SFN (there is simply too many reports to put them all in footnotes, you can see them all here).
He responded mockingly by asking her if she read about this in a women magazine.
This just shows the general level of ridicule people are met with when reporting such issues. Now, imagine you are actually someone being barely able to move due to pain in your feet, are mostly bedbound, crippled by something that was supposed to help your health, and all you are being met with is your doctor taking a big fat dump on you. Because those issues are rare enough to not be met with any recognition, and it is easier for your doctor to believe that you are a psychosomatic case (or at best that your problems are due to vaguely unhealthy lifestyle you’ve been leading or to one of the dozens of supplements you’ve been taking after already getting harmed), you are not going to get any help. Even if you happen to be lucky enough for them to believe you, there are no established diagnostic or treatment protocols. The drugs for chronic pain are very much a crapshoot, so there is no guarantee you will get better (It was quite an eye opener for someone sympathetic to science, such as myself, to see that an “effective treatment” in various studies is often considered to be a drug with NNT of 6-7; and that a large chunk of medical science is based on treatment like that or worse).
All of this should lead you to hate the very interplay of capitalism and modern governments with their overgrown bureaucracy, those indifferent faceless leviathans, where the balance of human suffering is innately calculated into the state economy.
Nonetheless, it is not difficult to see how instead of this one may get a mistaken impression that all doctors must be in cahoots.
Footnotes:
- Only loosely related side note: when Noam Chomsky discussed victims of al-Shifa pharmaceuticals plant bombing during Clinton administration (as a result of which many people died), Chomsky argued that one may consider this worse than an intentional bombing of civilian populations. Because even though Clinton was not aiming to specifically kill civilians, but rather to destroy the pharmaceuticals plant, he must have known that many people would die, yet still carried out the operation. This shows that he did not recognize their human status, because he simply did not care about them, same as one does not feel particularly guilty about “killing ants when walking down the street”.
Despite this being obviously a very different situation, I think one can find a good parallel between this and how people with rare disabling adverse events are being treated. Not harmed on purpose, but no tears are being shed for them either, as some “ants” were expected to be trampled in the process.
More about this in this heated exchange: https://www.samharris.org/blog/the-limits-of-discourse ↩︎ - Ly, N.F., Flach, C., Lysen, T.S. et al. Impact of European Union Label Changes for Fluoroquinolone-Containing Medicinal Products for Systemic and Inhalation Use: Post-Referral Prescribing Trends. Drug Saf 46, 405–416 (2023). https://doi.org/10.1007/s40264-023-01286-4
“The regulatory actions on reducing fluoroquinolone use associated with the 2018 referral was not associated with a significant impact on fluoroquinolone prescribing in primary care based on our analysis. For future work, researchers may consider looking into prescription changes in secondary care, potential country-specific changes, or to include longer follow-up time to evaluate potential lagged effects.”
and
Bratsman A, Mathias K, Laubscher R, Grigoryan L, Rose S. Outpatient fluoroquinolone prescribing patterns before and after US FDA boxed warning. Pharmacoepidemiol Drug Saf. 2020; 29: 701–707. https://doi.org/10.1002/pds.5018
“The 2016 US FDA boxed warning against fluoroquinolone use for uUTI, acute sinusitis, and acute bronchitis was not associated with a statistically significant reduction in the rate of fluoroquinolone prescriptions for these diagnoses.” ↩︎