COLUMBIA UNIVERSITY PRESS, MARCH 2012
Modern Forms of Boundary Work in Defense of Science
Because the rejection of medical science has adverse implications for public health—as evidenced by unnecessary AIDS deaths and declining vaccination rates—this cultural tolerance for alternative medicine has not gone unchallenged, especially in the Internet era. In the past, those wishing to explore the cultic milieu and related alternative lifestyles did so primarily by subscribing to print editions of alternative healing magazines such as Mothering—the magazine that featured a cover photograph of Christine Maggiore with “No AZT” emblazoned on her pregnant abdomen. Today, like many other fringe publications, Mothering no longer produces a print edition. Consumers of alternative health services now surf the Internet like everyone else. In so doing, they will encounter alternative websites by the dozen, but they will also come across anti–AIDS denial sites and advice from conventional medical practitioners. They will find sites telling them Maggiore’s daughter Eliza Jane died because a doctor gave her an antibiotic and that Maggiore died of stress—but they will also find information showing that both Eliza Jane and Maggiore died of AIDS. The Internet, in other words, is both a source of opportunity for cultropreneurs—and a site of danger for them as converts can easily be lost.
This determination to fight back and expose the dangers of denialism is evident also in the more conventional print media. For example, the popular magazine for science and reason, Skeptical Inquirer, which started off life investigating claims about UFO sightings, ghosts, psychic powers, and similar paranormal phenomena gradually found its focus shifting to exposing the claims of alternative healers. More recently, medical professionals such as Goldacre, Kalichman, and Offit have penned popular books critiquing bad science, AIDS denialism, and the anti-vaccination movement. As such, they form part of a broader critical set of writings about the false claims and dangers of alternative medicine—for example, Dan Hurley’s exposé of the US vitamin and herbal supplement industry, Edzard Ernst and Simon Singh’s evaluation of the evidence for alternative therapies, and Michael Specter’s critique of denialism and irrational thinking. It is too early to tell whether this counteroffensive by pro-science advocates has achieved much success, but the fact that Goldacre and Singh have both been sued for libel (unsuccessfully) by alternative therapists suggests that some of their blows have hit home.
The electronic media has proved to be a crucial mobilizing instrument for pro-science activists. Supporters of Simon Singh used Twitter and Facebook to keep abreast of the libel case, to organize events, and to lobby for reform of the UK’s libel laws. Both Goldacre and Kalichman operate blogs on topics linked to their books, and they are active within the broader community of pro-science Internet activists. Goldacre refers to the wider group of pro-science bloggers as “the posse” and posts links to them on his website. And their actions are not merely intellectual. When the British Chiropractic Association sued Singh, the posse flooded the association with complaints about individual chiropractors, all of which required investigation. For Goldacre, the lessons are clear:
First, if you have reputation and superficial plausibility more than evidence to support your activities, then it may be wise to keep under the radar, rather than start expensive fights. But more interestingly than that, a ragged band of bloggers from all walks of life has, to my mind, done a better job of subjecting an entire industry’s claims to meaningful, public, scientific scrutiny than the media, the industry itself, and even its own regulator. It’s strange this task has fallen to them, but I’m glad someone is doing it, and they do it very, very well indeed.
In other words, boundary work in defense of science has not only adapted to the modern age by taking place online and with the help of electronic media, but it is being undertaken by members of the public. Whereas, in the past, boundary work was conducted primarily by scholars seeking to develop and maintain public respect for science and to relegate “pseudosciences” like phrenology beyond the pale of academia, today the battle is more diffuse, public, and decentralized—indeed often fought at an individual level via cut-and-thrust debate on blog postings. As Goldacre suggests, it may be that this is more effective than action taken by the scientific community.
Damien Thompson is similarly optimistic, noting in his populist polemic Counterknowledge: How We Surrendered to Conspiracy Theories, Quack Medicine, Bogus Science and Fake History that high-profile alternative therapists have proved “surprisingly vulnerable to guerrilla attacks from the blogosphere”:
Freelance defenders of empirical truth, armed to the teeth with hard data, have mounted devastating ambushes on quacks and frauds who have ventured too far into the public domain. The tactic is an antiretroviral rather than a vaccine, and too modest in scope to effect dramatic change in society, but it does seem to work. . . . Reputations are easily damaged in a furiously competitive market, and people rather enjoy the spectacle of smug, rich lifestyle gurus being humiliated.
This social phenomenon of “angry nerds” and “guerilla bloggers” dedicated to defending evidence-based medicine and challenging quackery is important. Rather than relying on the scientific community to defend the boundaries of science, we are seeing a much more socially embedded struggle over values and how we should be approaching our health and that of others.
Reprinted from The AIDS Conspiracy: Science Fights Back, by Nicoli Natrass © 2012 by Nicoli Natrass. Used with permission of the publisher, Columbia University Press.