Australasian Science: Australia's authority on science since 1938

Protecting Your Health in a Post-Truth World

By Rob Morrison

As scientific literacy declines and “post-truth” and “alternative facts” take centre stage, how can you ensure that you get proper health treatments that will actually do some good?

“Post-truth” is a term coined in 2010 to describe a political culture in which appeals to emotion defeat factual evidence in debate. It has now gone mainstream, selected in 2016 by The Oxford English Dictionary as the word of the year. One year later, “alternative fact” entered the lexicon as US President Donald Trump’s advisers fabricated stories about his inauguration that were easily falsified by well-documented and even photographic evidence.

These terms came from politics, but could well have come decades ago from science as climate change, genetically modified organisms, nanotechnology, alternative energy and other scientific and technological advances produced barrages of hostile and falsifiable criticism that was readily shown to be untrue by huge amounts of consistent, published and replicated data. To this day such rebuttal, relying on factual evidence rather than heightened emotion, proves remarkably ineffective in shaping public attitudes.

Nowhere is this more evident than in what now masquerades as the health industry, with discredited “wellness warriors”, anti-vaccination proponents, revolutionary diets, mystical healers and miracle fruits flooding the electronic media daily.

Why? Explanations vary, but “confirmation bias” is central; the tendency to seek out, prefer, believe and remember information that fits with one’s pre-existing beliefs while discounting evidence that does not.

Journalists know that someone watching, reading or hearing their story has an invisible thought bubble above their head saying: “How does this affect me or the people I love?” As with politics and religion, health is a fertile emotional field to seed with alternative facts and post-truths.

It is made worse by the internet, but perhaps in unexpected ways. The internet was hailed as a creation that would revolutionise and assist both education and communication, and it can, but everything that technology produces is a two-edged sword; whatever is powerful can be powerfully good or equally powerfully bad. The internet gives us untold opportunities for education, communication and news but also unrivalled opportunities for pornography, terrorism and cyberbullying. Now add fraudulent health treatments.

The public is very much at risk here. The Australian Institute of Health and Welfare maintains that 59% of Australians aged 15–74 lack the health literacy skills adequate to access health services and manage their health effectively.

Doctors and pharmacists were the traditional authorities to whom patients turned for advice. Increasingly it is the internet, complete with hucksters, self-appointed gurus, unethical marketers and proponents of completely untested and even impossible cures. Worse, some doctors and pharmacists are joining them, with pharmacists promoting products such as homeopathic preparations and useless vitamin supplements and some doctors embracing dubious alternative practices as “integrative medicine”. Financial viability is the usual excuse.

In the clamour of online claims from celebrity actors, chefs or sporting champions, expecting those with poor health literacy to understand the relevance of evidence-based treatments, derived from well-run clinical trials reported in refereed journals of high quality, is getting much harder in this post-truth world.

You might expect professional and governmental bodies will protect consumers against false health claims. They exist, but can be remarkably weak. Most are under-resourced, while others rely on self-accreditation that is easily flouted. Some will explore complaints but take months or years to do so, with few or any penalties imposed, while various supervisory boards have a predominance of the very practitioners they are supposed to police, and vested interest renders them useless.

Of course, climate change, genetically modified organisms, nanotechnology, alternative energy and orthodox medicine have all produced their own errors, and even frauds. They get wide media coverage, but we know of these because the time-proven scientific method, with its onus on publication, encourages challenges to and replication of results. This makes it possible to detect unlikely findings and reveal them as the scientific “post-truths” and “alternative facts” that they are.

It is an imperfect system, but it is far superior to accepting at face value the self descriptions and non-validated claims of those who want your dollar in return for the treatment of their own devising. No such checks and balances apply there.

Dr Rob Morrison is a Professorial Fellow at Flinders University and Vice-President of Friends of Science in Medicine.