The Landscape of Denial

By Chuck Dinerstein, MD, MBA — Jan 10, 2022
No, denial is not the name of a river in Egypt. It has, and still is, alive and well in many of our most contentious political and scientific concerns. But in order to combat denial, one must be aware of what’s in the denialist’s toolbox. Here are the hammers, screwdrivers, and saws used to construct the denialist platform.
Image courtesy of DariuszSankowski on Pixabay

“There is an overwhelming consensus on the evidence among scientists yet there are also vocal commentators who reject this consensus, convincing many of the public, and often the media too, that the consensus is not based on ‘sound science’ or denying that there is a consensus by exhibiting individual dissenting voices as the ultimate authorities on the topic in question.”

There is perhaps no better demonstration that political affiliation has little to do with denialism than the fact that the preponderance of evidence and the overwhelming consensus of scientists maintain that global warming or climate change is underway and that GMOs are safe. The standard narrative suggests those that believe in climate change deny GMO safety and vice versa. So, let’s leave our political viewpoints here and consider denialism without that emotional baggage.

Conspiracies – secret collaborations exist, there is an element of truth to that assertion, but it is exceedingly challenging to conspire at scale. There are the classics, perhaps the best example of a conspiracy with an element of truth, the Illuminati. They were indeed a Bavarian secret society with a mission “to put an end to the machinations of the purveyors of injustice [superstition, religious influences, and abuses of state power], to control them without dominating them." They were outlawed and subsequently felt responsible for the French Revolution, among other events. Then there are the Elders of Zion and the Free Masons. More contemporary are the “Bigs,” you can supply the next term. Big Medicine conspires to deny the value of natural cures; Big Pharma conspires to deny cheap therapeutics – hydroxychloroquine, anyone?

A more insidious version, the pot calling the kettle black as it were, is defined as inversionism. When those Bigs manufacture the straw-man anti-big. No better example can be found than Big Tobacco who blamed an anti-smoking industry. On the other side of the ledger, we can discover anti-GMO lobbies, and dare I suggest an anti-vaccination complex?

Fake Experts – This too is nuanced; fake is often in the eye of the beholder. The best examples reflect expertise based upon eminence – the poster child, perhaps Linus Pauling. Dr. Pauling’s work on the nature of the chemical bond won him a Nobel, he was one of our most outstanding scientists, but his precise scope of expertise did not include the role of Vitamin C in our health. His Nobel provided the needed halo of expertise. Today, we find that among the many physician voices speaking out about COVID.

One of the difficulties in expertise is that it requires a thorough grounding in the common narrative, and often the process of gaining that knowledge limits your view. This is the quiet battlefield of expert panels where views contrary to the common narrative may be viewed as misguided or clearly erroneous. And those expert panels may choose articles to publish, promote guidelines or provide the “scientific rationale” for regulation. Diversity of viewpoint is not as heavily admired as the diversity of gender, race, age, and background. The classic example is Galileo, but the recent rise and fall of Dr. John Ioannides come to mind, as does the waning glow of Dr. Fauci.

Selective citation – The value of the poorly designed and performed study has been an overwhelming characteristic in the Age of COVID. Uncertainty mixed with fear has been an accelerant in the “hair on fire” way we have jumped from pre-print to pre-print, looking for some comfort and solace. This is not a new technique – one need look no further than the Lancet’s publication of Dr. Wakefield’s correlation of autism with vaccination or their publication of a study of hydroxychloroquine where none of the authors saw the underlying data which was entirely made up.

Intent also becomes entangled in selective citation. Were the researchers in the employ or the orbit of one of the Bigs (again, your choice) creating a conflict of interest? Financial disclosure is helpful for financial conflicts, but what about ideologic ones? Selective citation has many other forms, including statistical analysis, the narrative of the discussion section, and word choice.

Creation of impossible research expectations – we need to look no further than the attempt to prove a negative. “Absence of evidence is not evidence of absence.” We can never be certain of anything; at least, that is what I have taken away from my admittedly limited understanding of quantum mechanics. But denialism need only use the phrase “out of an abundance of caution.” Depending upon one’s viewpoint, the rest of that phrase might be “and I will not take an experimental vaccine,” or “I will go get my booster.”

Moreover, collecting data is messy and frequently subjective even though it is translated into numbers that feel more objective. For example, looking at all those pain scales used to communicate our level of pain. Is my 6 out of 10 the same as yours; my wife tells me my 8 out of 10 is her 2 out of 10 because I am a wussy.

Misrepresentation or logical fallacies – Perhaps the classic is the “nature is good,” and science and technology, which alter nature, are bad. GMOs fall in that group, so do the advocates of acquired vs. vaccinated immunity. And let me add that this applies as much to “chicken-pox or measle parties” as it does to embracing superspreader events. Other fallacies involve false equivalence; the claims of the health benefits or lack of health detriments to smoking are not equivalent to the claims that smoking leads to disease and premature death. Sometimes the false equivalence comes from the metaphors we use to communicate. The war against infectious disease requires us to vanquish our enemy. To that end, we have deployed the blunt tool of antibiotics, which is increasingly causing the collateral damage of antimicrobial resistance.

The viewpoint ends with this note on challenging denialism.

“[a process of debate] requires that both parties obey certain ground rules, such as a willingness to look at the evidence as a whole, to reject deliberate distortions and to accept principles of logic. A meaningful discourse is impossible when one party rejects these rules. Yet it would be wrong to prevent the denialists having a voice.”

It is wrong and impossible for social media to police the town square they have created. As a longtime writer on the Internet, I can attest to the impossibility of meaningful discourse much of the time. The writers of this viewpoint suggest we shift the conversation to the tools employed by the denialists rather than their arguments. Still, my experience is that often that results in accusations that shed more shade than light.

Point in case, every example used in this viewpoint was about Big Tobacco. Should I accuse them of selective representation, label them Big Academics conspiring to silence today’s Galileos. Does it matter that the first author is an economist, the second a physician, neither with a degree in communication? Or that the first author fails to mention he is an anti-tobacco activist and the second author, that he is the editor of the journal publishing their viewpoint?

I would argue that they have identified tools used by denialists but that denialists are found on both sides of the issues.

Source: Denialism: what is it and how should scientists respond? European Journal of Public Health DOI:10.1093/eurpub/ckn139

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Chuck Dinerstein, MD, MBA

Director of Medicine

Dr. Charles Dinerstein, M.D., MBA, FACS is Director of Medicine at the American Council on Science and Health. He has over 25 years of experience as a vascular surgeon.

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