Chiropractic: Worse Than You Might Think
Monday, June 26, 2017
Over at The Outline is a lengthy
piece about the pseudoscience of chiropractic. Even if, like
myself, you have always dismissed chiropractic out of hand, you will
probably have an even lower opinion of it afterwards. (e.g.,
A séance was important in its founding during a period
rife with quackery.) And, if you don't have a strong opinion of it, or
didn't realize that there are efforts underway to allow athletic
physicals by chiropractors to suffice for physical requirements in
school athletics, you should take a look.
Oh, and
chiropractors are, unsurprisingly, on the anti-vaccination
bandwagon:
"Freedom of medical choice" has become a popular way to phrase anti-vaccination views in the chiropractic community. The American Chiropractic Association's public policy on vaccinations states that "since the scientific community acknowledges that the use of vaccines is not without risk,(...)The ACA is supportive of a conscience clause or waiver in compulsory vaccination laws thereby maintaining an individual's right to freedom of choice in health care matters and providing an alternative elective course of action regarding vaccination." The World Chiropractic Alliance cloaks its anti-vaccine stance under "freedom of choice" as well, saying that medical practitioners should inform patients of all risks associated with vaccinating.Although I oppose licensing laws and compulsory vaccination, I recognize that we are far off from the time that abolition will be seriously considered. Given that fact, we should, in the meantime, insist that the standards such laws are supposed to enforce be based as much as possible on actual science.
That doesn't seem too unfair until you consider that chiropractors are not asked to tell patients the risks associated with polio, whooping cough, measles, or chiropractic care itself. Fun experiment if you ever go to a chiropractor: ask them what the proper back-cracking procedure is to immunize oneself to zika or malaria. Bring your pet mosquito.
In a free society, if someone wants to make stupid health decisions, he won't have anyone to blame but himself. But in our mixed economy, he could potentially have the government there to mislead him/help him pretend he is making a wise choice by setting corrupt official standards.
-- CAV
9 comments:
Hello Gus. I read your post yesterday, "Chiropractic: Worse Than You Might Think," and the last part, your last two paragraphs, stuck with me, puzzled me. Off and on since, what you said came back to me and I decided to take more time to consider it and to perhaps respond. I have decided to respond
If we had no licensing laws, then presumably there would be all kinds of alternatives offered for health related issues in the way of products and services, and many of them, if not all, would be quackery (not based on valid science).
In a free market, people would free to make all kinds of "stupid health decisions." However, not being under the illusion that they are being protected from quackery via government licensing, they would, I would think, in general, be less likely to make those "stupid health decisions" based upon what are now corrupt official standards for licensing.
In the context of a free market, people would be more skeptical generally, therefore, and there would be a market incentive for some means of ensuring that their health decisions are not stupid, perhaps consumer protection organizations on the model of Good Housekeeping or Consumer Reports, etc., private organizations that investigate various health-related products and services, approving and endorsing some, disapproving and refusing to endorse others, thereby offering consumers information to help them in making their health decisions.
But, you say, as I understand you, that in the context of a mixed economy, such as ours, in which we are "far off from the time that abolition will be seriously considered," licensing laws create the generally accepted view that the government is doing what free market organizations, like Good Housekeeping or Consumer Reports, would do in protecting us from quackery, from health related products and services that are not based upon valid science, and that, in such a context, "we should . . . insist that the standards such laws are supposed to enforce be based as much as possible on actual science."
So, in other words, in our context, you are basically calling for more rigorous licensing laws and licensing enforcement, and perhaps even more licensing laws, because of the false sense of quality created by licensing laws.
Is that a fair understanding of your view and what you are calling for in the context of our mixed economy?
John,
I agree with much of what you say, regarding the fact that a freer economy would generally encourage people to exercise the kind of vigilance the can and should regarding their own health. On top of that, having to pay one's own health expenses would probably go even farther in that direction.
Regarding your question, I don't have a good answer since the mixed economy militates against the ability to apply principles in so many ways. A more clear-cut example is that I think social security should be sunsetted, rather than abolished at once, given that so many people have been prevented from it from properly planning their own later-life finances. (I think there might be lots of room for disagreement on this point and on details of implementation. Too bad we aren't close to having to deal with it practically.)
The best answer I can give regarding your specific question is in part that government shouldn't compound the injustice of licensing laws with non-objective criteria that a free market would ensure never got broad support. Should we have more such regulations, almost certainly not, but if so, only conceivably as a temporarily measure on the path towards deregulation.
The situation is similar to the creationism fight in public education. We should abolish public education, but until we do, we shouldn't permit that not-even pseudoscience from being taught as if it were a science.
I'm not sure that helps, but I hope it does. Thanks for the thoughtful question.
Gus
Thank you for your thoughtful reply.
I question your analogy between licensing laws and social security or the teaching of creationism in public schools. I understand the argument for phasing out social security, etc., and I think that the primary concern re the teaching of creationism in public schools is the issue of the separation of church and state, not so much the teaching of creationism per se, which is not banned outside of the public schools, and should not be banned, as stupid as I think it is.
I actually think that licensing laws should be abolished as quickly as possible and see no reason, other than the lack of popular and political support, for phasing them out or even for refining them or enforcing them more rigorously along more rigorous, objective, criteria (it's not as though licensing law truly do pretext us from pseudoscience or quackery). If anything, I think the requirements should be loosened if the laws are not repealed, which they should be. However, I need to think about this more. Perhaps I'll respond another time in the comments here.
Certainly, the mixed economy is very serious issue.
For now, I thought I would recommend a few things related to this issue and which you may find to be worth your while. It's quite possible that you're already familiar with them, however. Still:
1) Chapter 20 of George Reisman's Capitalism: A Treatise on Economics (He offers various proposals as to how to move towards capitalism from our mixed economy, discussing licensing laws as well, in this long, inspirational chapter.):
http://www.capitalism.net/Capitalism/Laissez-Faire%20Capitalism.htm
2) "The Real Right to Medical Care vs Socialized Medicine" (some discussion of licensing laws here as well in this lengthy essay):
https://mises.org/library/real-right-medical-care-versus-socialized-medicine
3) "Reisman vs. Binswanger on 'The Real Right to Medical Care'" by Per-Olof Samuelsson
https://perolofsamuelsson1.wordpress.com/?s=Reisman+vs.+Binswanger+on+%E2%80%9CThe+Real+Right+to+Medical+Care%E2%80%9D
Back when I first read Reisman's essay, in the 1990s, I happened across this criticism, as presented by Per-Olof Samuelsson, by Harry Binswanger of Reisman's essay: Reisman's use of the phrase "right to medical care," and his lack of emphasis on altruism as the reason that we have moved to socialized medicine and that makes licensing laws possible. I still think that Reisman's lengthy essay is worthwhile, but I agree with Binswanger's criticisms. So, I often recommend them both.
Thanks again for your thoughtful reply, and thank you for your regular blog posts, which I read regularly.
John
John,
Thanks for the recommendations.
We may be talking past each other a little here. I'm going to clarify a couple of points and leave it at that.
(1) Not allowing public schools to teach creationism is (also) an issue of separation of church and state. However, making sure standards for teaching science prohibit teaching it as science is NOT the same as banning all discussion of it within public schools (or even in classrooms).
(2) I also favor dumping licensing laws altogether. That said, I don't think that's politically viable in our culture just yet. My demand that such laws at least recognize/be based on actual science is not the same as wanting to phase them out. Until we can get rid of them, those parts that perform the kinds of functions watchdog organizations and standard-setting bodies would ideally perform should be made as similar to what they would come out with as possible.
Gus
You are very welcome, Gus, for the recommendations. I hope you find them to be worth your while.
Yes, perhaps we are talking past each other a little. We both agree that licensing laws should be abolished.
I think that the problem I have with what I understand to be your position — that as long as we have licensing laws, then they should be rigorously based upon science (which makes sense on the surface) — is that I see licensing laws as a form of regulation, and so I see your position as similar to saying that as long as we have regulations, then they should be rigorously based upon science (which also makes sense on the surface).
But then, in your more recent post, "Can Regulators Act Honestly?," you state, referencing Ayn Rand and "Public Interest" in The Ayn Rand Lexicon:
'It isn't that the power to act "in the public interest" can be used dishonestly -- It has. -- but that, as Ayn Rand notes, "it cannot be used honestly."'
Doesn't that apply to licensing laws as well?
John,
Yes. The confusion is coming from two things:
(1) As you correctly note, licensing laws, as regulations, are based on incorrect premises, such as "the public good," and so they are necessarily motivated by someone deciding what is best for the customer. At best, this hinders an individual from getting the guidance he judges best, even if it is only by establishing a government monopoly (or near-monopoly) on sources of guidance, as the education system does by taking money away from parents AND offering a "free" product that makes private education rarer and less attractive in terms of price. At worst, what's good for the consumer? What is he? An individual or part of a collective? How will different answers affect guidance from a given regulator? So, yes, even the "best" licensing laws are compromised by a contradictory premise.
(2) Often, something like licensing laws might exist in a free market, since nobody can be an expert on everything. There would doubtless be non-government entities staffed by experts who would give their imprimatur to various professionals who met their standards. So the government shouldn't license doctors or dictate educational standards, but you'd probably have something like medical licenses or accreditation instead of what we have now. In such cases, the government regulators are illegitimately subsuming a legitimate activity, just as the government wrongly runs schools -- which would exist (and be much better) in their absence. In such cases, one should rightly express opposition to the government involvement and support for it doing its job as not-badly as possible.
Note that I basing a regulation on sound science probably doesn't apply when the regulation isn't even for an activity that would occur in a free market. Cap-and-trade serves absolutely no legitimate goal, no matter how up-to-date the measurement of plant emissions might be.
Hope that makes my stand clearer.
Gus
Yo, Gus, you write, "Even if, like myself, you have always dismissed chiropractic out of hand, you will probably have an even lower opinion of it afterwards."
Thanks; that was an interesting article. Chiropractic is one of the many forms of blossoming nonsense I've simply avoided learning much about--there's so much of it out there. My one real bit of experience (third-hand at that) was a professor at Rice who was a great fan of chiropractic and several times seriously injured his back splitting wood or doing other outdoor chores after each of his latest trips to the quacktor. --In any case, by an interesting coincidence, I was sent this link by a friend, which has much of the same information about chiropractic in the course of a discussion of unnecessary surgery and other treatments of lower back pain.
Yes, Gus, that is clear. I think I understand your position. I still have questions, but I think that I should give myself time to think about it before saying anything more. Perhaps I will say more another time, here or on another of your posts. And perhaps you will writing more on this issue in the future. I hope so. It is certainly a conundrum, how to move from our mixed economy toward a free market (free society).
Thank you for taking the time to discuss this.
Enjoy your day, Gus.
John
Snedcat,
Thanks for the link.
John,
Thanks for the discussion.
Gus
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