Why do people fall for ‘snake oil’ products, those claimed to provide miracle cures and quick fixes for various problems, perceived and real: excess weight, wrinkles and other cosmetic ravages of aging, and of course, pain? Yet, such claims are not supported by scientific evidence, and the claimed effects fail to materialize. Nevertheless, many businesses thrive on selling snake oil products and therapies: weight loss pills, wrinkle creams, pain reduction therapies, and the like.
I have been reading an excellent book, Snake Oil Science: The Truth about Complementary and Alternative Medicine, by biostatistician R. Barker Bausell (Oxford University Press, 2007). While serving as the director of research of Complementary Medicine Program (now the Center for Integrative Medicine) at the University of Maryland for five years, Dr. Bausell designed and supervised randomized clinical trials on whether acupuncture and other complementary therapies did increase physical functioning and reduce pain for several medical conditions.
Barker Bausell’s overall conclusion is: acupuncture and other complementary medicine therapies do not reduce pain. Yet, the patients participating in the clinical trials perceived reduced pain, whether they received actual treatment or a placebo (a fake procedure that merely pretended to provide the effect of the actual therapy). This is called the placebo effect: patients perceive reduced pain when they merely believe that they are receiving a treatment. But because there is no actual treatment, the placebo effect does not last: the patients’ pain returns, or other medical conditions remain.
While Dr. Bausell’s research was about complementary and alternative medicine (CAM) therapies such as acupuncture and homeopathy, the placebo effect seems to extend to other products—weight loss pills and anti-wrinkle creams—that claim to solve problems that people desperately want to fix. Discussing belief in CAM therapies, Bausell hits the nail in the head (p. 125):
“If we believe in CAM therapies, then they will most likely work for us. If they don’t work for us, then we will find a reason for this failure and continue to believe in them—thereby prohibiting reality from conflicting with our beliefs.”
According to Dr. Bausell, scientists are not immune to the placebo effect, either: it is hard for them to remain objective, and “much of the results they [their research] produce are influenced by their personal beliefs and expectations.” But, reassuringly, Bausell concludes that the truth is out there—we just need to dig for it when searching for therapies and products to address our problems.
We know from Aristotle, Francis Bacon, Ayn Rand, and a few other philosophers that to achieve values, whether a cure for a medical condition, a healthy weight, or anything else, we must adhere to reality. Mere pretending or wishful thinking will not yield those values. Yet the placebo effect remains hard to resist, because we want to believe, in the absence of evidence or even in the face of conflicting evidence, in snake oil products and therapies.
This is what all snake oil businesses count on: our gullibility—our willingness to abandon reason for unsubstantiated belief. Yet, as those philosophers have shown, going on blind belief and not adhering to reality is hazardous to our survival and flourishing. It is one thing to waste our money on harmless but ineffective skin creams, but entirely other thing to swallow potentially harmful diet pills or to abandon conventional—science-based—medicine and depend on CAM therapies and products instead. Wasting our money on harmless but ineffective products and therapies deters us from achieving real values, but consuming harmful products or relying solely on unproven therapies can be fatal.
(I am not suggesting that all snake oil businesses are ruthless exploiters of our gullibility; many of them are true believers themselves, which makes them more dangerous. Their sincere belief in their products is more likely to persuade their customers than a conniving predator is.)
So what are we as potential customers of snake oil companies to do, when we have a real need to solve problems their products claim to overcome?
Regarding health problems and CAM therapies, Barker Bausell offers this advice: always consult your physician first, to find out if there are science (reality) based medical therapies available for your problem. If yes, they should be chosen. If not, ask the physician what CAM therapies he might recommend. They might be used sequentially, to benefit from the placebo effect until it wears out, then moving on to the next one while waiting for the discovery of a reality-based solution.
This method of finding out whether there is science-based real evidence should be applied to evaluating other snake oil products as well.
In an ideal world, businesses (and scientists) would be spending their resources developing not snake oil products but real ones that would fulfil real needs and provide real value. But as long as there is demand for (willingness-to-buy) snake oil products there will be snake oil businesses, to the detriment to us all, except for the fleeting placebo effect.
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