Skeptical Pearls #2: Beware the Testimonial…..
Faster than a speeding case report. More powerful than a double-blind, placebo-controlled study. Able to leap peer review in a single bound. Look! Up on the internet! It’s a story. It’s an anecdote. It’s a testimonial!
Every implausible and unproven quack therapy, from acupuncture to quantum healing, comes bearing testimonials of its effectiveness. These stories are typically brief, to the point, extremely powerful and, across the board, absolutely worthless. To anyone with a decent skeptical filter in place, the reliance on testimonials is an obvious sign of a complete lack of credible support for one’s claims. Yet to far too many people there is no introductory phrase more meaningful than “In my experience”. And no amount of published contradictory data or number of explanations from critically minded experts can match the effect from just one of the seemingly neverending supply of these uncontrolled, unblinded, and often tall, tales.
Sadly, even outright harm and suffering, or the complete lack of achieving the claimed benefit, are often unable to shake the faith of one who has stepped over the line that seperates credulity from a more critical approach to one’s health. It is far too easy to rationalize away these failures, placing the blame on themselves or the medical community, when the stranger whose gout was cured by taking goat urine supplements is trusted more than the family doctor. Perhaps the believer doesn’t realize that the near totality of the testimonials seen on television or on the internet are fabricated. Maybe they don’t realize that a significant number of them, as is often the case with fraudulent cancer cures, even when provided by real people are found to be the former words of the now deceased, victims of their disease process, their lack of critical thinking skills, and the bastards profiting off of them. It is more likely, however, that the undue influence of testimonials is hard-wired in the human brain, a remnant of something which at one point bestowed a survival advantage on our primitive ancestors.
There is a reason why quacks rely on testimonials. And that is because they don’t have science in their corner. Sure they will jump on poorly designed studies, usually coming out of the National Center for Complementary and Alternative Medicine and published in biased pseudojournals, and tout them as proof of their legitimacy. But they will just as quickly denigrate methodological naturalism and the methods of so-called “western science” when better studies come along revealing their pet delusion to be a charade. The testimonial circumvents this problem, rendering science irrelevant. This is a recipe for disaster, or at the very least a lighter wallet.
Proven treatments don’t need stories. In my line of work I often am faced with parents who refuse recommended practices such as vaccines and the administration of intramuscular vitamin K for newborns. When I am discussing the care of a child with parents, and presenting them with treatment options or evidence-based prophylaxis regimens, I don’t tell them about the time I used a particular treatment and how it cured the patient, or how I had this one kid who suffered a poor outcome because they didn’t get something I recommended. There are too many uncontrolled variables in most clinical situations to trust such anecdotes. I have to rely on good data, which should not consist of anecdotes regardless of how many I might collect over my career. I would be no better than the quacks I often rant about were I to attempt to manipulate parents with emotional testimonials.