Cancer Evolution Intelligent design/creationism Medicine Science Skepticism/critical thinking Surgery

Time to get out the paper bag or Doctor Doom mask again…



He’s baaack. Yes, that dualism-loving Energizer Bunny of antievolution nonsense, that “intelligent design” apologist neurosurgeon whose nonsense has driven me time and time again to contemplate hiding my head in a paper bag or even a Doctor Doom mask because of the shame of knowing that he is also a surgeon, that physician who denies that an understanding of evolution is important to medicine and who just doesn’t know when to quit, Dr. Michael Egnor, is back to embarrass me yet again. It’s been a long time–months, actually–and, quite frankly I found the break from his specious arguments, straw men, and misunderstandings of science to be most refreshing. Only David Kirby moving on to other pastures of woo than antivaccinationism might make me happier than Dr. Egnor’s recent sojourn into mangling neuroscience instead of evolutionary biology (a truly frightening thought, given that we would really, really hope that a neurosurgeon, of all people, should have a solid understanding of neuroscience), which left the field wide open to Steve Novella to deal with.

But you knew he just couldn’t stay away for long, and, worse, he’s muscled into my territory. That’s right, he’s blundered into the field of cancer research. In response to a call for more funding for cancer research by P.Z. Myers, whose sister-in-law died of melanoma several years ago, Dr. Egnor is in essence claiming that religion is mostly responsible for the advances in cancer treatment that P.Z. mentioned in his post.

Now I have to admit that I’ve become a bit weary of P.Z.’s anti-religion tirades. I’m not a flame-throwing, take-no-prisoners athiest, as he is. I’m not even sure I’m an agnostic. One might even say I’m confused about religion or just plain lazy and apathetic. Whatever the case, whether I’m in fact an atheist but won’t admit it to myself yet (as P.Z. once told me I was) or a closet apologist for religion just waiting for the chance to find Jesus again, I tend to call myself a “lapsed Catholic.” These days, when I see the word “atheist” or “religion” in the title or preview of a post on Pharyngula, I usually don’t bother to read the rest of it anymore. That being said, if there’s one thing that I’m totally on board with P.Z. about when it comes to flame-throwing attacks on religion, it’s when people rely on wishful thinking, superstition, and prayer rather than scientific medicine. When I find out about such cases, as my regular readers well know, I’m liable to go off on a tirade, sometimes even approaching the level of of a Pharyngu-rant. Just look up my posts on Jehovah’s Witnesses refusing blood transfusions (especially when children are involved), fundamentalist religious kooks substituting prayer for treating their diabetic daughter with insulin and thereby causing her death, patients deluding themselves that prayer is growing back a traumatically amputed limb, or physicians injecting religion into their medical practice if you don’t believe me. (Or if you really don’t believe me, read this post.) With that in mind, though, the post by P.Z. that drew Dr. Egnor’s ire was actually quite mild by Pharyngula standards. In fact, it wasn’t even specifically about religion, and there isn’t even one mention of the word “religion” in the post, although relying on prayer instead of medicine is mentioned. Instead, P.Z. pointed out how in childhood cancers survival rates today are far better than they were 30 years ago and quite correctly pointed out that this improvement is because science- and evidence-based medicine works, while alternative medicine, shamanism, pseudoscientific woo, and prayer do not. (If they did, I like to ask, wouldn’t we have always done this well against cancer?) See what I mean:

You will sometimes hear people claim that the answer is found in the natural healing power of the body, and that doctors don’t really do anything but let nature do all the work (or worse, that treatments for cancer poison people and hinder nature’s healing power). They may also say that children are just especially tough and healthy, so pediatric cancers are relatively easy…but look at the data. When doctors don’t have effective treatments and don’t intervene, we get those yellow lines from the 1960s. We get 90%+ survival when doctors can exercise their hard-earned knowledge.


It’s not just children’s cancers, either. If we want to cure adult cancers, like the melanoma that killed Karen, don’t look to magic, or wishful thinking, or ancient shamanistic wisdom, or prayer — we’ve had those for millennia, and they do nothing. What we need is more research, more doctors, more clinical trials, and more money.

Preach it, brother!

He’s exactly right in lumping together shamism, prayer, and faith healing along with the non-science-based woo, the skeptical and science-based discussion of which is one of the overarching themes of this blog and has been since the beginning, as he does here:

We must push our politicians to invest in science, and to do so sensibly. It seems that the news nowadays is full of politicians wasting their efforts on naturopathy, homeopathy, “alternative” medicine, creationism, and other pointless exercises in pandering to useless ideological feel-good nonsense.

That’s just what I’ve been saying over and over again over the last three and a half years on this blog and long before that on Usenet. Indeed, I didn’t interpret the post so much as an attack on religion (except peripherally); rather, I interpreted it as an attack on irrational and non-science-based approaches to medicine in general, with prayer as only a side issue. Not surprisingly, as is his wont, Dr. Egnor zeroes in on religion like a laser beam to the exclusion of all else. He also takes a special case and tries to generalize it to all Christianity:

But, leaving aside his dubious tactic of using the death of a relative to advance his ideology, I take exception to his claim that prayer and religious faith had nothing to do with the improvements in the treatment of cancer.

The remarkable progress in the treatment of cancer in the past several decades had a lot to do with faith and prayer. Myers misunderstands the origins of modern medical science and the history and nature of cancer treatment.

Advances in science and cancer treatment emerged, not from science in isolation, but from a culture that made science possible and that directed the fruits of scientific work toward good and compassionate goals. The culture from which science has emerged is Judeo-Christian culture, and modern science has arisen only in Judeo-Christian culture. Why has science been so closely linked to this specific culture?

The scientific investigation of nature using the scientific method depends on the metaphysical view that nature is rational and that natural laws can be discovered and used by human beings. The Judeo-Christian understanding of God and of man’s relationship to God accords with these preconditions for successful science. The application of science to care for the sick presupposes the view that we have an ethical obligation to help the weakest among us. The atheist view of metaphysics — that the universe has no purpose and no designer and no transcendent ethical code — provides no impetus to scientific inquiry or to the compassionate application of scientific knowledge. Modern science arose in Judeo-Christian culture — a milieu of faith and prayer. It arose from Judeo-Christian culture — and nowhere else — for a reason.

I’m guessing that the ancient Greeks might have something to say about that “nowhere else” part. Or even the ancient Egyptians or the Babylonians or the ancient Indians or Chinese, pre-Christian societies all. Science began long before there ever were Christians and arguably even before Judaism. True, that’s not “modern” science, but it laid the groundwork for science. Without it, modern science would likely have developed much later. Modern science, of course, began in what is often called the scientific revolution of the 16th and 17th centuries. But what also happened in that same time period? It wasn’t an increase in piety. Rather, it was the the age of Galileo, whose discoveries earned him punishment, not praise, from the Catholic Church.

Indeed, modern science didn’t truly kick into high gear until the Enlightenment, which, not so coincidentally, was a time of unprecedented questioning of religion and the time of the development of the concept of universal rights that did not depend on religion and that church and state should be separate. Religion may not always be hostile to science, but history certainly argues that it has been so often enough and over a long enough time that more often than not religion tends to hinder scientific development. Science is all about questioning and requiring evidence before accepting a statement as true; religion is about acceptance on faith because authorities teach us that a supernatural being tells us it’s true. When religion holds sway and any science that suggests that a teaching of the dominant religion is incorrect, religion tends not to meekly acquiesce. Rather, it tends to try to deny or suppress the science. We see this phenomenon to this very day with the manner in which such a well-supported theory as evolution is routinely denied and denigrated by fundamentalists espousing a literal interpretation of their holy book. Given the scope of history, it’s sure hard to argue that religion promotes scientific progress, as Dr. Egnor does. He even goes so far as to say at one point:

The scientific investigation of nature using the scientific method depends on the metaphysical view that nature is rational and that natural laws can be discovered and used by human beings. The Judeo-Christian understanding of God and of man’s relationship to God accords with these preconditions for successful science.

Actually, science does not depend on the metaphysical view that nature is rational; it depends on the metaphysical view that there is order and consistency in nature and that nature’s order can be deduced. It doesn’t really matter if one believes that God made the universe orderly or that the universe is orderly for another reason (or for no apparent reason at all). All that matters is that there be order and predictability. If there is, science is possible. If, for example, the gravitational constant changed in a totally random fashion at an unpredictable rate, Newton could never have worked out the Laws of Motion. But it doesn’t; so he could.

Of course, Dr. Egnor concentrates on the Catholic Church. I was raised Catholic. I even went to a Catholic high school, and I know that the Catholic Church is actually not so bad when it comes to science in some ways. The Church has been very good in some areas of science and pretty bad in others. For example, there was no pseudoscientific “questioning” of evolution when I was in high school. Priests taught biology and evolution straight up with no mention of God–and they taught it better than the vast majority of public schools in the area. Ditto pretty much every other science. If it weren’t for the mandatory religion classes and the weekly mass that we attended, there would have been nothing to distinguish what my high school taught from any public school. Indeed, applied science (like medicine) rarely results in many objections from the Church. One huge exception, of course, is when medical science bumps up against Catholic teachings. Think embryonic stem cell research. Then suddenly the Catholic Church isn’t so accommodating to science anymore. Like nearly all religions, when science bumps up against dogma, the Church defends dogma.

Dr. Egnor points out that the Catholic Church has long supported hospitals and caring for the sick. That’s good, and it is a long-standing tradition in the Church driven by its teachings. (Indeed, caring for the sick and poor is arguably the best aspect of the Church.) He then takes that ball and runs with it far out of bounds by trying to generalize that the Church’s teaching of “love your neighbor” was somehow responsible for the very development of science in general and the increase in cancer survival in particular. He seems to think it some great, devastating blow to P.Z. that the graphs of survival data for childhood acute lymphoblastic leukemia showing just how much better we’re doing treating this cancer now than we did 40 years ago came from St. Jude Children’s Research Hospital. He tries to make hay out of this by pointing out that St. Jude’s will take care of any patient regardless of ability to pay.

Of course, no one’s claiming that St. Jude’s isn’t a fantastic place that has contributed mightily to improving the medical care of children. It is; it’s one of the very best. But however great St. Jude’s is, its progress in treating cancer was more due to the way the Catholic Church pretty much stays out of the science–at least where the science does not conflict with Catholic dogma. I’ve found this to be true at most Catholic institutions where I have colleagues and collaborators. Indeed, not long ago I considered a job at Loyola, a Jesuit-run medical center. More than once, researchers whom I met there told me that they couldn’t do anything that involved embryonic stem cells there but that there were no other restrictions. If the cure for cancer, Parkinson’s disease, or any other disease depends on embryonic stem cells, it certainly isn’t going to be discovered at a Catholic institution, and if such a cure is developed elsewhere it almost certainly won’t be offered to patients at Catholic hospitals.

Egnor then goes off the deep end:

When science is explanted from Christian culture and is idolized–consider evolutionary psychology and eugenics–it becomes banal and even evil.

Dr. Egnor appears to be channeling Ben Stein here. He’s just one step away from Ben Stein’s statement that science leads inevitably to killing people. I bet it’s coming in a future post.

Medical science inspired by Judeo-Christian values has given us St. Jude’s Hospital, St. Mary’s Hospital (at the Mayo Clinic), Presbyterian Hospital (at Columbia, my alma mater), and thousands of other hospitals with names like St. Joseph’s, St. Vincent’s, St. Luke’s, St. John’s, St. Agnes, St. Anthony, St. Barnabas, St. Catherine, St. Clares, St. Charles, St. Elizabeth, St. Francis, St. James, St. Jerome, St. Peter, St. Margaret, Mary Immaculate, Our Lady Of Lourdes, Our Lady Of Mercy, Sisters Of Charity, Lutheran, Methodist, Baptist, Mt. Sinai, Maimonides, Beth Israel, Jewish Memorial, Holy Cross, Scared Heart, Mercy, and Good Samaritan. Where are the hospitals founded on Myers’ atheist principles? What medical advances has hatred for Judeo-Christian values given mankind?

Talk about a false dilemma! To Egnor, apparently, it’s either religion or hatred of religion. Science is either Judeo-Christian or it’s his overblown parody of religion-hating “militant” atheism, with no middle ground. In any case, altruism and caring for each other are almost certainly hard-wired into our biology; religion is simply one post hoc explanation and justification for this natural tendency of humans. Dr. Egnor’s question is the wrong question anyway. In fact, I’d answer Dr. Egnor’s question with a question after noting that all the religious-affiliated hospitals and medical centers that he mentions above are all, as far as I know, associated with moderate religions. So, I’d ask Dr. Egnor, instead: What medical advances has fundamentalist religion ever given mankind? I’ll wait. The very success of the religious hospitals listed above is because, for the most part, they do not interfere with the scientific research or the science of taking care of patients. The religion is there for comforting patients and trying to provide medical care for them regardless of whether they can pay or not, which is as it should be. If all religious organizations were like the hospitals listed above, there’d be very little reason to have a problem with them. In any case, the religious aspect of the above hospitals is not there to inform the science, and when it does even address the science at all it’s more likely to suppress any science that conflicts with religion, such as the use of embryonic stem cells.

In addition, secular science has produced many, many medical advances, and the vast majority of medical schools were not founded by a religion at all. Some examples include the University Hospitals of Cleveland, the University of Michigan, and the University of Chicago, all institutions where I trained at one point and none of them founded by clergy or a church. There are many others, such as the Cleveland Clinic, Harvard, UCSF, Stanford, the University of Texas M.D. Anderson Cancer Center, Memorial Sloan-Kettering Cancer Center, the National Institutes of Health, George Washington University, and many others. Then there are institutions that were originally formed as religious but have since–I can’t resist–evolved to be completely secular. Yale University comes to mind. The bottom line is that there is nothing inherent in a “religious culture” that leads to science–and much in a religious culture that holds science back, as science is frequently threatening to religion, particularly fundamentalist religion, to which science is most threatening of all. In actuality, medical science thrives in a secular environment. No religion is necessary, just a desire to help one’s fellow human being and a commitment to the scientific method.

Now where was that Doctor Doom mask again?

In the meantime while I’m looking for that mask, if Dr. Egnor wants a real anti-religion rant to get upset about he should read P.Z.’s response to his nonsense.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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