The term “conspiracy theory” summons images from The X-Files and the stories of Thomas Pynchon. But as I argued in my 2011 HarperCollins book, Among the Truthers, conspiracy theories can have real and corrosive effects on the marketplace of ideas and on the political sphere that depends on it. How, for instance, does one have an intelligent debate about national security policy with someone who believes 9/11 was an “inside job” hatched by Dick Cheney? How does one have an intelligent discussion about U.S. domestic politics with someone who thinks Barack Obama is an illegal alien who was born in Kenya?
In the medical realm, the pernicious effects of conspiracy theories are especially tangible. Consider the 30-year-old conspiracy theory that the U.S. Army created AIDS at its Fort Detrick, Maryland testing facility as part of a genocidal plan to kill black people. In a 2010 study of 214 Los Angeles-area African-American men undergoing treatment for HIV, 31 per cent of respondents said that AIDS “is a form of genocide, or planned destruction, against blacks.” The study found that a belief in such AIDS conspiracy theories correlates negatively with adherence to prescribed antiretroviral drug regimens.
In the domain of medicine, conspiracy theories can have life-and-death consequences.
Common conspiracy theory ‘threads’
In the course of my research, I have met people who believe a bewildering range of conspiracy theories – from Holocaust deniers, to followers of David Icke (who promotes the idea that our political leaders are the terrestrial manifestations of giant inter-dimensional space lizards), to the vaccine-related conspiracy theories described below. Yet all of these theories, I concluded, are bound together by two main elements:
1) Evil. Except in rare cases, conspiracy theories purport to address the problem of evil in the world and, more specifically, the age-old question of why bad things happen to good people (the branch of thought known to theologians as theodicy). In this sense, conspiracism acts as a secular replacement for supernatural devil figures, projecting responsibility for human suffering onto Jews, Freemasons, the New World Order or other more obscure villains. This aspect of conspiracism explains why conspiracy theories always proliferate in the shadow of mass human-suffering events or sociologically traumatic expressions of evil such as World War I, the Holocaust, the assassination of JFK, 9/11 and the AIDS epidemic of the 1980s. On a personal level, conspiracy theories often are embraced by people afflicted with private traumas such as a bankruptcy or (as discussed in more detail below) a medical catastrophe.
2) Distrust. Conspiracy theories reflect widespread distrust in powerful institutions – including not only national governments, but also NGOs, the United Nations, the mass media and the health-care industry. Many 9/11 conspiracy theorists, for instance, told me that the defining moment in their political evolution came when U.S. forces failed to find weapons of mass destruction following the 2003 invasion of Iraq. “The government lied to us – and I wanted to find out what else they were lying about” was a common refrain. Of course, all citizens rightly treat government pronouncements with a degree of skepticism, but for hard-boiled conspiracy theorists, this skepticism becomes all-encompassing – and the entire world of politics, mass media and even public health is seen as one giant lie.
The Fort Detrick AIDS thesis, described above, is one example of how these two elements – distrust and the need to explain human suffering – combine to produce a stubbornly popular conspiracy theory that inhibits life-saving medical therapies. Another example lies with anti-vaccine activists who falsely claim a proven linkage between the widely administered MMR (measles, mumps and rubella) vaccine and autism spectrum disorder.
Conspiracy theories about the medical world
Of all the medical conspiracy theories that traffic on the Internet, this is one of the most durable and widespread – in large part thanks to the advocacy of celebrity laypersons such as former Playboy model Jenny McCarthy. Since 1998, when the theory was first put forward in a study published in the Lancet medical journal (subsequently retracted in 2010 and further discredited by a detailed investigation by journalist Brian Deer, untold millions of parents across the Western world have avoided vaccinating their children, leaving them exposed to deadly, and entirely preventable, diseases such as measles, whooping cough and Hib influenza.
Vaccines typically are administered to small children in the first two years of life, at around the same time that the first behavioral symptoms of autism manifest themselves. Many doctors believe autism is a genetic disorder programmed into a child’s brain before birth. But parents cannot see their child’s genes. What they can see are the steel needles injecting a mysterious foreign substance into their then-apparently-perfect bundles of joy. When this experience is closely followed by a devastating diagnosis, many parents forge a link between the two experiences – a link that, as many will confess quite candidly, can never be shaken by science.
The myth that vaccines cause autism permits emotionally vulnerable parents to blame politically accountable, human evildoers – the big pharmaceutical companies and their apologists at the Food and Drug Administration (FDA) and Health Canada – for a trauma that might otherwise be seen as a mere act of God. The myth thereby allows them to substitute their frustration and disappointment with the more psychologically manageable emotion of anger.
Such myths provide another psychotherapeutic dividend: hope. The debunked vaccine-autism link is actually two conspiracies in one. Not only have McCarthy and her followers argued that the medical establishment is covering up evidence that its drugs are harming children’s brains, they also promote the piggyback conspiracy theory that vitamins and other natural remedies can be used to “heal” the damage done by vaccines and that this cure is falsely discredited by the very same medical establishment evildoers.
Other conspiracists I have interviewed have experienced other forms of harrowing, life-threatening medical crises. These stories tend to follow the same pattern: Doctors tried to cure their condition with expensive drugs and painful surgical procedures – but failed. It was only once they had turned to a “natural” cure – faith healing, homeopathy, Gerson Therapy (a crackpot diet-based cancer treatment), and so forth – that their condition went away. In the aftermath of this experience, they become convinced that profit-obsessed pharmaceutical companies and the medical establishment have been conspiring to prevent ordinary citizens from discovering the power of these natural cures.
Fears of fluoridation
Of course, such theories have been around for generations. The campaign against water fluoridation, for instance, has been suffused with conspiracist themes since the practice became widespread in the 1950s.
Far from being a dangerous toxin, fluoride is a naturally occurring element in many communities’ water supplies. This is how the United States Public Health Service first noticed the correlation between fluoride and tooth-decay prevention in the 1930s. Mainstream scientists judged the practice to be safe; and over the last 60 years, numerous epidemiological studies have done nothing to shake this consensus.
Yet from the beginning, scattered activists became bothered by the idea that the government was adding something, anything, to their drinking water. As Gretchen Ann Reilly reported in the 2004 book “The Politics of Healing,” these often were the same activists who objected to mass polio vaccination: Both public-health campaigns tapped into the same instinctive human fear surrounding body integrity.
The fact that mainstream scientists supported fluoridation did little to discourage such activism: Paranoiacs such as Dr. Leo Spira — author of the wonderfully titled “The Drama of Fluorine: Arch Enemy of Mankind” — argued that all the major laboratories, journals and research institutions had entered into a grand conspiracy to suppress dissenting views (much in the same way that today’s climate-change skeptics imagine a similar conspiracy afoot in regard to anthropogenic global warming).
The Internet has turbocharged the spread of such conspiracy theories by permitting their propagandists to create blogs — complete with high-quality video propaganda – that speak directly to patients stricken with specific health conditions. Doctors I have interviewed describe their frustration in dealing with such patients, who often arrive at medical appointments with thick dossiers of printouts from their favourite Web sites.
Arguing with these patients can be difficult. In many cases, they are so psychologically invested in their conspiracy theories that they reject or ignore any argument offered on behalf of mainstream medical science, no matter how compelling the available peer-reviewed medical data may be. The result: frustration for the practitioner and increased health risks for the patient.
So, how can medical practitioners combat the spread of conspiracy theories?
Let me answer that question by reference to the two ingredients in all conspiracy theories: evil and distrust. Obviously, doctors cannot put an end to the former, but they can do something to abate the latter.
The medieval views of Ms. Suzanne Somers
By way of explanation, it is worth considering a particular case study – that of Three’s Company sitcom star and ThighMaster pitchwoman, Suzanne Somers, a breast-cancer survivor who has become an outspoken critic of chemotherapy, conventional cancer drugs and mainstream oncology more generally.
In her 2009 alternative medicine manifesto, Knockout: Interviews with Doctors Who are Curing Cancer, and other best-selling books, Somers follows in the path of other alternative medicine advocates by describing the human body in essentially medieval terms. According to this view – of which there are endless variations, each with its own cult following and mail-order industry – we all have a natural energy field that becomes compromised when exposed to artificial Western foods, medicines and medical therapies. Vitamins, obscure extracts, oils, balms, herbs and meditation are presumptively good. Prescription drugs, radiological treatments and surgical interventions are presumptively bad. It is a distinction upon which Somers herself is willing to stake her life: She tells readers that, if again faced with a cancer diagnosis, “my choice overwhelmingly would be to use only alternative treatments.”
Knockout promotes a variety of dubious therapies – such as laetrile, an apricot extract that was proven ineffective decades ago, and the Gonzalez protocol, a regimen involving twice-daily coffee enemas (you read that correctly). If only the medical establishment and the FDA took these treatments seriously, Somers argues, researchers would receive the funds needed to prove their effectiveness. Instead, the health-care industry and its cynical government allies conspire behind closed doors to protect the cash cow of conventional cancer therapies.
Somers’ case against conventional cancer treatments is built around her own (admittedly accurate) observation that such treatments often are painful and debilitating. Specialists assure her that this pain and debilitation is worth the sacrifice in the long run. But following that advice is an act of trust. And as noted, trust is something that conspiracy theorists hold in short supply. And so, patients such as Somers follow the only thing they do trust: their five senses – a path that more often leads them to herbs, roots and special spas than to the pharmacy or hospital.
As maddening as all this may seem to trained medical professionals, these trends speak to powerful psychological forces that affect a large swathe of the population. Indeed, the pervasive influence of amateur Internet-circulated media, coupled with survey results that show steadily increasing levels of popular distrust in all public institutions, suggests the problem may get worse.
The most viable strategy for medical professionals to use to address this trust deficit is building trust at a personal level with patients who are at risk of embracing conspiratorial views of the health sciences. By
creating strong person-to-person relationships with patients, doctors and other practitioners can escape the jaded attitude that many people exhibit toward the medical establishment in general. Doctors and hospitals might also facilitate the creation of support groups of similarly situated patients who can speak to one another on a peer-to-peer basis about the beneficial effects of their therapies.
Obviously, the best approach to such trust building will differ on a case-by-case basis, but in general, I would say that such an approach would de-emphasize appeals to statistics and epidemiology and highlight case studies that speak directly to the patient’s circumstances. Doctors might also choose to couch their recommendations in references to the knowledge they have gained in their clinical practice, since such information is more difficult to dismiss as industry propaganda.
Many patients who come to embrace conspiracy theories do so because they were proselytized by someone within their own trusted circle of contacts – a relative, neighbour or fellow parent in the schoolyard. If a doctor can gain a comparable level of social trust through an ongoing checkup and treatment regimen, he or she will be in a position to advocate on an equal footing for evidence-based medicine and thereby help patients avoid the conspiracy theories that are doing a brisk and dangerous trade in the medical marketplace of ideas.
Jonathan Kay is Managing Editor for Comment at the National Post, and the author of Among The Truthers (HarperCollins, 2011). His columns appear online at www.fullcomment.com.