Boredom. Daily practice can
become humdrum. Pseudoscientific ideas can be exciting. The late Carl
Sagan believed that the qualities that make pseudoscience appealing
are the same that make scientific enterprises so fascinating. He said,
"I make a distinction between those who perpetuate and promote
borderline belief systems and those who accept them. The latter are
often taken by the novelty of the systems, and the feeling of insight
and grandeur they provide" [1] Sagan lamented the fact that so
many are willing to settle for pseudoscience when true science offers
so much to those willing to work at it.
Low professional esteem.
Nonphysicians who don't believe their professions is sufficiently
appreciated sometimes compensate by making extravagant claims. Dental
renegades have said "All diseases can be seen in a patient's
mouth." Fringe podiatrists may claim to be able to judge health
entirely by examining the feet. Iridologists point to the eye,
chiropractors the spine, auriculotherapists the ear, Registered Nurses
an alleged "human energy field," and so on. Even physicians
are not immune from raising their personal status by pretension. By
claiming to cure cancer or to reverse heart disease without bypass
surgery, general physicians can elevate themselves above the highly
trained specialists in oncology or cardiology. By claiming to heal
diseases that doctors cannot, faith healers advance above physicians
on the social status chart (physicians are normally at the top of the
chart while preachers have been slipping in modern times).
Psychologists, physicians, actors, or others who become health gurus
often become darlings of the popular press.
Paranormal tendencies. Many
health systems are actually hygienic religions with deeply-held,
emotionally significant beliefs about the nature of reality,
salvation, and proper lifestyles. Vegetarianism, chiropractic,
naturopathy, homeopathy, energy medicine, therapeutic touch, crystal
healing, and many more are rooted in vitalism, which has been defined
as "a doctrine that the functions of a living organism are due to
a vital principle ["life force"] distinct from
physicochemical forces" and "the theory that biological
activities are directed by a supernatural force." [2,3] Vitalists
are not just nonscientific, they are antiscientific because they abhor
the reductionism, materialism, and mechanistic causal processes of
science. They prefer subjective experience to objective testing, and
place intuitiveness above reason and logic. Vitalism is linked to the
concept of an immortal human soul, which also links it to religious
ideologies [4].
Paranoid mental state. Some
people are prone to seeing conspiracies everywhere. Such people may
readily believe that fluoridation is a conspiracy to poison America,
that AIDS was invented and spread to destroy Africans or homosexuals,
and that organized medicine is withholding the cure for cancer.
Whereas individuals who complain about conspiracies directed toward
themselves are likely to be regarded as mentally ill, those who
perceive them as directed against a nation, culture, or way of life
may seem more rational. Perceiving their political passions are
unselfish and patriotic intensifies their feelings of righteousness
and moral indignation [5]. Many such people belong to the world of
American fascism, Holocaust deniers, tax rebels, the radical militia
movement, and other "libertarian" causes. Liberty Lobby's
newspaper The Spotlight champions such causes and also promotes
quack cancer cures and attacks fluoridation.
Reality shock. Everyone is
vulnerable to death anxiety. Health personnel who regularly deal with
terminally ill patients must make psychological adjustments. Some are
simply not up to it. Investigation of quack cancer clinics have found
physicians, nurses, and others who became disillusioned with standard
care because of the harsh realities of the side effects or
acknowledged limitations of proven therapies.
Beliefs encroachment . Science
is limited to dealing with observable, measurable, and repeatable
phenomena. Beliefs that transcend science fall into the realms of
philosophy and religion. Some people allow such beliefs to encroach
upon their practices. While one may exercise religious or
philosophical values of compassion, generosity, mercy and integrity
(which is the foundation of the scientific method's search for
objective truth), it is not appropriate for a health professional to
permit metaphysical (supernatural) notions to displace or distort
scientific diagnostic, prescriptive or therapeutic procedures.
Individuals who wish to work in the area of religious belief should
pursue a different career.
The profit motive. Quackery can
be extremely lucrative. Claiming to have a "better
mousetrap" can cause the world to beat a path to one's door.
Greed can motivate entrepreneurial practitioners to set ethical
principles aside.
The prophet motive . Just as Old
Testament prophets called for conversion and repentance, doctors have
to "convert" patients away from smoking, obesity, stress,
alcohol and other indulgences [6]. As prognosticators, doctors
foretell what is going to happen if patients don't change their way of
life. The prophet role provides power over people. Some doctors
consciously avoid it. They encourage patients to be self-reliant
rather than dependent, but in doing so they may fail to meet important
emotional needs. Quacks, on the other hand, revel in, encourage, and
exploit this power. Egomania is commonly found among quacks. They
enjoy the adulation and discipleship their pretense of superiority
evokes.
Psychopathic tendencies. Studies
of the psychopathic personality provide insight into the
psychodynamics of quackery. Dr. Robert Hare who investigated for more
than twenty years, states, "You find psychopaths in all
professions. . . the shyster lawyer, the physician always on the verge
of losing his license, the businessman with a string of deals where
his partners always lost out." [7] Hare describes psychopaths as
lacking a capacity to feel compassion or pangs of conscience, and as
exhibiting glibness, superficial charm, grandiosity, pathological
lying, conning/manipulative behavior, lack of guilt, proneness to
boredom, lack of empathy, and other traits often seen in quacks.
According to Hare, such people suffer from a cognitive defect that
prevents them from experiencing sympathy or remorse.
The conversion phenomenon . The
"brainwashing" that North Koreans used on American prisoners
of war involved stress to the point that it produced protective
inhibition and dysfunction. In some cases, positive conditioning
causes the victim to love what he had previously hated, and
vice-versa; and in other cases, the brain stops computing critically
the impressions received. Many individuals who become quacks undergo a
midlife crisis, painful divorce, life-threatening disease, or another
severely stressful experience. The conversion theory is supported by a
study of why physicians had taken up "holistic" practices.
By far the greatest reason given (51.7%) was "spiritual or
religious experiences." [8]
