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Where’s the criticism?

 •  • by Paul Ingraham
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Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

A savvy reader noticed a well-known manual therapy brand making blatantly extraordinary claims of healing prowess on their posh, slick website. He went looking for critique, and found nothing at all, not even here on — well-known for debunking and “negativity.” So he wrote to ask:

How do they get away with that? How can a significant brand in healthcare be so well-insulated from criticism?

Simple: because it’s legally dangerous to criticize brands in general, and even worse in this field, where bullshit abounds and skins are thin.

About half the serious anti-quackery activists I know have been sued at least once, and nearly all have been threatened or significantly harassed in some way. The danger is real. It doesn’t matter how right you are or how ridiculous the legal claim is: it’s expensive to fend off a determined SLAPP — strategic lawsuit against public participation — because that’s the whole point of them. There are anti-SLAPP laws in many places around the world now, so it’s getting better, but it’s still tricky and risky, especially because plaintiffs can often find a way to sue in a jurisdiction without anti-SLAPP laws (or ones with significant loopholes).

The successful snake oil brands also excel at creating social media echo chambers, where the only people tuned in are the “true believers” and a discouraging word is never permitted, swarms of the faithful who will gleefully attack anyone who challenges their hive of dogma. I know several people who make a hobby of being voices of reason in such places, but usually all that comes of it is a quick block, their comments deleted. The idea is that such interventions are for the benefit of less militant observers — they witness someone disagreeing for reasonable reasons, and they might start to notice the problems with the brand.

Maybe. I applaud the effort, but I would rather stick my hand in a blender than be that kind of activist myself. I’ll stick to reviewing therapy claims in principle, rarely pointing at specific brands, or only quite strategically chosen ones (like ones that already have much more serious problems than critical bloggers). Most educated people already know the major examples anyway…and/or they can easily pick out the red flags themselves.

Have a look at John Oliver’s comedic reporting on SLAPP suits. It’s more fun than mine (obviously).

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