Veterinary medicine is a science-based profession. Taken by veterinary graduates in North America, the Veterinarian’s Oath begins, “I solemnly swear to use my scientific knowledge and skills for the benefit of society.”1 The centrality of science and scientific evidence is similarly acknowledged in statements of principles and ethics by veterinary organizations around the world.2-4 Modern veterinary practice relies on science to develop the tests and treatments we use and guide their application. Scientific research has enabled tremendous improvements in human and animal well-being, and it is indisputably the most effective means of understanding the natural world we have. Unfortunately, the role of science as a source of knowledge—in health care and many other domains—is too often controversial. The scientific approach is sometimes threatening to people committed to other ways of validating their beliefs, whether organized philosophical or religious traditions or simply our individual life experiences. Also, the tools for manipulating nature that scientific knowledge allows us to develop can be misused or are harmful, and negative views of some of these tools can lead people to view science and technology in general with suspicion or mistrust. Mistrust of science and disdain for scientific expertise, especially when applied to public policy, has become depressingly widespread in our society. Too many people have become convinced that either scientists cannot be trusted or that every individual can become a self-taught expert in any subject with sufficient motivation and an internet connection. As a result, scientific expertise has lost much of its influence in the public sphere. This has grave consequences. COVID: Unnecessarily devastating The resurgence of preventable infectious disease due to declining vaccination has been the most prominent example of this for years.5-11 However, the current COVID pandemic has taken pride of place as the clearest and most brutal example of the consequences of anti-scientific attitudes and behavior. Tens of thousands, perhaps hundreds of thousands of people, have experienced illness and death unnecessarily due to the refusal of their neighbors and their governments to heed the expertise of public health scientists and take appropriate measures to prepare, prevent, and respond to a pandemic. Voices expressing doubt and contempt toward science have gone from the fringes to the center of society with devastating consequences. Prominent anti-scientific beliefs hampering our ability to deal with COVID include claims that:12-15 The virus and pandemic are mere hoaxes The virus was manufactured or released deliberately The morbidity and mortality rates have been intentionally exaggerated Face masks are useless or even cause harm to one’s health Unproven or disproven treatments can prevent or cure COVID, from hydroxychloroquine to oleander extract, homeopathy to herbal remedies The rejection of the scientific approach to COVID has been so severe that up to 50 percent of people surveyed in some countries have already decided they will not accept a coronavirus vaccine when one is developed.16-18 Public health officials fighting the pandemic have been threatened, and many have had to accept bodyguards or have simply left their jobs.19-21 As members of a scientific profession, veterinarians ought to be somewhat resistant to such anti-scientific views and beliefs. Any sufficiently large group, of course, is bound to have a few outliers, individuals whose commitment to some ideology or belief system outweighs their scientific training. However, outright anti-scientific views about COVID and many other health-care issues should have difficulty taking root in members of a health-care profession such as ours. Shouldn’t they? The danger of outliers Unfortunately, such views have long been present in veterinary medicine. A small, but passionate, subset of veterinarians routinely denounces scientific veterinary medicine as worthless or actively harmful, and promote alternative approaches for diagnosing and treating disease. These veterinarians not only rely on untested, unproven, or demonstrably useless methods such as homeopathy, energy medicine, esoteric diets, herbal remedies, and many others, but they promote these by claiming the vaccines, medicine, foods, and other interventions developed and supported by scientific research cause disease more than prevent or treat it.22,23 Too many people have become convinced that either scientists cannot be trusted or that every individual can become a self-taught expert in any subject with sufficient motivation It is easy to dismiss such claims as mere differences of opinion or to write off such individuals as outliers. They are not numerous, and even most other proponents of the same alternative therapies don’t go so far in rejecting science and scientific approaches. However, these individuals are one end of a continuum of anti-scientific thinking that has led us to the crisis we face today. This is illustrated quite clearly in the promotion of myths and misinformation about COVID by some veterinarians. Members of our profession are publicly calling the pandemic a hoax, suggesting the rates of illness and death are exaggerated, blaming Wi-Fi or Bill Gates for COVID, and denouncing masks or any potential vaccine, all while promoting unproven or disproven therapies for COVID, including homeopathy, ozone, exotic diets, and herbal remedies.24-32 Nearly all these individuals have a history of disparaging science-based veterinary medicine and promoting alternative therapies. The association is not accidental, but rather a reflection of a world view that mistrusts and misconstrues science, and privileges personal experience, historical tradition, intuition, and revelation over empirical research as methods for understanding health, disease, and the effects of our interventions. There is room for plenty of difference of opinion in veterinary medicine. The evidence is far from strong enough to define a clear standard of care for most situations. And novel or untested treatments deserve to be carefully and fairly evaluated scientifically. The use of as-yet unproven therapies can be completely appropriate and consistent with a science-based perspective when the evidence is incomplete and the need is great enough. Evidence-based medicine can be a pretty big tent. However, there is real knowledge and actual facts about the disease we treat and the methods we use, and this comes from science. Personal experience and anecdote are useful as generators of hypotheses and to help us when we have no better source of knowledge, but they are deeply unreliable and prone to bias. When there is high-quality scientific evidence available, we must be prepared to abandon beliefs and practices contradicting that evidence. Clinging to our experiences, intuitions, and habits in the face of better sources of knowledge is an abdication of our responsibilities as members of a science-based profession. Promoting pseudoscience and attacking real science is not brave or a sign of independence or critical thinking. It is counterproductive and dangerous, as the current COVID crisis illustrates. Anti-scientific views, such as anti-vaccine ideology and promotion of disproven or pseudoscientific therapies, are not mere curiosities or legitimate differences of opinion. They are a direct attack on the scientific approach, and we are now seeing this has consequences. As a profession based on science, we have a responsibility to resist the encroachment of such views and adhere to the scientific approach, which has more than proven its value. In most of my columns, I always try to provide practical information and evidence regarding specific tests or treatments. However, I also have the underlying goal of promoting science-based medicine and pushing back against the lowering of standards of evidence and the acceptance of unscientific views and methods. Myths and misinformation about COVID coming from veterinarians who routinely promote these views and methods is a reminder this work is needed, and that we all have to think critically and carefully about the central role of science in veterinary medicine, now and in more normal times. References American Veterinary Medical Association. Veterinarian’s Oath. https://www.avma.org/resources-tools/avma-policies/veterinarians-oath. Published 2010. Accessed August 23, 2020. Federation of Veterinarians of Europe. European Veterinary Code of Conduct. Brussels; 2017. www.quartiergraphique.be. Accessed August 21, 2020. Australian Veterinary Association. Improving animal welfare. https://www.ava.com.au/policy-advocacy/advocacy/improving-animal-welfare/. Published 2020. Accessed August 23, 2020. RCVS Knowledge, Sense About Science. EVIDENCE-BASED VETERINARY MEDICINE MATTERS. London; 2019. https://wordpress-398250-1278369.cloudwaysapps.com/wp-content/uploads/2019/11/Evidence-based-veterinary-medicine-matters.pdf. Accessed August 23, 2020. Wolfe RM, Sharp LK. Anti-vaccinationists past and present. BMJ. 2002;325(7361):430-432. doi:10.1136/BMJ.325.7361.430 Larson HJ, de Figueiredo A, Xiahong Z, et al. The State of Vaccine Confidence 2016: Global Insights Through a 67-Country Survey. EBioMedicine. 2016;12:295-301. doi:10.1016/j.ebiom.2016.08.042 Hussain A, Ali S, Ahmed M, Hussain S. The Anti-vaccination Movement: A Regression in Modern Medicine. Cureus. 2018;10(7):e2919. doi:10.7759/cureus.2919 Lengyel K. Anti-Vaccination Movement Going to the Dogs? Am Vet. August 2017. Clifton J. Stop the Shots! : Are Vaccinations Killing Our Pets? New York, NY: Foley Square Books; 2007. Kluger J. Some Anti-Vaxxers Aren’t Getting Their Pets Vaccinated. Here’s Why That’s So Dangerous. Time.com. March 2019. Duan N. Inside the World of Pet Anti-Vaxxers. The Awl.com. January 2018. U.S. Food and Drug Administration. Fraudulent Coronavirus Disease 2019 (COVID-19) Products. https://www.fda.gov/consumers/health-fraud-scams/fraudulent-coronavirus-disease-2019-covid-19-products. Published 2020. Accessed August 23, 2020. Ian Freckelton QC. COVID-19: Fear, quackery, false representations and the law. Int J Law Psychiatry. July 2020:101611. doi:10.1016/j.ijlp.2020.101611 Wikipedia. List of unproven methods against COVID-19. Wikipedia. https://en.wikipedia.org/wiki/List_of_unproven_methods_against_COVID-19. Published 2020. The Coronavirus Collection: Fact-Checking COVID-19. Snopes.com. https://www.snopes.com/collections/new-coronavirus-collection/. Published 2020. Accessed August 23, 2020. Hern A. Nearly one in six Britons would refuse Covid-19 vaccine – survey. The Guardian. July 6, 2020. Cornwall W. Just 50% of Americans plan to get a COVID-19 vaccine. Here’s how to win over the rest. Science (80- ). June 2020. doi:10.1126/science.abd6018 Shannon Mullen O’Keefe. One in Three Americans Would Not Get COVID-19 Vaccine. Gallup. https://news.gallup.com/poll/317018/one-three-americans-not-covid-vaccine.aspx. Published 2020. Accessed August 23, 2020. Jonathan E. Fielding, Public Health Institute. When the truth becomes the threat: Standing in Support of our Public Health Officials. https://www.phi.org/press/when-the-truth-becomes-the-threat-standing-in-support-of-our-public-health-officials/. Published 2020. Accessed August 23, 2020. Mello MM, Greene JA, Sharfstein JM. Attacks on Public Health Officials During COVID-19. JAMA. August 2020. doi:10.1001/jama.2020.14423 Susan R. Bailey, American Medical Association. AMA statement on intimidation, threats toward public health officials. AMA Web Site. https://www.ama-assn.org/press-center/ama-statements/ama-statement-intimidation-threats-toward-public-health-officials. Published 2020. Accessed August 23, 2020. SkeptVet.com. 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It Just Takes Common Sense: Dr. Marty Goldstein on The Dog Doc. 2020. https://www.rogerebert.com/interviews/it-just-takes-common-sense-dr-marty-goldstein-on-the-dog-doc. Accessed August 23, 2020. CBSN New York. Dr. Marty Goldstein On Dogs & Coronavirus. https://newyork.cbslocal.com/2020/03/20/dr-marty-goldstein-dogs-coronavirus-interview/. Published 2020. Accessed August 23, 2020. Falconer W. COVID-19: Remedy of the Pandemic | Vital Animal® § The Natural Path. https://vitalanimal.com/covid-19-remedy-of-the-pandemic/. Published 2020. Accessed August 23, 2020. U.S> Food and Drug Administration. Court Prohibits Dallas Wellness Center from Touting ‘Ozone Therapy’ as COVID-19 Treatment. https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/press-releases/court-prohibits-dallas-wellness-center-touting-ozone-therapy-covid-19-treatment. Published 2020. Accessed August 23, 2020. Gellman K, Roman M. COVID-19 - Main Street Animal Services of Hopkinton. http://www.mashvet.com/covid-19.html. Published 2020. Accessed August 23, 2020. Brennen McKenzie, MA, MSc, VMD, cVMA, discovered evidence-based veterinary medicine after attending the University of Pennsylvania School of Veterinary Medicine and working as a small animal general practice veterinarian. He has served as president of the Evidence-Based Veterinary Medicine Association and reaches out to the public through his SkeptVet blog, the Science-Based Medicine blog, and more. He is certified in medical acupuncture for veterinarians. Columnists’ opinions do not necessarily reflect those of Veterinary Practice News.
