I chair a committee at work that makes decisions by consensus. What I've observed about consensus is that folks have to come to l the discussion with an openness or willingness to change their mind based on what they hear, otherwise they'll be dug in on their opinion. If the folks who want to debate are coming to you in good faith, with that openness to changing their mind (even a little bit -- consensus isn't about agreeing about every detail), go ahead and join in. But part of the reason why we are polarized is because people are not open to changing their minds and admitting they might have had incomplete or incorrect information, and if that's the case, no debate will help the situation.
Thanks Marissa! The problem is that many/most of the "other side" I'm thinking about here is not truly in good faith. The question is whether a small "moveable middle" tunes into these debates. If so, that's the target audience. I won't convince the lunatic fringe and they won't convince the reasonable people on our side. But if there are 10% in the middle who need to hear b.s. debunked, even bad-faith debaters may be worth debating.
I see your point. It's possible that there might be a moveable middle, but in that case my personal opinion is that the one-on-one approach that Amy mentioned in her comment might work better than having those folks watch/read a debate.
I agree with Marissa. One reason it’s so difficult to debate these people is that they aren’t spreading these lies in question (i.e. here’s something I heard, is it true?), they are doing it as though it were fact. They are dead set on these ideas, having been confirmed countless times by their own echo chambers of misinformed people. In my experience, the only way to deal with this is to listen and try to understand where that person is coming from, and responding with a, “that’s an interesting idea, but have you thought about this, this and this thing that seems to state the opposite?” When you come at these people on a soapbox, they shut their ears even more tightly. I do think it’s important for experts to engage and defend in these instances, but the way we go about it is just as important as the facts. Otherwise, we end up sowing more seeds of distrust and hate among those who disagree. It’s a tricky line to walk. If I’m answering the specific question of “should you specifically engage?”, then I have to say yes, as long as it is balanced with the other good you put into the world.
I have had one on one conversations with many people who believe the fraudulent information that they are hearing in their community. I have had some success having a thoughtful, non-combative dialogue making sure I hear them out first and have the science at hand for my rebuttal (of course you would have a lot more information than I do!) However, I wouldn’t encourage you to take more time out of your busy schedule it there does not seem to be a willingness for both sides to listen. I wish I had a bigger audience. I don’t like the feeling that everyone has thrown up their hands, either through exhaustion or misinformation. I also understand that when met with a barrage of nonsense it is hard to keep fighting the information fight.
For what it’s worth, these are a few of my own opinions on why I think you should debate. Opinions that are from someone on the other side of the isle, that is navigating the diverse range of views from competing expert opinions. I am accused of being an anti-vaxxer… though it’s a description I disagree with.
Debate academics that have appropriate qualifications, in a public forum with a large audience. With a fair moderator, and clear guidelines.
From my perspective this would be appreciated. You probably won’t convince the person you are arguing with, but maybe those watching will get something out of it. One of the main reasons there is so much skepticism is because there has been so little debate. Not wanting to give the opposition a platform is not an excuse - they already have a platform, and it is probably bigger than yours. The lack of dialogue between competing factions over the last few years has only widened the void. If you think your views are correct, especially if they transpire as public policy, you should be required to defend those views in the public sphere.
Don’t debate on twitter if you don’t have the time. How important is it to you that there are people out there that disagree with you. The world is full of diverse ideologies, interpretations, and beliefs (It has always been this way). It is futile to aspire to complete consensus. It’s most likely the positions people hold have much more to do with personality profiles, and their worldview, than scientific interpretation.
If you encounter people on twitter that have reasonable questions, or they have a point of interest that they have at least put some thought into - it maybe worth engaging. Remember, while your purpose is to educate, you may learn something too. There are a significant number of reasons why someone may not want medical interventions.
If you do engage online, no matter how esteemed your qualifications and how lacking are theirs - never be condescending. Don’t use terms like ‘deniers’, or ‘conspiracy’. And don’t call people anti-vaxxers. These have religious connotations coming from a position of dogma, or indicate you don’t have answers to questions. This doesn't make a good argument based on evidence.
Don’t use the term “misinformation”. Be specific and address the points you disagree with.
Don’t engage if they are anonymous. And tell them that’s why you won’t engage. Twitter would be a much better place if people couldn’t hide behind avatars.
Don’t engage if they are rude or insulting.
Don’t claim they can’t have an opinion because they aren’t an expert… eg “You aren’t an epidemiologist”. History is full of experts that have been wrong. And EVERYONE makes decisions across a wide range of industries that will often contradict expert advice. Just because a Hedge Fund manager recommends an investment, doesn’t mean I “HAVE TO” invest in it.
Respectfully end the debate when you end up going in circles. It will benefit both you and your opponent… and your audience. Just agree to disagree.
Don’t engage with the purpose of changing their mind. Just state why you disagree and present your evidence. And be prepared to have that evidence challenged. Maybe instead of debating, try to find out why they believe what they believe.
Steve Kirsch’s Twitter Space debates have been interesting. This maybe the best place to join in, they have a large audience. There have been a number of pro vaccine advocates join to argue their case.
One definitive difference is emerging. Those supporting the mRNA vaccines appear not to trust evidence that is supported by observation, clinical experience, or small studies. Those that oppose the mRNA vaccines don’t trust any evidence that has been touched by the hand of Pharma. This is a stalemate decades in the making, so any full resolution may not be possible. It’s likely that the discourse will continue, and effective debate can’t take place, until the systems of drug approval and safety monitoring have had a complete overhaul.
In a perfect world you’d debate in person, where you can look into their eyes - not online when most of our means of communication disappears. It’s so easy to lose site of the fact that the avatar you are arguing with is a human being.
Online media is now how most get their information - this is the new normal. If you refuse to debate they will win.
I say debate. Knowledge is power. Information is knowledge. Misinformation is the lack of knowledge, and can be made worse with the dissemination of ignorance. The ignorance mongers must be challenged. To allow their unchallenged nonsense is dangerous to everyone. Good luck, Jeremy!
As much I do not like to legitimize these fringe groups, we have sat idle too long to let it continue. The misinformation people have done so much harm to both our profession and our communities. Unfortunately, very few scientists and even fewer medical leaders have fought back, with the exception of those like you and a few others who have used social media to show the real information. This does not seem to be getting through to the public or to the misinformation group. Perhaps with scientists like you, along with some medical leaders, in a public debate, science will prevail.
“Do not engage with false information online because this may increase visibility from website algorithms. It is best not to reshare or comment on misinformation, even in an attempt to correct it. For the same reason, beware of and ignore internet bots, trolls, and spam.
The most effective solution to limit the reach of inaccurate online information is to expose internet users to more accurate than inaccurate information. Contribute to improving this balance by viewing, liking, resharing, and commenting on verified content from reliable sources.
If you have an online presence as a family physician, build and cultivate your audience. Post accurate information often and consistently. Develop a publication routine and stick to it. This will help you become your audience's go-to source for reliable information.”
~
On substack I struggle when I see a post by Vinay Prasad come across my recommended reading list. But I don’t think I’ll change many minds that are reading his stuff, especially since I have less reach.
I’m trying to find some other evidence based, mainstream, medical voices on here, and that’s why I’ve subscribed to your project. Feel free to subscribe to mine if you want to keep expanding a network here... I’ll comp you as a gesture of appreciation for all your excellent writing!
Hope this helps.
Don’t feed the trolls I guess.
And if we do respond, make an occasional non-confrontational-kill them with kindness surgical strike?
As I said in my bio, in my immediate family of six adults, two are physicians, I worked in the medical community, and one is a psychologist. Five of us are East Coast liberals now living in the Midwest. One kid, my stepson, is a "Rand Paul" anti-vaxxer, and believes in conspiracies. We have been unable to reach him and drag him back out of the rabbit holes he frequents. I don't know what you could say to change his mind. We have tried. How different would it be to talk to someone like him? I believe that people with a conspiracy believing mindset are pleased that they "know the truth." Scientific data does not matter, to them, or is twisted. They process data, but not in a recognized scientific manner.
I don't think engaging with people who traffic in misinformation is worthwhile. They have an agenda, so you won't change their minds. As far as the audience: You can't reason someone out of something they were never reasoned into. I think it is more important to continue to put good information out there. People who are earnestly searching for answers will find it.
Good point. I do think there are some who are genuinely looking for answers who stumble into these forums...and the question is whether the return on investment is good enough
Be careful of the moral injury these debates could inflict upon you even subconsciously. You are a preacher of science in service to mankind’s It is demoralizing to acknowledge and realize the magnitude of others who are marching toward their demise by denying science.
I am not a medical doctor or scientist, and these days I get most of my information about Covid from Twitter. It feels a bit embarrassing to write that -- generally for topics outside my own expertise I look to trusted authorities for guidance. However, with Covid my sense is that organizations like the CDC and WHO have failed spectacularly in their guidance time and again. Meanwhile, on Twitter I was able to find a few experts regularly discussing what we can learn from the latest publications on topics like Long Covid, viral surveillance, and vaccine safety.
Lately I've perceived an uptick in Covid-specific anti-vax content. I won't include links, but common narratives involve vaccine-induced cardiac damage and vaccine-induced immune dysfunction. The posts often include links to journal articles and, superficially, look scientific. My sense is that they are usually based on some kernel of truth, but then misconstrue or simply misrepresent things in order to fit the narrative. I've seen a few rebuttals of the "sudden cardiac-related deaths" claims, but so far I haven't seen anyone I trust address the claims about immune system damage.
Others have noted the risk that engaging with this sort of thing may increase its visibility -- a very valid point, though sometimes I wonder if that ship has sailed.
Communication is such important work! CoViD communication seems ~functional within the scientific choir but ~broken in other large populations: CoViD skepticism is rising, self-funding disinfo machines are growing (Epoch / Died Suddenly), and zeitgeist will ultimately move public policy in a democracy. Psych studies suggest vax conspiracists 1) choose their CoViD positions more like fashion brands than rational theses, 2) imagine most people agree with them and 3) are influenced by what seems fashionable in their time/space. This was the catalyst for the Vaccinated.US molecular art project — to elevate presence of vaccine gratitude and reason - especially for those who don't know if anyone still respects science! Would love your take: https://vaccinated.us/canartboostreason/
As someone who is part of many pro vaccine groups, combating misinformation on the Internet, this is a discussion we’ve had, and the answer is a resounding “no.“ All that does is bring attention to the science deniers. It’s not possible to have a rational debate. And it’s likely the only people who are watching will be those who support the science deniers. You’re not going to change any of your minds. Those who have done it have regretted it.
I chair a committee at work that makes decisions by consensus. What I've observed about consensus is that folks have to come to l the discussion with an openness or willingness to change their mind based on what they hear, otherwise they'll be dug in on their opinion. If the folks who want to debate are coming to you in good faith, with that openness to changing their mind (even a little bit -- consensus isn't about agreeing about every detail), go ahead and join in. But part of the reason why we are polarized is because people are not open to changing their minds and admitting they might have had incomplete or incorrect information, and if that's the case, no debate will help the situation.
Thanks Marissa! The problem is that many/most of the "other side" I'm thinking about here is not truly in good faith. The question is whether a small "moveable middle" tunes into these debates. If so, that's the target audience. I won't convince the lunatic fringe and they won't convince the reasonable people on our side. But if there are 10% in the middle who need to hear b.s. debunked, even bad-faith debaters may be worth debating.
I see your point. It's possible that there might be a moveable middle, but in that case my personal opinion is that the one-on-one approach that Amy mentioned in her comment might work better than having those folks watch/read a debate.
You’d be wasting valuable time.
Which is why I don't respond to BS on twitter nearly as much anymore. Also, having THIS community is lot more worthwhile :)
I agree with Marissa. One reason it’s so difficult to debate these people is that they aren’t spreading these lies in question (i.e. here’s something I heard, is it true?), they are doing it as though it were fact. They are dead set on these ideas, having been confirmed countless times by their own echo chambers of misinformed people. In my experience, the only way to deal with this is to listen and try to understand where that person is coming from, and responding with a, “that’s an interesting idea, but have you thought about this, this and this thing that seems to state the opposite?” When you come at these people on a soapbox, they shut their ears even more tightly. I do think it’s important for experts to engage and defend in these instances, but the way we go about it is just as important as the facts. Otherwise, we end up sowing more seeds of distrust and hate among those who disagree. It’s a tricky line to walk. If I’m answering the specific question of “should you specifically engage?”, then I have to say yes, as long as it is balanced with the other good you put into the world.
Don't give them the oxygen of publicity -- or enable them to "live off" *your* credibility. My 2.2c...
Thanks Peter. As per above, I wonder about whether reaching the "moveable middle" (a minority of folks who tune into these). But I hear you!
On-line? No.
But, if it’s a moderated in-person event somewhat like a debate- absolutely.
Thanks Dave. What about online forums like Twitter Spaces and Clubhouse (moderated, though it can vary to what extent)
I’m not familiar with those particular forums on-line.
I have had one on one conversations with many people who believe the fraudulent information that they are hearing in their community. I have had some success having a thoughtful, non-combative dialogue making sure I hear them out first and have the science at hand for my rebuttal (of course you would have a lot more information than I do!) However, I wouldn’t encourage you to take more time out of your busy schedule it there does not seem to be a willingness for both sides to listen. I wish I had a bigger audience. I don’t like the feeling that everyone has thrown up their hands, either through exhaustion or misinformation. I also understand that when met with a barrage of nonsense it is hard to keep fighting the information fight.
For what it’s worth, these are a few of my own opinions on why I think you should debate. Opinions that are from someone on the other side of the isle, that is navigating the diverse range of views from competing expert opinions. I am accused of being an anti-vaxxer… though it’s a description I disagree with.
Debate academics that have appropriate qualifications, in a public forum with a large audience. With a fair moderator, and clear guidelines.
From my perspective this would be appreciated. You probably won’t convince the person you are arguing with, but maybe those watching will get something out of it. One of the main reasons there is so much skepticism is because there has been so little debate. Not wanting to give the opposition a platform is not an excuse - they already have a platform, and it is probably bigger than yours. The lack of dialogue between competing factions over the last few years has only widened the void. If you think your views are correct, especially if they transpire as public policy, you should be required to defend those views in the public sphere.
Don’t debate on twitter if you don’t have the time. How important is it to you that there are people out there that disagree with you. The world is full of diverse ideologies, interpretations, and beliefs (It has always been this way). It is futile to aspire to complete consensus. It’s most likely the positions people hold have much more to do with personality profiles, and their worldview, than scientific interpretation.
If you encounter people on twitter that have reasonable questions, or they have a point of interest that they have at least put some thought into - it maybe worth engaging. Remember, while your purpose is to educate, you may learn something too. There are a significant number of reasons why someone may not want medical interventions.
If you do engage online, no matter how esteemed your qualifications and how lacking are theirs - never be condescending. Don’t use terms like ‘deniers’, or ‘conspiracy’. And don’t call people anti-vaxxers. These have religious connotations coming from a position of dogma, or indicate you don’t have answers to questions. This doesn't make a good argument based on evidence.
Don’t use the term “misinformation”. Be specific and address the points you disagree with.
Don’t engage if they are anonymous. And tell them that’s why you won’t engage. Twitter would be a much better place if people couldn’t hide behind avatars.
Don’t engage if they are rude or insulting.
Don’t claim they can’t have an opinion because they aren’t an expert… eg “You aren’t an epidemiologist”. History is full of experts that have been wrong. And EVERYONE makes decisions across a wide range of industries that will often contradict expert advice. Just because a Hedge Fund manager recommends an investment, doesn’t mean I “HAVE TO” invest in it.
Respectfully end the debate when you end up going in circles. It will benefit both you and your opponent… and your audience. Just agree to disagree.
Don’t engage with the purpose of changing their mind. Just state why you disagree and present your evidence. And be prepared to have that evidence challenged. Maybe instead of debating, try to find out why they believe what they believe.
Steve Kirsch’s Twitter Space debates have been interesting. This maybe the best place to join in, they have a large audience. There have been a number of pro vaccine advocates join to argue their case.
One definitive difference is emerging. Those supporting the mRNA vaccines appear not to trust evidence that is supported by observation, clinical experience, or small studies. Those that oppose the mRNA vaccines don’t trust any evidence that has been touched by the hand of Pharma. This is a stalemate decades in the making, so any full resolution may not be possible. It’s likely that the discourse will continue, and effective debate can’t take place, until the systems of drug approval and safety monitoring have had a complete overhaul.
In a perfect world you’d debate in person, where you can look into their eyes - not online when most of our means of communication disappears. It’s so easy to lose site of the fact that the avatar you are arguing with is a human being.
Online media is now how most get their information - this is the new normal. If you refuse to debate they will win.
I say debate. Knowledge is power. Information is knowledge. Misinformation is the lack of knowledge, and can be made worse with the dissemination of ignorance. The ignorance mongers must be challenged. To allow their unchallenged nonsense is dangerous to everyone. Good luck, Jeremy!
As much I do not like to legitimize these fringe groups, we have sat idle too long to let it continue. The misinformation people have done so much harm to both our profession and our communities. Unfortunately, very few scientists and even fewer medical leaders have fought back, with the exception of those like you and a few others who have used social media to show the real information. This does not seem to be getting through to the public or to the misinformation group. Perhaps with scientists like you, along with some medical leaders, in a public debate, science will prevail.
I think of this constantly, even though I struggle to find the time to post my own content weekly! I would say don’t chase windmills or feed trolls.
There is a good article about this from the AAFP which I will link to, and then cut and paste the key paragraphs:
https://www.aafp.org/pubs/afp/issues/2022/0800/editorial-countering-medical-misinformtion.html
“Do not engage with false information online because this may increase visibility from website algorithms. It is best not to reshare or comment on misinformation, even in an attempt to correct it. For the same reason, beware of and ignore internet bots, trolls, and spam.
The most effective solution to limit the reach of inaccurate online information is to expose internet users to more accurate than inaccurate information. Contribute to improving this balance by viewing, liking, resharing, and commenting on verified content from reliable sources.
If you have an online presence as a family physician, build and cultivate your audience. Post accurate information often and consistently. Develop a publication routine and stick to it. This will help you become your audience's go-to source for reliable information.”
~
On substack I struggle when I see a post by Vinay Prasad come across my recommended reading list. But I don’t think I’ll change many minds that are reading his stuff, especially since I have less reach.
I’m trying to find some other evidence based, mainstream, medical voices on here, and that’s why I’ve subscribed to your project. Feel free to subscribe to mine if you want to keep expanding a network here... I’ll comp you as a gesture of appreciation for all your excellent writing!
Hope this helps.
Don’t feed the trolls I guess.
And if we do respond, make an occasional non-confrontational-kill them with kindness surgical strike?
As I said in my bio, in my immediate family of six adults, two are physicians, I worked in the medical community, and one is a psychologist. Five of us are East Coast liberals now living in the Midwest. One kid, my stepson, is a "Rand Paul" anti-vaxxer, and believes in conspiracies. We have been unable to reach him and drag him back out of the rabbit holes he frequents. I don't know what you could say to change his mind. We have tried. How different would it be to talk to someone like him? I believe that people with a conspiracy believing mindset are pleased that they "know the truth." Scientific data does not matter, to them, or is twisted. They process data, but not in a recognized scientific manner.
I don't think engaging with people who traffic in misinformation is worthwhile. They have an agenda, so you won't change their minds. As far as the audience: You can't reason someone out of something they were never reasoned into. I think it is more important to continue to put good information out there. People who are earnestly searching for answers will find it.
Good point. I do think there are some who are genuinely looking for answers who stumble into these forums...and the question is whether the return on investment is good enough
Be careful of the moral injury these debates could inflict upon you even subconsciously. You are a preacher of science in service to mankind’s It is demoralizing to acknowledge and realize the magnitude of others who are marching toward their demise by denying science.
I am not a medical doctor or scientist, and these days I get most of my information about Covid from Twitter. It feels a bit embarrassing to write that -- generally for topics outside my own expertise I look to trusted authorities for guidance. However, with Covid my sense is that organizations like the CDC and WHO have failed spectacularly in their guidance time and again. Meanwhile, on Twitter I was able to find a few experts regularly discussing what we can learn from the latest publications on topics like Long Covid, viral surveillance, and vaccine safety.
Lately I've perceived an uptick in Covid-specific anti-vax content. I won't include links, but common narratives involve vaccine-induced cardiac damage and vaccine-induced immune dysfunction. The posts often include links to journal articles and, superficially, look scientific. My sense is that they are usually based on some kernel of truth, but then misconstrue or simply misrepresent things in order to fit the narrative. I've seen a few rebuttals of the "sudden cardiac-related deaths" claims, but so far I haven't seen anyone I trust address the claims about immune system damage.
Others have noted the risk that engaging with this sort of thing may increase its visibility -- a very valid point, though sometimes I wonder if that ship has sailed.
Communication is such important work! CoViD communication seems ~functional within the scientific choir but ~broken in other large populations: CoViD skepticism is rising, self-funding disinfo machines are growing (Epoch / Died Suddenly), and zeitgeist will ultimately move public policy in a democracy. Psych studies suggest vax conspiracists 1) choose their CoViD positions more like fashion brands than rational theses, 2) imagine most people agree with them and 3) are influenced by what seems fashionable in their time/space. This was the catalyst for the Vaccinated.US molecular art project — to elevate presence of vaccine gratitude and reason - especially for those who don't know if anyone still respects science! Would love your take: https://vaccinated.us/canartboostreason/
As someone who is part of many pro vaccine groups, combating misinformation on the Internet, this is a discussion we’ve had, and the answer is a resounding “no.“ All that does is bring attention to the science deniers. It’s not possible to have a rational debate. And it’s likely the only people who are watching will be those who support the science deniers. You’re not going to change any of your minds. Those who have done it have regretted it.