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Volume 67, Number 6, June, 2021
SECTIONS
EDITORIALS
772 How to treat erectile dysfunction in young patients
during the pandemic?
774 University indigenous uses social media to report
the impact of COVID-19 on their communities
LETTER TO THE EDITOR
777 Pseudoskeptical and pseudoscientific strategies used
in attacks on homeopathy
SHORT COMMUNICATIONS
781 Pulmonary rehabilitation: a unfairly forgotten
therapeutic tool even in the worst scenarios
785 Atypical presentation of COVID-19 with multi-organ
involvement in a pediatric patient
ARTICLES
ORIGINAL ARTICLES
789 Evaluation of taste and smell disorders in pediatric
COVID-19 Cases
795 Ophthalmological knowledge of Family
Health Network physicians working as
first care providers in Brazil
800 Potentially inappropriate medications, drug-drug
interactions, and prescribing practices in elderly
patients: a cross-sectional study
806 Expression of metalloproteinases 2 and 9 and
plasma zinc concentrations in women with
fibroadenoma
811 Value of magnetic resonance combined with dual-
source spectral computed tomography in improving
the clinical diagnosis and treatment efficiency of
lumbar disk herniation
816 Lead-DBS: an additional tool for stereotactic surgery
822 Study on the changes of blood glucose in
hemodialysis patients with diabetes
828 Association between hyperuricemia and
hypertension: a case–control study
833 The effects of Coronavirus disease-2019 (COVID-19)
pandemic on routine antenatal care visits and
complications of pregnancy
839 Validity and reference values for the 3-minute
shuttle run test in spanish preschoolers
845 Factors affecting pathological complete response
after neoadjuvant chemotherapy in breast cancer: a
single-center experience
851 Pelvic floor muscle training program for women
in the puerperal period: clinical progress after
intervention
857 Correlation between tactile acuity, pain intensity,
and functional capacity in individuals with chronic
neck pain
862 Sleep analysis in emergency nurses’ department
868 Fibrinogen-to-albumin ratio may be a predictor for
ascending aortic aneurysm
873 Can various complete blood count parameters
helpful in preoperative diagnosis of adnexal
torsion?
878 Relationship between obstructive sleep apnea
syndrome and functional capacity in patients
with diabetes mellitus type 2: an observational
transversal study
882 Turkish validity and reliability of the COVERS pain
scale
REVIEW ARTICLES
889 Management of gastrointestinal complications of
enteral nutritional therapy in the ICU
895 The relationship between smoking and brain
aneurysms: from formation to rupture
900 Asymptomatic microscopic hematuria in women
COMMENTARIES
903 Comment on “Seasonal variation of clinical
characteristics and prognostic of adult patients
admitted to an intensive care unit”
904 Comment on “Homeobox B2 is a potential
prognostic glioblastoma biomarker”
905 The relationship between physical performance and
vision may be an accompanying relationship
906 Comment on “Ankle-brachial Index and associated
factors in individuals with coronary artery disease”
907 Comment on “Depression, anxiety and spirituality in
oncology patients”
908 Comment on “Nutritional and hematological factors
associated with the progression of Alzheimer’s
disease: a cohort study”
909 Comment on “Response to direct-acting antiviral
agents in chronic hepatitis C patients with end-
stage renal disease: a clinical experience”
910 Comment on“Association between changes in body
fat distribution, biochemical profile, time of HIV
diagnosis, and antiretroviral treatment in adults
living with and without virus infection”
Journal of e Brazilian Medical Association ISSN 0104-4320
ISSN 1806-9282 (On-line)
777
Rev Assoc Med Bras 2021;67(6):777-780
Pseudoskeptical and pseudoscientic
strategies used in attacks on homeopathy
Marcus Zulian Teixeira1*
LETTER TO THE EDITOR
https://doi.org/10.1590/1806-9282.20210367
Dear Editors,
In October 2020, a manifesto against European legislation
was posted on social networks, which supports the practices of
Complementary/Alternative Medicine (CAM; “First worldwide
manifesto against pseudosciences in health”), written by “pseu-
doskeptical” associations or groups without scientic expres-
siveness, and which present in their associative body individ-
uals who are assumed to have the rights to criticize the health
practices that they do not accept by personal, dogmatic, and
autocratic opinions, systematically disparaging and denying
any scientic evidence that substantiates them. In view of its
wide acceptance, use, and worldwide recognition, homeopa-
thy was the preferred target of this manifesto.
I say “pseudoskeptical” associations because the doctrinal
current of true “skepticism” (sképsis in Greek means “exam-
ination” or “evaluation”), founded in ancient Greece by the
Philosopher Pyrrhus (4th-century BC), argues, “it is not pos-
sible to arm the absolute truth of anything, with it being
necessary to be in constant questioning.”1 e term “pseudo-
skepticism” emerged in the second half of the 19th century,
indicating the explicit tendency toward negationism, instead
of evaluation and ethical and objective questioning proposed
by Greek skepticism.
In 1987, Marcelo Truzzi (1935–2003), a Danish sociologist
and professor of sociology based in the USA (Eastern Michigan
University), elaborated a very illuminating analysis of the term
“pseudoskepticism” or “pathological skepticism,” saying that it
is used to denote the forms of skepticism which deviate from
objectivity, dogmatically denying everything which is not
known, instead of doubting, investigating, and accepting the
evidence that appears with an agnostic and neutral position,
with an open mind, and free from prejudice2,3.
“Since ‘skepticism’ properly refers to doubt rather than
denial–nonbelief rather than belief–critics who take the negative
rather than an agnostic position but still call themselves ‘skep-
tics’ are actually ‘pseudoskeptics’ and have, I believed, gained
a false advantage by usurping that label”2.
“Critics who assert negative claims, but who mistakenly call
themselves ‘skeptics,’ often act as though they have no burden
of proof placed on them at all, though such a stance would be
appropriate only for the agnostic or true sceptic. A result of this
is that many critics seem to feel it is only necessary to present a
case for their counter-claims based upon plausibility rather than
empirical evidence. […] Showing evidence is unconvincing is
not grounds for completely dismissing it. If a critic asserts that
the result was due to artifact X, that critic then has the burden
of proof to demonstrate that artifact X can and probably did
produce such results under such circumstances.”2
In his isolated analysis, Marcello Truzzi described the strat-
egies used by pseudoskeptics to deny and disqualify new ideas
and their respective scientic evidence: the tendency to deny,
rather than doubt; double standards in the application of crit-
icism; the making of judgments without full inquiry; ten-
dency to discredit rather than to investigate; use of ridicule or
ad hominem attacks; presenting insucient evidence or proof;
pejorative labeling of proponents as “promoters,” “pseudosci-
entists,” or practitioners of “pathological science”; assuming
criticism requires no burden of proof; making unsubstantiated
counter-claims; counter-claims based on plausibility rather than
empirical evidence; suggesting that unconvincing studies are
grounds for dismissing it; and tendency to dismiss all evidence2,3.
Marcoen Cabbolet, researcher at the Department of
Philosophy, Centre for Logic and Philosophy of Science,
Vrije Universiteit Brussel, scholar of elementary particle phys-
ics4, in his essay “Tell-Tale Signs of Pseudoskepticism (Bogus
Skepticism),”5 warned that “pseudoscepticism, which typically
is portraying someone’s work as despicable with scientically
1Universidade de São Paulo, School of Medicine – São Paulo (SP), Brazil.
*Corresponding author: marcus@homeozulian.med.br
Conicts of interest: the authors declare there are no conicts of interest. Funding: none.
Received on April 01, 2021. Accepted on April 26, 2021.
Pseudoskeptical strategies in attacks on homeopathy
778
Rev Assoc Med Bras 2021;67(6):777-780
unsound polemics, is a modern day threat to the traditional
standard of discussion in science and popular science.”
us, “where the sceptic merely states that he doesn’t believe
in someone else’s claims, the pseudosceptic comes himself up
with claims and these are always (very) negative. But pseu-
doscepticism is not just making negative claims: the keywords
are ‘dishonesty’ and ‘foul play’. And it is not aimed at nding
out the truth, but at discrediting someone’s research.”5
In another article6, Cabbolet addressed this “pseudosci-
ence,” clearly and objectively describing “scientic misconduct”
with several classic examples that lead to “negative conclusions
about someone else’s work that are downright false.” He clari-
ed that “three known issues are identied as specic forms of
such scientic misconduct: biased quality assessment, smear,
and ocially condoning scientic misconduct.”
Cabbolet reiterated that pseudoskepticism is the central
focus of this scientic misconduct, which has the objective of
“uttering negative conclusions about someone else’s work that
are downright false,” further suggesting that this posture may
be “a calculated strategy,” rather than a passionate attitude, and
provides recommendations for preventing and dealing with
these three forms of scientic misconduct through educational
and punitive measures6.
In the rst quoted essay5, Cabbolet explains “seven tell-tale
signs of pseudoskepticism” in detail (Table 1), most of which
were initially described by Marcelo Truzzi, through which the
conduct and strategy of pseudoskeptics can be notably recognized.
Expanding the tell-tale signs of pseudoskepticism, Cabbolet
also warned of the fact that “pseudosceptics never publish a
retraction”: “Usually in science, if researcher A publishes a claim
and researcher B refutes the proof, then A publishes a retraction
of the claim. But not so the pseudosceptic. Even when con-
fronted with conclusive proof that his allegations are false, he
will refuse to publish a retraction or to publicly acknowledge
that the claims were fabricated: the typical pseudosceptic will
stick to his fabrications as if not a word has been said […]”5.
As Cabbolet described5, pseudoskepticism is also observed
in the reports of peer reviews of scientic publications, in all
areas of knowledge, when the prejudiced and pseudoscien-
tic opinion of a reviewer denies the publication of an article
which disagrees with their dogmatic view, even if it fullls all
the requirements of the scientic method. is is commonly
observed when we forwarded homeopathic scientic articles
to non-homeopathic journals. Paradoxically, following a pseu-
doskeptical ruse (#7: straight to the mass media)5, the biased
and prejudiced allegations against homeopathy are repeatedly
transmitted through articles and opinion interviews in news-
papers and various popular media, refraining from following
the usual scientic path of submitting them to a peer-reviewed
scientic journal.
erefore, pseudoskeptics act according to two weights and
two measures: they require homeopathic researchers to publish
their studies in non-homeopathic scientic journals (although
studies related to any medical specialization are published in
specialized journals), but they discard this premise, dissemi-
nating their criticisms of homeopathy, propagating them in
nonscientic mass media as “double standards in the applica-
tion of criticism.”
Brazilian homeopathy also suers constant attacks from
pseudoskeptical groups just as in Europe. In order to demystify
the pseudoskeptical fallacy that “there is no scientic evidence
for homeopathy,” the Technical Chamber for Homeopathy
(TC-Homeopathy), Regional Medical Council of the State
of São Paulo (Cremesp, Brazil) prepared a Special Dossier in
2017 entitled “Scientic Evidence for Homeopathy”7,8, which
is available online in Portuguese and English in the Revista de
Homeopatia, the scientic journal of the São Paulo Homeopathic
Medical Association (APH).
e dossier encompasses nine narrative reviews in several
lines of homeopathic research (i.e., historical, social, medical
education, pharmacological, basics, clinical, patient safety, and
pathogenetic) and two randomized clinical trials developed by
TC-Homeopathy members contain hundreds of scientic arti-
cles published in several peer-reviewed and indexed scientic
journals; it seeks to highlight the state-of-the-art in homeo-
pathic research7,8.
Bothered by the excellence of these lots of evidence, in
November 2020, a group of Brazilian pseudoskeptics dis-
closed a derisory and fallacious manuscript (“Counter-dossier
of Evidence on Homeopathy”) in the media and social net-
works to evaluate some of the articles published in the referred
dossier according to “the best scientic rigor” and “inform the
population about what science says about the supposed eec-
tiveness of Homeopathy.”
Unfortunately, none of this happened in the aforementioned
manuscript. Contrary to the announced “best scientic rigor”
in the analysis of the articles of the dossier, what is observed
throughout the text is a set of criticisms based on “pseudoskep-
tical strategies” to debunk and disqualify any scientic work:
the tendency to deny, rather than doubt; double standards in
the application of criticism; the making of judgments without
full inquiry; use of ridicule or ad hominem attacks; presenting
insucient evidence or proof; pejorative labeling of authors;
assuming criticism requires no burden of proof (absence of
proof); making unsubstantiated counter-claims (nonspecic
comments); suggesting that unconvincing studies are grounds
for dismissing it; tendency to dismiss all evidence; vitriolic tone;
Teixeira, M. Z. et al.
779
Rev Assoc Med Bras 2021;67(6):777-780
Table 1. Seven tell-tale signs of pseudoskepticism according to Marcoen Cabbolet5.
Seven tell-tale signs of pseudoskepticism
#1: Ad hominem
attacks
Typically, a pseudoskeptic is so eager to portray the author of the targeted work as an amateur that he resorts
to ad hominem attacks: this is a rhetorical technique that is absolutely inadmissible in a scientic discourse, and
therefore this is the number one tell-tale sign that a piece is nothing but a pseudoskeptical attack. It is thus a
real giveaway when the author of the targeted work is called “incompetent,” an “amateur,” a “charlatan,” a
“crackpot,” “ignorant,” “only out to brag about it in a pub,” etc. So, the occurrence of any of these words alone
is already an indication that the entire piece is of doubtful merit.
#2: Vitriolic tone
Typically, a pseudoskeptical attack portrays the targeted work as despicable: usually this is done by riddling
the text with belittling phrases and strong pejoratives. Consequently, the piece has a vitriolic or even libelous
tone that is immediately evident even from a quick supercial reading: that tone is the tell-tale sign of
pseudoskepticism. The archetypical belittling phrase is “every rst-year student could have come up with the
same thing.” Illustrative examples of strong pejoratives are “nonsense,” “perverse,” “a disgrace,” “worth-
less,” “meaningless,” “inferior,” “devoid of content,” “complete rubbish,” and the like, which are then
typically said about the targeted work as a whole.
#3: Nonspecic
comments
In science, when commenting on someone else’s work, one very specically addresses the details of the work
in question. A pseudoskeptic, however, typically doesn’t go through the hard work of really understanding
the targeted work. This feature manifests itself in superciality of the comments. It is therefore a tell-tale
sign of pseudoskepticism when a piece concerns nothing but negative allegations at the metalevel, that is,
negative allegations about the targeted work as a whole, without going into the details of the targeted work.
#4: Absence of
proof
Another typical feature of pseudoskeptics is that they have no shame: one of the most shameless ways to attack
someone else’s work is to put forward outright fabrications, which, if true, would imply gross incompetence of
the author of the targeted work. But fabrications cannot be proven by their very nature. Consequently, absence
of proof of the (usually grave) allegations in a piece is a sure tell-tale sign of pseudoskepticism at its worst, and a
strong indication that the piece may contain fabricated allegations. An illustrative example is an absence of proof
of the one statement that is probably the most abused phrase of all in modern science: “this work is of insufcient
scientic quality.” In a pseudoskeptical attack, this is typically said of the targeted work without specifying which
criteria of scientic quality are not met, and why or how they are not met–there are peer-reviewed reports that
consist of just this one phrase.
#5: False
metaphors
In science, comments on someone else’s work remain conned to that work: one doesn’t indulge oneself in
metaphors. In a pseudoskeptical attack, however, often the targeted work is compared with a theory that is
known to be false or that is obviously ridiculous, as if it is the same thing. Illustrative examples are phrases
like “this is the same as saying that the earth is at,” or “this is the same as saying that the phenomenon is
caused by angels”: these are tell-tale signs of a pseudoskeptical attack. There are more sophisticated cases,
but the point is that this use of metaphors is a rhetorical technique that is absolutely inadmissible in a scientic
discourse. The error is the same in all these cases: contrary to what is stated by the pseudoskeptic, it is not
at all the same.
#6: Contradiction
with history and
basic principles of
science
When attacking a new theory that has not yet been experimentally tested, a pseudoskeptical piece often
blatantly contradicts well-known facts from the history of science, as well as basic scientic principles. The
three archetypical examples that turn up time and time again are
i. stating that scientic discoveries are nowadays only made by large international collaborations, to insinuate
that the work of a single author cannot be a scientic discovery;
ii. stating that scientic theories are always developed from experimental facts, to insinuate that anything
else cannot ever be a scientic theory; and
iii. using an accepted model (other than Einstein’s Special Relativity) beyond its established area of application
as a criterion of truth, to insinuate that a work that contradicts that model cannot be a scientic theory.
The arguments (i) and (ii) completely ignore that virtually all of modern science is built on the work of individuals,
who more often than not theoretically predicted phenomena before these were experimentally observed
(Einstein: time dilation and curvature of space; Dirac: antimatter), and who often did their groundbreaking
work in relative isolation (Einstein, Bohr). The argument (iii) ignores the fact that historical breakthroughs
in science often went squarely against the accepted model of the time, and contradicts a basic principle of
science, put into words by Feynman as follows: “experiment is the sole judge of scientic truth.”
Continue...
Pseudoskeptical strategies in attacks on homeopathy
780
Rev Assoc Med Bras 2021;67(6):777-780
false metaphors; and straight to the mass media among others
(“Pseudoskeptic and pseudoscientic fallacies of the ‘Counter-
dossier of Evidence on Homeopathy’”)9.
In highlighting these pseudoskeptical strategies in the detailed
analysis of the presented criticisms9, we unmasked these pseu-
doskeptics disguised as pseudoscientists as the false and hypo-
critical image of being the “defenders of science,” as they call
themselves in the aforementioned contra-dossier. eblind-
ness caused by pseudoskepticism or pathological skepticism
caused “experienced and renowned researchers in their areas of
concentration” to incur childish errors in their prejudiced anal-
yses, such as simple attentive reading of the texts they attacked
in a fallacious way, denoting noncompliance with basic prem-
ises of the scientic method.
“e rst was never to accept anything for true which I did
not clearly know to be such; that is to say, carefully to avoid pre-
cipitancy and prejudice, and to comprise nothing more in my
judgment than what was presented to my mind so clearly and
distinctly as to exclude all ground of doubt” (René Descartes,
“Discourse on Method”).
REFERENCES
1. Dumont JP. Le scepticisme et le phénomène: essai sur la
signication et les origines du pyrrhonisme. Partie 1. Paris:
Vrin; 1972 [cited on Apr. 1, 2021]. 415 p. Available from:
https://philpapers.org/rec/DUMLSE
2. Truzzi M. On pseudo-skepticism. Zetetic Scholar. 1987 [cited
on Apr. 1, 2021]; (12-13). Available from: https://www.
anomalist.com/commentaries/pseudo.html
3. The plasma universe. Pseudoskepticism. [cited on Apr. 01,
2021]. Available from: https://www.plasma-universe.com/
pseudoskepticism/#cite_note-22
4. Cabbolet M. Elementary process theory: a formal axiomatic
system with a potential application as a foundational framework
for physics supporting gravitational repulsion of matter and
antimatter. Ann Phys. 2010;522(10):699-738. https://doi.
org/10.1002/andp.201000063
5. Cabbolet MJTF. Tell-tale signs of pseudoskepticism (bogus
skepticism). [cited on Apr. 01, 2021]. Available from: https://
philpapers.org/rec/CABTSO-3
6. Cabbolet MJTF. Scientic misconduct: three forms that directly
harm others as the modus operandi of Mill’s tyranny of the
prevailing opinion. Sci Eng Ethics. 2014;20(1):41-54. https://
doi.org/10.1007/s11948-013-9433-8
7. Teixeira MZ. Proofs that Homeopathic Medicine Works: Dossier
“Scientic Evidence for Homeopathy” (Revista de Homeopatia,
São Paulo Homeopathic Medical Association). Homeopathy.
2018;107(1):45. https://doi.org/10.1055/s-0037-1613677
8. Teixeira MZ. Special Dossier: “Scientific Evidence for
Homeopathy”. Rev Assoc Med Bras. 2018;64(2):93-4. https://
doi.org/10.1590/1806-9282.64.02.93
9. Teixeira MZ. Falácias pseudocéticas e pseudocientíficas
do “Contradossiê das Evidências sobre a Homeopatia”
[Pseudoskeptic and pseudoscientic fallacies of the “Counter-
dossier of Evidence on Homeopathy”]. São Paulo: Associação
Paulista de Homeopatia (APH); 2020 [cited on Apr. 1, 2021].
43 p. Available from: https://pesquisa.bvsalud.org/portal/
resource/pt/biblio-1145551?lang=en
Seven tell-tale signs of pseudoskepticism
#7: Straight to the
mass media
It is a bad sign when a scientic claim is taken straight to the mass media (e.g. the cold nuclear fusion
case), but it is an equally bad sign when an attack on someone else’s work is taken straight to the mass
media. When writing a scientic critical comment on a work, the right method is to rst contact its author
and discuss the criticism with him/her. When submitting the critical comment for publication in a scientic
journal, one is often required to present evidence of such a prior contact with the author of the targeted
work. But not so the pseudoskeptic. Typically, he doesn’t contact the author of the targeted work, nor
does he attempt to publish his “ndings” in a peer-reviewed journal: he takes his allegations straight to
the mass media. So an editor of a newspaper or university weekly who sees that an attack on someone’s
work is submitted for publication, can—especially when the piece contains grave accusations—simply
ask for evidence of contact with the author of the targeted work: any failure to provide such evidence
is then a tell-tale sign that the piece is nothing but a pseudoskeptical attack, and an indication that it
may contain fabrications.
Table 1. Continuation.
