A Little Something About Hoaxes, Frauds and Pranks
It’s pretty easy to hoax people. We all want to be deceived, but only up to a point. Some hoaxes are fun and pleasant, others malicious and unpleasant. We’d like a way to tell the difference.
I think Pascal is right. We want to be deceived. Deception is an essential tool for the survival of our species. We might well be hardwired for deceiving others and taking delight in being deceived. On the other hand, there are many times when we don’t appreciate deceiving or being deceived. And most of us feel uncomfortable when we’re not sure whether we’re being hoaxed. Is there any way to reconcile our love of a good prank or magic trick with our hatred of being defrauded or made to look foolish? Is there any surefire way to avoid being hoaxed? Maybe. Maybe not.
Most of us have been victims of pranks, hoaxes, or frauds. We may even have mistaken one for the other. For example, in April 2002, in Loomis, California, two teenagers got inspired by the MTV reality show Jackass. One of them videotaped his buddy as he ran along a rural road wearing handcuffs and an orange jail jumpsuit that he’d bought at a flea market. Unfortunately, some local citizens and law enforcement officers didn’t know it was a prank, and they pursued the “escapee” with tracking dogs, patrol cars, and a helicopter. Folsom Prison ordered a full-scale lockdown and did a head count. They also did head counts at the jails in Placer and Sacramento counties, at some expense to the taxpayer.
It’s sometimes hard to know whether something is a prank or a hoax or whether we’re being defrauded. The jackass could well have been an escapee. If you saw someone in an orange jumpsuit and handcuffs running down the road and you didn’t see the cameraman, your first thought probably would not be: “Ah, another Jackass prank.”
Most of us have heard of the 1938 Halloween Eve radio broadcast by Orson Welles of an adaptation of H. G. Wells’s War of the Worlds that many took to be an announcement that Earth had been invaded by Martians. Announcements that the story was fiction were made four times during the broadcast. Welles ended the show by announcing that the broadcast was a “holiday offering”: “the Mercury Theater’s own radio version of dressing up in a sheet and jumping out of a bush and shouting boo.” The disclaimers did little to prevent many people from believing we’d been invaded by Martians. It’s been called the hoax of the century, but it wasn’t even a hoax. It wasn’t a prank, either. It wasn’t intended to fool people but to entertain them. Yet it fooled many people for several reasons: it was presented realistically and authoritatively, the story itself was credible at the time and radio would have been the medium used to announce such an invasion.
We can excuse ourselves, I think, for being taken in by some hoaxes because they’re so believable. But others are so unbelievable, we have to wonder how anybody could fall for them. For example, how could Sir Arthur Conan Doyle, the creator of the Sherlock Holmes mysteries, have fallen for the Cottingley Fairy hoax? Two children, Frances and Elsie, photographed cutouts of fairies that shouldn’t have fooled anybody. And how could the King’s surgeon and the most famous obstetrician in eighteenth century England be duped into believing that the servant girl Mary Toft had given birth to rabbits?
How did the children and the servant fool such eminent men? It was easy: (1) The hoaxers put on a good game face. The kids didn’t let on that they were making it all up—and we all know that children don’t lie. Frances maintained until her death in 1986 that at least one of the photos was genuine. It wasn’t until Elsie was a grandmother that she gave broad hints that the stunt was a hoax. And Mary Toft must have been a pretty fair actress as well. (2) The hoax fit with the beliefs of the eminent men. Doyle was a believer in the occult and paranormal, so the idea of fairies appearing to children and allowing themselves to be photographed did not strike him as obviously preposterous. He corresponded with Elsie and even wrote a book about the fairies (The Coming of the Fairies). The event was within the realm of the possible for him. And once Doyle gave his nod to the belief, others would follow.
The belief that a human could give birth to rabbits is a bit more complicated, yet the same principle applies. The medical establishment seemed to be willing to believe in this absurdity because of another false belief that was consistent with the rabbit-birth hypothesis: the theory of maternal impressions.
Maternal impressions is the notion, widely believed in eighteenth-century England, that a pregnant woman’s experiences could be directly imprinted on her unborn child. The theory was used to explain birth defects. A child being born deaf was due to the mother having been shocked by a loud sound during pregnancy. If a pregnant woman looked at a blind person her baby might be born blind. Toft, who had been pregnant but miscarried, claimed to have had an intense craving for roast rabbit. She said she admired rabbits, dreamed about them, and spent time trying to catch them. Thus, her claim of giving birth to rabbits fit with the notion of maternal impressions and didn’t seem absurd to the local doctor, the King’s surgeon, or a famous obstetrician, and with their support for the claim Mary’s hoax took root.
Science Education Does Not Ensure Healthy Skepticism
Many skeptics take a measured amount of pleasure in the kinds of tasks often set before them: evaluating blurry photographs, conducting laboratory experiments that reduce or eliminate trickery, critiquing flawed science and pseudoscience, and countering the claims of obvious charlatans. Of course, skeptics hope that their efforts aid in advancing science education. In spite of these efforts, survey data from several sources suggests that paranormal belief and pseudoscientific thinking continue to be commonplace.
Skeptics often use these findings to reinforce arguments for more science education. Their argument is based upon the largely untested assumption that increased science knowledge reduces the number of paranormal beliefs an individual holds. However, this assumption may not be valid. Andrew Ede recently argued that science education may do little to raise the level of rational thinking and may, in fact, actually deter it! Recent debates about including creation science and/or eliminating evolution from high school biology curricula are a case in point indicating that many policy makers, members of the public, and a few educators are confused about how to critique and compare theories in order to separate facts from beliefs. Ede identified three reasons why this may be true:
Science classes, broadly defined, primarily teach technical skills rather than emphasizing critical thinking. Labs are conducted in which there is a “right answer” that the instructor knows, and it is up to the student to manipulate the project until the “right answer” is realized.
Science classes typically review research findings without placing the research in the proper context. This can lead to incorrect assumptions or overgeneralizations.
Science implicitly emphasizes its elite status over other points of view. Therefore, data and graphs are accepted uncritically because they are based on “scientific,” “clinical,” or “laboratory” studies. A lab coat guarantees an aura of expertise.
The overall result is that teaching scientific “facts” is emphasized, while individuals are not given the skills with which to critically evaluate the claims that are presented to them. People are placed in the position of accepting or rejecting claims based on what they are told to believe, rather than being able to critically evaluate the evidence.
A quick inspection of introductory college textbooks supports Ede’s basic arguments. As an example, most introductory psychology texts are now in excess of 500 pages, yet fewer than 15 pages are typically spent on research issues. Little or no discussion is given to the importance of evidence or how scientific methods can be used to weigh evidence. Instead, the primary emphasis of many texts is to enumerate as many scientific findings as possible. Since it is reasonable to suspect that many instructors follow the basic format of the text that has been selected for class, it is likely that class lectures spend more time on specific research findings than on the more abstract topics of empiricism and skepticism. Hence, it is possible for a student to accumulate a fairly sizable science knowledge base without learning how to properly distinguish between reputable science and pseudoscience. Fortunately, there is recently a stronger push in introductory psychology texts to correct this oversight, most strikingly by Carole Wade and Carol Tavris,7 but it still remains the exception to the rule.
The Placebo Effect
Jane D. was a regular visitor to our ER, usually showing up late at night demanding an injection of the narcotic Demerol, the only thing that worked for her severe headaches. One night the staff psychiatrist had the nurse give her an injection of saline instead. It worked! He told Jane she had responded to a placebo, discussed the implications, and thought he’d helped her understand that her problem was psychological. But as he was leaving the room, Jane asked, “Can I get that new medicine again next time instead of the Demerol? It really worked great!”
What’s going on here? What is the placebo effect and how does it work?
The term “placebo effect” is unfortunate; it leads to misunderstandings. Placebos themselves don’t have any effect. They are inert: that’s what placebo means. The word placebo comes from the Latin for “I please.” You can think of it as the opposite of “I benefit.” What we really mean by “the placebo effect” is not some mysterious effect from giving an inert treatment, but the complex web of psychosocial effects surrounding medical treatment. Those effects occur with effective treatments too, not just with inert treatments.
Mark Crislip, MD, thinks the placebo effect is a myth. “I think that the placebo effect with pain is a mild example of cognitive behavioral therapy; the pain stays the same, it is the emotional response that is altered … Ain’t no such thing as a placebo effect, only a change in perception.”1 He’s correct in saying that the placebo effect does nothing to change the pain signals in the nerves. But most people think the change in perception is the placebo effect and is worth pursuing.
There is a big difference between pain and suffering. A woman’s labor pains hurt, but with a joyful end in sight she may not suffer as much as a man who has milder pain sensations but is worried that his injured leg may need to be amputated. Some people say that morphine doesn’t relieve pain so much as make you not care about it. The experience of pain and the meaning of pain for the patient matter as much as the strength of the pain stimulus. If the placebo effect can do anything to divert the patient’s attention or help him reframe the meaning of his pain, his altered perception can reduce his experience of suffering.
In 1955, Dr. Henry Beecher published a seminal paper entitled “The Powerful Placebo” in the Journal of the American Medical Association.2 He reviewed studies that compared an active treatment to a placebo, and found that on average 35% of patients improved with the placebo. So any study that doesn’t have a placebo group for comparison is likely to give a false positive result. The placebo-controlled trial is now one of the cornerstones of medical science. It’s not enough to show that Miracle-mycin works; we have to show that it works better than a dummy pill that looks like Miracle-mycin but only contains sugar.
Beecher’s paper has been widely cited as evidence that 35% of patients respond to placebos, but that’s not really what it showed. He wasn’t measuring the placebo effect in isolation — he was actually measuring a combination of the placebo effect, the natural course of disease, and other factors. The patients who apparently responded to placebo included patients who showed improvement for other reasons. Reasons like spontaneous improvement, fluctuation of symptoms, regression to the mean, answers of politeness, experimental subordination, conditioned answers, misjudgment, etc.
To tease out how much of that 35% should be attributable to placebo, we need to know how many patients might have reported improvement without any treatment. In 2001 two Danish researchers, Asbjorn Hrobjartsson and Peter Gotzsche, published a paper entitled “Is the Placebo Powerless?” in the New England Journal of Medicine.3 They reviewed studies that included a no-treatment group, and they compared the improvement with placebos to the improvement with no treatment. They “found little evidence in general that placebos had powerful clinical effects.”
For studies with a binary outcome (improved versus not improved) there was no significant difference between the placebo and no treatment groups. For studies with continuous outcomes, there was some apparent effect of placebo; but not so for objective outcomes that could be measured by someone else, such as blood pressure, but only for subjective outcomes that depended on self-reports, such as pain. They weren’t even sure about that, however, because the effect was greater in smaller trials, indicating possible bias.
It’s hard to reconcile a study like this with what we know about placebos from experiences like the case of Jane D. They do seem to work, and they seem to work very dramatically at times.
In a study of pain after dental surgery, patients were given either intravenous morphine or a saline placebo. If they were told that the saline was a powerful new painkiller, they got just as much relief as the patients who received morphine. In another study, all patients were given morphine for post-op pain, but only half were told they were getting it. The patients who didn’t know they were getting it only experienced half as much pain relief. In a study of acupuncture for post-op dental pain, there was no difference between the “real” acupuncture and placebo “sham” acupuncture groups, but when they asked patients which group they thought they were in, they discovered that those who believed they were in the “real” group reported significantly more pain relief than those who believed they were in the “sham” group — regardless of which group they were actually in!