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start with epistemic bubbles

That omission might be purposeful

But that omission can also be entirely inadvertent. Even if we’re not actively trying to avoid disagreement, our Facebook friends tend to share our views and interests

An ‘echo chamber’ is a social structure from which other relevant voices have been actively discredited. Where an epistemic bubble merely omits contrary views, an echo chamber brings its members to actively distrust outsiders.

an echo chamber is something like a cult. A cult isolates its members by actively alienating them from any outside sources. Those outside are actively labelled as malignant and untrustworthy.

In epistemic bubbles, other voices are not heard; in echo chambers, other voices are actively undermined.

The way to break an echo chamber is not to wave “the facts” in the faces of its members. It is to attack the echo chamber at its root and repair that broken trust.

Looking to others for corroboration is a basic method for checking whether one has reasoned well or badly

They have been in the limelight lately, most famously in Eli Pariser’s The Filter Bubble (2011) and Cass Sunstein’s #Republic: Divided Democracy in the Age of Social Media (2017).

The general gist: we get much of our news from Facebook feeds and similar sorts of social media. Our Facebook feed consists mostly of our friends and colleagues, the majority of whom share our own political and cultural views

various algorithms behind the scenes, such as those inside Google search, invisibly personalise our searches, making it more likely that we’ll see only what we want to see. These processes all impose filters on information.

Such filters aren’t necessarily bad. The world is overstuffed with information, and one can’t sort through it all by oneself: filters need to be outsourced.

That’s why we all depend on extended social networks to deliver us knowledge

any such informational network needs the right sort of broadness and variety to work

Each individual person in my network might be superbly reliable about her particular informational patch but, as an aggregate structure, my network lacks what Sanford Goldberg in his book Relying on Others (2010) calls ‘coverage-reliability’. It doesn’t deliver to me a sufficiently broad and representative coverage of all the relevant information.

Epistemic bubbles also threaten us with a second danger: excessive self-confidence.

An ‘epistemic bubble’ is an informational network from which relevant voices have been excluded by omission

Suppose that I believe that the Paleo diet is the greatest diet of all time. I assemble a Facebook group called ‘Great Health Facts!’ and fill it only with people who already believe that Paleo is the best diet. The fact that everybody in that group agrees with me about Paleo shouldn’t increase my confidence level one bit. They’re not mere copies – they actually might have reached their conclusions independently – but their agreement can be entirely explained by my method of selection.

Luckily, though, epistemic bubbles are easily shattered. We can pop an epistemic bubble simply by exposing its members to the information and arguments that they’ve missed.

echo chambers are a far more pernicious and robust phenomenon.

amieson and Cappella’s book is the first empirical study into how echo chambers function

echo chambers work by systematically alienating their members from all outside epistemic sources.

Their research centres on Rush Limbaugh, a wildly successful conservative firebrand in the United States, along with Fox News and related media

His constant attacks on the ‘mainstream media’ are attempts to discredit all other sources of knowledge. He systematically undermines the integrity of anybody who expresses any kind of contrary view.

outsiders are not simply mistaken – they are malicious, manipulative and actively working to destroy Limbaugh and his followers. The resulting worldview is one of deeply opposed force, an all-or-nothing war between good and evil

The result is a rather striking parallel to the techniques of emotional isolation typically practised in cult indoctrination

cult indoctrination involves new cult members being brought to distrust all non-cult members. This provides a social buffer against any attempts to extract the indoctrinated person from the cult.

The echo chamber doesn’t need any bad connectivity to function. Limbaugh’s followers have full access to outside sources of information

As Elijah Millgram argues in The Great Endarkenment (2015), modern knowledge depends on trusting long chains of experts. And no single person is in the position to check up on the reliability of every member of that chain

Their worldview can survive exposure to those outside voices because their belief system has prepared them for such intellectual onslaught.

exposure to contrary views could actually reinforce their views. Limbaugh might offer his followers a conspiracy theory: anybody who criticises him is doing it at the behest of a secret cabal of evil elites, which has already seized control of the mainstream media.

Perversely, exposure to outsiders with contrary views can thus increase echo-chamber members’ confidence in their insider sources, and hence their attachment to their worldview.

‘evidential pre-emption’. What’s happening is a kind of intellectual judo, in which the power and enthusiasm of contrary voices are turned against those contrary voices through a carefully rigged internal structure of belief.

One might be tempted to think that the solution is just more intellectual autonomy. Echo chambers arise because we trust others too much, so the solution is to start thinking for ourselves.

that kind of radical intellectual autonomy is a pipe dream. If the philosophical study of knowledge has taught us anything in the past half-century, it is that we are irredeemably dependent on each other in almost every domain of knowledge

Limbaugh’s followers regularly read – but do not accept – mainstream and liberal news sources. They are isolated, not by selective exposure, but by changes in who they accept as authorities, experts and trusted sources.

we depend on a vastly complicated social structure of trust. We must trust each other, but, as the philosopher Annette Baier says, that trust makes us vulnerable. Echo chambers operate as a kind of social parasite on that vulnerability, taking advantage of our epistemic condition and social dependency.

I am quite confident that there are plenty of echo chambers on the political Left. More importantly, nothing about echo chambers restricts them to the arena of politics

The world of anti-vaccination is clearly an echo chamber, and it is one that crosses political lines. I’ve also encountered echo chambers on topics as broad as diet (Paleo!), exercise technique (CrossFit!), breastfeeding, some academic intellectual traditions, and many, many more

Here’s a basic check: does a community’s belief system actively undermine the trustworthiness of any outsiders who don’t subscribe to its central dogmas? Then it’s probably an echo chamber.

much of the recent analysis has lumped epistemic bubbles together with echo chambers into a single, unified phenomenon. But it is absolutely crucial to distinguish between the two.

Epistemic bubbles are rather ramshackle; they go up easily, and they collapse easily

Echo chambers are far more pernicious and far more robust. They can start to seem almost like living things. Their belief systems provide structural integrity, resilience and active responses to outside attacks

the two phenomena can also exist independently. And of the events we’re most worried about, it’s the echo-chamber effects that are really causing most of the trouble.

new data does, in fact, seem to show that people on Facebook actually do see posts from the other side, or that people often visit websites with opposite political affiliation.

their basis for evaluation – their background beliefs about whom to trust – are radically different. They are not irrational, but systematically misinformed about where to place their trust.

Many people have claimed that we have entered an era of ‘post-truth’.

Not only do some political figures seem to speak with a blatant disregard for the facts, but their supporters seem utterly unswayed by evidence. It seems, to some, that truth no longer matters.

This is an explanation in terms of total irrationality. To accept it, you must believe that a great number of people have lost all interest in evidence or investigation, and have fallen away from the ways of reason.

echo chambers offers a less damning and far more modest explanation. The apparent ‘post-truth’ attitude can be explained as the result of the manipulations of trust wrought by echo chambers.

We don’t have to attribute a complete disinterest in facts, evidence or reason to explain the post-truth attitude. We simply have to attribute to certain communities a vastly divergent set of trusted authorities.

An echo chamber doesn’t destroy their members’ interest in the truth; it merely manipulates whom they trust and changes whom they accept as trustworthy sources and institutions.

in many ways, echo-chamber members are following reasonable and rational procedures of enquiry. They’re engaging in critical reasoning. They’re questioning, they’re evaluating sources for themselves, they’re assessing different pathways to information. They are critically examining those who claim expertise and trustworthiness, using what they already know about the world

none of this weighs against the existence of echo chambers. We should not dismiss the threat of echo chambers based only on evidence about connectivity and exposure.

Notice how different what’s going on here is from, say, Orwellian doublespeak, a deliberately ambiguous, euphemism-filled language designed to hide the intent of the speaker.

echo chambers don’t trade in vague, ambiguous pseudo-speech. We should expect that echo chambers would deliver crisp, clear, unambiguous claims about who is trustworthy and who is not

clearly articulated conspiracy theories, and crisply worded accusations of an outside world rife with untrustworthiness and corruption.

Once an echo chamber starts to grip a person, its mechanisms will reinforce themselves.

In an epistemically healthy life, the variety of our informational sources will put an upper limit to how much we’re willing to trust any single person. Everybody’s fallible; a healthy informational network tends to discover people’s mistakes and point them out. This puts an upper ceiling on how much you can trust even your most beloved leader

nside an echo chamber, that upper ceiling disappears.

Being caught in an echo chamber is not always the result of laziness or bad faith. Imagine, for instance, that somebody has been raised and educated entirely inside an echo chamber

when the child finally comes into contact with the larger world – say, as a teenager – the echo chamber’s worldview is firmly in place. That teenager will distrust all sources outside her echo chamber, and she will have gotten there by following normal procedures for trust and learning.

It certainly seems like our teenager is behaving reasonably. She could be going about her intellectual life in perfectly good faith. She might be intellectually voracious, seeking out new sources, investigating them, and evaluating them using what she already knows.

The worry is that she’s intellectually trapped. Her earnest attempts at intellectual investigation are led astray by her upbringing and the social structure in which she is embedded.

Echo chambers might function like addiction, under certain accounts. It might be irrational to become addicted, but all it takes is a momentary lapse – once you’re addicted, your internal landscape is sufficiently rearranged such that it’s rational to continue with your addiction

Similarly, all it takes to enter an echo chamber is a momentary lapse of intellectual vigilance. Once you’re in, the echo chamber’s belief systems function as a trap, making future acts of intellectual vigilance only reinforce the echo chamber’s worldview.

There is at least one possible escape route, however. Notice that the logic of the echo chamber depends on the order in which we encounter the evidence. An echo chamber can bring our teenager to discredit outside beliefs precisely because she encountered the echo chamber’s claims first. Imagine a counterpart to our teenager who was raised outside of the echo chamber and exposed to a wide range of beliefs. Our free-range counterpart would, when she encounters that same echo chamber, likely see its many flaws

Those caught in an echo chamber are giving far too much weight to the evidence they encounter first, just because it’s first. Rationally, they should reconsider their beliefs without that arbitrary preference. But how does one enforce such informational a-historicity?

The escape route is a modified version of René Descartes’s infamous method.

Meditations on First Philosophy (1641). He had come to realise that many of the beliefs he had acquired in his early life were false. But early beliefs lead to all sorts of other beliefs, and any early falsehoods he’d accepted had surely infected the rest of his belief system.

The only solution, thought Descartes, was to throw all his beliefs away and start over again from scratch.

He could start over, trusting nothing and no one except those things that he could be entirely certain of, and stamping out those sneaky falsehoods once and for all. Let’s call this the Cartesian epistemic reboot.

Notice how close Descartes’s problem is to our hapless teenager’s, and how useful the solution might be. Our teenager, like Descartes, has problematic beliefs acquired in early childhood. These beliefs have infected outwards, infesting that teenager’s whole belief system. Our teenager, too, needs to throw everything away, and start over again.

Let’s call the modernised version of Descartes’s methodology the social-epistemic reboot.

when she starts from scratch, we won’t demand that she trust only what she’s absolutely certain of, nor will we demand that she go it alone

For the social reboot, she can proceed, after throwing everything away, in an utterly mundane way – trusting her senses, trusting others. But she must begin afresh socially – she must reconsider all possible sources of information with a presumptively equanimous eye. She must take the posture of a cognitive newborn, open and equally trusting to all outside sources

we’re not asking people to change their basic methods for learning about the world. They are permitted to trust, and trust freely. But after the social reboot, that trust will not be narrowly confined and deeply conditioned by the particular people they happened to be raised by.

Such a profound deep-cleanse of one’s whole belief system seems to be what’s actually required to escape. Look at the many stories of people leaving cults and echo chambers

Take, for example, the story of Derek Black in Florida – raised by a neo-Nazi father, and groomed from childhood to be a neo-Nazi leader. Black left the movement by, basically, performing a social reboot. He completely abandoned everything he’d believed in, and spent years building a new belief system from scratch. He immersed himself broadly and open-mindedly in everything he’d missed – pop culture, Arabic literature, the mainstream media, rap – all with an overall attitude of generosity and trust.

It was the project of years and a major act of self-reconstruction, but those extraordinary lengths might just be what’s actually required to undo the effects of an echo-chambered upbringing.

we need to attack the root, the systems of discredit themselves, and restore trust in some outside voices.

Stories of actual escapes from echo chambers often turn on particular encounters – moments when the echo-chambered individual starts to trust somebody on the outside.

Black’s is case in point. By high school, he was already something of a star on neo-Nazi media, with his own radio talk-show. He went on to college, openly neo-Nazi, and was shunned by almost every other student in his community college. But then Matthew Stevenson, a Jewish fellow undergraduate, started inviting Black to Stevenson’s Shabbat dinners. In Black’s telling, Stevenson was unfailingly kind, open and generous, and slowly earned Black’s trust. This was the seed, says Black, that led to a massive intellectual upheaval – a slow-dawning realisation of the depths to which he had been misled

Similarly, accounts of people leaving echo-chambered homophobia rarely involve them encountering some institutionally reported fact. Rather, they tend to revolve around personal encounters – a child, a family member, a close friend coming out.

hese encounters matter because a personal connection comes with a substantial store of trust.

We don’t simply trust people as educated experts in a field – we rely on their goodwill. And this is why trust, rather than mere reliability, is the key concept

goodwill is a general feature of a person’s character. If I demonstrate goodwill in action, then you have some reason to think that I also have goodwill in matters of thought and knowledge.

f one can demonstrate goodwill to an echo-chambered member – as Stevenson did with Black – then perhaps one can start to pierce that echo chamber.

the path I’m describing is a winding, narrow and fragile one. There is no guarantee that such trust can be established, and no clear path to its being established systematically.

what we’ve found here isn’t an escape route at all. It depends on the intervention of another. This path is not even one an echo-chamber member can trigger on her own; it is only a whisper-thin hope for rescue from the outside.

it is necessary to strip away the irrelevancies in which this controversy is usually wrapped up.

The enemies of intellectual liberty always try to present their case as a plea for discipline versus individualism.

The issue truth-versus-untruth is as far as possible kept in the background.

the writer who refuses to sell his opinions is always branded as a mere egoist, He is accused, that is, either of wanting to shut himself up in an ivory tower, or of making an exhibitionist display of his own personality, or of resisting the inevitable current, of history in an attempt to cling to unjustified privileges.

Each of them tacitly claims that “the truth” has already been revealed, and that the heretic, if he is not simply a fool, is secretly aware of “the truth” and merely resists it out of selfish motives.

Freedom of the intellect means the freedom to report what one has seen, heard, and fell, and not to be obliged to fabricate imaginary facts and feelings.

known facts are suppressed and distorted to such an extent as to make it doubtful whether a true history of our times can ever be written.

A totalitarian state is in effect a theocracy, and its ruling caste, in order to keep its position, has to be thought of as infallible. But since, in practice, no one is infallible, it is frequently necessary to rearrange past events in order to show that this or that mistake was not made, or that this or that imaginary triumph actually happened

Then, again, every major change in policy demands a corresponding change of doctrine and a revaluation of prominent historical figures. This kind of thing happens everywhere, but clearly it is likelier to lead to outright falsification in societies where only one opinion is permissible at any given moment.

The friends of totalitarianism in England usually tend to argue that since absolute truth is not attainable, a big lie is no worse than a little lie. It is pointed out that all historical records are biased and inaccurate, or, on the other hand, that modem physics has proved that what seems to us the real world is an illusion, so that to believe in the evidence of one’s senses is simply vulgar philistinism.

The volatility of chatbots has made it impossible to predict their impact. In one second, the systems impress by fielding a complex request for a five-day itinerary, making Google’s search engine look archaic. A moment later, they disturb by taking conversations in dark directions and launching verbal assaults.

The result is an industry gripped with the question: What do we do now?

The A.I. systems could disrupt $100 billion in cloud spending, $500 billion in digital advertising and $5.4 trillion in e-commerce sales,

As Microsoft figures out a chatbot business model, it is forging ahead with plans to sell the technology to others. It charges $10 a month for a cloud service, built in conjunction with the OpenAI lab, that provides developers with coding suggestions, among other things.

Smaller companies like Box need help building chatbot tools, so they are turning to the giants that process, store and manage information across the web. Those companies — Google, Microsoft and Amazon — are in a race to provide businesses with the software and substantial computing power behind their A.I. chatbots.

“The cloud computing providers have gone all in on A.I. over the last few months,

“They are realizing that in a few years, most of the spending will be on A.I., so it is important for them to make big bets.”

Yusuf Mehdi, the head of Bing, said the company was wrestling with how the new version would make money. Advertising will be a major driver, he said, but the company expects fewer ads than traditional search allows.

Google, perhaps more than any other company, has reason to both love and hate the chatbots. It has declared a “code red” because their abilities could be a blow to its $162 billion business showing ads on searches.

“The discourse on A.I. is rather narrow and focused on text and the chat experience,” Mr. Taylor said. “Our vision for search is about understanding information and all its forms: language, images, video, navigating the real world.”

Sridhar Ramaswamy, who led Google’s advertising division from 2013 to 2018, said Microsoft and Google recognized that their current search business might not survive. “The wall of ads and sea of blue links is a thing of the past,” said Mr. Ramaswamy, who now runs Neeva, a subscription-based search engine.

As that underlying tech, known as generative A.I., becomes more widely available, it could fuel new ideas in e-commerce. Late last year, Manish Chandra, the chief executive of Poshmark, a popular online secondhand store, found himself daydreaming during a long flight from India about chatbots building profiles of people’s tastes, then recommending and buying clothes or electronics. He imagined grocers instantly fulfilling orders for a recipe.

“It becomes your mini-Amazon,” said Mr. Chandra, who has made integrating generative A.I. into Poshmark one of the company’s top priorities over the next three years. “That layer is going to be very powerful and disruptive and start almost a new layer of retail.”

In early December, users of Stack Overflow, a popular social network for computer programmers, began posting substandard coding advice written by ChatGPT. Moderators quickly banned A.I.-generated text

t people could post this questionable content far faster than they could write posts on their own, said Dennis Soemers, a moderator for the site. “Content generated by ChatGPT looks trustworthy and professional, but often isn’t,”

When websites thrived during the pandemic as traffic from Google surged, Nilay Patel, editor in chief of The Verge, a tech news site, warned publishers that the search giant would one day turn off the spigot. He had seen Facebook stop linking out to websites and foresaw Google following suit in a bid to boost its own business.

He predicted that visitors from Google would drop from a third of websites’ traffic to nothing. He called that day “Google zero.”

Because chatbots replace website search links with footnotes to answers, he said, many publishers are now asking if his prophecy is coming true.

, strategists and engineers at the digital advertising company CafeMedia have met twice a week to contemplate a future where A.I. chatbots replace search engines and squeeze web traffic.

The group recently discussed what websites should do if chatbots lift information but send fewer visitors. One possible solution would be to encourage CafeMedia’s network of 4,200 websites to insert code that limited A.I. companies from taking content, a practice currently allowed because it contributes to search rankings.

Courts are expected to be the ultimate arbiter of content ownership. Last month, Getty Images sued Stability AI, the start-up behind the art generator tool Stable Diffusion, accusing it of unlawfully copying millions of images. The Wall Street Journal has said using its articles to train an A.I. system requires a license.

In the meantime, A.I. companies continue collecting information across the web under the “fair use” doctrine, which permits limited use of material without permission.

Functional Medicine isn't a protected title and a medical qualification isn't a prerequisite to practice. The result is an unregulated and disparate field, with medical doctors, nutritionists, naturopaths and homeopaths among the many practitioners.

Some other chronic illnesses the field claims to treat include heart disease, type 2 diabetes, irritable bowel syndrome, ulcerative colitis, depression, anxiety and arthritis

ll kinds of different reasons, some might have gluten issues, gut issues, others might have a deficiency causing neurological issues, MS is a symptom."

"There are components of Functional Medicine that absolutely lack an evidence base and there are practitioners of what they call Functional Medicine, they charge people for intravenous nutritional injections, they exaggerate claims, and that is professionally inappropriate, unethical and it lacks evidence.

On Dr Mark Hyman's view of MS he says, "there are a lot of terms put together there, all of which individually make a lot of sense, but put together in that way they do not.

"What does FM actually mean? It means nothing. It's a gift-gallop of words thrown together. It's criticised by advocates of evidence-based medicine because it's giving a veneer of scientific legitimacy to ideas that are considered pseudoscientific. For example, it'll take alternative medicine modalities like homeopathy and then call them 'bio-infusions' or something similar, rebranding it as something that works.

"It's a redundant name, real medicine is functional."

Next month the third annual Lifestyle and Functional Medical conference will take place in Salthill, Galway on November 3. Last year's event was attended by more than 500 people and featured a keynote address by honorary consultant cardiologist Dr Aseem Malhotra, author of bestselling The Pioppi Diet (which was named one of the top five worst celebrity diets to avoid in 2018 by the British Dietetic Foundation).

Dr David Robert Grimes is physicist and visiting fellow of Oxford and QUB. His research into cancer focuses on modelling tumour metabolism and radiation interactions. For Dr Grimes, the lack of definition, or "double-speak" as he puts it, in FM is troubling.

As well as the cost of appointments, FM practitioners commonly charge extra for tests. An omega finger prick test is around €100. A vitamin D test can cost upwards of €60, full thyroid panel more than €150 and a gut function test €400. Prices vary between practitioners.

"If I, as a GP, engaged in some of these behaviours I would be struck off." Specifically? "If I was recommending treatments that lacked an evidence base, or if I was promoting diagnostic tests which are expensive and lack an evidence base.

GPs engage every year in ongoing continuous professional development, I spend my evenings and my weekends outside of working hours attending educational events, small-group learning, large-group learning, engaging in research. This is an accusation that was levelled at the profession 30 years ago and then it was correct, but the profession has caught up…

"Obviously promoting wellness and healthy diet is very welcome but going beyond that and stating that certain aspects of 'functional medicine' can lead to reduced inflammation or prevent cancer, we have to be very careful about those claims.

Often the outcome of such tests are seemingly 'benign' prescriptions of vitamins or cleanses. However, dietitian Orla Walsh stresses that even these can have potentially harmful effects, especially on "vulnerable" patients, if not prescribed judiciously.

FM has five basic principles. 1. We are all genetically and biochemically unique so it treats the individual, not the disease. 2. It's science-based. 3. The body is intelligent and has the capacity for self-regulation. 4. The body has the ability to heal and prevent nearly all the diseases of ageing. 5. Health is not just the absence of disease, but a state of immense vitality.

She began her Functional Medicine career while training as a medical doctor and now travels the world working with high-profile clients. Dr McHale charges €425 for an initial consultation and €175 for follow-up appointments. Straightforward lab tests are €250 to €750, for complex cases testing fees can be up to €2,000.

"The term [Functional Medicine] tends to be bandied around quite a bit. Other things people say, such as 'functional nutritionist', can be misleading as a term. Many people are Functional Medicine practitioners but don't have any real medical background at all... I think regulation is always probably the best way forward."

"There's an awful lot to it in terms of biochemistry and physiology," she says. "You do need to have a very solid and well ingrained bio-chemistry background. A solely clinical background doesn't equip you with the knowledge to read a test.

"Evidence-base is the cornerstone of medicine and that has to be maintained. It becomes problematic in this area because you are looking at personalised medicine and that can be very difficult to evidence-base."

GP Christine Ritter travelled from England to attend the Galway conference last year with a view to integrating Functional Medicine into her practice.

"It was very motivating," she says. "Where it wasn't perhaps as strong was to find the evidence. The Functional Medicine people would say, 'we've done this study and this trial and we've used this supplement that was successful', but they can't show massive research data which might make it difficult to bring it into the mainstream.

"I also know the rigorous standard of trials we have in medicine they're not usually that great either, it's often driven by who's behind the trial and who's paying for it.

"Every approach that empowers patient to work on their destiny [is beneficial], but you'd have to be mindful that you're not missing any serious conditions."

Dr Hyman is working to grow the evidence-base for Functional Medicine worldwide. "The future is looking very bright," he says. "At the Cleveland Centre we're establishing a research base, building educational platforms, fellowships, residency programmes, rotations. We're advancing the field that's spreading across the world. We're seeing in China the development of a programme of Functional Medicine, South Africa, the UK, in London the Cleveland Clinic will hopefully have a Functional Medicine centre."

For Dr Mark Murphy regulation is a moot point as it can only apply once the field meets the standards of evidence-based medicine.

"Despite well intentioned calls for regulation, complementary and alternative medical therapies cannot be regulated," he says. "Only therapies that possess an evidence-base can enter our standard regulatory processes, including the Irish Medical Council, the Health Products Regulatory Authority and Irish advertising standards. In situations where complementary and alternative therapies develop an evidence base, they are no longer 'complementary and alternative', but in effect they become part of mainstream 'Medicine'.

l What are the principles?

"There's a huge variation between therapists, some are brilliant and some are okay, and some are ludicrous snake oil salesmen."

He is so concerned that patients' health and wealth are being put at risk by alternative therapies that earlier this year he joined Fine Gael TD Kate O'Connell and the Irish Cancer Society in introducing draft legislation earlier this year making it illegal to sell unproven treatments to cancer patients. Violators face jail and heavy fines.

Dr Grimes says criticism of variations in the standards of traditional medical research can be fair, however due to the weight of research it is ultimately self-correcting. He adds, "The reality is that good trials are transparent, independent and pre-registered.

"My involvement in shaping the Bill came from seeing first-hand the exploitation of patients and their families. Most patients undergoing treatment will take some alternative modalities in conjunction but a significant portion are talked out of their conventional medicine and seduced by false promises