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shot up as a result of at least the first French Paradox broadcast:
The study also found that the benefits of wine drinking extended to
people who drank from three to five glasses of wine per day. "What
surprised us most was that wine intake signified much lower mortality
rates," Safer said to the television show's audience.
Overall, the segment should prove a big boost to the argument that wine
drinking in moderation can be a boon to one's health. The segment was
seen by more than 20 million people. "It isn't just information," said
John De Luca, president of California's Wine Institute, "it's the
credibility that comes with Morley Safer interviewing the scientists."
After the first French Paradox episode aired in November 1991 the
consumption of red wine shot up in the United States, and it has yet to
dip.
The Kim Marcus article underlined your failure to question the conclusion that wine
consumption increases life expectancy:
Throughout the episode, Safer didn't challenge the fact that wine is
linked to longer life; rather, he was interested in what it was about
wine that made it unique. "The central question is what is it about
wine, especially red wine, that promotes coronary health," he said.
Safer came to the conclusion that it is not only alcohol but other
unnamed compounds in wine that contributed to higher levels of
beneficial high-density lipoprotein (HDL) cholesterol.
I had already seen that French Paradox broadcast. As a matter of fact, I had watched your
French Paradox story when it was first broadcast on 5Nov95, and even while watching it I
had immediately recognized that your conclusion attributing longer life to wine drinking
was unjustified, and that you were causing harm in passing this conclusion along to a
large audience almost all of whom would accept it as true. At bottom, then, I see
little difference between your French Paradox story of 5Nov95 and your Ugly Face of
Freedom story of 23Oct94 - in each case, you ventured beyond your depth, giving
superficial judgments on topics that you were unqualified to speak on, discussing
questions that your education had given you no grounding in, and causing damage because
your conclusions proved to be false.
In the case of the Ugly Face of Freedom, the number of your errors was large, and the
amount of data that needed to be examined to demonstrate your errors was large as well,
as can be seen by the length of my rebuttal The Ugly Face of 60 Minutes. In the case of
the French Paradox, however, you make only one fundamental error which is to fail to
grasp the difference between experimental and correlational data - and my demonstration
of your error can compactly be contained within the present letter.
The reason that I am able to assert with some confidence that your conclusion that wine
drinking increases longevity is unjustified is as follows. I have a Ph.D. in
experimental psychology from Stanford, I taught in the Department of Psychology at the
University of Western Ontario for eleven years, and my teaching and my interests fell
largely into the areas of statistics, research methodology, and data interpretation.
Everyone with expertise in scientific method will agree with me that your conclusion in
The French Paradox was unwarranted. It is not necessary to read the original research
papers on which you rely to arrive at this same judgment - even the brief review of the
research data in your broadcast, even the briefer review of your broadcast in the Kim
Marcus quotations above - is enough for someone who has studied scientific method to see
that you were wrong. Below is my explanation.
The French Paradox Research
Cannot Have Been Experimental
There are two ways in which data relating wine consumption to longevity could have been
gathered - either in an experiment, or in a correlational study. If the data had been
gathered in an experiment, then it would have been done something like this. A number
of subjects (by which I mean human experimental subjects) would have been randomly
assigned to groups, let us say 11 different groups. The benefit of random assignment is
that it guarantees that the subjects in each group are initially equivalent in every
conceivable respect - equivalent in male-female ratio, in age, in health, in income, in
diet, in smoking, in drug use, and so on. That is the magic of random assignment, and
we cannot pause to discuss it - you will have to take my word for it.
To groups that enjoy pre-treatment equality, the experimenter administers his treatment.
After constituting his random groups, the experimenter would require the subjects in
each group to drink different volumes of wine each day over many years - let us say over
the course of 30 years. Subjects assigned to the zero-glass group would be required to
drink no wine. Subjects assigned to the 1-glass group would be required to drink one
glass of wine each day. Subjects assigned to the 2-glass group would be required to
drink two glasses of wine each day. And so on up to, say, a 10-glass group, which given
that we started with a zero-glass group gives us the 11 groups that I started out
positing that we would need. As the experiment progressed, the number dying in each
group as well as the cause of death, and the health of those still alive, would be
monitored periodically.
There are many ways in which this simplest of all experiments could be refined or
elaborated, but we need not pause to discuss such complications here what I have
outlined above constitutes a simple experiment which in many circumstances would be all
that is required to determine the effect of wine consumption on longevity.
Such an experiment has never been conducted
And so you can see from my outline of what an experiment would be like that such an
experiment could never have been conducted. We know this without doing a review of the
literature, without having read a single paper on wine consumption and health.
Manipulating long-term alcohol consumption in an experiment is impracticable. We know it
because, in the first place, it would be impossible to get experimental subjects to
comply with the particular wine-drinking regimen to which the experimenter had assigned
them. For example, many of the subjects who found themselves in the zero-glass
condition would refuse to pass the next 30 years without drinking a drop of wine. There
is no conceivable inducement within the power of the experimenter to offer that would
tempt these experimental subjects to become teetotallers for what could be the rest of
their lives. The same at the other end of the scale - most people requested to drink
large volumes of wine each day would refuse, and the experimenter would find that he had
no resources available to him by means of which he could win compliance.
And even if the experimenter were able to offer such vast sums of money to his subjects
that every last one of them agreed to comply with the required drinking regimen - and no
experimenter has such resources - then two things would happen: (1) the subjects would
cheat, as by many in the zero-glass group sneaking drinks whenever they could, and many
in the many-glass groups drinking less than was required of them; and (2) subjects who
found their drinking regimens uncomfortable would quit the experiment. Subjects
quitting the experiment constitutes a fatal blow to experimental validity because it
transforms groups that started out randomly constituted (and thus equivalent in every
conceivable respect) into groups that are naturally constituted (and which must be
assumed to be probably different in many conceivable respects) - a conclusion that I
will not pause to explain in detail.
Manipulating long-term alcohol consumption in an experiment is unethical. And we know
that no such experiment has ever been conducted because it would be unethical to conduct
it, and would inevitably lead to the experimenter being sued. That is, it is unethical
in scientific research to transform people's lives in possibly harmful ways. Most
specifically, it is unethical to transform people's lives by inducing them to drink
substantial amounts of alcohol every day for several decades. The potential harm is
readily evident.
For example, drinking 10 glasses of wine per day, or even several glasses, will
predispose a person to accidents. A single experimental subject who consumed several
glasses of wine and then was incapacitated in an automobile accident would be all that
it would take to bring such research to a halt forever. The accident victim might
readily argue that the experiment requiring him to drink wine was responsible for his
accident, and that the experimenter - and the university at which he worked, and the
granting agency that funded his research - were liable for millions of dollars. In
anticipation of no more than the possibility of such a law suit, no granting agency
would fund such research, and no university or research institution would allow it to be
conducted under its roof.
Consuming substantial amounts of alcohol can not only cause accidents, but it can also
ruin health, destroy careers, distort personalities, break up marriages - for which
reason no experiment will ever require subjects to consume substantial amounts of
alcohol over extended periods of time. The possibility of harm, and thus of law suits,
can even be conceived at the low end of the alcohol-consumption continuum. That is, a
subject prohibited from drinking any alcohol might argue that this for him unnatural and
unaccustomed regimen changed his personality, undermined his career, and ruined his
marriage, and with this claim in hand, could readily find a lawyer willing to help him
sue for damages.
And if such an experiment had ever been conducted, it would
be invalid
Manipulating long-term alcohol consumption in an experiment would fail to meet the
double-blind requirement. And although we are certain that an experiment manipulating
alcohol consumption over an extended period has never been conducted, even if it were
conducted, it would nevertheless contain inescapable flaws which would stand in the way
of permitting cause-effect conclusions. For example, you may be aware that the best
experiments are ones that are "double-blind." A "blind" experiment is one in which the
subjects do not know what experimental condition they are in - they might not know, for
example, whether the pill they are swallowing contains a curative drug, or only a
placebo. In our alcohol experiment, they would not know whether the liquid they were
drinking was wine, or only some wine-colored and wine-flavored water that had been
sealed in wine bottles. Already, we see the impossibility of our wine experiment being
even so much as blind. Just about every subject in our wine experiment would
immediately realize what it was that he was drinking. Tinted water is clearly
distinguishable by its appearance and taste and effect from wine. A blind wine
experiment, then, is an utter impossibility. Most subjects would be able to quickly
infer approximately what experimental condition they had been placed into.
A "double-blind" experiment would be one in which neither the subject nor the
experimenter knew what experimental condition any particular subject was in. For
example, the experimenter hands the subject a capsule, but does not himself know until
the experiment is over whether that capsule contains a curative drug or only a placebo.
In our alcohol experiment, a double-blind experiment would involve the experimenter
monitoring the life and health of each subject, but only after the experiment was over
opening up the sealed envelope to find out how much alcohol that subject had been
consuming over the past 30 years. Utterly impossible as well.
The reason that the double-blind requirement is essential is that without it,
confounding factors appear that might be responsible for any observed longevity
effects. For example, subjects aware that they are in a large-alcohol-consumption group
would also tend to realize that such alcohol consumption might harm them, and so they
might attempt to compensate by taking vitamin pills, not smoking, upgrading their diets,
exercising, and so on. Or, they might start eating fats prior to drinking alcohol, in
order to coat their stomachs and slow the absorption of the alcohol. They might do a
large number of things. What is important is that the knowledge of one's experimental
treatment can lead to one or more changes in behavior, and that it is these unintended
changes, and not the wine consumption itself, that could affect longevity, either in one
direction or the other.
Or, here is a particularly plausible confounding that might appear. Imagine that the
experiment attempts to control wine drinking, and no more than that, and that subjects
do faithfully follow the wine regimen that is imposed on them. Nevertheless, the less
wine that they were allowed to drink, the more beer and hard alcohol they would probably
end up drinking, but which would make the initially equal groups unequal on beer and
hard-alcohol consumption. And so then it would be impossible to tell if differences in
longevity should be attributed to differences in wine consumption, or to differences in
beer consumption, or to differences in hard-alcohol consumption.
But while we may choose to pause and speculate as to what confounding variables may
appear, scientific method does not obligate us to do so. We know that confounding
variables are possible in non-double-blind experiments, and the number that we are able
to imagine is limited only by the time that we allocate to trying. If I cared to spend
a few hours thinking about it, I could write several pages of possibilities. If I chose
to spend a few months thinking about it, I could write a book of possibilities. I am
able to imagine confounding variables either improving health or impairing it at the low
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