Healthy dissent: resisting attacks on alternative medicine
Brian Martin’s publications on vaccination
Imagine that you have taken a stand challenging medical orthodoxy. It might be on cancer treatments, diet, alternative therapies, or any number of other issues. You start to come under attack. Critics write hostile comments on blogs; complaints are made to medical authorities; your attempts to organize public talks are sabotaged. What should you do?
Challenging orthodox opinion has seldom been easy. In principle, science is open to dissenting views – research findings are supposed to be examined on their merits – but in practice intolerance is quite common. There are numerous examples of suppression of dissent in scientific fields,[1-2] as well as suppression of social movements more generally.
Health and medicine are prime areas for suppression.[4-8] Governments have a long record of suppressing practitioners who threaten medical monopolies, and the US government is one of the worst offenders in this regard. In the more extreme scenarios, practitioners are arrested and prosecuted; some of them seek refuge in other countries.
In the debate over fluoridation of public water supplies, for example, it can be risky to challenge orthodoxy – especially if you are a dentist. Some dentists have been threatened or deregistered because of their opposition to fluoridation. Although only a few are directly affected, others see what happens to dissenters and keep quiet to protect themselves. Suppression of dissent sends a signal more far-reaching than its impacts on the immediate targets.
The rise of the Internet has provided an opportunity for those with unorthodox views to present their ideas to a wider audience. Free of the controls imposed by editors, online publication offers a way around censorship. Critics of Internet information say there is less quality control. In practice, readers increasingly make decisions about the credibility of information on the basis of consistency across different sources rather than relying solely on those with the greatest formal authority.
However, the Internet also provides new avenues for attacking dissent. It is important for anyone with dissenting views, or who cares about dissent, to be aware of options and risks.
To illustrate the dangers and give suggestions about how to defend against them, I present here an extreme case study: the systematic attack on a group critical of vaccination. This case reveals a range of methods of attack as well as the strengths and weaknesses of different types of responses. It is important to learn the lessons from this case because if the attackers are successful, others may copy their methods.
Personally, I do not have strong views about vaccination. My interest in this case is to defend free speech.
I have corresponded with partisans from each side of the struggle. I subscribed to the magazine Living Wisdom and thereby automatically became a member of the Australian Vaccination Network. Beginning in the 1990s, I subscribed to the magazine The Skeptic and automatically became a member of the Skeptics Society, a sister organization of the Australian Skeptics, closely connected to Stop the Australian Vaccination Network.
The attack on the Australian Vaccination Network
The Australian Vaccination Network (AVN) was set up in 1994 by Meryl Dorey, whose son suffered an adverse reaction to his vaccinations. The AVN, like other citizen vaccine-critical groups, provides information to concerned parents about the risks of vaccination and argues in favor of parental choice in vaccination decisions. The AVN’s magazine Living Wisdom has featured articles on a range of topics in holistic health. Of the Australian groups critical of vaccination, the AVN is the largest, with several thousand members. The group hosts a large website, including a blog.
In 2009, another group was set up: Stop the Australian Vaccination Network (SAVN), with the stated aim of shutting down the AVN. SAVN’s main presence is a Facebook page with several thousand friends; the group is not incorporated and apparently has no bank account, office bearers or formal leader. Some of those involved with SAVN are health professionals, but the group has no formal connection with mainstream organizations supportive of vaccination, such as the Australian Medical Association.
Those involved with SAVN – called here SAVNers – have used a range of techniques to oppose the AVN. The number of different modes of attack is astounding; only some are mentioned here.
It is important to note that SAVNers and AVN members have the same goal: protecting children’s health. However, they have very different views about how to achieve this goal. My focus here is not on motivations but on the methods used by SAVNers and how to respond to them.
SAVNers made posts on the AVN’s blog, some of them polite and constructive and others abusive. The result was that what had previously been amiable discussions among generally like-minded individuals often became heated and contentious.
Dorey has occasionally made comments on blogs hosted by other vaccine-critical groups, including in other countries. After the formation of SAVN, she sometimes found that her comments would quickly be followed by hostile responses, for example questioning whether children had actually been damaged by vaccines. Some SAVNers presumably had put Google Alerts on Dorey’s name so they were immediately notified of any comment Dorey made on the Internet, and then joined blogs and made comments derogatory of Dorey.
On SAVN’s Facebook page, abusive comments about the AVN, and Dorey in particular, were frequent. She was called a liar, seemingly on the basis that she continued to express views that SAVNers believed they had shown to be wrong. SAVNer Ken McLeod compiled a large dossier on Dorey’s alleged lies.
Another SAVN technique was to prepare graphics making fun of the AVN and/or Dorey. One, for example, was titled “The Bangalow nutfarm,” referring to her home in Bangalow where her husband is a macadamia nut farmer. The graphic has a photo of some nuts with an arrow pointing to them captioned “Nuts,” and a photo of Dorey with an arrow pointing to her captioned “Even more nuts!”
SAVNers monitored comments on the AVN’s blog. In many cases, they took screenshots of comments, posted them on SAVN’s page and made derogatory remarks about them. As a result of this sort of treatment, many AVN sympathizers were reluctant to post comments on the AVN’s blog.
SAVNers have made numerous complaints to government bodies about the AVN, asking for action to be taken against the organization. There is no public record of these complaints, but indications are that there have been dozens or even hundreds of them. The AVN has been notified about some of the complaints, and in some instances asked to respond to the relevant government agency.
The AVN is incorporated in the Australian state of New South Wales, so many of the complaints have been to regulatory bodies in the state. One of them is the Health Care Complaints Commission (HCCC), set up to handle complaints about health practitioners. SAVNer Ken McLeod made a lengthy complaint to the HCCC, which, following an investigation, demanded that the AVN add a disclaimer to its website. The AVN declined to do this – it already had a disclaimer – and the HCCC then issued a “public warning” about the AVN, which was widely reported in the mass media. On every available opportunity, SAVNers referred to the HCCC warning.
The HCCC’s decision was questionable, given that the AVN was not a body of health practitioners, but rather a citizens’ organization presenting a viewpoint on a controversial health matter. The AVN challenged the HCCC in court and won on the matter of jurisdiction; the HCCC immediately withdrew its warning.
Meanwhile, based on the HCCC decision, another government body took action against the AVN, again in response to SAVN complaints. The Office of Liquor, Gaming and Racing (OLGR), which regulates charitable organizations in the state, ruled that the AVN could not do any fundraising nor accept any new members. After the HCCC lost in court, the OLGR reversed its ruling.
The AVN advertised and sold a video about a product called “black salve,” claimed to be effective against cancer. After complaints made to the Therapeutic Goods Administration (TGA), this body ruled that the AVN was not allowed to sell or even mention the black salve video. The TGA, an industry-funded government agency regulating therapeutic drugs and devices, has draconian powers that have been used against alternative health products and companies. The TGA’s action affected only the AVN; the video about black salve remained freely available for purchase at numerous other websites. Note that the AVN had been selling a video about black salve – not black salve itself.
The Department of Fair Trading (DFT), which regulates organizations incorporated in the state of New South Wales, received numerous complaints about the AVN. One was that the AVN did not include “Inc.” after its name on every mention, for example on its website – seemingly a petty matter, given that few incorporated bodies followed this legal technicality. More potent were complaints that the AVN’s name was misleading. In December 2012, the DFT ruled that the AVN must change its name. The DFT publicized its demand, so there were numerous news reports about it. The state’s Minister of Fair Trading, Anthony Roberts, added his own public criticism about the AVN in making the announcement about the forced name change. The Minister did not give an example of any other organization that had ever been forced to change its name. In essence, the DFT succumbed to the anti-AVN campaigners rather than looking independently at the names of the hundreds of organizations in its purview.
The tactic of making numerous complaints against an organization has similarities to SLAPPs – Strategic Lawsuits Against Public Participation. In a typical SLAPP in the US, a property developer sues someone who has protested against a development, for example by writing a letter or even just signing a petition. These legal actions seldom succeed in court, but often intimidate the targets, which is the whole point. So great has been the abuse of the legal process in the US that many states have passed anti-SLAPP legislation.
The complaints against the AVN serve a similar function, and can be called Strategic Complaints Against Public Participation or SCAPPs. When the AVN is forced to respond to complaints, this takes up time, money, and effort that could otherwise be used for campaigning, and discourages many AVN members from commenting freely on the issues. Out of dozens of complaints, only a few led to adverse findings – but these served as warnings to any others who might follow in the AVN’s footsteps. In Australia, there is no constitutional protection of free speech, so anti-SLAPP legislation is not available, and in any case such legislation would not protect against SCAPPs.
On many occasions when Dorey has been scheduled to give a public talk, SAVNers have written to the group providing the venue, for example a library, saying that Dorey is a liar and a threat to public health, that the AVN has been subject to an HCCC warning, and other damaging claims. As a result, some venue managers have cancelled the AVN’s bookings. On some occasions, because of the perception of threat, they have required the AVN to hire security guards.
Similarly, when Dorey has been quoted in news reports, SAVNers send numerous complaints to the newspaper or radio station where the story appeared. Dorey’s media opportunities seem to have shrunk as a result of these complaints and from the adverse publicity following the HCCC’s public warning.
For several years, Dorey had given a talk at the annual Woodford Folk Festival, held in Queensland. In December 2011, SAVNers wrote to the festival director, criticizing Dorey and the decision to host her talk. At least 18 individuals wrote their own blogs criticizing Dorey and the decision, and there were newspaper stories about the issue. Pressure was also put on some of the sponsors of the festival. Dorey’s talk was changed to a debate (with her agreement). SAVNers paid for a plane to carry a banner over the festival saying, “Vaccination saves lives.” Dorey was not invited to speak at the festival in 2012.
Several of the bloggers criticizing Dorey giving a talk at the festival said they supported free speech. For example, “Bastard Sheep” wrote “Remember, this isn’t censorship. It isn’t silencing her either. It is just refusing her a stage. She is still free to spout her misinformation, but she’ll have to do it elsewhere.” The actions of SAVNers suggest that “elsewhere” means nowhere publicly advertised.
A different group from SAVN, Vaccination Awareness and Information Service, set up a “Hall of Shame” listing the names and contact details of advertisers in the AVN’s magazine Living Wisdom. Some advertisers were contacted by anti-AVN campaigners in a way they found threatening. In this context, the Hall of Shame might seem to those listed as an invitation to harassment. Dorey responded by not running any new advertisements in Living Wisdom, not wanting to open individuals or businesses to possible harassment.
Dorey and some others in the AVN received pornographic images, including ones that would be illegal in Australia, through the post and email. SAVN disowned responsibility and, on its Facebook page, condemned this sort of action. However, it might said that the pattern of abuse of Dorey on SAVN’s Facebook page fostered a hostile attitude in which others might think sending pornography was justified.
Dorey has received a number of threats. In one instance, in late 2012, she received messages recorded on her phone. One of the messages said “Die in a fire” over and over. Dorey captured the number of the caller; the call was made from a house where a prominent SAVN figure lived.
Because of the threats and the potential for harassment, other members of the AVN’s committee did not want their names or contact details made public. Some members were discouraged from commenting on the AVN’s blog or being involved at all.
SAVN’s attacks involved a wide range of methods. SAVN’s Facebook page was filled with extensive commentary every day, often including derogatory comment about Dorey and the AVN. SAVNers made numerous complaints to government agencies, eating up much of the time of Dorey and others in the AVN in responding. As a result, production of the AVN’s magazine Living Wisdom fell far behind its usual schedule – and SAVNers complained about that.
As well as the methods of disruption, abuse, complaint, censorship, and threat mentioned here, SAVNers were active on other fronts, for example dominating the Wikipedia entry on the AVN, and making complaints to the Web of Trust – an online rating system for websites – not to trust the AVN’s website. It seemed that SAVNers would look for any possible way to harass or discredit the AVN, suggest it on the SAVN Facebook page and encourage other SAVNers to join in. The result was a flurry of comment and complaints seemingly any time members of the AVN did anything in public, from commenting on a blog to being mentioned in the mass media. This can be called a “swarming” attack.
SAVN’s attack was so intense and persistent that much of Dorey’s time was spent dealing with the consequences. She has been remarkably resilient in the face of such a relentless and personally abusive attack.
SAVN, despite its name, has never been solely about the AVN. Its page contains discussions about various topics, especially criticism of various alternative health modalities and practitioners. SAVN has connections with the Australian Skeptics, a group skeptical of acupuncture, vitamin supplements, homeopathy, holistic health, and alternative medicine, among many other items. Members of the Australian Skeptics have targeted some practitioner groups for attack.
Beyond the fate of the AVN, the significance of SAVN is in providing a template for attack. SAVN relies on large numbers of passionate participants who, rather than try to debate the issues or attempt to educate the public, combine to mount an attack on those with whom they disagree. SAVN uses the relative anonymity of online coordination, so the accountability of any individual is limited. SAVN’s techniques include sustained abuse and humorous denigration, disruption of the target’s discussions, attempted censorship of the target’s public communications (talks, articles, media coverage), and numerous complaints through government agencies. SAVN disowns threats and abuse, but its campaigning methods provide an atmosphere conducive to making personal threats.
The effectiveness of SAVN’s methods depends, in part, on tacit approval by mainstream authorities, the mass media, and public opinion. If government agencies simply ignored or dismissed SAVN’s complaints, they would have no effect. Likewise, if public health officials unanimously condemned SAVN’s methods, it is likely that SAVN’s support would decline greatly. SAVN has flourished in a climate of official tolerance, and occasional overt support, for its methods.
If a SAVN-style swarming attack is seen as effective, it is likely to be mimicked elsewhere. Therefore it is valuable to analyze the ways the AVN has responded, in order to learn how to stymie such attacks and even to make them counterproductive.
If you are the target of a swarming attack, what can you do? The immediate instinct of targets is simply to ward off the latest threat and seek to survive, imagining that the attackers will give up. This sometimes happens, but when attackers are persistent, something more is required. It is useful to write down the main options for responding.
1. Use formal processes
4. Reduce vulnerabilities
5. Build support
For each of these, I describe the experiences of the AVN and mention some general considerations.
The AVN has tried various formal processes for relief from attacks. These have occasionally worked, but have provided no lasting protection.
Most of SAVN’s activity is coordinated from its Facebook page. Given that the stated goal of SAVN is to destroy the AVN and that the page contains repeated instances of personal abuse of Dorey and the AVN, it might seem that SAVN’s page is in violation of Facebook’s terms of operation. The AVN complained to Facebook. Initially, nothing happened. Finally, in 2011, SAVN blocked public access to its page. Meanwhile, it started a new public page, continuing with the same sort of activities. Some months later, it reopened its previous page to general view. Complaining to Facebook did not lead to any lasting improvement.
When the HCCC issued a public warning about the AVN, the AVN went to court to challenge the HCCC’s jurisdiction – and won. This was a miraculous result for a small organization against a well-funded government body. However, the AVN’s court victory did not lead to a cessation of complaints to government agencies. Instead, the complaints seemed to increase in frequency. There were new complaints to the HCCC, trying to get around the technicalities of the court ruling. Furthermore, the HCCC lobbied to have its enabling legislation changed to give it the capacity to initiate investigations of groups like the AVN. In May 2013, the state parliament increased the HCCC’s powers; soon afterwards, the HCCC launched a new investigation into the AVN.
After receiving threats, Dorey sometimes went to the police. She found this a frustrating process. Usually the police could or would do nothing. In 2012, after Dorey recorded phoned threats and tracked down the address from which the calls were made, she reported this to the police. However, the police took weeks to do anything and then, when the SAVNer living at the house denied making the call, declined to take any formal action.
Many people imagine that if there is a problem, formal processes are available and will provide a solution. There are many choices, such as complaint procedures, ombudsmen, government regulators, company boards, politicians, police, and courts. If you come under an unfair attack, then it seems one of these might provide assistance.
Unfortunately, when the perpetrators are much more powerful, formal processes may give only an illusion of protection. Consider the option of going to court to redress a wrong. If you lose, things become much worse: the costs are great, and the court has provided a judgment that you are in the wrong, a judgment that can be trumpeted by your opponents far and wide. On the other hand, even if you win, you have had to devote large amounts of time and effort to mounting and running the case.
In the face of SCAPPs, relying on formal channels is a losing proposition, because it soaks up time and energy that could otherwise be used for the goals of the practitioner or organization. That is precisely the purpose of SCAPPs: to harass and divert the target.
Note that SCAPPs serve to move an issue from one forum to another, typically from a forum of debate and policy to one of law, procedure, and process. Responding using formal processes is to respond in the SCAPP forum and thus allow it to succeed in diverting or derailing normal operations.
On a few occasions, AVN members tried to match SAVN at its own game, for example making adverse comments about SAVNers. This has never been successful. In terms of numbers and energy for a fight, SAVN is far superior. Whenever AVN members have been the least bit abusive, contemptuous, or dismissive, SAVNers highlighted these remarks, used them to justify their own methods, and replied with their own abuse.
The lesson is that when you are outnumbered, attacking is foolish. It goads on the opponents and provides them moral justification for their own methods.
When SAVNers posted on the AVN’s blog and disrupted discussions, AVN moderators removed the offending posts and blocked the posters. Some AVN members posted using pseudonyms, to reduce the risk of suffering harassment. The AVN has a committee elected by the members, in accordance with its constitution. According to the rules for incorporated bodies, the names and addresses of the committee members are supposed to be publicly available, but because of the risk of harassment, no committee members aside from Dorey provided their names and addresses.
Dorey, to protect against possible complaints that she was providing medical advice, added a disclaimer in the footer for all her emails.
SAVNers have complained mightily about AVN protection methods, saying that removing their posts was censorship. They did not seem to see the irony of trying to censor the AVN, indeed to shut it down, and crying censorship when some of their efforts were thwarted.
Protecting is the simplest and often the most effective method for responding to attacks. It is worthwhile when it can be used, but has limits. The AVN could have protected those posting on its blog even more by making the blog private, but this would have limited its audience and impact. There can be a trade-off between protection and outreach: too much protection means one’s message is stifled.
The AVN was vulnerable to SCAPPs because it was an incorporated body and hence subject to various government regulations. SAVNers could make complaints to the Office of Liquor, Gaming and Racing about the AVN’s charitable status: the OLGR could and did prevent the AVN from accepting new members.
The Department of Fair Trading, which regulates incorporated bodies, provided a crucial leverage point for the AVN’s opponents. Following complaints, it demanded that the AVN change its name. Behind this lay the threat of shutting down the AVN entirely, which would involve confiscating its assets.
Given the power of SCAPPs to cripple an organization, it is worth thinking how these might be avoided. One option is not to incorporate. The process of incorporation is supposed to provide protection to members of an organization: they are not personally liable for debts of the organization. This is important protection for large commercial bodies, but for a relatively small campaigning group, incorporation can be a serious vulnerability.
If the AVN reconstituted itself, there are several possibilities. One is to become a network only; this would mean being unincorporated. Another is to become a business hosted in another country, not subject to Australian regulations.
Thinking further, it is important to identify the crucial assets of the AVN. These include its website, its membership list, its reputation among its members, the skills of its members, and assets such as financial reserves, photocopiers, and offices. In switching to a different mode of operation, it is vital to identify the most crucial assets and to preserve them. For example, the website could be maintained by an individual or another group, in another country. The membership list could become an email list.
When under fierce attack, reducing vulnerabilities is vitally important. The assets that can be seized or destroyed include buildings, equipment, money, membership lists, and websites. Careful thought needs to be given to worst-case scenarios, such as a police raid, an organizational takeover by a hostile group, or a fire bombing. Physical and financial assets are hardest to protect, so reliance on these should be minimized. Information assets, such as websites and membership lists, are more easily copied and moved; however, they are vulnerable to infiltrators and takeovers. They should be carefully backed up and, in some cases, located outside the country.
In the face of attack, networks are usually more mobile, flexible, and resilient. The Internet is a prime example, being designed to continue functioning when particular nodes are disabled. So it is worthwhile imagining that parts of your group’s operations are disabled due to internal or external attack, and planning how the rest of the operations can continue.
The attacks on the AVN were seen by some observers as outrageous – indeed so outrageous that they became more interested in or supportive of the AVN. The AVN’s own membership learned about the attacks through regular emails. Some of them became more committed as a result.
Some of SAVN’s attempts at censorship generated greater awareness of the AVN. For example, the barrage of attacks on Dorey speaking at the Woodford Folk Festival led to local publicity. As a result, the crowd at the debate where Dorey spoke was overflowing.
Even negative publicity can sometimes be valuable. A story about the HCCC’s warning about the AVN may stimulate some readers to think, “What is so dangerous about this information?” and seek to find out more about it. SAVN’s Facebook-page attacks on the AVN may be leading to increased traffic to the AVN’s website.
Coming under attack can be an opportunity for building greater support. The basic idea is to gain sympathy, build alliances, and obtain publicity.
When powerful attackers do something that might trigger popular outrage, they commonly use five sorts of methods to reduce this outrage: (1) cover up the attack; (2) devalue the target; (3) reinterpret their actions through lying, minimizing, blaming, and framing; (4) use official channels to give an appearance of justice; and (5) intimidate targets and their supporters. Opponents of the AVN used some of these methods. (1) Some of their attacks were disguised, for example the threats over the phone. (2) SAVN’s most used tactic was devaluation, with the continual derogatory comments about Dorey and the AVN. (3) SAVNers minimized the impact of their actions on Dorey, and framed their attempts at censorship as their own freedom of speech to tell people about Dorey’s supposed lies. (4) In making complaints through government agencies, they sought to use the credibility of these agencies to give their own attacks legitimacy. The “public warning” from the HCCC had far greater legitimacy than the repeated warnings from SAVNers. (5) Finally, AVN opponents used abuse and threats as methods of intimidation.
To increase outrage over attacks, five counter-methods can be used: (1) expose the attack; (2) validate the target; (3) interpret the attack as an injustice; (4) mobilize support and avoid official channels; and (5) stand up to intimidation. The AVN used several of the outrage-increasing methods. Dorey put out regular reports about the attacks, and in 2012 produced a dossier of attacks by particular individuals, posted on the AVN’s website. Her regular posts to AVN members interpreted SAVN’s activities as an attack on free speech on an issue of conscience. As a result of this emphasis on free speech, some SAVNers began to justify their own actions as compatible with free speech, a sign that the AVN was having some success in shifting the terms of the struggle. Most impressively, Dorey was able to stand up to SAVN’s abuse for several years.
The AVN was not so successful in recruiting allies that would increase the AVN’s status. Most potential allies were scared away by SAVN’s relentless attacks.
The Australian Vaccination Network’s struggle for survival in the face of diverse and relentless attacks provides lessons for any alternative practitioner, campaigner, or organization. In the face of persistent opponents who show little respect for free expression or fair play, it is often tempting to turn for assistance from official bodies, or to counter-attack. However, neither of these approaches is promising when the opponents are on the side of medical orthodoxy and have greater numbers and energy.
Rather than wait to be attacked, it is worth preparing in advance. Protection of vital assets is essential. In many cases, intangible assets are more important, including reputation, visibility, websites, contact lists, and goodwill among clients. Each of these can be considered in turn, with measures taken to protect against possible attack. For example, collecting supportive statements from clients can be a way of providing insurance against an attack on one’s reputation.
Closely related to protection is reducing vulnerabilities, which means removing avenues for opponents to attack. Moving a website to a foreign host is an example. More drastically, it can mean minimizing physical or financial assets, registering businesses in other countries, and operating as a network rather than a formal organization.
Finally, it is possible to use attacks to mobilize greater support. By documenting hostile actions and communicating with potential allies, including the general public, it is possible to make attacks backfire. This requires a change in thinking, from being frightened about threats and attacks to seeing them as opportunities for stimulating greater awareness and support. This is not easy and not always successful, but the more who are prepared to mobilize support, the more reluctant opponents will be to attack in the first place.
I thank Meryl Dorey and Eve Hillary for useful feedback on drafts.
About the author
Brian Martin is professor of social sciences at the University of Wollongong, Australia. He is the author of a dozen books and hundreds of articles on dissent, nonviolent action, scientific controversies, and other issues. He is vice-president of Whistleblowers Australia and hosts a large website on suppression of dissent. Web:http://www.bmartin.cc/; email email@example.com
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