Several recent exchanges about Covid-19 vaccination and a medication called Ivermectin—for example in a recent podcast hosted by Bret Weinstein and Heather Heying—have raised an important question: What responsibility, if any, does someone with a large platform have to help protect public health?
Imagine that you are in charge of deciding what information people get to hear. There is a vibrant marketplace of ideas, but you oversee it and can manipulate it as you like. What would you allow, and what would you forbid?
If, like me, you’re a fan of free inquiry, then your first pass might be an anything goes playground, in which anyone can say almost anything they like, short of a call to violence. You might assemble a compelling slate of reasons in defence of that choice, even though it’s likely that some unanticipated harms will result.
For example, you might reason that you want ideas to meet each other on the field of battle, on the assumption that beliefs that correspond well to reality (good ideas) will eventually triumph over ones that don’t (bad ideas). You may recognise that bad ideas can spread alarmingly fast because they flatter the needs and wants of their human hosts, yet believe that good ideas still have the advantage: they have the weight of the evidence on their side, and the benefit of an underlying reality that never goes away. Good ideas, like the fabled tortoise, will eventually outpace the hare-brained ones and become accepted as common knowledge.
And you might reason that you don’t necessarily have the right answers—even with fact-checking resources and expertise at your disposal—so you can’t be sure which ideas to forbid. Moreover, you’re reluctant to be responsible for making such calls, because then the results—including any bad ones—are yours to own. No matter how Zuckerbergian your powers may be, you are fortunately not possessed of enough hubris to think that you’ve figured this all out.
A third reason might be that you know of famous instances throughout history in which the counterintuitive and contrarian takes of iconoclastic thinkers have upended the scientific consensus—not only the Galileos and Pasteurs of yesteryear, but also modern thinkers like Judith Rich Harris. By challenging a prevailing scientific paradigm, they advanced our understanding of the world. Yes, 99.9% of people’s wild takes are nonsense, but why should we foreclose discussion of them, given the chance that some bravely heterodox thinker is getting something right—even if what she is saying is deeply unpopular?
These familiar arguments serve an important purpose: protecting unfettered speech, which is a vital social value because it results in a crucial social good refining our understanding of each other and of our world.
But we also know that free speech can be used irresponsibly and can cause indirect harm, in more subtle ways than the well-worn example of causing a panicked stampede in a theatre. The fact that the merits and risks of vaccines and their alternatives are currently being debated in the midst of a pandemic puts an interesting spin on the theatre metaphor: what if the crowded theatre were actually on fire, and someone with a microphone was shouting at the crowd to remain seated, or to head for an alternative exit? The discussion of the drug Ivermectin is a test case for how far speech can go without indirectly causing harms that we may not be willing to accept.
It is 2021, and the world is on fire. A pandemic is claiming lives and spreading rapidly. Into the breach step the scientists who specialise in vaccine development. They have trained for this moment, and they represent a pinnacle of modern scientific expertise. In an unprecedentedly short time, a new approach to the concept of vaccines has borne fruit, new vaccines have been developed and we are getting those vaccines into the bodies of the world’s population.
But we pesky laypeople and non-medical scientists have questions and concerns. We haven’t got a grip on the long-term effects of mRNA vaccines (and how could we, when their use is so new?) What if there is an alternative? What if there is a long-established medication—inexpensive and readily available in drugstores worldwide—that could prevent or treat the disease? Wouldn’t you want to know more about it, to consider it as a potential alternative?
Enter Ivermectin. It is an anti-parasitic with some track record of antiviral effects, and there are a handful of small but interesting studies and meta-analyses suggesting that it may be effective against the SARS-CoV2 virus—but there are no large clinical studies demonstrating that it is, which is what’s necessary if you want to attract endorsement from the medical community and from government agencies like the FDA and CDC. And the conversation about Ivermectin is heating up at a time when many would prefer to focus exclusively on getting people vaccinated with one of the big breakthrough mRNA show-stoppers so that we can all get back to normal life.
The mRNA vaccines have saved, and will continue to save, countless lives. Because they are new, we lack scientific certainty about whether they have any long-term negative effects, but as yet there is no reason to think that they will, and, for most, any such hypothetical risks seem more than justified by the magnitude and danger of the fire they are putting out. Ivermectin, by contrast, is more of a question mark. It is a quirky, old-fashioned potential Covid treatment, and it is attracting a following of similarly quirky sceptics, many of whom question the narrative coming from on high—perhaps simply because they are contrarians. The studies suggesting that Ivermectin has promise can seem impressive to the uninitiated, despite how weak those studies are compared to those supporting the mRNA vaccines. Still, it’s not an idle question to ask why the powers-that-be aren’t running bigger Ivermectin trials, since its long-term safety record is well established.
At the time of this writing, YouTube has banned videos promoting Ivermectin because of concerns that excitement about an unproven medication could dissuade some people from getting vaccinated. YouTube’s decision was made for you, and you can’t easily consult them about it. This understandably rankles some people. On the other hand, the ban could promote the public welfare by reducing vaccine hesitancy. Was it the right call? Would you make the same decision if you were in charge?
I am sympathetic towards people who are drawn to conspiratorial thinking, which I view as a kind of bug in some people’s thought patterns. I am also often sceptical about claims to expertise, probably because, in the past few years, replication failures have plagued research in fields like medicine and psychology, humanistic scholarship has been overtaken by stifling jargon and trivial wordplay, and a moral panic has cast a pall over the academy. When someone tells me they always trust the experts, I generally ask whether they’d make plans based on what an expert astrologer says about their future. I have a similar reaction when people are advised to follow the science: science is less like a tunnel leading to the bright light of knowledge and more like the Labyrinth of Crete—complete with Minotaurs.
When I try to evaluate some edge case in the free speech debate, I usually ask myself, Where’s the harm here? and How grievous is it, on a scale of 0–10? For example, a flat-Earth society with no political leverage, holding their annual meeting in a grateful-for-business hotel, registers near zero—whereas direct threats of violence are an obvious 10. Gwyneth Paltrow selling essential oils? Maybe that’s a threat to the wallets of rubes, so I’ll rate it a 2. A guru peddling a snake-oil cure for cancer? Depends—if she wants customers to shun proven medicine, that’s a serious 8, but if she presents it only as a complement to evidence-based treatments, that’s maybe a 2. I might even rate it as helpful considering that placebos have a few proven health benefits.
What about the promotion of Ivermectin? On their Dark Horse podcast, Heather Heying and Bret Weinstein clarify that they are not giving medical advice, but merely arguing that it makes sense to find out whether Ivermectin works, and why institutions have failed to investigate it more thoroughly. I agree with a lot of what they have to say. For example, I agree that large pharmaceutical companies have little direct financial incentive to study Ivermectin. People who make decisions about which drugs or vaccines are tested in large clinical trials may be influenced by their predictions about which ones will be the most financially profitable. I also agree that Ivermectin seems to have been unfairly stigmatised before it even got out of the gate, because it was quickly embraced by people who, for honest reasons, can sound a bit wacky.
In general, I have found Heying and Weinstein’s ideas nuanced and thoughtful, but of late they have ceased to be careful enough. In their long-form discussions, they frequently cross over into conspiratorial thinking. Maybe this is partly a function of the podcast format: it is sensible to say, we don’t really know, and should investigate, but that doesn’t fill a podcast episode. And so they say lots of other things as well, some of which, particularly Weinstein’s extemporaneous riffing, seem very far from sensible, even verging into conspiratorial. For example, he has said that taking the mRNA vaccine is like playing Russian roulette, that he is “95%” confident that SARS-CoV2 was the result of a lab leak, and that information about this alleged lab leak was suppressed to protect the Asian community from a hate-crime backlash.
Weinstein’s remarks increasingly sound like what philosopher Aaron Rabinowitz has called cheap talk scepticism: namely, “when someone expresses scepticism in a way that comes at little cost to them, though it frequently comes at a significant cost to others.” Rabinowitz argues:
Besides putting lives at risk by promoting a cavalier approach to a global health crisis, cheap talk scepticism externalises a social cost by driving quality scepticism out of the marketplace of ideas. Quality scepticism is research intensive. It’s not easy to do quality scepticism and still produce hot takes across a wide range of topics, which is something that public intellectuals are unfortunately pressured to do in order to stay relevant.
If Ivermectin were subjected to a large study and found to be ineffective against Covid, Heying and Weinstein should be willing to acknowledge that. However, Weinstein recently tweeted:
The rejection of all evidence short of a large-scale, Randomized, Controlled, Trial is not rigorous. It is anti-rigorous. It’s amazing that otherwise intelligent adults have allowed themselves to accept and broadcast it as if it was a sophisticated, pro-science position.
— Bret Weinstein (@BretWeinstein) June 9, 2021
These are not the words of somebody who is merely insisting that the scientific community take Ivermectin seriously and who hopes for more conclusive trials. Note the contrast between this position on Ivermectin and Weinstein’s stated concerns about possible long-term effects of the mRNA vaccine and the need to more thoroughly evaluate its safety. This is not a clear-headed call for inquiry – it is a sports team’s coach arguing with the referee.
Those who worry about harms from speech may be sympathetic to Rabinowitz’s observation about the negative externalities of irresponsible speech by those with large platforms. The insurrection at the US Capitol last January, which was directly inspired by conspiratorial agitprop, is a vivid example of such harms. A US president was impeached for having egged the rioters on—and it doesn’t take much imagination to also assign some responsibility to certain news media outlets.
Nevertheless, I’m not entirely on board with the idea that we can make the causal connection between irresponsible speech and harm convincingly enough to justify suppressing speech based entirely on how listeners might react. Such a policy can easily morph into a political bludgeon for people who encounter ideas that they find unpleasant or invalidating. Witness, for example, the increasing trend of recasting mundane social disagreements over matters like gender or education as matters of violence and harm.
But is the scepticism about Ivermectin and the mRNA vaccine exhibited by Weinstein and Heying potentially harmful? Their discussions might persuade some already hesitant listeners to avoid getting vaccinated—perhaps pushed over the line by Weinstein’s Russian roulette rhetoric. Does that justify suppressing such speech? YouTube seems to think so, having issued strikes against their Dark Horse podcast for promoting the idea that the vaccine is cytotoxic (a view rejected by multiple fact-checking organizations). The presence of Dr Robert Malone, a co-inventor of mRNA vaccination, on that particular episode suggests this is not merely wild-eyed Alex Jones-style pontification. One might argue that listeners should be free to choose the risk of getting Covid over the hypothetical risk of experiencing long-term negative side effects from an mRNA vaccine and that everyone has the right to hear what anyone wants to say about the topic and decide for themselves. But now imagine that listeners are persuaded to avoid getting vaccinated, after which they catch the virus and transmit it to others who didn’t have access to the vaccine. Here the waters of responsibility get murkier.
On the other hand, I can imagine a scenario in which their podcast calls widespread attention to Ivermectin, which results in public pressure, which results in a large-scale, high quality clinical trial. Indeed, such a trial has just got underway at the time of this writing. Ivermectin is inexpensive and readily available. If it is found to be effective, it could be deployed widely in countries that can’t afford the mRNA vaccine. In this scenario, Heying and Weinstein might be seen as heroic for drawing attention to the medication—bold iconoclasts who did a public service, rather than wild-eyed sceptics.
I don’t know whether the Dark Horse podcast discussions about mRNA and Ivermectin should be praised or condemned, but I see cause for concern. Bret Weinstein increasingly uses conspiratorial language by talking about malevolent “forces” suppressing the truth. He has chosen to deploy his considerable rhetorical skill and intellect and his scientific background to sow fear (“Russian roulette”) about a lifesaving vaccine at a time when the world is in dire need of it. On the other hand, we should not foreclose discussion of possible drawbacks to the mRNA vaccine, particularly given how rushed its development was. There is a fire in a public theatre, and the mRNA vaccine is the exit that is saving many lives—do we silence the critics for worrying about a Minotaur in that direction? The discussion of Ivermectin highlights a possibility that might not otherwise have been considered. Should YouTube be deciding on its medical validity on our behalf?
We must be clear-eyed about the costs of unfettered speculation—there is a price to be paid for free speech. But perhaps we should pay it gladly.