Introduction: Cons and Scams in Science and Medicine

science and medicine represent broad areas in which cons and scams can affect lives at every level of society. Within science, a scam can influence the ways in which we understand and treat the natural world around us. A medical scam, by contrast, can transform the way we understand and treat our own bodies. In both cases, the stakes for differentiating between evidence-based theory earnestly presented and the con intended to swindle could not be higher. The ramifications for failing to distinguish between the two can be broad or incredibly intimate: from ill-advised government policy and spending to what a person chooses to eat for breakfast.

But how do we decide what is a scam in the fields of science and medicine? The waters here are murkier than they might initially appear. First, there is a way in which deceit is practiced in science and medicine that is fairly acceptable in routine ways. Many researchers argue that the use of deception to conduct clinical trials, for instance, is necessary to reach honest findings. Deceiving participants about whether the nature of the study will affect their behavior, particularly in double-blind studies of drug treatments, is an accepted protocol intended to prevent bias from skewing the results. One might argue that what separates the ethics of routine forms of deception in research from blatant charlatanism is the intention to establish truth through duplicity.

The question of intention, however, leads us to another way in which defining a scam is problematic: the existence of individuals who believe, or at least partially believe, in the "scientific" theory or miracle cure they are presenting to the public. Genuine belief on the part of those who are promoting a new idea or a new drug makes it all the more complicated for those around them to dismiss what is being presented. Is someone who believes in the truth or efficacy of what they are selling really scamming others? It would seem that while such things as wishful thinking, genuine belief, intentional deceit, and—of course—the drive for self-gain may all be part of our under-standing of what a con may look like, how these fit together, and what they mean for how we recognize a scam, are not so straightforward.

Scamming in the fields of medicine and science is a multilayered issue that challenges us to scrutinize the categories we use to identify and discuss deception. The papers by Daniel Kevles and Nina Shapiro approach this challenge in quite different but equally fruitful ways. Both authors work from the implicit assumption that a scam, regardless of the knowledge or intentions of its author, promotes a theory or treatment that is either ineffective or harmful. Kevles's paper introduces readers to the problem of "scientific charlatanism" and efforts to unmask scientific charlatans in the United States during the second half of the nineteenth century. Particularly in his analysis of the geologist John Wesley Powell's battle to convince both government officials and the public that the arid lands of the American West were not conducive to settlement, Kevles reveals that recognizing and defining charlatanism is a process—an ongoing debate between supporters and detractors. In this debate, charlatanism becomes a moving target that does not develop into a fixed point generally agreed upon until enough time has passed to vindicate one side or the other.

Kevles and Shapiro both cite the influencing factors of economic and even political pressure that might persuade scientists, medical professionals, and politicians to choose to advocate for what is desirable and convenient over a less appealing theory or set of data results. Shapiro's paper goes further to engage with the vulnerabilities of the general public in the United States today that render the average person susceptible to scammers. Although Shapiro views a yearning for the strange and miraculous as a timeless and fundamental aspect of human nature, she shows that twenty-first century technologies of mass media and communication—whether a flashing banner on a webpage or a tweet from a celebrity—are spreading misinformation that is increasingly...