SGEM Xtra: Illusion – What you Don’t Know and Why it Matters - The Skeptics Guide to Emergency Medicine

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Date: July 10, 2025

Guest Skeptics: Professor Timothy Caulfield is a Canadian professor of law at the University of Alberta, the Research Director of its Health Law Institute. His area of expertise is in legal, policy and ethical issues in medical research and its commercialization.

This is another SGEM Xtra book review. Tim was our guest skeptic a few years ago, discussing his book called Relax, Dammit! A User’s Guide to the Age of Anxiety. He is back on the SGEM to discuss his latest book called The Certainty Illusion: What You Don’t Know and Why It Matters. I asked Tim several questions about his book. Please listen to the podcast to hear his responses.

Questions for Professor Caulfield

The book is structured into three main parts. In Part I: The Science Illusion, you examine how scientific language and imagery are co-opted to confer credibility on dubious claims. You discuss how quantum physics has been misappropriated by the wellness and alternative medicine industries.
- Why do you think “quantum” has become such a powerful marketing tool?
- The phrase “It’s Science!” is often used to shut down debate. What are the dangers of weaponizing the language of science?
- You talk about Zombie Science (ideas that refuse to die despite mountains of evidence). I’ve given a lecture for the Gateway Centre of Excellence in Rural Health on zombie ideas about hospital crowding. What is a good example of zombie science in health and wellness?
- At the end of Part I, you introduce ‘The Humility Fix” as a potential solution. Can you explain why intellectual humility is a necessary antidote to misinformation?
In Part II: The Goodness Illusion, you unpack how concepts of health, sustainability, and morality are manipulated to create a false sense of certainty. You explore things like “health halos,” in which terms like “clean,” “organic,” and “natural” are used to mislead consumers. Can you expand on that concept?
- You list 12 words in total that you call the “Devious Dozen”. These are a set of misleading or overhyped health and wellness claims that exploit public perception and create a false sense of certainty. These terms and concepts are often used in marketing, politics, and public discourse to manipulate consumers and reinforce misinformation. Do you have a couple of favourites?
- You also talk about how virtue signalling and ideological narratives shape public opinion, often overriding evidence-based reasoning. The idea that our desire to do what’s “right” can be exploited through misleading claims about health, wellness, and even sustainability. What’s an example of this in the medical field, and how can healthcare professionals push back against it?
- You also discuss the White Hat Bias in this section of the book. It is a phenomenon where research findings are distorted in the service of what is perceived as a noble or righteous cause. This bias leads to the overrepresentation of certain findings, particularly in fields like public health, nutrition, and medicine, where there is strong societal motivation to support outcomes. Who coined the term White Hat Bias?
- Can you give an example of the White Hat Bias from the COVID-19 pandemic?
In Part III of the book, you discuss The Opinion Illusion. This delves into how the digital age has fueled an economy of opinion, where ratings, reviews, and social media influence create misleading perceptions of truth and expertise.
- How has the “opinion economy” shaped modern decision-making?
- How has this shift impacted our ability to discern truth from misinformation?
- You highlight the influence of online reviews and rankings. Why do people trust anonymous reviews more than expert opinions or personal recommendations?
- What role do algorithms play in distorting our perception of consensus and credibility?
The book isn’t all doom and gloom. You do offer some solutions for navigating this chaotic information environment.
- What would it look like if you could design an ideal system for verifying the credibility of online opinions?
- How can individuals cultivate a healthier skepticism toward online rankings without becoming entirely cynical?
- What role do educational institutions and policymakers play in addressing the certainty illusion in digital spaces?
- You mention that authenticity itself has been commodified. Do you think there is a way to reclaim genuine trust in reviews and expert opinions?
- What’s the most surprising or unexpected thing you discovered while researching The Certainty Illusion?

That’s it for this SGEM Xtra. Remember, the SGEM is about cutting the knowledge translation (KT) window down from over ten years to less than a year, but ultimately, it’s about patients getting the best care, based on the best evidence.