Unless this blog is your only source of news, you can’t help but notice that the story of Dr. Andrew Wakefield and his 1998 paper alleging that MMR Vaccine was linked to childhood Autism has been all over the news – a story gone Madoff. One has to ask, "Why now?"
This story has been around for twelve years – since Wakefield’s 1998 paper was published in the Lancet, a prominent medical journal in the UK. I remember it from back then. He [and twelve other authors] wrote about 12 cases who developed Autism after receiving the MMR [mumps, measles, rubella] vaccination. One never knows when something like that gets published whether it’s the first hint of something big [like the early AIDS papers were] or a spurious, paranoid piece of pseudo-science. It raised a big hub-ub, a polarity between the world of medicine and the anti-vaccine groups, fueled by parents of Autistic children. It turned into an ad hominem war of words. The medical opinion was that Wakefield was taking advantage of the desperate feelings of these poor parents. The other side said that the medical community was being bought off by PHARMA, the vaccine makers. By 2001, Wakefield resigned [was fired, left by mutual agreement] from his position at the Royal Free Hospital in London. So he left the UK for the US where he continued his research in Florida, and later as the director of an Autism research center in Texas.
The story broadened in 2004 when the Sunday Times reported that Wakefield’s Study was financed by a group of lawyers opposed to vaccines, who planned to brings suits against the manufacturers and who had actually recruited the patients for his paper. The Lancet called the Study "fatally flawed" and ten of Wakefield’s coauthors withdrew their names from the interpretation part of the original paper. A UK reporter from Channel 4, Brian Deer, got involved and revealed that Wakefield had been paid £400,000 by the lawyers and had applied for a patent for an alternative vaccine before publishing his paper. They commenced to all sue each other. The General Medical Council got involved, and after the longest "fitness to practice" hearings in it’s history, took away Wakefield’s medical license this year. Then the Lancet finally withdrew the article altogether. Wakefield’s book, Callous Disregard, was published the day he lost his license with a forward by Jenny McCarthy, a former Playboy Bunny turned Autism Activist.
My summary doesn’t do justice to the contentious battles that have swirled around Andrew Wakefield, yet the question remains, "Why now? Why is it in every paper now?" This story is older than George Bush, older than 911, reaching back to the days when the Internet was just catching on [1998 was the year Google was first founded!]. It appears to me that it’s everywhere because of the series currently being run in the
British Medical Journal [above]. That somehow legitimizes things. The story headlines in all of the newspapers are now written differently [eg
Link between MMR Vaccines and Autism conclusively broken]. Wakefield’s deceit is now a fact rather than an allegation. In the
BMJ Editorial introducing the series, they say:
Who perpetrated this fraud? There is no doubt that it was Wakefield. Is it possible that he was wrong, but not dishonest: that he was so incompetent that he was unable to fairly describe the project, or to report even one of the 12 children’s cases accurately? No. A great deal of thought and effort must have gone into drafting the paper to achieve the results he wanted: the discrepancies all led in one direction; misreporting was gross. Moreover, although the scale of the GMC’s 217 day hearing precluded additional charges focused directly on the fraud, the panel found him guilty of dishonesty concerning the study’s admissions criteria, its funding by the Legal Aid Board, and his statements about it afterwards.
I’ve actually never seen anything quite like this, an exposé written by a reporter being run by a mainstream straight-arrow medical journal. In the UK, the Lancet and the BMJ are sort of rivals, so there must be a gloat factor here in pointing out the Lancet’s error in publishing the original study in the first place [the study was lame from the outset, even before all the misbehavior was revealed]. But still, an exposé in a major medical journal? written by a reporter? That’s kind of remarkable. I’m actually glad to see it, as odd as it seems. Organized Medicine taking on this kind of misbehavior is a good thing.
Where I’m headed with this will be obvious to anyone who has read this blog in recent months. When POGO published some pretty damning evidence last month that strongly suggested that a textbook was ghostwritten by a firm working for a Pharmaceutical Company whose drug was viewed through rose colored glasses in the book, the American Psychiatric Association immediately jumped to the supposed authors’ defense [one of the authors was the organization’s immediate past president, and the book was published by their own press]. And over the last decade as revelation after revelation has made it clear that there has been downright criminal level intrusion of the Pharmaceutical Industry into Academic Medicine, Continuing Medical Education, and the medical literature – particularly in Psychiatry – the responses from organized medicine and the major medical journals has been muted at best. Senator Grassley’s investigations stand out as an exception along with some of the provisions of the Healthcare Reform Act [if it survives]. But I am not expecting to read an editorial like the one above or see an exposé by an investigative reporter in the Journal of the American Medical Association anytime soon. And I’m doubting that the Composite Board of Medical Examiners in Georgia will be investigating the Emory Psychiatrists involved in some of the worst of things for "fitness to practice."
The British General Medical Council looked into the situation swirling around Andrew Wakefield, and pulled his medical license. The British Medical Journal took on his story and is publishing an exposé of his deceit. We need to take a lesson from our friends across the sea and get our heads out of the sand. The behavior of some of our major medical figures has been every bit as unethical as that of Andrew Wakefield, and much more widespread. If American medicine is to be "self-policing," where in the hell are the cops?!..
Excellent post and report. Thank you for opening our eyes.
I’ll tell you why it’s happening now and not 10 years ago.
1. People as a rule don’t like to immediately examine the worst of human behavior.
2. The misbehaviour threatened the core of several social foundations. The perception of doctors as an almost universal social good was knocked down. The perception that the medical industry isn’t the fountain of social good. The sometimes good perception of lawyer-types.
3. Someone probably did call the malicious (worse than bad) science out 10 years ago. They are typically marginalized because of the factors mentioned in #2.
Think of it like a communal form of denial. See C.G. Jung.