Date:   2/25/2004 3:07:35 PM ( 20 y ago)
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SECOND OPINION - SPECIAL EDITION

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DR. ANDREW WAKEFIELD AND THE MMR CONTROVERSY

By Nicholas Regush, RFD Editor

It doesn’t look very good for Dr. Andrew Wakefield, an English physician and researcher who has championed the need to investigate the potential relationship between the MMR (measles, mumps, rubella) vaccine and autism.

Today, the scavengers of British journalism surfaced and attacked him and his work, and attempted to destroy whatever chance he may have to rescue his scientific reputation.

And today, British mainstream medicine hit-men also surfaced to stick him with a knife and twist it round and round.

I am not surprised by these events. It is what one can expect these days when a so-called “maverick” researcher dares to challenge the Medical Establishment. And it is certainly what one expects when the “maverick” runs against the drift of vaccine promotion and zealotry. And it is also what one expects of the mainstream press when someone has been wounded.

Nor am I surprised that politics have now entered the fray. Tony Blair, undoubtedly still traumatized by his recent encounters with Iraqi realities, has stepped in to add his cent or two, calling for an end to the MMR vaccine debate. An end to the MMR vaccine debate? Really? But I suppose this is a fitting sophmoric intellectual stand for a British Prime Minister who desperately needs to remove attention from his own trials by stuffing his nose once again where it doesn’t belong.

As for Wakefield , let there be no doubt that he appears to have been caught in a vice of his own making. In 1998, his study (along with numerous colleagues) published in The Lancet, possibly linking bowel disease with autism and suggesting, however briefly, that the relationship may have been triggered by the three-in-one shot MMR vaccine, should have included a disclosure, indicating that he had received money from a legal aid group via a lawyer representing parents, to conduct a separate investigation of whether the MMR was linked to autism. The fact is, he reportedly didn’t even bother to tell his research colleagues about this contract.

At a time when conflict of interest issues were percolating in medicine (at long last), there was no excuse to not have this potential conflict foremost in mind. The Lancet might have regarded the science differently had it known about Wakefield ’s financial relationship with attorneys who were seeking to prove an MMR-autism link. To say, as Wakefield has, that he had nothing to be embarrassed about – apparently the journal’s simplistically-stated test at the time for conflict of interest – is to show a tremendous lack of smarts for what needs to be done to protect one’s reputation and integrity in science. I’m assuming here, of course, that the timeline established in an investigative piece yesterday in the Sunday Times is accurate, namely that Wakefield had already received up to $55,000 pounds sterling from the legal aid group prior to publication of his study in The Lancet .

There have been calls for an inquiry. Even Blair immediately knee-jerked in this direction, following others who want to see the General Medical Council investigate.

Here is what Blair told the press: “There’s absolutely no evidence to support this link between MMR and autism…If there was, I can assure you that any Government would be looking at it and trying to act on it.” If Blair actually believes what he said, he must either be loopy or very poorly briefed..

A defiant Wakefield is also eager for a broad airing of the issues surrounding the 1998 study. By his expressed desire to participate in an investigation, one assumes that Wakefield either has something in his hip pocket that might dispel the conflict-of-interest accusation or that he believes he can make a strong case for the integrity of the science he produced. This will be a tall order because it is generally and rightly believed that a conflict of interest or the appearance of conflict taints a study, no matter how it may have been conducted. The issue is credibility and this is why conflict of interest rules are in place – to allow others to decide whether to look upon research seriously or not. Conducting science is not an objective enterprise. Human personality and desires enter the picture whether one realizes this or not. Too many doctors and researchers think they are somehow immune to this process. They actually believe they can withstand outside influence of any kind – if they wish to do so. How utterly foolish this is. What do they teach in medical school?

When the Wakefield story first broke, my immediate reaction was that the hit-men of the Medical Establishment would exploit the opportunity to condemn the very idea that the MMR could be associated in some way with some cases of autism. This is what has happened.

Imagine the so-called “top doctor” in Britain, Liam Donaldson, telling the press today that “Dr. Wakefield’s original study was poor science...(and) independent experts and independent medical bodies around the world have criticized it.” So what? Numbers win in science? Apparently yes. But here we also discover the type of hyperbole that appears to be political. Either that or Donaldson is blissfully uneducated about the scant research of value actually done on the MMR and the fact that there is insufficient evidence to rule out a relationship between the vaccine and autism. Top Doctor wouldn’t have a prayer in a public forum on the issue with some intelligent researchers who understand the complexity and difficulty of researching vaccines. Donaldson also avoids, out of ignorance or stealth, the simple fact that there is some evidence produced elsewhere in the world that suggests that Wakefield may have been on a good track to get to the bottom of a major medical mystery. But more about that in another column.

As for the other man on the hot seat, editor Richard Horton of The Lancet, he is also living on another planet. He’s been quoted as stating that the MMR is safe. How revealing. And he is the editor of The Lancet? I think it's time for him to go. And How does he know that the MMR is safe? I'd give a tooth or two to be on a public stage with him. I thought he was a scientist, but apparently he is into some sort of crystal-ball gazing. Or worse.

The simple fact is, Wakefield has raised some major issues about autism and vaccines and the entire area is begging to be investigated in great detail, and not in the shameful manner that drug companies and their drone researchers conduct business.

The press. Well, what can one say that hasn’t been said many, many times before? That ludicrous headlines trample on any attempt to get at the truth? No, that’s often been said. That many health reporters show their ignorance of basic ethics and the fundamentals of research all too often when they tackle medical controversies? No, that’s also been said many times. In other words, business as usual.

The sad part of all this is that this sorry episode will likely drain further attempts to better determine if the MMR is safe. The conclusion that it is absolutely safe, now so strongly pushed by the Medical Establishment and the press, is a huge disservice to parents, children and the whole damn world.

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