Letter to BMJ - MMR/Wakefield by Hilary Butler.
http://bmj.bmjjournals.com/cgi/eletters/328/7438/483-a#52356
Dear Sir,
What should the purpose of any enquiry into the MMR vaccine issues really
be?
Clare Dyer re****ts the media facts, but the article skirts the fundamental
concerns. Which ironically are touched on in another BMJ article in this
issue, http://bmj.bmjjournals.com/cgi/content/full/bmj;328/7438/473
Perhaps
the MMR vaccine should be seen through glasses labelled not "What we don't
know, we don't know" but "Why we don't know what we should know"?
Richard Horton's comments that Dr Wakefield's funding negated the validity
of the research were extraordinary, incorrect, and transparently foolish
to
anyone with a finger on "real science". To shoot the messenger on the
unconfirmed basis of information from one re****ter is potentially hasty,
to
be polite. And looking further down the line, I wonder how many bullets he
will subsequently fire off into both his own feet.
The correspondents to Clare Dyer's article, however, start to touch on a
few actual issues...
Pru Hobson-West is concerned about the media exposing the financial
conflict of interests held by most medical people who promote vaccination,
something well known by those who follow such things as congressional
hearing admissions from the horses mouths, and discovery files in court
cases....
Doesn't she think though, that people out there, (beyond those who put
their brain into gear and research these things for themselves) should
know
that this situation is really a massive pot-calling-kettle-black scenario
where some of the messenger-shooting finger-pointers can often be up to
their necks in "financial-conflict tills" themselves?
Or does she prefer the old patriarchic mode of "Trust us, you don't need
to
know more than that we wouldn't advise this if it weren't the best thing
to
do."?
And does she think that the whole axis of the MMR vaccine argument
revolves
around one paper?
Since the original Lancet study, many others have confirmed and expanded
on
Dr Wakefield's findings, but these appear to have been ignored by "the
medical system", in the seeming desire to pillory and discredit Dr
Wakefield personally, and thereby by implication, all other "articles" and
"persons" that come after. Such an action seems to be that of desperate
drowning persons' last irrational gasp. Or medico-political necessity...as
it was in the days of William Harvey, Semmelweis, Theobald Smith and Louis
Pillemer to mention just a few "run over" by the medical majority, or
"flat
earthers" of their day.
Regarding Christ McVittie, et al's comments... the reason that
epidemiological studies thus far, cut no ice, has everything to do with
the
fact that such studies are easily subject to manipulation of definitions
and data to suit the outcome desired. For instance, in the Finnish study,
the definition of Autism appears to have been changed part way through the
study, and there were other methodological biases and errors which were
blatently obvious to anyone with a basic understanding of statistical
manipulation.
Most of the other epidemiological studies on MMR have also suffered from
these rather obvious outworkings of conflicts of interest, in my opinion,
precisely BECAUSE they were done by people who have every reason to NOT
find the truth, who therefore couched the questions and methods to get a
specific result. And whose primary aim appears to have been to create a
fallacy of authority, not by science, but by "weight of numbers".
But this is not unique. And if we look at why we don't know, what we don't
know, in the context of history a couple of examples serve us well.
As John Emery once said about SIDS (1) "We have not found the right
answers
because we have not asked the right questions" and when discussing as to
why this might be in the BMJ (2) he said:
"Among research workers there is much vested interest against change. Lip
service is paid to possible multiple causes, but each acts as if his or
her
own theory is universal"
Another relevant quote from To Rognum (3) is:
"Where you "stand" depends upon where you "sit", and different groups of
pathologists are likely to adopt their own pragmatic criteria for the SIS
diagnosis" Or as David Peat puts it in "Science, Order and Creativity"
when
discussing the difficulty of challenging scientific research;
"One particularly significant mechanism which the mind employs to defend
itself against the inadequacy of its basic ideas is to deny that it is
relevant to explore these ideas. Indeed the whole process generally goes
further because it is implicitly denied that anything im****tant is being
denied! Scientists, for example, may avoid confronting deeper ideas by
assuming that each particular difficulty or contradiction can be dealt
with
through some suitable modification of a commonly accepted theory.
Each problem therefore produces a burst of activity in which the
scientists
seeks a "new idea." But rather than looking for something truly
fundamental, scientists often attempt an addition or modification that
will
simply meet the current problem without seriously disturbing the
underlying
infrastructure.
the whole problem of ending the mind's defense of its tacitly held ideas
and assumption against evidence of their inadequacy cannot be solved
within
the present climate of scientific research. For within this context, every
step that is taken will, from the very outset, be deeply conditioned by
the
automatic defense of the whole infrastructure".
Nothing changes under the sun. Just the topic heading, and different
vested
interests...
The only form of study which will cut any ice with parents of autistic
children, are studies of THEIR children, in which the doctors conclusively
eliminate the existence of vaccine related compounds causing trouble, in
the bodies of their children. Nothing else will suffice. And to argue
speciously, that the tests administered were unethical is rather rich from
a profession that specialises in agressive neonatal management sometimes
to
the point of exsanguination.
In epidemiological terms, it's no good studying the causes of car crashes,
by bean counting, number crunching, or other circuitous means. AS with car
crashes, autism will only be unravelled when epidemiologists stop pu****ng
pens and desks, put their shoes on, get out their microscopes, and for
once
put aside their preconceived ideas, and financial conflicts of interests,
and actually LOOK AT THE CHILDREN. As Wakefield and others have tried to
do.
Counteracting the REASONS why some parents won't vaccinate their children
will not "fix" the problem as doctors perceive it, though no doubt the
medical profession would wish that. Parents aren't stupid.
Dr McVittie is right in that the ONLY thing that will START parents
listening, is clear unambiguous evidence as to the safety of all vaccines.
(IF... that is, that parents haven't woken up to all the other litany of
"disasters" scattered far and wide through medical practice in general)
Furthermore, IF vaccine manufacturers are so sure of their products, they
should have the confidence not only to fund the studies required, but to
allow the appointment of a panel of doctors equally split down the middle.
One lot with "vested interests" and the others, the likes of Andrew
Wakefield whose "vested" interests lies with the children, rather than
with
a vaccine. Parents should also be allowed input into study protocols...
You would think that if everyone's primary goal was "first do no harm"
then
these three groups would have no trouble working together. Do I think it
might happen? Only when pigs grow wings.
There is far too much at stake here for the pro vaccine medical
profession,
medical bodies like WHO, Governments and the pharmaceutical companies to
risk such a child-centred scientifically accurate, altruistically helpful
approach.
To make matters worse, this situation is further compounded by the fact
that we STILL have a "poverty of medical evidence" in so much of medicine,
(Why we don't know, what we don't know) as elaborated years back by David
Eddy in the BMJ (4):
"only about 15% of medical interventions are sup****ted by solid scientific
evidence, David Eddy, Professor of Health Policy and Management at Duke
University, North Carolina, told a conference in Manchester last week.
This
is partly because only 1% of the articles in medical journals are
scientifically sound and partly because many treatments have never been
assessed at all.
"If," said Professor Eddy "it is true, as the total quality management
gurus tell us, that 'every defect is a treasure' then we are sitting on
King Solomon's mine."
I am sure that Robert Good would have also understood this, when he wrote
(5) many years ago:
"I sat in the front row of every class. I took down everything the
professor said, complemented this body of knowledge with the information I
learned from my instructors in the laboratory, from relevant information I
would glean from reading and digesting the best textbooks on each subject,
and even from extracting the substance of the most relevant articles in
contem****ary scientific journals. All this I included in my notes for
study
in beautiful Morocco-bound notebooks. The scheme seemed to work because it
gave me very high grades in school, top scores in state and national board
examinations, and my choice of training spots and fellow****ps. I closed my
notebooks, however, for 10 years. When I opened them again and studied
them
10 years after so carefully completing them, I was astonished to find that
they were almost entirely filled with lies. Except for a few descriptions,
such as well-established anatomy, everything that seemed so orderly and
beautiful with the rather comprehensive treatment I had given it for one
moment in history had changed, grown and been reordered by the scholar****p
of the intervening 10 years."
The medical profession should return to its altruistic roots of honest
enquiry, unencumbered by status, money, reputation, prestige, and a love
for the largesse of pharmaceuticals, and start looking at the King
Solomon's mine they sit on.
I fear it might just be too late. The public can only stand so many bad
apples in the barrel labelled "The Medical System" before they decide the
whole breed might also be likewise corrupt, through and through.
But I wish that I would be proved wrong.
Hilary Butler.
1) Emery J. L. Sudden Infant Death: Modern Medicine October 1984 pgs 9 -
11
"Are we asking the right questions?"
2) Emery J. L. BMJ 18 November 1989 volume 299 pg 1240 "Is sudden infant
death syndrome a diagnosis? Or is it just a diagnostic dustbin?"
3) Rognum, T., Acta Paediatr 85: 401 - 3, 1996. "SIDS or not SIDS?
Classification problems of sudden infant death syndrome"
4) BMJ Vol. 303, 5 October 1991 The poverty of medical evidence"
5) Dr Robert Good in :The Immunoglobin A System" 1973, pages 514 - 515
Competing interests: None declared
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