The martyrdom of St. Andy


Looks like I picked the wrong week to give up sniffing glue.

Well, not really. Maybe it looks more like I picked the wrong NIH grant cycle to be submitting an R01. After all, the deadline for my getting my grant to my university's grant's office coincided very closely with the announcement of the General Medical Council's ruling in the Andrew Wakefield case on Thursday. As I pointed out in a brief post yesterday, the complete 143-page ruling can be found here (if you want to avoid AoA or Generation Rescue) or here (if you want to annoy J.B. Handley by showing traffic coming from this blog). It's long, tedious document to read but can be boiled down to one brief passage:

In reaching its decision, the Panel notes that the project reported in the Lancet paper was established with the purpose to investigate a postulated new syndrome and yet the Lancet paper did not describe this fact at all. Because you drafted and wrote the final version of the paper, and omitted correct information about the purpose of the study or the patient population, the Panel is satisfied that your conduct was irresponsible and dishonest.

Irresponsible and dishonest. Dishonest and irresponsible.

Those two words describe Andrew Wakefield in a nutshell, although I would also humbly suggest adding to them the words "unethical" and "incompetent." After all, here is a man who did not disclose his conflicts of interest, namely that he was in the pocket of trial lawyers interested in suing vaccine manufacturers to the tune of £435,643 in fees, plus £3,910 expenses. As we say, them's some seriously righteous bucks, the equivalent of a full R01 grant here in the U.S. But it was worse than that. As Brian Deer discovered, Wakefield was also working on a competing vaccine alternative to the MMR and had even filed a patent application for it, meaning that results casting doubt on the safety of the MMR vaccine would be very helpful to him in marketing a competing vaccine. As for Wakefield's incompetence, that was made manifest during the Autism Omnibus proceeding when world-renowned PCR expert Stephen Bustin testified about the laboratory where the specimens from Wakefield's clinical trial were sent to be analyzed for measles virus sequences. The long version of his testimony is discussed here. The short version is that the laboratory was contaminated with plasmid containing measles virus sequences, and that the "positive" readings for measles virus in the ileal samples sent to the laboratory were false positives because of the contamination. Add to that the findings of the GMC, namely that he experimented on children without obtaining proper ethics committee approval and that he did invasive procedures on children that were not medically indicated, and the picture of Andrew Wakefield that emerges is anything but flattering:

The verdict, read out by panel chairman Dr Surendra Kumar, criticised Dr Wakefield for the invasive tests, such as spinal taps, that were carried out on children and which were found to be against their best clinical interests.

The panel said Dr Wakefield, who was working at London's Royal Free Hospital as a gastroenterologist at the time, did not have the ethical approval or relevant qualifications for such tests.

The GMC also took exception with the way he gathered blood samples. Dr Wakefield paid children £5 for the samples at his son's birthday party.

Dr Kumar said he had acted with "callous disregard for the distress and pain the children might suffer".

He also said Dr Wakefield should have disclosed the fact that he had been paid to advise solicitors acting for parents who believed their children had been harmed by the MMR.

If you want to see callous disregard for the children at that birthday party, take a look at this video. Unfortunately, the quality is poor, but it clearly shows Andrew Wakefield joking about children throwing up or passing out in fear:

Yes, that is laughter and joking, and that is but one incident that led the GMC to declare Andrew Wakefield's "callous disregard" for children. In my opinion, that is the real Andrew Wakefield. Dishonest. Callous. Unethical. Incompetent. These words do not begin to describe the vile human being that I consider Andrew Wakefield to be. Moreover, his incompetent, COI-riddled "research" (it still sticks in my craw to use that word to discuss anything associated with Wakefield's MMR work), aided and abetted by the sensationalistic and credulous U.K. press, led to a scare over the MMR that has not yet abated even now, more than a decade later. MMR uptake plunged throughout the U.K., dropping to as low as 50% in some areas. The result was very predictable. Over the last decade, the incidence of measles has skyrocketed in the U.K. Indeed, in 2008, 14 years after measles had been declared under control in the U.K., the Health Protection Agency stated that, as a result of almost a decade of low mumps-measles-rubella (MMR) vaccination coverage across the UK, "the number of children susceptible to measles is now sufficient to support the continuous spread of measles" and declared measles to be endemic again in the U.K.

That is the true legacy of Andrew Wakefield: The resurgence of a once-defeated vaccine-preventable disease, with all the attendant suffering its return brought with it. Truly, few people can be said to have done more harm to public health in a nation than Andrew Wakefield did in the U.K. with his incompetent, unethical, callous research.


Not surprisingly, the anti-vaccine movement is circling the wagons to defend the martyred Saint Andrew. Proving its utter crankitude, it is reacting exactly as cranks do when their views are attacked or one of their own is brought to task for his deeds. Those who brought those misdeeds to light are being vilified, as Brian Deer has been. Indeed, in an article published in the Sunday Times yesterday, Brian Deer describes just that phenomenon. First, there's the disbelief:

It began with a few murmurs. As Surendra Kumar, a Cheshire GP, read out the verdict of the General Medical Council (GMC) panel on the conduct of Dr Andrew Wakefield and two colleagues last Thursday there was muttering in the public seats. "Disgraceful," grunted one woman. "Rubbish," spat another.

As Kumar spoke the key words -- "dishonest", "irresponsible", "contrary to the clinical interests of this child" -- a crackle of anger and amazement erupted. I wondered if a fight would break out in the London committee room.

It wouldn't have surprised me one bit if there had been a fight. Then there's the vilification of "enemy," or at least the perceived enemy, as described by Brian Deer:

To many of the parents I was just as much of a villain as Kumar. They blamed me for the fallout from my investigations in The Sunday Times into Wakefield's research.


For one woman it was all too much. "It's Brian Deer who should be on trial," she called out. Such is the highly charged world of MMR.

For six years Wakefield and I have been locked in battle. It was my investigation that triggered the GMC's case. He sued me for libel -- and was then forced to send me a cheque to cover my legal costs when the action was withdrawn.

True to form, the anti-vaccine propaganda blog Age of Autism leapt to Andrew Wakefield's defense using apocalyptic imagery. To the anti-vaccine cranks at AoA, this hearing was nothing less than a battle of the good Saint Andy versus Big Pharma Evil, and its verdict proof positive that the pharma conspiracy to "poison" children with vaccines was taking its vengeance on poor, poor Andy for speaking truth to power. As it became clear that, finally after all this time, the GMC was on the verge of announcing its ruling, I noticed that the AoA ramped up an increasingly bizarre and unhinged last minute propaganda campaign, complete with a hilariously inapt post by Mark Blaxill comparing Wakefield to Galileo and the GMC to the Inquisition and containing references to Stalin and Mao (I suppose I should be relieved that Blaxill refrained from playing the Hitler card); a defense of "that paper" by Wakefield himself; claims that parent witnesses had been "silenced" at the GMC hearings; and a whole series of posts by John Stone over the last few months trying to discredit the GMC.

Of course, Wakefield's vision of himself as a brave Galileo persecuted by the forces of dogmatism is nothing new. He pulled that gambit right after the GMC Fitness to Practise Panel Hearing began in July 2007, likening himself to Václav Havel, the playwright turned political activist in Czechoslovakia who spent several terms in prison for his political activities opposing its Soviet-style Communist government in the 1970s and 1980s and ultimately played a major role in the Velvet Revolution of 1989 that led to the bloodless overthrow of Communism.

Galileo? Václav Havel? Wakefield surely does have an inflated view of himself! Next he'll be comparing himself to Gandhi or Martin Luther King.

After the findings were announced, the smear campaign only got more heated and histrionic. That's because in the decade since his Lancet paper began the movement that led to the resurgence of measles in the U.K. Andrew Wakefield has become a hero to the movement dedicated to the discredited idea that vaccines cause autism. He is the prototypical "brave maverick doctor" and don't need no steeenkin' science to know that he's "recovering" autistic children. Evidence of this delusion is everywhere; so I'll pick and choose. Perhaps the most obvious manifestation of the Wakefield cult of personality is this barf-inducing website We Support Dr. Andrew Wakefield. I first became aware of this website last year after Brian Deer's revelations regarding the likely scientific fraud committed by Andrew Wakefield came to light. On the day that the GMC's findings were announced, the website declared it a "sad day for the future of our children" and further declared:

The General Medical Council's (GMC) verdict today concerning Dr. Andrew Wakefield brings together autism organizations across the United States who stand united in support of him, unequivocally renounce the GMC's findings, and demand an investigation into possible conflicts of interests at the GMC. We further challenge the U.K. and U.S. governments to offer grants for gold standard research into why so many children with autism have gastrointestinal pathology, as well as any links between this pathology and the symptoms of autism, before all of the children of the world are affected.

Today's verdict by the General Medical Council epitomized their negligence in respecting all of the sound scientific studies worldwide replicating the findings of Dr. Andrew Wakefield. In the United States we will continue to fund studies replicating Wakefield's work. We will focus more heavily on helping to educate the British public about the dangers of the MMR. We will look with renewed vigor into possible misconduct by the GMC. And, most importantly, we will continue to recover children from autism thanks, in large measure, to Dr. Wakefield's pioneering work. We have witnessed and applaud the sustained courage and dignity of Dr. Andrew Wakefield. He has stood by the children, and we will stand by him.

This statement is signed by AutismOne (a favorite target of mine over the last couple of years), the Autism Research Institute, Generation Rescue (big surprise there, given that GR has already declared its support for Andrew Wakefield in no uncertain terms and, in the lead up to the GMC's findings, tried its best to demonize GMC and cast doubt on the legitimacy of the entire proceeding), SafeMinds, Schafer Autism Report, Talk About Curing Autism (TACA), Unlocking Autism. In other words, the vaccine-autism glitterati are lining up to support this statement. Notice how the statement alleges conflicts of interest and misconduct on the part of the GMC without any actual proof of such COIs. Also notice how it declares that other researchers have "replicated" the findings of Andrew Wakefield. Of course, that is true if you count charlatans and quacks, but no reputable researchers have been able to replicate his findings. More specifically, no researchers not affiliated with Wakefield and/or the anti-vaccine movement have ever been able to replicate Wakefield's work. Indeed, the latest "study" being touted by the anti-vaccine movement as "confirming" Wakefield's results is by...Dr. Arthur Krigsman of Thoughtful House, who happens to be on the editorial board of the journal in which the "study" was published! (Maybe I'll take this particular study on in a separate post if I'm in the mood later this week.) Even more curious is that this paper was published in a new vanity journal that gives the appearance of being dedicated to autism pseudoscience. Most recently, as I pointed out above, a sympathetic researcher named Mady Hornig, who had previously published research seemingly supporting a link between thimerosal and autism, failed to replicate Wakefield's results. Finally, notice how, despite numerous studies supporting the safety of the MMR and its lack of association with autism or bowel complaints in autism, these organizations continue to cling to the belief that the MMR is "dangerous" and vow to "educate" the public about the "dangers" of the MMR vaccine.

Consistent with previous reactions to criticisms of the anti-vaccine movement or one if its leaders, multiple organizations are also going on the attack, painting itself as the underdog being persecuted for speaking truth to power. For instance, here's what the TACA wrote:

The most frightening aspect of these GMC findings is the silencing effect it could cause to scientist and researchers. These verdicts now prove that researchers who stumble upon science that is controversial have to worry about losing their licenses and careers.

Consistent with the persecution complex that the anti-vaccine movement has, yesterday AoA contributor Martin Walker tried with some truly bad writing, writing worthy of consideration for the 2010 Bulwer-Lytton Fiction Contest (given that it is pretty much fiction and its prose is the equal of previous winners) with some incredibly heated rhetoric to show just how much reason has checked out among Wakefield's defenders:

As the recitation of the crimes of Dr Wakefield came to an end, it appeared as if Dr Wakefield, had in the mid nineties, been some kind of inhuman Nazi experimenter practicing on children in the heart of England; an overlooked human vivisector who stalked a large North London hospital committing serious crimes with the two other criminals in his firm, invisible to his colleagues and unseen by the hospital administration.

It's actually funny that Walker would mention Nazis. It was Nazi experimentation, among other things, that led to the Helsinki Declaration, the Belmont Report and the Common Rule in the U.S., and all the other protections for human subjects involved in clinical research. These rules are quite strict, although some would argue whether they're even strict enough. They prevent atrocities like the Tuskegee syphilis experiment. They are the same rules that Wakefield flouted.

Undeterred by reality, Walker then likens the ruling to knight knocked off his horse during a joust. I can only guess who in this contest is the White Knight and who is the Black Knight:

Today I know will be one of those times that signify a dark night of the soul, for defendants, parents and campaigners alike. This afternoon the defendants will be knocked from their horses by rib smashing lance blows, on the ground they will lie dazed and have to figure whether it is right or even possible to remount and continue the battle. Parents will contemplate the bleak landscape of their children's illness without any treatment and with open skepticism from medical practitioners from whom they seek help. Activists and campaigners like myself will have to face the melancholic prospect of either continuing the campaign or slipping away to support apparently more equitable battles.

This particular battle is a post-modern struggle, one in which the most powerful forces, multinational companies, reshape the world hand in hand with governments. This is a struggle from which parents and citizens have been expunged. A blind struggle, in an age where all the ties between governments and citizens have been severed, where it is no longer possible for citizens to have any real effect on either the processes of industrial science or of national politics.

The "battle," such as it is, is indeed postmodern, just not in the way that Walker seems to think it is. It is Walker's side that is actually producing the postmodern arguments, of course, but he's too oblivious in the depths of his conspiracy mongering, self-pity, and whining to see that.

Perhaps the most over-the-top conspiracy-packed "defense" of Andrew Wakefield comes from Mark Blaxill, published on the anti-vaccine crank blog Age of Autism and entitled Naked Intimidation: The Wakefield Inquisition is Only the Tip of the Autism Censorship Iceberg. It's all there, nearly every common crank gambit you can think of. Check it out!

Claims that the GMC finding was designed to "intimidate" those "brave maverick scientists"? Check:

The GMC proceeding is a frightening and thoroughly modern form of tyranny. It makes you shudder to think what Stalin or McCarthy might have accomplished if their public relations had been more skillful and better organized.

The extremity of the GMC's verdict--all three men guilty on all counts--lays bare any pretense that the British medical establishment cares one whit about the welfare of its patients. Let's put in perspective the actions at issue here. No children were harmed and no parent or guardian has complained about the care these three men provided. In fact, the procedures involved were routine, the resulting treatments standard and the careful attention to gastrointestinal illness in autistic children has recently been endorsed by a consensus statement published in the journal Pediatrics (no friend of the autism community). Considered in this light, the GMC hearing process stands exposed for what it is. It was not about medical standards. It was not about evidence. It was not even civilized. It was, rather, a naked exercise in intimidation, a fateful moment of moral decision in which the medical industrial complex exposed its ruthless, repressive essence. They are a frightening bunch and their conduct here raises issues well beyond autism.

Actually, Wakefield was not found "guilty on all counts"; he was found guilty on several of the most egregious counts but he was also exonerated on several. Blaxill should try--oh, you know--actually reading the ruling. In any case, the only thing frightening about this case is how much Andrew Wakefield got away with and how long it took for him to be exposed as the unethical fraud he's been shown to be by Brian Deer, the GMC, and numerous other sources.

Attacks on peer review? Of course they're there, too:

Since the National Institutes of Health (NIH) hold a virtual monopsony ("a sole or predominant buyer" in a particular market) on scientific research in the United State, NIH grant reviews are one prominent place where researchers can be effectively intimidated. One scientist, who authored a sensitive, previous publication, when asked to join in the effort to draft a review paper, demurred with the following explanation.

I have had two rejections of NIH grants in the last two weeks. This is most remarkable, in that the grants were not deemed good enough to even be scored. In my X years on the faculty, I have never had an unscored grant. Moreover, in one grant it is clear that there is a personal vendetta ongoing. This is not totally surprising but nonetheless disturbing. I am not ready to throw my career away, and I don't look at how Andy Wakefield has handled such problems as a good model for me. It is vital that the science of this problem get out, and this is where I want to focus my attention. Therefore, I have decided that I do not want my name on [this new review publication], for I don't need more persecution right now, and as good as the paper is (and I think it is extraordinary), it is not going to be a definitive scientific publication. I am enclosing a section I wrote-some of this is already included-feel free to use any of it.

If an intrepid researcher goes so far as to submit a paper for publication, that's where the more overt forms of censorship can enter in, all in the guise of "peer review." Admittedly, rejection at the point of peer review is a common part of science, but the autism problem is especially radioactive and is a place where I have seen the unmistakable cold hand of censorship take many forms: some unwelcome research can be headed off at the pass, with journal editors making clear that papers on certain autism topics are unwelcome and won't even be sent out for review; or unwelcome papers can be sent to anonymous reviewers the editor knows to be hostile to the topic of environmental influences;

Let's see. I just found out on Friday that not only was a revision of a paper I wrote still not deemed acceptable for publication in the journal to which I submitted it (reviewer three strikes again!), but I also found out that I didn't get a grant I really wanted that I had thought I had a good chance of getting. That's academia and biomedical science. It happens all the time (although I can't recall having had such a one-two body blow to my ego occur both in the same day, much less one at 4:30 AM after my having been up all night putting the finishing touches on a grant and then the second arriving at around 5 PM). The latter example of my failed grant is apt, too, in that the reviewers praised my proposed experimental design as being excellent but were very skeptical of the actual hypothesis being tested. Obviously, with my "dangerous hypothesis," I must be too close to The Truth about breast cancer and how to treat it. (Yeah, yeah, that's what I'll tell myself, rather than that I just didn't do a good enough job selling the project or that I didn't have enough preliminary data to convince the reviewers of its worth.)

In any case, the complaint that "I've never had a grant not scored" is not indicative of "censorship." The amount of money available for the NIH to fund grants compared to the number of grants submitted fell precipitously between 2003 and 2009. Lots of senior researchers who had never had a grant found to be "not worthy" of being given a numeric score (which indicates that the two or three primary reviewers deemed it to be in the bottom half--or even bottom 60%--of all grants being ranked in that cycle and therefore possessing no chance of being funded) have discovered the painful experience that many of us have had from time to time all along of having NIH grants coming back unscored. In these tight fiscal times, that's just reality. In this sort of environment, though, it's easy for scientists to tell themselves that they're the victim of groupthink whether there's anything to it or not.

However, Blaxill completely shattered yet another of my irony meters when he wrote his conclusion:

The GMC verdict, that honest scientists like Andy Wakefield have "failed in their duty", makes a mockery of the value of civil debate in an open society.

The medical industrial complex is closing ranks. It's time for responsible citizens--health consumers and principled scientists alike--to raise their voices in opposition.

No, the anti-vaccine movement has made a mockery of civil debate in an open society. Indeed, its reflexive reaction to criticism of attacking the messenger, sometimes in the most vile ways imaginable, is legendary. Journalists Amy Wallace and Trine Tsouderos, both of whom have published recent articles shedding light on the pseudoscience of the anti-vaccine movement, have been the victims of it and discovered what Brian Deer has been experiencing for several years, sometimes in the form of homophobic attacks in which his sexuality is linked to his supposed "indifference" to children. Steve Novella has been a victim of it. Paul Offit has been nearly continuously a victim of such bile and harassment, up to and including frivolous lawsuits. Sometimes, as when AoA represented Paul Offit, Steve Novella, and journalists Trine Tsouderos and Amy Wallace as sitting down to have a Thanksgiving feast, the main course of which was a dead baby, it can get unbelievably vicious. I myself have been harassed similarly on many occasions.

I suppose that's the definition of "civil" debate from the anti-vaccine movement.


As I have pointed out on numerous occasions before, both here and elsewhere, the anti-vaccine movement has much in common with cults. It believes, despite all scientific evidence, that vaccines cause autism and many other chronic health conditions. Its adherents see themselves as the keeper of a hidden truth that "they" don't want you to know about, a "truth" that it desperately wants everyone to know. No facts, no science can sway them, and when one of their prophets is found to have behaved unethically, to have had massive conflicts of interest, and possibly even to have falsified research, it's all part of a plot by The Man to keep them down. That is why, as necessary as it is for the GMC to have ruled against Andrew Wakefield, I know that it will not stop him from plying his trade on children in Texas, and I especially know that it will only feed his cult of personality by adding martyr to his list of attributes in their eyes. It will not stop him from raking in money hand over fist or Thoughtful House from racking up a huge war chest that do nothing to help autistic children.

Indeed, Wakefield himself has said as much, as Brian Deer reports:

Lawyers have told me that any one of the more than 30 charges that were proved against Wakefield would typically lead to his being struck off. His days as a medical practitioner will soon be history. A further hearing will determine whether "serious professional misconduct" was committed.


Wakefield's economic and fan base are undented, however. He is now executive director of an autism clinic in Austin, Texas, where he earns a reported £175,000 a year. "My wife loves it here," he said last year. "My family love it here."


On American television in August he was asked what effect being struck off would have on him. Wakefield replied: "Well, I think my credibility among the people who I believe count -- that is the children who are affected, the parents of the children who are affected -- will probably remain completely unchanged."

No doubt about that. Of course, this is a legal ruling, and as such in and of itself it doesn't demonstrate that Wakefield was wrong. Science does. What's gratifying is that this is an occasion where a legal ruling actually agrees with the science.

In any case, don't cry for Andy Wakefield, antivaccinationists. He appears to be doing just fine. At today's currency conversion rate, he's making close to $280,000 a year selling woo to desperate parents and managing to garner creampuff "investigations" on national TV here in the U.S. Even if the GMC ultimately decides that Wakefield has committed professional misconduct (which, from its ruling, it seems to me that he has), none of that will change. In fact, as I've speculated before, he will likely become even more credible to the anti-vaccine movement, because it will see him as a martyred prophet, having suffered for the faith--having suffered "for autistic children." Mark my words, the GMC is about to do Andrew Wakefield one of the biggest favors possible; he just doesn't know it yet. He'll be able to charge more, and he'll be the subject of more fanatical devotion than ever. One can only hope that the Texas Medical Board takes notice, but I see no sign of that happening any time soon. Wakefield's gravy train appears to be safe.

So does the lack of concrete effect of the GMC's ruling on Andrew Wakefield's activities mean that it's a waste of time? I don't think so. I think that Brian Deer gets it right when he quotes a physician:

Wakefield will probably never admit to his errors. But exposing his methods has been worthwhile, according to medical sources.

"People can't understand whether a scientific study is valid or invalid," said a senior doctor who had watched vaccination rates slump, even in the face of endless research on MMR safety. "But they can understand 'right' and 'wrong', and they can understand 'honest' and 'dishonest'."

I have found this to be true as well. People understand dishonesty. They understand unethical behavior. They understand callous disregard for children and the suffering to which they are subjected when medically unnecessary invasive procedures are performed on them. That Andrew Wakefield engaged in all of these is the finding of the GMC, and it's very important that this be emphasized. In the long run, I'd like for the public to understand why Andrew Wakefield's "research" is pseudoscience, but in the short run I'll settle for the GMC concluding that he behaved dishonestly, unethically, and callously.

Until the public can understand the reasons why the "research" supported by people like Andrew Wakefield and the anti-vaccine movement he played such a large role in fueling is bad science or pseudoscience, I fear that the madness and fear fueled by the anti-vaccine movement will only end when vaccine-preventable diseases return to the point where every parent fears them again. No, it'll have to be more than that. After all, vaccine-preventable diseases are already returning. That's why I fear it will only end when they return to the point where the fear of disease is more intense than the fear of the vaccine-autism bogeyman. In the meantime, while Third World countries clamor for life-saving vaccines and Bill Gates pledges $10 billion to bring vaccines to the world, here in the developed world we have men like Andrew Wakefield feeding an irrational fear of vaccines that threatens to reverse all the progress of the last few decades.

Maybe 20 years from now, we'll need the Bill and Melinda Gates Foundation to be pledging billions of dollars to bring vaccines to us.


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I'm really scratching my head over all the lumbar punctures. What were the rationale for these - to exclude meningitis (but why would one suspect that in a case of autism)?

He hates vaccines but readily sticks needles into spines?

I'm convinced that every time Wakefield opens his mouth, Jonas Salk spins just a little bit more in his grave.

By HopefulNebula (not verified) on 31 Jan 2010 #permalink

Something I think deserves special attention is a "complaint" being publicized alleging "false testimony" in the GMC hearing. I have tried to cover this, in a preliminary way, in an essay titled "Condemning the Innocent to Defend the Guilty" at I hope to finish another essay in the next few days. I encourage others to take their own shots at the latest Wakefield canard.
We should also make a point to remind people that it is Wakefield who has all along been using all kinds of threats and harassment in an attempt to silence HIS critics, as I outlined in an article that LBRB and a couple other blogs picked up last week.

By David N. Brown (not verified) on 31 Jan 2010 #permalink

This is a wonderful outcome but I predict it might still take many years for MMR to regain credibility amongst those parents who were so easily led by Wakefield and his lies. I've just caught up with A0A's breathless account of proceedings and would respectfully suggest that their correspondent Martin Walker might be better employed at Vogue or Harper's Bazaar. In the midst of Friday's GMC conclusions he still found time to run a fashion commentary, describing two of the mothers present at the hearing in London thus: "Suddenly one parent exploded in a clutter of bags and clothing, a scarf and a jacket, she stood up, twisted round a blur of mustard, shouting as she made her way out of the hearing room. She evaded the GMC security as they tried to manhandling her. After a short quiet with Kumar continuing, another parent, dressed attractively in purples, fury on her face, raged against him, repeating 'the children' over and again".

By NZ Sceptic (not verified) on 31 Jan 2010 #permalink

I read the AoA and a handful of other responses to the ruling before I read the actual ruling. From the ichor and venom in the responses, I assumed that I'd find the decision dripping with an equal amount of abuse. Instead, I found a methodical, carefully thought out, rational listing and explanation of each charge and each decision. In many cases, the Panel said that there was insufficient evidence to support many of the allegations. This was in NO WAY a group that has a personal vendetta against an honest man; this is a deliberate listing of the many ways in which Wakefield operated outside the bounds of medical and professional ethics.

The Panel even went out of its way to say that it wasn't ruling on the validity of the science, only whether or not he had ethical clearance to do the things he did. He didn't! It's not a question of values or whether or not he's a good man; it's a question of whether or not he behaved in a manner consistent to the ethical prescriptions of his field, which he didn't.

I notice more and more that there is no sense of irony or self-reflection in the crank-magnetized. It's the same lack of introspection we see in politicians and the major media outlets - a complete unwillingness to examine one's own position and evaluate its merits. How does one discuss something with a person whose position a priori is that they are absolutely right?

I swear, if I lost all my morals and standards tomorrow, I would try one of these two snakeoil salesmen ventures. One, is do the Dr. Andy routine (with a few additions). Get a online MD, develop some really bogus research and then use my popularity among the proles to lateral into a in-house position at one of these kooky "autism clinics". From that point on, I could sell my own patented industrial chelator, homeopathic remedies, coffee enemas or glut-free diet to confused parents with autistic children. Maybe I could get GMC or the local alternative food/medicine stories to carry my products. That would be on top of my 300K a year salary, for directing the clinic.

My other idea revolves around creating a for-profit tier 4/non-ABA accredited law school, admitting the sub-145 LSAT scorers and charging 40k a year. Hire a group of unemployed attorneys as professors. I could name it after a president or a local landmark or something.

Did discover a vaccine side effect recently (n=2) - kids (2 and 4 yo) had the swine flu vaccine on Friday afternoon, and slept in till 8:30am *both* weekend mornings. Now.. how many vaccines can I get for them?

By Andrew Dodds (not verified) on 31 Jan 2010 #permalink

I left the following comment on AoA, under the post Naked Intimididation, by Mark Blaxill, but for some reason it didn't pass through the moderation process:

Have any of the posters actually read the GMC findings? It may be enlightening to do so. For starters, they make clear that they are making no judgement on the vaccine /autism link. They also do NOT find Dr Wakefield "guilty on all counts",as Blaxill has stated.
The findings against Dr Wakefield are based on a number of factors:
Timelines - many of the procedures on the children were conducted before approval was granted by the Hospital Ethics Committee
Procedures - a number of procedures were not "clinically indicated", which was one of the conditions of the project
Authorisation - Dr Wakefield signed for a number of procedures, which under the terms of the project he was not authorised to do.
Patients - a number of the children were found not to satisfy the criteria for the project, as set out by Dr Wakefield and co in their submission to the Ethics Committee, some not actually diagnosed with autism or gastric issues.
Quite simply, if Dr Wakefield had complied with the terms of the project which he assisted to write up, there would be no grounds for these complaints.
The conflicts of interest and dishonesty complaints are also mainly upheld, in part due to Dr Wakefield's own actions (eg videotaped conference at which he spoke about paying children for blood tests at his son's birthday party).
Before railing against the "Conspiracy" it would pay for people to read the findings, so they can speak authoritatively against them.

I think it outrageous that so many "national" organisations are protesting the GMC findings. Parents new to autism will unfortunately find these people on the Web, and take their "woo" for granted. Very, very scary

By Sean Howie (not verified) on 31 Jan 2010 #permalink

@Jen (7)
To clarify, the Melanie Phillips article in the Daily Mail linked to is old. It's undated but isn't new; a fine example of the kind of stuff the Daily Mail printed for years, though.
Daily Mail this Saturday (30th) had 2 columnists (Peter Hitchens, Amanda Platell) each including "Wakefield's only crime was to care for patients and now the Big Establishment is crushing him under their jackboot" stuff in their opinion columns. Mel Phillips hasn't written on MMR since the GMC verdict to my knowledge.

Rob -
Yes, I see it isn't dated. I'm pretty sure I found it on a simple news search; interesting.

Today's health section features this on top

Daily Mail -Agony of doctor's receptionist paralysed by swine flu jab

and this several stories below
Daily Mail - Damning verdict on MMR doctor: Anger as GMC attacks 'callous disregard' for sick children, dated the 30th

I saw that Peter Hitchens column; that was really something. As usual, I would be happy to collect coverage here if anyone would like.

Won't someone PLEASE think of the children?

You know, I don't care if people do research. I really don't care if they have this loopy notion that MMR causes autism (tell that to my non-vaccinating European friends who have autistic children! In other words, they NEVER RECEIVED the MMR). What bothers me is that he did unethical things in his research. The panel found as much. This was NOT a personal attack on Andrew Wakefield, it was an investigation into whether or not a doctor practiced medicine with ethics. Clearly he did not.

Once again, diseases that were nearly eradicated in my area and in my lifetime are making a resurgence. And people don't seem to care as long as their kids don't "get autistic." It's madness! Apparently, they've never seen how awful these diseases can be for children and the general public. When Measles, Mumps and Rubella start doing some heavy-duty damage to the public, are the non-vacc'ers going to be held liable for spreading disease? I don't want my immuno-suppressed child (Autistic! OH NOES!) being affected by those who are supposed to help keep my child safe. It just isn't fair. What am I supposed to do, keep him inside forever?

Irresponsible. I liken it to neglect or abuse.

Did people catch the bit where Wakefield created a biotechnology Ltd company to exploit and sell his patented "transfer factor" in conjunction with the father of one of the children, and then gave it to the child under the umbrella of his research study?
No, I am not joking, he really did try that. (I'd struggle to invent a tale that twisted).

The GMC slammed him for that one too - never mind the conflict of interest and potential financial gains but they found it was clincially innappropriate and should never have been done.

In the UK there's still high amounts of very dubious press coverage as well as some highly hypocritical pontificating by other journalists complicit in the original scare. ho hum.

Wakefield either has a very dark sense of humour or is a sociopath. Discuss.

I always chuckle when vaccine defenders bring up Helsinki. Didn't stop the FDA from approving Prevnar 7 using the efficacy data from a trial (NCKP) in which the control group received an investigational vaccine. The hypocrisy, it burns.

It's probably worthwhile to read the complaint that Moody filed on behalf of Wakefield, and the entire testimony if people are so inclined. It's cumbersome, but it's probably in the best interest of those looking for any sort of unbiased accounting of what happened.

Over at Left Brain/Right Brain there is a "What happens next" thread going on Andrew Wakefield. One issue is whether the likely outcome of Wakefield being erased from the UK medical register (de-licenced) would have any implications, legal or otherwise, for his activities in the US.

From a comment there:

An interesting question is this; if Wakefield were found to be wholly unfit to be a doctor, and âa potential danger to the public if left on the doctorsâ registerâ (a form of words that the GMC sometimes use) would that have any impact on his legal ability to be the Executive Director (CEO, in effect) of a clinic in the US?

I doubt that the decision to strike him off (if that is the way it goes) will affect his standing among the fringe anti-vaccine groups and the biomedical underground; but is there any test in Texas on whether someone is a âfit and proper personâ (in the British phrase) to operate that kind of medical business?

Anyone here got any insight into /expertise on this?

No children were harmed and no parent or guardian has complained about the care these three men provided.

I can understand that a perforated bowel doesn't qualify as "harmed." After all, the child isn't really human anyway.

As for the lack of complaints, that should settle it. The children are, after all, their parents' property to dispose of as they see fit. I understand that orchiectomy can be very beneficial in managing unruly boys, and can have beneficial side effects on their musical careers. There should be no problem with medical practitioners offering this valuable service and I'm sure that the tireless crusaders for medical freedom in AoA and the like will take a stand on this procedure as well.

Oh, wait ...

By D. C. Sessions (not verified) on 01 Feb 2010 #permalink

Is your point that if prevnar trials violate the helsinki protocols Wakefield should be allowed also?

By superdave (not verified) on 01 Feb 2010 #permalink

According to this article, there have been reports that Wakefield, though not licensed to practice medicine in the U.S., has been present during examinations of patients in connection with Thoughtful House (it's unclear whether any complaints were filed with the Texas Medical Board). Anyone know if the TMB investigated Wakefield?

Brian Deer has it right, as usual:

"Thus the âmaverickâ doctor stood exposed as a two-timer. An apparent quester after truth â but for a lawyer and, potentially, for his own benefit.

More than that, he had fuelled a public health scare. MMR has been proved to be safe in countless tests, yet in the wake of Wakefieldâs Lancet paper immunisation rates in Britain dropped dramatically and led to a surge in measles cases. In April 2006 a child died of the disease in Britain for the first time in 14 years."

As far as "brave mavericks" go, Deer qualifies - bravery in the face of intimidation and abuse, maverick in the sense that he dug deeply into the story while most of his colleagues settled for shallow sensationalism. Wakefield on the other hand is a dishonest promoter of quackery. Nothing maverick about that, just the latest in a long, dismal line of self-promoting deception.

By Dangerous Bacon (not verified) on 01 Feb 2010 #permalink

I am surprised that the findings at 4(a) (ii) in the GMC report i.e. the diversion of £25000 of state money to uses that were out side the agreement with the Legal Aid Board,have not been referred to the police for investigation. The GMC board found "breach of care" proven but dishonesty not proven. I think a jury in a criminal trial may well find Wakefield guilty of Fraud.
As a British Taxpayer I think a criminal investigation into the findings at 4(a)(ii)is called for.

First of all, I like the pictorial choices(I studied art early on; I suspect Orac learned the iconography in a *slightly* different way)however, when I saw the title, my first thought was of St.Sebastian(usually depicted as a hot young guy pierced with arrows)photo-shopped with hypodermics.2.Thoughtful House lists Andy as a researcher only- not that lack of a valid medical license has ever stopped woo-meisters from practicing medicine- I assumed all along that he was as shady in Texas as he was in the UK.3.Interestingly, Mike Adams hasn't posted on this yet-he's probably too busy working on his new 115 part series and (allegedly) rigging web contests;I did read the Blaxill conspiracy rant;I predict Null will go ballistic, linking the damage to poor Andy to his health freedom agenda and libertarian dismantling of the federal government.

By Denice Walter (not verified) on 01 Feb 2010 #permalink

As far as whether or not losing his license in Britain would adversely affect his Texas practice (assuming the GMC does revoke his license), if I'm not mistaken, it would have no effect. It would be just as illegal for him to practice medicine in Texas as it is right now. I believe foreign doctors need to obtain local licenses before they can legally practice, though IANAL, so I may be wrong.

Wouldn't slow him down anyway. He's obviously ready for that. This ruling has come as absolutely no surprise for him; Wakefield has an advantage over old-time quacks like "Dr" Brinkley in that he's shrewd enough to anticipate the moves against him.

By Calli Arcale (not verified) on 01 Feb 2010 #permalink

Just posted the following on Blaxill's "cencorship" post:

@Mr. Blaxill

"all three men guilty on all counts"

False. There are a number of counts for which the GMC ruled "Found not proved". Please refrain from distortions like this.

"the procedures involved were routine"

False. Wakefield, et al., conducted clinically irrelevant colonoscopies, MRIs and lumbar punctures, despite documentary evidence that such procedures were not indicated (see, e.g., 23(d)(ii)).

Ultimately, the GMC looked solely at Wakefield's, Walker-Smith and Murch's ethical conduct in their research. They did not look at the science they were attempting. They did not evaluate the claims they made with regard to MMR and autism. They only looked at whether they behaved according to proper ethical principles, such as those spelled out in the Declaration of Helsinki, Nuremburg Code, Belmont Report, and ICH human protections guidelines, among others. They found that the physicians conducted their research unethically.

Wakefield, et al., should be punished accordingly, as should any physician-researcher who conducts themselves contrary to accepted ethical guidelines. This is not censorship.

Now, I hope you will allow this comment through, rather than censor it. It will be cross-posted elsewhere on the web.

Todd W.
Good post. I do hope Blaxill does not moderated it into oblivion but I'll not hold my breath.

Wakefield, in my opinion, should face criminal charges for his role in causing outbreaks of vaccine preventable disease. He should be made to publicly repudiate his unethical behavior and his crap science and pay for the pain and suffering he has caused. A lot.


Yeah, I hope they let it through. I was pleasantly surprised, recently, when Kim Stagliano let several of my posts through on a different thread, but my tone in this one was a bit confrontational. I'm not holding my breath.

We should also remember the history of this thing. It's not like the GMC went "hey, there's this doctor who is trying to attack vaccines - let's see if we can get him."

It was like this. Brian Deer documented Wakefield's conflicts of interest. The editor of The Lancet, Richard Horton, said that Wakefield had breached The Lancet's rules by failing to disclose the COI.

Wakefield's reaction was as follows:

âSerious allegations have been made against me in relation to the provision of clinical care for children with autism and bowel disease, and the reporting of their disease. It has been proposed that my role in this matter should be investigated by the GMC. I not only welcome this, I insist on it and I will be making contact with the GMC personally.â

(See press reports from February 2004.)

The GMC investigation was thusly carried out at Wakefield's own insistence.

Moreover, his incompetent, COI-riddled "research" (it still sticks in my craw to use that word to discuss anything associated with Wakefield's MMR work), aided and abetted by the sensationalistic and credulous U.K. press, led to a scare over the MMR that has not yet abated even now, more than a decade later.

Then why use that term at all?

Looking through the actual report I see many instances where the term "research study" has been struck through and replaced with the term "project". Other variations of the term have been treated similarly.(Examples are on p.16, 17, 19, 22, 23,25, 28, and 31.)

If the GMC is not willing to call what Wakefield did to those children research then I would say call it whatever you want.


Thanks for the reminder. I'd forgotten that Wakefield outright asked for the GMC to investigate the claims against him.

Anyone know the answer to this? Wakefield's medical qualification is at the bachelor level. In the UK, it's standard for doctors to qualify MB BS, which isn't MD. They are entitled then to call themselves a doctor. But if he's struck off the medical register - which he certainly will be, with four dishonesty charges found proven, including financial and research dishonsty - can he still call himself "Doctor?"

Visitor, it is a slightly different system in the UK. They still get the same numbers of years, and yes, he is a doctor. Not a very good one, but one none the less.

As far as I know understand it "doctor" is not a protected title in the UK, since it can refer to us Ph.D. doctors, or to someone with a higher research degree (D.Sc., cf. the German Habilitation), or can be a "courtesy title" used by medical practitioners with Bachelor of Medicine degree (MB BS or similar). In everyday speech people in the UK assume "doctor" equals "medical practitioner".

Were Wakefield to be running a clinic in the UK, and to be struck off / "disbarred", and then to continue styling himself "Dr", I suspect there might be a case against him in Trading Standards law, since the use of the term "Dr" in the clinic's materials would then be arguably misleading (since people would likely assume it meant he was a licenced medical practitioner). But I rather doubt there would be any other breach of civil, let alone criminal law. And unless you were very high profile I doubt the Trading Standards folk would bother either. The most they tend to do is tell the person/business to change the advertising.

Re my comment at 21, I have now complained to the Metropolitan Police re Wakefields misuse of public funds-watch this space
The Daily Telegraph had 2 pieces on this case-one a news item and one a piece about where wakefield claimed he had been badly treated. The DT also had an editorial which backed the GMC

Further thought suggests that the Wakefield 3 were guilty of assault and grievous bodily harm in doing clinically unneeded tests.

@Todd W. #26

It's been a while now, and your post still isn't up. Surprise, surprise.


Yeah. Though it did take Kim a while to get my comments up on her thread. I'll be charitable, for the time being, and assume that Blaxill is busy, since there haven't been any other posts allowed through, either, including supportive ones.

Orac wrote about the birthday party blood draws: "Yes, that is laughter and joking, and that is but one incident that led the GMC to declare Andrew Wakefield's "callous disregard" for children."

It's not just Wakers laughing - the audience is as well. But that's OK, because they are parents of children with autism, and moreover are Wakefield fans. They and are, by their own definition, martyrs who would perform any number of experiments on their own children to get back the normal child they think they are entitled to. To them, a simple blood draw is no big deal at all. And besides, serves those "normal" kids right - they should have some suffering - why should their kids have all the blood draws?

When you hear that laughter, you aren't surprised at the AoA attitude towards the ruling.

By Broken Link (not verified) on 01 Feb 2010 #permalink

colmcq states:

"Wakefield either has a very dark sense of humour or is a sociopath. Discuss."

I'd offer another option: Andrew Wakefield is a narcissist.

I base my "diagnosis" on three observations:

[1] Dr. Wakefield has - on numerous occasions - been shown that his research is rubbish, yet he has refused to either acknowledge his errors/omissions or stop publicly promoting his thoroughly disproven hypothesis. Most other people in his position would shut up and fade away - a few would publicly admit their mistakes. Dr. Wakefield has done neither, suggesting that he is not aware that his research has been disproven in detail. This inability to admit - to himself - that he has made mistakes is characteristic (but not diagnostic) of narcissism.

[2] Dr. Wakefield has publicly admitted that he did not follow "the rules" about human research (he even joked about his rule-breaking), yet he is adamant that everybody else must follow "the rules" scrupulously. A "sociopath" would characteristically see anyone who follows the rules as "stupid" or "a chump" - narcissists typically feel that they alone don't need to "follow the rules" because they are somehow "special".

[3] Dr. Wakefield blames others - the GMC, reporters, other doctors, etc. - for all his problems with respect to medicine (and possibly everything else). He seems truly incapable of seeing that he has contributed to (or is entirely responsible for) the trouble he is in. At a point when most non-narcissists would throw themselves on the mercy of the public (or check into rehab), he insists that he has been "wronged". This may be only a "narrative" for public consumption, but he seems to truly believe it.



I'd offer another option: Andrew Wakefield is a narcissist.

Careful now. Once you start applying axis ii characteristics to movement anti-vaxxers, it becomes very hard to stop.

Here's the summary of "narcissistic personality disorder" from the DSM IV (TR):

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

[1] Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)

[2] Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love

[3] Believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)

[4] Requires excessive admiration

[5] Has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations

[6] Is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends

[7] Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others

[8] Is often envious of others or believes others are envious of him or her

[9] Shows arrogant, haughty behaviors or attitudes

I can count at least five in what I've seen in Wakefield's public appearances.


Other antivaxers who've been regular "guests" here might have him beat.

The "grandiose sense of self-importance" and "sense of entitlement" in particular ring bells.

By Dangerous Bacon (not verified) on 01 Feb 2010 #permalink

I think Orac hit it on the head when he used the word "cult" to describe anti-vaxers. It does not matter that Andrew Wakefield was found to have acted callously and with little regard for children. He's a doctor who believes vaccines cause autism, and to the disease promoters he will always be a hero.

Heck, these quacks seriously injure and sometimes even kill children, yet some anti-vax group goes out and defends them anyway.


I'm having some problem with your statement "The volume of applications to the NIH compared to the money there to fund them fell precipitously between 2003 and 2009." Wouldn't that mean that there was money for each application? Or am I just being pedantic?

#7 and #8 Are those two related?

By Colin Day (not verified) on 01 Feb 2010 #permalink

From the Fiona Phillips article linked in the comments:

Well, Dr Andrew Wakefield didn't stand a chance, did he? Not up against the might of the medical profession.

He has been branded dishonest, irresponsible and that he showed a "callous disregard" for the suffering of children.

Odd, then, that he now continues to work in the field of autism in Texas, where he set up Thoughtful House, a non-profit autism centre.

This is a little like saying "If Harold Shipman hadn't sincerely cared about the welfare of his elderly patients, he wouldn't have continued to treat so many of them."

By Antaeus Feldspar (not verified) on 01 Feb 2010 #permalink

My own diagnosis has long been that Wakefield is a "narcissistic sociopath", which is my idea of a clinical description of a school bully. Characteristics are sociopathic abusiveness, dishonesty, and dehumanization toward others, combined with a need for approval from a SELECT group.
I have also referred to Wakefield as an "underachieving narcissist". That got an angry reply denying that he is an underachiever.

By David N. Brown (not verified) on 01 Feb 2010 #permalink

"I think Orac hit it on the head when he used the word "cult" to describe anti-vaxers"

Regular Scientology watchers see it clearly.

Colin Day
"#7 and #8 Are those two related?"

In the fact that they show that the UK still has a serious problem with the press. At least Oprah (hiring Harriet Hall) and HuffPo (featuring Bill Gates' vaccine development) have started to back off. UK press is in deep denial, and IMO they need to be SOUNDLY spanked.

PS I find it enormously humorous that the HuffPo's banner at the mo is
How The GOP Created The 'Deficit Crisis' Narrative And Everyone Else Bought In"

No self-awareness.
How The _______ Created The "_________ Crisis' Narrative And Everyone Else Bought In"

Irony meter, or something.


...sounds like Blair ;)

I wonder how Wakefield explains his dishonesty and callous indifference to his worshipers? Does he just deny the facts? Does he have cool sounding, medical-like responses ready? There were enough serious issues raised that if the audience had even a few working brain cells, they could hardly fail to miss them. Cult indeed.

I was wondering why some random researcher can inspire such devotion. It can't just be because of some centuries old lingering suspicion about vaccines.
So I looked up his talk in Chicago from 08 (I think); He's one smooth dude who can really work a room. Like a combo between a guru and a hero doctor from an eighties soap.
Dispelling the movement behind him is going to take some doing.

So as for the question, how does he defend himself to his followers? I wager he never gets asked to.


I have to echo Muzz, here. He probably never needs to. They are quite able to rationalize away any criticisms against him without his needing to say a word.

James Arthur Ray exhibits the same tendencies. How do we break the guru spell? (Besides endless comments on blog posts)

By Anonymous (not verified) on 02 Feb 2010 #permalink

I'm having some problem with your statement "The volume of applications to the NIH compared to the money there to fund them fell precipitously between 2003 and 2009." Wouldn't that mean that there was money for each application? Or am I just being pedantic?

From context it's pretty clear that he did mean the opposite of what he technically said, and simply made an error in the phrasing. So yes, you're just being pedantic.

I read this report (the whole thing) and what I couldn't get over was the cruel and excessive testing he did on these children. Lumbar punctures, a colonoscopy for every child (even the one with mild diarrhea that was improving).

I just know how hard it is for my son to get a dental check-up, how could these parents put their children through this?

It is like Broken Link wrote:

They and are, by their own definition, martyrs who would perform any number of experiments on their own children to get back the normal child they think they are entitled to.

But I would add, they don't think of these children as children at all, just problems who need to be fixed. Do any of these anti-vaccers put their 'normal' children through this crap? I don't know the answer, but I am betting they don't.

Actually, the I heart Andy website has some useful info. I frequently am trying to tell my friends and family that not all autism "advocacy" organizations are the same, and they have to be careful about which ones they choose to donate to. That support site for him lists them all in one place for me, how convenient. Now when someone says to me "Should I donate to so-and-so?" I won't have to try to remember if they're on my list of faves or not.

By backtolurkingnow (not verified) on 02 Feb 2010 #permalink

The Lancet has retracted the paper.…

"Following the judgment of the UK General Medical
Councilâs Fitness to Practise Panel on Jan 28, 2010, it
has become clear that several elements of the 1998
paper by Wakefield et al1 are incorrect, contrary to
the findings of an earlier investigation.2 In particular,
the claims in the original paper that children were
âconsecutively referredâ and that investigations were
âapprovedâ by the local ethics committee have been
proven to be false. Therefore we fully retract this paper
from the published record."

Any takers on a bet that this doesn't stop groups like Thoughtful House or Generation Rescue from keeping the paper as part of their "see vaccines cause autism" arsenal?

I read this report (the whole thing) and what I couldn't get over was the cruel and excessive testing he did on these children. Lumbar punctures, a colonoscopy for every child (even the one with mild diarrhea that was improving).

I just know how hard it is for my son to get a dental check-up, how could these parents put their children through this?

This highlights one of the nuances of pediatrics compared to other specialties; the difference between the child's best interest (as the child is the patient) and the parents' wishes. This clearly adds an extra, and potentially very difficult, ethical dimension for the treating doctors; sometimes they have to oppose or countermand parents' wishes in the child's best interest. And sometimes these things end up in court - for a tragic recent example from the UK see here.

In the Wakefield et al. case, you could certainly argue the doctors had failed in this respect. This is basically what the GMC has said; they were not acting in the childrens' best interests, as required by their professional ethical code. The implication, though it is not explicitly stated, is presumably that they were acting in their own and the parents' interests. The coincidence of these overrode the intended safeguards provided by both the doctors' personal ethical codes, AND the safeguards put in place by the institutional ethical review process.

If you can find the full version of the GMC verdict, an interesting insight into the different approaches of different doctors can be found in the section on page 107-111, where Prof Walker-Smith, prompted by Wakefield, has a couple of goes at convincing a reluctant community paediatrician of one of the children into allowing "child JS" to be put through the test protocol.

Perhaps the worst example of bypassing the safeguards is the example of Child 10, who was treated with an experimental "vaccine alternative" called "Transfer Factor", completely outside of any approved protocol.

So, my post in response to Blaxill's article "Naked Intimidation" is still not up. I've just posted the following comment:

Mr. Blaxill,

I realize that you are busy, but I'm curious why you have not yet allowed my comment through? It contained no links. It was not disrespectful. What reason did you find to not approve it?

Will Blaxill continue to censor me, showing himself a hypocrite, or will he allow a free and open discussion? I've got my guesses...

A thought just occurred to me. Since Wakefield has been in the U.S. for a number of years now, in light of the GMC ruling, I wonder if the Office of Human Research Protections at the U.S. Department of Health and Human Services will be taking a closer look at him. Has he committed any other ethical breaches while in the U.S.?

Todd W.
He is still advocating against vaccines but that seems to be okay even though outbreaks are on the rise.

Wakefield was on some morning news Tuesday where my wife tells me he is still advocating for his old positions and his supporters are going to the UK to picket and protest. I vote we don't allow them to come back.

I wonder how Wakefield explains his dishonesty and callous indifference to his worshipers?

Wakefield need do nothing; his audience will rationalize away his actions for him, no matter how outrageous they get. When you're that deeply invested in a lie, it is so much easier to keep on digging than stop and face your own culpability in the matter.

Hell, at this point Wakefield could be bumming eight-year-olds on the front steps of Thoughtful House, and the AoA types would hail it as the greatest cure since the Lupron Protocol.

Another great post Orac. The use of biblical images was funny. Keep up the good work!

Dr Aust,

That article you linked to is heartbreaking. I appreciate your reply, it boggles the mind how much pain and suffering some parents are willing to put their children through to make themselves feel better.

I am sure it is very difficult for a pediatric doctor to deny a child's parents the treatment they desire because it is not in the best interests of the child. There are many doctors who just give in (i.e. the above post), but I believe the great majority of doctors stay true to their ethical obligations. After all, they would not have chosen their specialty if they didn't want to help children.

I just find it particularly reprehensible that they subjected autistic children to these types of tests. I find that even the least invasive tests (checking ear drums, eyes, name it) are very upsetting to my son, he is 'not himself' for the rest of the day whenever he has a check-up.

I could not do what I have read other parents are doing. I value his comfort far too much. I just don't understand the mentality.

Re: #56 and 57 - If the quote I just saw on the New York Times story about this is any sign then the retraction isn't going to change anything in their minds:

Jim Moody, a director of SafeMinds, a parentsâ group that advances the notion the vaccines cause autism, said the retraction would strengthen Dr. Wakefieldâs credibility with many parents.

âAttacking scientists and attacking doctors is dangerous,â he said. âThis is about suppressing research, and it will fuel the controversy by bringing it all up again.â

If the trial actually works in Wakefield's favor in terms of his fan club, he will have legions of anti-vaccinists at his command. Hopefully, we will not one day live in a world where the majority refuses vaccination. H.G. Well's Country of the Blind comes to mind: "In the country of the blind, the one-eyed man is king."

Thanks, Kristen.

My wife is a hospital doctor - though not a paediatrician - so we discuss ethics Qs now and again, apart from where they come up when I teach medical students at the University. I remember when Brian Deer's article came out explaining just what the tests were that had been done outside the ethics protocol she was practically speechless, and I suspect most physicians would have had the same reaction.

I just find it particularly reprehensible that they subjected autistic children to these types of tests.

Agreed, particularly because you would have to think there would be less chance than with neurotypical children that the children would be able to comprehend why what was being done was being done. Hence I would have said there would have had, if anything, to be an even more compelling clinical reason to do the tests.

I think Prometheus' amateur psychology view of Wakefield (#38 and #40 above) would get a lot of support from many of the doctors and scientists who have followed the case, at least judging by my conversations about this over the years. I am left wondering about the other two paediatricians (Prof Walker-Smith and then Dr, now Prof, Murch), though. I find it hard to accept they would have done all this unless they did believe that they were onto something important that would ultimately help childen. I wonder whether what this is telling us isn't that they were bamboozled by Wakefield as well.

There is an interesting new article on the GMC verdict and the whole sorry business by UK doctor and long-time Wakefield opponent Dr Mike Fitzpatrick - himself the father of an autistic child - here. As he says, the greatest casualties of the whole affair are the families of children with autism drawn into futile litigation, and spending years in pursuit of a non-existent something, or someone, to blame.

âAttacking scientists and attacking doctors is dangerous,â he said. âThis is about suppressing research, and it will fuel the controversy by bringing it all up again.â

Part of me hopes so, because the weight of the science so heavily lies on the side of vaccines not causing autism. Maybe a few fence-sitters or reluctant vaxers will take a second look and realize how wrong tyhey were.

Hey, I recognize that middle painting! It's The Martyrdom of St. Erasmus by Nicolas Poussin, 1628. It's in the Musei Vaticani. The method of torture portrayed is disembowelment.

By Trin Tragula (not verified) on 03 Feb 2010 #permalink

Hi, so this might be a really stupid question, but I'm throwing it out there anyway.

What can I DO about this? I'm not a doctor or even a graduate student - I'm still a senior in high school. I'm not publishing papers or teaching anyone.

But ignorance like this drives me absolutely up the wall, and I honestly do not know how to fix it. Are there anti-anti-vaccine funds I can donate to? Outrach clinics I can volunteer at? Educational programs I can somehow help with?

Without being a scientist, without a lot of weight behind my name, what can I do?

By Orange Lettuce (not verified) on 05 Feb 2010 #permalink

@Orange Lettuce

When you encounter someone who holds anti-vax beliefs, point them to resources like Science-Based Medicine blog, LeftBrain/RightBrain,, the CDC, FDA and AAP vaccine pages.

The antiantivax site is a good place to get a basic overview, with links to a bunch of other resources.

Hey, I recognize that middle painting! It's The Martyrdom of St. Erasmus by Nicolas Poussin, 1628. It's in the Musei Vaticani. The method of torture portrayed is disembowelment.

And I thought it was someone getting a colonoscopy.....

"Wakefield was also working on a competing vaccine alternative to the MMR and had even filed a patent application for it, meaning that results casting doubt on the safety of the MMR vaccine would be very helpful to him in marketing a competing vaccine."

Are you sure about this, Orac? I've heard that the patent was not for a competing vaccine, but a Transfer Factor intended to antidote MMR damage. Leaving aside for a moment the fact that noone here actually believes MMR causes damage, it still was not intended as a *competitor* to MMR - rather an adjunct in what would presumably be a small number of cases.

Yes Dale, the patent expressly mentions intent and function of the 'preparation' as both a vaccine component (to replace the contemporary measles one in the MMR) and (always mentioned secondarily to it's role as a vaccine component) as a treatment in IBD.

The preamble and claims section makes it clear that it was intended as a vaccine component. It is the primary claim on at least one of the applications.

Wakefield is technically correct that he was not patenting a rival vaccine, but it is pure semantics. He stood to benefit if his 'preperation' was used to replace the measles component of the MMR, which is the stated primary purpose of the preperation.

Orac merely shills for the status quo. A crafty verbose sociopath, an accomplished motormouth. He takes delight in playing the devil's advocate and my guess is he will switch sides one day just because he can.

Dr Wakefield committed no crime and the charges from the GMC were nothing more than opinion on clinical necessity or ethical behavior. To even consider charges against an excellent, though small, study and it's dedicated lead author after it's been available for peer review for 9 years shows the depths Big Pharma and government regulatory agencies will sink to set an example for those who go against them. Unfortunately it also shows how brazen they have become. This does not bode well for most of us

We are better off for the courage of heroes like Andrew Wakefield, Richard Convertino, David Graham, Brooksley Born, Frances Kelsey, Harry Markopolos, Eric Topol, Bunnatine Greenhouse, David Lewis, Colleen Rowley, Steven Nissen, Cynthia Cooper... and many others who stood up for what they believed was right, who by their selfless example point the way to where we should go and what we can be. We have to find the will and strength to support them.

Then you have people like orac... Who knows he is lying and lies anyway. Who knows he is hurting innocent children but doesn't care. Who apparently delights in burdening families with the care, for life, of a regressively autistic innocent child.

I believe orac wants to be the leader of the sociopaths who use what intelligence they have to foster the greed of Big Pharma. Who offers his services to protect not only pharmaceutical companies but, inadvertantly, the regulatory agency heads that appease the manipulating executives and scientists in their greedy pursuit of government health care dollars. How will he be thanked for his service? Alas poor orac, we no longer need your pretentiousness...

I would give you facts and figures and studies sweetie, but we know you know the truth.

By michael0156 (not verified) on 13 Mar 2010 #permalink

"Dr Wakefield committed no crime and the charges from the GMC were nothing more than opinion on clinical necessity or ethical behavior."

As determined by the highest relevant authourity, after a direct request to investigate from Wakefield himself, based on documents including legally0admissable clinical documents signed by Wakefield, including documents that explicitly stated that some of the pre-trial assessments were for research - not clinical purposes. In short, Wakefield left a papertrail all over the place and justifiably got got caught and caned.

You really must do better Micheal. The GMC found several direct pieces of evidence that led to thier conclusion. You have failed once again to even attempt to provide the 'two pieces of evidence' you so love to demand.

You can deny the authourity of the GMC all you want, but they outmatch you for expertise, time spent and evidence presented. You are just some badly misinformed guy who can't even go a single blog post without flinging snide little insults and accusations around.

You still have not answered the concerns about your crass and insulting behaviour over at lb/rb and your inability to meet your own standards of arguementation. I suggest you get too it.

You wouldn't want to look like a hypocrite now would you? Your ego won't allow you to stand for that.


Here is the first paragraph of description from Wakefield's patent application:

he present invention relates to a new vaccine/immunisation for the prevention and/or prophylaxis against measles virus infection and to a pharmaceutical or therapeutic composition for the treatment of IBD (Inflammatory Bowel Disease); particularly Crohn's Disease and Ulcerative Colitis and regressive behavioural disease (RBD) (also referred to as"Pervasive Developmental Disorder").

(emphasis added)

And from later in the application:

What is needed therefore is a safer vaccine which does not give rise to-these problems, and a treatment for those with existing IBD. I have now discovered a combined vaccine/therapeutic agent which is not only most probably safer to administer to children and others by way of vaccination/immunisation, but which also can be used to treat IBD whether as a complete cure or to alleviate symptoms.

(emphasis added)

The evidence seems very clear, coming from Wakefield himself: even if he believed his invention was also a therapeutic agent, he himself saw it as a vaccine, one which should be used in preference to the supposedly unsafe MMR.

By Antaeus Feldspar (not verified) on 14 Mar 2010 #permalink

Over at Left Brain/Right Brain there is a "What happens next" thread going on Andrew Wakefield. One issue is whether the likely outcome of Wakefield being erased from the UK medical register (de-licenced) would have any implications, legal or otherwise, for his activities in the US.