Letter to BMJ - MMR/Wakefield by Hilary Butler.

Discussion in 'Health and medical' started by John, Mar 9, 2004.

  1. John

    John Guest

    Letter to BMJ - MMR/Wakefield by Hilary Butler.


    Dear Sir,

    What should the purpose of any enquiry into the MMR vaccine
    issues really be?

    Clare Dyer reports the media facts, but the article skirts
    the fundamental concerns. Which ironically are touched on
    in another BMJ article in this issue, http://bmj.bmjjourna-
    ls.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 reporter 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

    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

    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 important 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

    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

    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

    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 pushing 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.
    (dp... 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 supported 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 contemporary 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 fellowships. 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
    scholarship 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.

    6) Emery J. L. Sudden Infant Death: Modern Medicine October
    1984 pgs 9 - 11 "Are we asking the right questions?"

    7) 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?"

    8) Rognum, T., Acta Paediatr 85: 401 - 3, 1996. "SIDS or
    not SIDS? Classification problems of sudden infant
    death syndrome"

    9) BMJ Vol. 303, 5 October 1991 The poverty of
    medical evidence"

    10) Dr Robert Good in :The Immunoglobin A System" 1973,
    pages 514 - 515

    Competing interests: None declared

  2. Pf Riley

    Pf Riley Guest

    On 9 Mar 2004 09:07:58 -0800, [email protected] (john) wrote:
    >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".

    Gosh, John -- does this mean you'll stop complaining about
    research funded by drug companies?