J
John
Guest
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 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
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 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
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 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
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 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
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 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
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 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