Respectful Insolence

The antivaccine counterattack against Brian Deer continues.

As you recall, about a month ago British reporter Brian Deer published an exposé, a tour de force of investigative journalism that led him to discover that Andre Wakefield had not only had incredibly blatant undisclosed conflicts of interest (his having been in the pocket of trial lawyers suing vaccine manufacturers and his forgetting to mention the little fact that he had been developing a competing version of a measles vaccine that he had been hoping to market) when he published his infamous 1998 Lancet paper linking MMR to regressive autism and enterocolitis, but that he had in fact committed scientific fraud and falsified data. Although it took longer than I thought, the counterattack was forthcoming, first with David Kirby playing Keith Olbermann for a fool by using Olbermann’s hatred for Rupert Murdoch to convince him that somehow Brian Deer had an undisclosed and irreconcilable conflict of interest. He did not. Next up was the “We Support Dr. Andrew Wakefield” petition, which was as blatant of example of cultish behavior as I’ve ever seen. Most recently, the counterattack involved some seriously burning stupid laid down by that tag-team of antivaccine propaganda, David Kirby and Robert F. Kennedy, Jr., twisting and distorting an old Vaccine Court case to make it sound as though the U.S. Government had conceded that MMR can cause autism. So what’s left?

Why, a different tag-team attacking Brian Deer, of course! Behold, David Kirby serving once again in his role as Andrew Wakefield’s mouthpiece in both the antivaccine crank blog Age of Autism and that repository of antivaccine pseudoscience The Huffington Post by trumpeting Wakefield’s “complaint” to the UK’s Press Complaints Commission (PCC) about Brian Deer!

Rarely have I seen two pieces of writing so utterly toxic and destructive to my irony meter. It’s like the acid that runs in the veins of the title beings in the Alien movies.

I’m not going to deal (much) with David Kirby’s HuffPo piece because, quite frankly, it’s nothing more than the credulous parroting of Wakefield’s complaint. I will, however, point out that in any dictionary of sayings, under the saying “pot calling the kettle black,” they should put a picture of David Kirby alongside that of Andrew Wakefield. The man made his name publishing a fear mongering book sympathetic to the mercury militia (i.e., the movement that, confusing correlation with causation, believed against all science and reason that the mercury in the thimerosal preservative that used to be in vaccines was the cause of the “autism epidemic”). Since then (four years ago now), he has been one of the primary mouthpieces of the antivaccine movement, and, as far as I (or anyone else) have been able to tell, has no other source of income. Yet he somehow manages to blog prolifically for Age of Autism and The Huffington Post and has, as far as I can tell, published nothing else, not even freelance. As far as anyone knows, Kirby is not independently wealthy; so the question becomes: Where does David Kirby get his income? He’s never answered this question, and it’s hard not to conclude that he derives his money from his antivaccine activities. Of course, Kirby could always set me (and everyone else who wonders about this) straight and make us eat crow about this very easily, but for some reason he never has. In any case, Kirby’s prominence, name, fame, and possibly his income all depend on continuing to stoke the fires of the myth that vaccines cause autism. If that manufactroversy went away, so would all the attention and adoring minions of the mercury militia who currently lionize Kirby. He is, as much as Andrew Wakfield, a walking, talking, writing, distorting, and dissembling embodiment of a conflict of interest.

Unfortunately for him and David Kirby, Wakefield’s “defense” of himself and “complaint” against Brian Deer is thin gruel indeed, consisting of a whole lot of nitpicking pedantry mixed in with bad science and logical fallacies. Let’s take a look. First, Wakefield whines:

The articles presented, as fact, allegations that I committed scientific fraud inasmuch as I “changed and misreported results in [my] research”2 in a paper in the medical journal The Lancet in 1998, with the clear implication that this was intended to create the appearance of a possible link between MMR vaccination and autism and that I did it for money.

These allegations are false and/or misleading and will have a hugely adverse effect on my credibility as a scientist and my ability to ever practice again in my chosen field.

I have news for Wakefield. His credibility has been shot for at least five or six years, although the good ship Wakefield took one torpedo under the waterline when Deer showed his massive conflicts of interest that were undisclosed at the time of his publication of his Lancet paper, as well as the documented fact that he had held back data that contradicted his hypothesis. Then Wakefield took yet another torpedo when PCR expert Stephen Bustin testified at the Autism Omnibus and demonstrated the utter ineptitude of the laboratory that he later used to report PCR. Brian Deer’s revelations that Wakefield had falsified data was only the last torpedo below the waterline. In reality, Deer’s final report last month was more akin to torpedoing an already sunken wreck and, in essence, rearranging the barely recognizable scraps of rusted metal on the seabed, but Wakefield just refuses to admit defeat. If you’ll forgive me for shamelessly mixing metaphors, these days Wakefield reminds me more than anything else of the Black Knight in Monty Python and the Holy Grail, who, having had all of his arms and legs hacked off by King Arthur, continues to refuse to admit defeat. We last see him yelling at Arthur, who continues on his path, “Oh. Oh, I see. Running away, eh? You yellow bastards! Come back here and take what’s coming to you. I’ll bite your legs off!”

So here comes his bite, and all I can say is that Brian Deer doesn’t have anything to fear for his legs. All Wakefield can do is nibble around the edges, throw everything he can think of against Deer and hope it sticks, and in the end failing to produce anything that would call into doubt the firm conclusions of Deer’s reporting. He begins by repeating his charge that Deer initiated the British General Medical Council investigation that has been going on since 2007:

Mr. Deer’s latest article was based upon ‘evidence’ that he claims was presented at the GMC hearing – which started in 2007, is due to conclude sometime in 2009 – without disclosing the fact that it was he who brought the original complaint. He therefore has an undeclared interest in its conclusions. Failure to have disclosed this conflict to readers of the Sunday Times is misleading.

Brian Deer has answered that charge and it has figured prominently in the antivaccine counterattack against Brian Deer, but even if it were true that Deer had brought the complaint, his alleged conflict of interest would not even be in the same solar system as Wakefield’s extensive and documented undisclosed conflicts of interest at the time he published the Lancet paper. It would be like comparing an ant to the planet Jupiter; indeed, even if it were true that Deer had brought the complaint, that would not invalidate what he wrote. Wakefield and his antivaccine supporters want you to believe it would, but it wouldn’t. Besides, this is the same Andrew Wakefield who boldly declared in 2004:

In February 2004, after a Sunday Times investigation, Wakefield declared that he would welcome an inquiry as an opportunity to clear his name.

“It has been proposed that my role in this matter be investigated by the General Medical Council,” he said in a statement. “I not only welcome this, I insist on it.”

Wakefield got what he wanted. What’s he complaining about?

Wakefield also makes the proverbial mountain out of a molehill:

“Although the research paper claimed that problems came on within days of the jab, in only one case did medical records suggest this was true, and in many of the cases medical concerns had been raised before the children were vaccinated.”

There are two parts to this allegation.

“the research paper”

This was not a “research paper”. It was a clinical ‘case series’ that contained additional research elements. Labeling it as a research paper is intended to convey the impression that the children were investigated purely for the purposes of experimentation; an allegation that formed a central part of Mr. Deer’s original complaint to the GMC. In contrast, the paper reported on clinical referrals who were investigated on the basis of the presenting symptoms.

I’m really not sure what Wakefield is trying to accomplish here. For purposes of medical ethics and the requirement of approval by an institutional review board (or the British equivalent), there is no difference between a case series and a research protocol. It’s still human subjects research, even if a case series involves looking at retrospective patient data. The same ethical guidelines apply, namely those laid down in the Helsinki Declaration and the Belmont Report. The bottom line is that it’s the logical fallacy known as the red herring, a seemingly important but in fact a irrelevant fact thrown out to distract from the main issue. Much of Wakefield’s “complaint” consists of the legalistic parsing of words similar to that in the above passage in order to distract.

I once said that there were only two likely explanations for Wakefield’s misreporting of the timeframe of vaccination relative to the onset of autistic regression symptoms: scientific fraud or sloppiness passing the line into incompetence. Wakefield in essence pleads sloppiness:

“However, our investigation, confirmed by evidence presented to the General Medical Council (GMC), reveals that: In most of the 12 cases, the children’s ailments as described in The Lancet were different from their hospital and GP records.”

The documents relevant to the evidence presented in the Lancet paper are clearly identified in that paper. These included the Royal Free Hospital records and, where available, the prospective developmental records from parents, Health Visitors and General Practitioners (GPs). The team therefore relied on the totality of the information available to them, as stated in the paper. This is entirely normal practice. Since then further records have been collated for the GMC enquiry, which were not available to the hospital team at the time of writing the paper.

The records that were before the GMC included a complete set of the children’s local hospital records, a full set of the GP records to include all GPs who had been 4 involved the child’s care, as well a the Royal Free Hospital records and any other records relating to the child e.g. school medical records.

Reliance on differences between these data sources, i.e. those relied on by the Lancet authors and those relied upon by Mr. Deer in his allegations, is disingenuous and misleading since the majority of the latter records were not available to the Royal Free doctors at the material time.

Of course, this excuse is highly disingenuous in that Wakefield should have been susipicious that nearly all of these children were referred from outside of the Royal Free Hospital’s normal catchment area, and given his close contacts with lawyers suing vaccine manufacturers for autism it strains credulity for him to claim that he didn’t have an inkling that there might be more to the stories of these 12 children. The charitable explanation is that didn’t want to know. The not-so-charitable explanation is that he falsified data. Be that as it may, if Wakefield were a good scientist, an honest scientist, he would feel betrayed by these parents for not not having given him and the Royal Free Hospital accurate medical histories. If Wakefield were an honest scientist, he would apologize for not having been thorough enough and then retract the paper, rather than going to the incredible extremes that he is going to in order to defend his own sloppiness.

Now here’s the meat of the matter:

“Hospital pathologists, looking for inflammatory bowel disease, reported in the majority of cases that the gut was normal. This was then reviewed and the Lancet paper showed them as abnormal.”

The substance of this latest allegation illustrates how rigorous clinical and scientific investigation is vulnerable to misrepresentation. I am accused of a grave scientific misdemeanor – falsifying data. As an example of the fallacy of this allegation, a detailed explanation is provided of the process by which the pathology in tissue biopsies from these children was diagnosed and reported. Crucially, I played no part in the diagnostic process at all. Further, the fact that a review of the samples took place is clearly spelled out for all to read in the Lancet paper itself. (See below). There was no sinister attempt to hide any initial assessments as implied by the Sunday Times.

Biopsies were initially reviewed by duty pathologists who often had no specialist expertise in gastrointestinal disease, particularly in children. Professor John Walker-Smith, the senior clinician, who has an unparalleled experience of the appearances of bowel disease in children, as was his normal clinical practice, reviewed all biopsies at a weekly clinico-pathological meeting of his team. This was undertaken with the assistance of histopathologist Dr. Sue Davies. At these meetings Professor Walker-Smith pointed out the fact that inflammation had been overlooked in some cases.

This would all be fair enough if it had been mentioned in the paper exactly for which patients there had significant disagreements between the initial reading and he readings used for the paper. It wasn’t. It might also be fair if the final pathological diagnoses reported by the hospital for these children agreed with what was reported in the paper. After all, if there were a significant disagreement between the diagnosis as originally reported and the diagnosis as determined in a review of the samples by another set of pathologists, the normal course of events would be for the pathologists who did the review to amend the diagnostic reports. Why wasn’t that done? It might even be fair if it weren’t for the fact that every single change in diagnosis made always went in the direction of supporting Wakefield’s hypothesis. That alone fails to pass the “sniff test.”

There’s a whole long section of Wakefield’s whine about individual patients that would probably drive you all screaming away if I were to go through it bit by bit in one post, and I don’t think I have the stomach to make a blog series out of it. Perhaps someone more intrepid than I could manage it. To make a long whine short, through most of them Wakefield in essence accuses Deer of either lying about what was in the medical records of these children or selectively citing it. (Again, the irony boggles the mind.) If he really thinks Deer was lying about him, he should sue Deer for libel. Given Britain’s notoriously plaintiff-friendly libel laws, he would be virtually guaranteed to succeed if his action had any merit. He might even succeed if his action had only dubious merit. He won’t, of course, because he knows he can’t win. Instead he makes excuses and concocts massive conspiracy theories.

Wakefield then goes on to claim that his “findings” have been reproduced or confirmed by other scientists. He cites the following papers:

  1. Gonzalez, L. et al., Endoscopic and Histological Characteristics of the Digestive Mucosa in Autistic Children with gastro-Intestinal Symptoms. Arch Venez Pueric Pediatr, 2005;69:19-25.
  2. Balzola, F., et al., Panenteric IBD-like disease in a patient with regressive autism shown for the first time by wireless capsule enteroscopy: Another piece in the jig-saw of the gut-brain syndrome? American Journal of Gastroenterology, 2005. 100(4): p. 979-981.
  3. Krigsman A et al. http://www.cevs.ucdavis.edu/Cofred/Public/Aca/WebSec.cfm?confid=238&webid=1245 (last accessed June 2007) (paper submitted for publication).
  4. Balzola F et al . Autistic enterocolitis: confirmation of a new inflammatory bowel disease in an Italian cohort of patients. Gastroenterology 2005;128(Suppl. 2);A-303.

Of course, whether these results have “replicated” or “confirmed” Wakefield’s results depends, as a former President would say, on what the meaning of the word “confirm” is. Reference #1 appears not to be in a journal indexed by PubMed; I couldn’t find it. All I could find was a reference in Whale.to that described its results thusly:

Additionally in 2005, a study (27) was published by Gonzalez, Lopez et al, seeking evidence of immunological alterations in 68 autistic children ages 22 months to 11 years and presenting with digestive systems, and examining biopsies from their digestive tracts. Endoscopies and colosopies were undertaken, with biopsies of the esophagus, stomach, duodenum and colon, with verification of presence of inflammation, eosiophil infiltration, lymphoid nodular hyperplasia and CD-4 and CD-8 cells. The results were that lymphoid nodular hyperplasia was discovered in 2/68 esophagus, 6/68 stomachs, 8/68 duodenums and 36/68 (53%) of colons. Eosiophil infiltration with more than 20 eosiphils per field were found in 3/68 eosphagus, 1/68 stomach, 8/68 duodenum and 24/68 (35%) colons. Inflammatory reactions were found in 56/68 (82%) esophogitis, 64/68 (94%) gastritis, and all (100%) presented with duodenitis and colitis. CD-4/CD-8 relationship existed of >3 in 42/68 (62%) and <1 in 16/68. The authors concluded that the children presented immunological and immunohistochemical alterations of the biopsies of their digestive tracts, and that there was a significant finding of lymphoid nodular hyperplasia, eosiophilinfiltration, and that prevalence of greater CD-4 than CD-8 cells in the inflammation of the intestinal wall demonstrated in favour of a Th2 type allergic reaction.

This is thin gruel indeed. All the children presented because of their bowel symptoms; so it’s not surprising at all that–ta-daaa!–many of them had evidence of inflammation in their GI tracts. What it does not show is that enterocolitis is more common in autistic children than it is in children without autism. That is actually a fairly controversial area, and it is not clear that autistic children are any more prone to bowel complaints. Even if they were, the way to verify that autistic children do in fact have more bowel complaints is not to study only autistic children with bowel complaints. The way to do it is to study children with and without autism and then determine if the incidence of bowel complaints is any higher in the group of autistic children. Moreover, remember that the claim made by Wakefield was that the MMR vaccine was associated with both regressive autism and GI symptoms, a claim that, as far as I can tell, this obscure paper published in an even obscurer journal fails to support.

The next paper is a single case report; you can’t make any conclusions from a single case report, only (possibly) formulate hypotheses to test. The third paper, I couldn’t access. The URL doesn’t work, anyway. In any case, it’s by Arthur Krigsman and, even if it shows what it purports to show, can hardly be considered independent verification, given that Krigsman now works at Wakefield’s Thoughtful House.

The final reference by Bazola et al, I couldn’t find on a PubMed search, even though I know that the journal is indexed by PubMed. So I went to the journal itself and found the specific issue mentioned. It appears to be just an abstract included in the Gastroenterology abstract supplement for the year 2005 and it only involved nine patients. All of them had autism and enterocolitis; so it is not surprising that selection bias led to a correlation. No, this is hardly replication of Wakefield’s findings, either, and, worse, it hasn’t been published since as a full journal article, as far as I can tell. Worse, still, the most recent and rigorous attempt to replicate Wakefield’s research utterly failed to confirm his results. Dr. Wakefield must be pretty hard up if these are the best papers he could come up with as “verification” of his work.

Perhaps the most hilariously badly timed part of Wakefield’s whine is this:

Indeed, the notion that any researcher can cook such data in any fashion that can be slipped past the medical community for his personal benefit is patent nonsense.

Dr. Wakefield, meet Dr. Reuben. Dr. Reuben, meet Dr. Wakefield.

What was that Wakefield was saying again about it being “patent nonsense” that any researcher can “cook data” and remain undetected by the medical community being “patent nonsense”? In fact, unfortunately, it wasn’t really the medical community in either case, that of Dr. Reuben or of Dr. Wakefield, who caught on to the fraud. In the former case, it was a hospital’s clinical trial office charged with human subjects protection who noted that Dr. Reuben had published two abstracts for which there was no record of an approved human subjects research protocol. In the case of Dr. Wakefield, although a lot of the medical community viewed his results with great suspicion and suspected that something was not quite kosher, it was an investigative journalist, not the medical community, who uncovered Andrew Wakefield’s irreconcilable undisclosed conflicts of interest and “data cooking.” In any case, now I suspect I know why Age of Autism hasn’t made a huge stink about the Reuben fraud case. Its silence struck me as profoundly anomalous, given what a huge, juicy target Reuben was as “proof” that scientists are in the pocket of big pharma and “cook” results to its liking, but now I think I understand. I could be wrong, but I suspect I’m not. It wouldn’t do to make a stink about that case of fraud when the antivaccine movement has its own fraud to worry about, especially if part of Wakefield’s defense was going to be that it’s not possible to “cook the data” for so long without the scientific community catching on. The Reuben case is an “inconvenient” counterexample that occurred in very close temporal proximity to Wakefield’s planned counterattack.

Personally, I’m rather glad that Wakefield made this complaint. The reason is that it will inevitably bring more attention to his scientific dishonesty. Moreover, if, as is likely, the Press Complaints Commission dismisses the complaint, it will be one more hit to Wakefield’s credibility, albeit a small one in comparison to the previous hits he’s taken. Personally, I’m more disturbed that it took so long for these allegations to come out. We in the biomedical science community have some soul-searching to do if frauds like Drs. Wakefield and Reuben can get away with their frauds for more than a decade.

Comments

  1. #1 csrster
    March 16, 2009

    “Indeed, the notion that any researcher can cook such data in any fashion that can be slipped past the medical community for his personal benefit is patent nonsense.”

    Or “You can’t accuse me of fraud because if I were a fraud someone else would have accused me of fraud”.

  2. #2 hat_eater
    March 16, 2009

    I think that on Wakefield’s part, it’s a performance for the admirers more than anything else. He has to defend himself somehow to give them an excuse – any excuse – to keep idolizing him. Because where would he go, what would he do with his life, were it not for the crowd of supporters that organize petitions and assure him that they must win because their cause is right?
    I’d feel for him if I weren’t convinced that he’s in it for the gold and fame, mostly.

  3. #3 Aj
    March 16, 2009

    I’m no expert, but I believe that the complaint won’t even be accepted, as there is a GMC hearing underway on the exact same subject as the article.

    Of course, Wakefield can always sue, again.

  4. #4 Rogue Medic
    March 16, 2009

    Chronic liars – they keep repeating that they are telling the truth, because somebody might believe them. They convince themselves that they are the victims of persecution, even though it is only criticism of their lies.

    The show must go on, because there is nothing else for him to do. He loves the crowd. The adoring vacuous crowd.

  5. #5 DPSisler
    March 16, 2009

    “These allegations are false and/or misleading and will have a hugely adverse effect on my credibility as a scientist and my ability to ever practice again in my chosen field.”

    My heart bleeds that he will no longer find work as a scientist */ sarcasm

  6. #6 Sam C
    March 16, 2009

    Two proper parts of top end professional quackery are (1) a persecution complex (“why oh why do they persecute me for telling Teh Troof about vaccines an’ measles an’ autism an’ stuff an’ even make me fabricate my own evidence?”) and (2) a litigious nature.

    If it walks like a doc, docs like a quack, squawks like a kookaburra, and swims in a cesspit, it is a quack. Didn’t get that right, did I?

    Pity the poor patients. The most shameful thing about these quack-scum is that they prey on people who already have enough difficulties without being scammed for hard cash and physically abused.

  7. #7 Mu
    March 16, 2009

    I don’t understand why he doesn’t retract the paper. The scientific community would be placated, and for the most part, just let it die. He published, it was questionable, he retracted, the way it should be.
    And the AoA crowd just wouldn’t care. To the contrary, they would probably take it as another example of the conspiracy grinding down the valiant fighter. Unless of course he’s so convinced of his own visionary work that he’s holding out for the Nobel price. Or maybe a Lasker. Or an attaboy letter from the local PTA.

  8. #8 Broken Link
    March 16, 2009

    Mu wrote: “I don’t understand why he doesn’t retract the paper. ”

    He can’t possibly retract the paper. He can’t admit fault of any kind. Because no matter how shredded his reputation is with the scientific community, he still has his reputation as a “brave maverick doctor” not to mention “Doctor Dreamy” and “only person brave enough to listen to the parents” to maintain. Maintaining that fiction is how he keeps his livelihood. He has no other livelihood in the absence of the true believers, and if he was to lose even one believer by retraction, that would be too much.

  9. #9 Shay
    March 16, 2009

    These allegations … will have a hugely adverse effect on my credibility as a scientist and my ability to ever practice again in my chosen field.”

    And this is bad how?

  10. #10 dt
    March 16, 2009

    Wakefield’s comment should really read:

    “These allegations will have a hugely positive effect on my status as a martyr unjustly victimised by the establishment, my credibility as a scientist among my gullible followers, and my ability to practice in my chosen field in the cosy, evidence-baseless environment of Thoughtful House. I therefore thank Brian Deer for his timely intervention, which has demonstrated the old showbiz addage that there is no such thing as bad publicity. Being in the business of showbiz, rather than science, I am supremely grateful to him for giving my “Saint Andy” moniker such a boost among my sycophantic acolytes. Following my canonization, I can now look forward to my divine elevation to immortality as the one and only true god over all things autistic.”

  11. #11 Wulfstan
    March 16, 2009

    Mu wrote: “I don’t understand why he doesn’t retract the paper. ”
    [Shay wrote:] He can’t possibly retract the paper. He can’t admit fault of any kind.

    If 10/12 of co-authors have ‘retracted an interpretation of the paper’ I don’t understand why they can’t unilaterally apply for the paper to be retracted or is this something like the senior author’s vote outweighs everyone else’s in such matters?

    I’m amazed that Andrew Wakefield had been being told since 1992 that he hadn’t really identified measles virus in the gut (back in his measles and Crohn’s Disease days) but still had unswerving faith in himself even when given advice by experts in the field and presented with evidence that his results were false positives.

    Sadly, I don’t share Wakefield’s pessimism that he will never be able to practise again, I’m sure that some loyal parents would be happy to have him along as a consultant no matter what.

  12. #12 Rev Matt
    March 16, 2009

    “will have a hugely adverse effect on my credibility as a scientist”

    That train left the station long ago. Credibility with the mercury militia does not equate to credibility as a scientist, which he lost at least half a decade ago.

  13. #13 Prometheus
    March 16, 2009

    “These allegations are false and/or misleading and will have a hugely adverse effect on my credibility as a scientist and my ability to ever practice again in my chosen field.”

    Sounds a lot like:

    “The removal of structural components from the wreck of the RMS Titanic will have a hugely adverse effect on its sea-worthiness and its ability to ever perform again as an economically viable ocean liner.”

    Dr. Wakefield, I hate to be the one to break it to you, but the ship of your scientific credibility has lain on the abyssal plain for nearly a decade and your ability to practice again in your “chosen field” (medicine, was it?) long ago foundered on the shoals of your own arrogance and recklessness.

    Brian Deer’s revelations that Dr. Wakefield manipulated and falsified data are merely confirmation of what the majority of people have long suspected. Mr. Deer is simply pointing out to Andy Wakefield that the good doctor has shot himself in the foot.

    Prometheus

  14. #14 Orac
    March 16, 2009

    Personally, I like my metaphor of the Black Knight from Monty Python and the Holy Grail better. :-)

  15. #15 Prometheus
    March 16, 2009

    Orac,

    I agree that (St.) Andy’s responses have much in common with the Black Knight, but his lamentations about his poor, injured credibility and the damage all this has done to his ability to return to medical practice struck me as ludicrous.

    No sane person could think that anything Brian Deer says about Wakefield’s “research methods” could do more damage to his “credibility” than Andy has already done. Credibility can only die once.

    Is it possible that he thinks he will be vindicated and that his reputation will be “restored”? Is he terminally delusional or simply playing to his “crowd”?

    Prometheus

  16. #16 Samia Hurst
    March 16, 2009

    Is he terminally delusional or simply playing to his “crowd”?

    Possibly neither. Most likely he is playing to yet others by ‘keeping the controversy alive’ . Precedents for this abound. And, sadly as seen from the vantage point of our Swiss measles epidemic , it seems very effective…

  17. #17 dt
    March 16, 2009

    I suspect the “risk management team” from Thoughtful House and AoA are discussing strategy as we speak. Saint Andy’s UK GMC judgement day is not far off.
    Unfortunately the hearing has nothing whatsoever to do with his scientific credibility, or the issue of whether MMR causes autism, but I can bet every last dollar that the propaganda machines are thinking of ways to exploit or spin every concluion from the GMC hearing, good or bad.

    If the saint is exonerated, this will be trumpeted from on high as a sign of his eternal blessedness and state of grace, he will soon be back into the swing of clinical practice and we should prepare for a media onslaught that would totally eclipse the Hannah Poling furore.

    If he is guilty, this will be proof positive of a grand conspiracy against the good name of the good selfless doctor, and his stock will rise further among the chattering classes who seek validation for their delusional ideas and desire for quack autism cures.

  18. #18 Monado
    March 16, 2009

    It’s odd that people who commit fraud then blame those who find them out exposing them instead of themselves for being fraud artists.

  19. #19 DLC
    March 16, 2009

    Wakefield is a liar. Hopefully the truth will out.

    I suppose Wakefield could hope that maybe Kirby will get lucky and manage to con Keith Olberman into naming Deer a “Worst Person” again. But it won’t un-do the lies Wakefield told.

  20. #20 Dr Aust
    March 16, 2009

    “These allegations are false and/or misleading and will have a hugely adverse effect on my credibility as a scientist and my ability to ever practice again in my chosen field.”

    “Credibility” …??!

    And “practice in my chosen field” ?

    If he means “field of medicine”, I wonder what field that would be? As has been well-documented on sceptical sites and by Brian Deer (though relentlessly obscured by Wakefield’s admirers in the JABS gang, and repeatedly and hopelessly misreported in the media) Wakefield last treated a patient as a junior doctor (junior resident, US-style) a good twenty years ago. Check out, e.g. the comments in this thread over at Left Brain/Right Brain.

    Furthermore, also discussed on the thread, he never completed specialist training (residency) in ANY clinical specialty – not general surgery, not GI surgery, not gastroenterology, not virology, not pathology.

    If one were being charitable, one might say that he chose “research” as his specialty. And look how he did with that.

  21. #21 Dr Aust
    March 16, 2009

    PS And I forgot “not paediatrics”

  22. #22 Chris
    March 16, 2009

    It doesn’t help that Wakefield has moved to another country and has not gone through the process to become a licensed medical doctor in the state where he is presently living.

    Though perhaps due to some lax laws he can be part of a shady clinic in Texas.

  23. #23 D. C. Sessions
    March 16, 2009

    Though perhaps due to some lax laws he can be part of a shady clinic in Texas.

    Given the time frame, it’s a sure bet that he isn’t a US citizen, and I’d be amazed to find that he even has a green card. Without even permanent-resident status, it doesn’t take much [1] to have him shipped back to his country of origin.

    [1] Having his license yanked for misconduct in Great Britain might do the trick — especially if he’s charged, never mind outcome, with practicing unlicensed medicine in Texas.

  24. #24 Matthew Cline
    March 17, 2009

    As far as anyone knows, Kirby is not independently wealthy; so the question becomes: Where does David Kirby get his income? He’s never answered this question, and it’s hard not to conclude that he derives his money from his antivaccine activities. Of course, Kirby could always set me (and everyone else who wonders about this) straight and make us eat crow about this very easily, but for some reason he never has.

    Why should it matter? He’s wrong regardless of whether or not he’s also a shill.

  25. #25 Antaeus Feldspar
    March 17, 2009
    As far as anyone knows, Kirby is not independently wealthy; so the question becomes: Where does David Kirby get his income? He’s never answered this question, and it’s hard not to conclude that he derives his money from his antivaccine activities. Of course, Kirby could always set me (and everyone else who wonders about this) straight and make us eat crow about this very easily, but for some reason he never has.

    Why should it matter? He’s wrong regardless of whether or not he’s also a shill.

    It matters because even though he’s quite wrong, there are still a number of people who believe he’s right, and who are making wrong, dangerous choices based on his bogus blather. It will probably never be possible to convince all of the people who currently believe in him to change their minds, all at once — it seems like no matter how thoroughly anything is debunked, there are always some people who want to stay in a state of denial.

    However, there are some people who can change their minds, if they are presented with the appropriate evidence. There are people out there who disregard all of Paul Offit’s well-researched writing, simply because a portion of his income comes from the RotaTeq vaccine — even though a completely logical interpretation of this is “a scientist who has done good work of which he can be fully proud is being financially compensated for a quarter-century of effort”, they can only see it as “he must be willing to say whatever will make him money and obviously saying that vaccines are safe will get him paid by Big Pharma.” But if we were able to prove that Kirby’s sole source of income was his saying that vaccines were dangerous, we would be able to confront those people are force them to decide: do they distrust Kirby just as much as they distrust Offit, or do they really not believe in this whole “you can’t trust anyone whose income is affected by what they say” idea?

  26. #26 MartinM
    March 17, 2009

    Without even permanent-resident status, it doesn’t take much to have him shipped back to his country of origin.

    Please don’t. We don’t want him back.

  27. #27 Brian Deer
    March 17, 2009

    Obviously, because Our Andy’s statement purports to be a complaint to the UK Press Complaints Commission, I can’t yet comment on the substance (although I have mentioned just a couple of generic Wakefield claims right up at the top, here: http://briandeer.com/solved/wakefield-veracity.htm ).

    But, in general, my reaction is that I’m stunned.

    Never before in my career in journalism have I seen so many assertions in a single complaint that can so easily be proven to be both (a) wrong and (b) dishonest. It’s really very striking.

    I don’t, in fact, believe that his complaint is really targeted at the PCC, since it won’t hear something that’s in front of the GMC. Wakefield would know that. And he would also know that it won’t hear something that hasn’t been raised with the paper. This is all on the PCC website, and he and his people will have read that. Disingenuous in principle.

    His strategy, in my opinion, is predicated on his personal and financial situation. This “complaint” is addressed to the narrowcasting of the web. He needs to get to parents of autistic children, to whom he may wish to suggest they should come to Austin with the kids, and to his bigger backers: particularly the money and reputations behind Thoughtful House. Through Kirby and Olmsted, he can get to those – perhaps a couple of thousand – people he wants to reach.

    But, as ever, this is a short-term strategy, since much of what he says can be checked. For example his suggestion that his possible MMR-autism link allegation has been backed by other published research. He even cites papers. Thoughtful House people, and indeed anyone, can pull those papers, and form a judgment about his integrity. Similarly, he denies that his 1998 Lancet paper said the kids in his research paper (the one they are taking about here: http://briandeer.com/mmr/royal-free-press-1998.pdf ) were “previously normal” (Go on, have a look, you know you want to: http://briandeer.com/mmr/lancet-paper.pdf. )

    His famed “charisma”, will stand him in good stead for a while, as it did at the Royal Free, but history shows (eg with the whistleblower Nick Chadwick) it doesn’t work with everyone, or forever. Eventually, people who know where any US bodies are buried will speak out.

    Meanwhile, in the unlikely event of the UK’s General Medical Council continuing to have jurisdiction over him, I would guess that there is a straight, pretty much open-and-shut, dishonesty action against him over his statement, widely published to vulnerable parents, which I reckon could have him struck off in a five day hearing.

    To me, it really beggars belief.

  28. #28 D. C. Sessions
    March 17, 2009

    Please don’t. We don’t want him back.

    So don’t let him through Customs and Immigration — he can spend the rest of his days in the International Wing for all we care.

  29. #29 Dr Aust
    March 17, 2009

    One of the (politer) adjectives that best describes Wakefield is “entrepreneurial”. His scientific career in the UK can be seen that way, as can the current Texas venture. I guess it is perfectly possible that there is nothing to stop Wakefield “fronting” Thoughful House without a Texas state medical licence or any relevant accreditation. Provided the people at the clinic who actually treat the patients are appropriately licenced and accredited, he probably doesn’t have to be in his role as “Director”, or whatever.

    It would be interesting to know whether being de-licenced in the UK would make a difference, though it remains a question whether this will actually happen.

    Of course, the problem with his being a “non-doctoring director” would be if he were to “blur” his roles, and effectively act like a treating physician. Though no doubt if this got to be an issue (e.g. if investigated) then we would hear the refrain of “Oh no, the clinical decisions were all made by Drs X, Y and Z”.

    The parallel between the Royal Free set up, as documented by Brian Deer and currently being put under the microscope via the GMC hearings, and the likely set-up at Thoughtful House, is rather striking.

  30. #30 Orac
    March 17, 2009

    But, as ever, this is a short-term strategy, since much of what he says can be checked. For example his suggestion that his possible MMR-autism link allegation has been backed by other published research. He even cites papers. Thoughtful House people, and indeed anyone, can pull those papers, and form a judgment about his integrity

    Which I tried to do, but some of them were so obscure that I couldn’t find them. In any event, they didn’t support his Lancet paper.

  31. #31 MC
    March 17, 2009

    “But, as ever, this is a short-term strategy, since much of what he says can be checked. ”

    I would respectfully disagree.

    Mr. Wakefield is sewing doubt. His audience is his customer base, as Mr. Deer points out. As long as he can sell hope (even false hope) and keep some segment of the autism parent community supporting him, he will keep getting new customers.

    New autism parents don’t have the time and energy to navigate the entire world of education/government services/medicine in depth. If a parent comes out of an IEP meeting, totally screwed over by their district and they know that someone is telling them, “pay me money and you and your kid will get out of this crazy world”, some segment of the population will listen.

    Take, for example, that guy who popped up in the last six months with the nonsense about microstrokes and was getting parents to pay him money to look at videos of their kids. He got John Best (OK, not the sharpest person) to buy into it for a while. There are probably still parents buying it.

    The data on the “thimerosal induced epidemic of autism” are pretty clearly against–and yet parents still are chelating their kids.

    Wakefield will get clients as long as he doesn’t admit to any mistakes.

  32. #32 Antaeus Feldspar
    March 19, 2009

    The really interesting thing will be to see if Melanie Phillips provides any information related to this supposed complaint to the PCC. If she does, someone should point out to her that she can then never mention Brian Deer in print ever again — not without violating the rules she seemed to think Deer should be constrained to, whereby providing information to a regulatory commission (what we used to think of as the duty of a citizen) automatically makes one a “principal player” in a story and ethically barred from ever reporting on it.

  33. #33 Jen
    March 22, 2009

    In any case, Kirby’s prominence, name, fame, and possibly his income all depend on continuing to stoke the fires of the myth that vaccines cause autism.>>>>>>>>

    Hey, speaking of conspiracies, consider again my previous comments regarding what I feel is behind the rise in autism, and then study the list of major contributors to Thoughtful House, and ask yourself who really benefits from “stoking the fires of the myth that vaccines cause autism.”

    http://thoughtfulhouse.org/annual-report-2007.pdf
    (page 11)

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