Respectful Insolence

Andrew Wakefield: Struck off!

It’s been a long time comin’
It’s goin’ to be a Long Time Gone.
And it appears to be a long,
appears to be a long,
appears to be a long
time, yes, a long, long, long ,long time before the dawn.

– from “Long Time Gone” by Crosby, Stills & Nash

Oh, happy day!

It’s finally happened, more than six years after investigative reporter Brian Deer first reported Wakefield’s massive conflicts of interest and dubious activities related to his “research” suggesting a link between the measles strain in the MMR vaccine and inflammation of the gut in autistic children, nearly three years after the start of the British General Medical Council’s hearings into anti-vaccine hero Andrew Wakefield’s fitness to practice, nearly a year and a half after solid evidence that Andrew Wakefield had committed research fraud for this “study,” and less than four months after the GMC ruled that Andrew Wakefield had acted with “callous disregard for the distress and pain the children [who were his research subjects] might suffer.” This morning in the U.K. the GMC ruled that, because of his unethical and dishonest behavior in conducting his research, Andrew Wakefield should be “struck off” the medical register, meaning that he will no longer be licensed to practice medicine in the U.K.:

The doctor who first suggested a link between MMR vaccinations and autism is to be struck off the medical register.

The General Medical Council found Dr Andrew Wakefield guilty of serious professional misconduct over the way he carried out his controversial research.
It follows a GMC ruling earlier this year that he had acted unethically.

Dr Wakefield, who is now based in the US, has consistently claimed the allegations are unfair. He now says he will appeal against the verdict.
His 1998 Lancet study caused vaccination rates to plummet, resulting in a rise in measles – but the findings were later discredited.

The GMC ruled in January Dr Wakefield had acted “dishonestly and irresponsibly” in conducting his research, but under its procedures the sanctions are made at a later date.

All anyone who supports science-based medicine can say is: It’s about time!

Unfortunately, none of this prevents Wakefield from, as Sullivan put it so well, turning public disgrace into publicity. For example, there was this interview with Matt Lauer on NBC’s The Today Show this morning:

Visit msnbc.com for breaking news, world news, and news about the economy


Is there a more arrogant and despicable physician out there right now? In the “flashback” from the irritating “tell both sides” NBC special Lauer did last summer on this issue, we see Wakefield lying baldly to Lauer by claiming that he had no conflict of interest from the hundreds of thousands of dollars he had received prior to the publication of his 1998 Lancet study from a trial lawyer who wanted to sue vaccine manufacturers for “vaccine injury” leading to autism. Particularly weasely was Wakefield’s justification for inducing children to give him blood samples by paying them £5.

Of course, given that this interview is clearly designed to counter the bad publicity from Wakefield’s loss of his medical license and to hawk his new book, I have to ask: If there was so much evidence to support his defense that he had done nothing wrong, why didn’t Wakefield–oh, you know–actually present that evidence during the GMC hearings? He had, after all, ample opportunity, well over two years!

Wakefield’s interview is nothing new, basically the same old whining about conspiracies and the government “pressuring” the GMC to strike him off the medical register. I do rather like that Lauer prefaced a question by pointing out that no independent replication of Wakefield’s results have been published, adding, “You lost your job down in Texas and now your medical license.” Too bad Wakefield simply repeats his same nonsense about how his findings have been “replicated.” Never mind that researchers have tried and failed.

Wakefield did drop one bomb–and a stinker it was, too–that I haven’t heard before. Apparently his new talking point is that the U.S. government has been settling cases of “vaccine-induced autism” on the down-low as early as 1991. He repeated it multiple times, in fact.

I sense a new anti-vaccine talking point that defenders of science-based medicine will have to deal with. As usual, Andrew Wakefield didn’t present any evidence to support his unfounded assertion, but I bet that there will soon be something up on the anti-vaccine propaganda blog Age of Autism or on that repository of quackery and anti-vaccine nonsense, The Huffington Post (calling David Kirby!) to try to “prove” that what Wakefield said is true. My guess is that it will be more spin and dissembling along the lines of the Hannah Poling or Bailey Banks cases.

In the meantime, Andrew Wakefield can appear at anti-vaccine rallies, as he will Wednesday. In fact, “health freedom” warrior Rima Lailbow herself was kind enough to inform me that Wakefield will be interviewed on her radio show the evening of May 30. She even pointed me towards some most excellently insane blog fodder for a later date, her article entitled The Syringe of Death.

What was that about not being “anti-vaccine” again?

Remember what I said about this years’ Autism One representing a confluence of the “health freedom” and anti-vaccine movements getting together to get their Tea Party on? I’d like to thank Dr. Lailbow for providing yet more evidence that I was correct.

ADDENDUM:

Thanks to, of all things, Age of Autism for publishing the complete text of a press release describing the GMC finding that Andrew Wakefield’s name should be erased from the medical register in the U.K.:

This case is being considered by a Fitness to Practise Panel applying the General Medical Council’s Preliminary Proceedings Committee and Professional Conduct Committee (Procedure) Rules 1988

Date: 24 May 2010

Dr Andrew Jeremy WAKEFIELD

Determination on Serious Professional Misconduct (SPM) and sanction:

The Panel has already given its findings on the facts and its reasons for determining that the facts as found proved could amount to serious professional misconduct.

It then went on to consider and determine whether, under Rule 29(1) of the General Medical Council Preliminary Proceedings Committee and Professional Conduct Committee (Procedure) Rules Order of Council 1988, the facts as admitted or found proved do amount to serious professional misconduct and if so, what, if any sanction it should impose. It has accepted the Legal Assessor’s advice in full as to the approach to be taken in this case, and has looked at each doctors’ case separately but, when considering whether Dr Wakefield is guilty of serious professional misconduct, has looked at the heads of charge found proved against him as a whole. It has not confined its consideration to the heads of charge; it has also had regard to the evidence that has been adduced and the submissions made by Ms Smith on behalf of the General Medical Council. On behalf of Dr Wakefield, no evidence has been adduced and no arguments or pleas in mitigation have been addressed to the Panel at this stage of the proceedings. In fact Mr Coonan specifically submitted:

“……we call no evidence and we make no substantive submissions on behalf of Dr Wakefield at this stage.” “…I am instructed to make no further observations in this case”.

Nevertheless, the Panel considered the totality of the evidence in Dr Wakefield’s case including the reference dated 27 October 1995, from Professor Leon Fine, the then Head of the Department of Medicine at the Royal Free Hospital, when reaching its decision at this stage, having been asked to consider that as part of Mr Coonan’s submissions at Stage 1.

Serious professional misconduct has no specific definition but in Roylance v General Medical Council [1999] Lloyd’s Rep. Med. 139 at 149 Lord Clyde, in giving the reasons of the Privy Council, said:

“Misconduct is a word of general effect, involving some act or omission which falls short of what would be proper in the circumstances. The standard of propriety may often be found by reference to the rules and standards ordinarily required by a medical practitioner in the particular circumstances…”

Lord Clyde went on to say:

“The misconduct is qualified in two respects. First, it is qualified by the word ‘professional’ which links the misconduct to the profession of medicine. Secondly, the misconduct is qualified by the word ‘serious’. It is not any professional misconduct which will qualify. The professional misconduct must be serious.”

The Panel has acted as an independent and impartial tribunal and exercised its own judgement on these matters. It has borne in mind the relevant GMC guidance at the time, namely the 1995 Good Medical Practice and, in so far as the findings relate to events after 1998, the 1998 Good Medical Practice. It has considered what has been adduced and submitted on behalf of the doctors about the standards and procedures which were prevalent at that time.

In considering Dr Wakefield’s case, the Panel has also taken into account the passage of time before these matters were brought before it and the length of time this case has taken. It noted that the multiple sittings were for a variety of reasons including professional commitments of the Panel and requests from Counsel for reasons such as illnesses, accidents, unavailability of witnesses and preparation time.

The Panel has noted Dr Wakefield’s previous good character and taken into account everything it has heard including his qualifications, experience and standing within the profession, with patients and the parents of patients.

The Panel considered the conduct of Dr Wakefield whilst he was registered as a medical practitioner and employed by the Royal Free Hospital Medical School in 1996 and 1997, initially as a Senior Lecturer in the Departments of Medicine and Histopathology. Later, from 1 May 1997 he was a Reader in Experimental Gastroenterology and an Honorary Consultant in Experimental Gastroenterology at the Royal Free Hospital.

The Panel has already found proved that Dr Wakefield’s Honorary Consultant appointment was subject to a stipulation that he would not have any involvement in the clinical management of patients. On five occasions (child 2, 4, 5, 12 and 7) he ordered investigations on children, when he had no paediatric qualifications, and in contravention of the limitations on his appointment. The Panel considered this alone constituted a breach of trust of patients and employers alike.

In February 1996 Dr Wakefield agreed to act as an expert in respect of MMR litigation. In relation to the Legal Aid Board (LAB), the Panel found that Dr Wakefield accepted monies totalling £50,000 procured through Mr Barr, the Claimants’ solicitor to pursue research. A costing proposal had been submitted by Mr Barr to the LAB containing detailed information provided by Dr Wakefield, and Dr Wakefield ought to have realised that Mr Barr would submit it to the LAB.

The costing proposal set out costs in respect of the investigation of five children. It covered each child’s four-night stay in hospital with colonoscopy, MRI and evoked potential studies. Dr Wakefield admitted that the funding subsequently provided by the Legal Aid Board had not been needed for these items because these costs were borne by the National Health Service as the patients were being admitted as NHS patients.

The Panel found that Dr Wakefield had a duty to disclose this information to the Legal Aid Board via Mr Barr. It was dishonest and misleading of him not to have done so. The Panel concluded that his intention to mislead the Legal Aid Board was sufficient on its own to amount to serious professional misconduct.

The Panel also found that in respect of £25,000 of LAB monies, Dr Wakefield caused or permitted it to be used for purposes other than those for which he said it was needed and for which it had been granted. In doing so he was in breach of his duties in relation to the managing of, and accounting for, funds.

In September 1996 Dr Wakefield made an application to the Ethical Practices Sub-Committee of the Royal Free Hospital (Ethics Committee) seeking approval for a research project involving 25 children. This was approved by the sub-Committee as Project 172-96. He named himself as one of the three Responsible Consultants, thereby taking on the shared responsibility for the information given in support of his application; for ensuring that only children meeting the inclusion criteria would be admitted to the study; that conditions attached to the Ethics Committee approval would be complied with; and that children would be treated in accordance with the terms of the approval given.

In respect of Research and Ethics Committee approval, the Panel had regard to the particular ethical guiding principles with regard to conducting research on children. It rejected Dr Wakefield’s overall contention that Project 172-96 was never undertaken; that all the investigations carried out on the children were clinically indicated and that the research elements of the project were covered by another Ethics Committee approval.

The Panel concluded that the programme of investigations that these children were subjected to was part of Project 172-96. It further determined that the conditions for approval and the inclusion criteria for that project were not complied with. The Ethics Committee’s reliance on the probity of Dr Wakefield as a Responsible Consultant was not met.

With regard to nine of the eleven children (2,1, 3, 4, 6, 9, 5,12 and 8) considered by the Panel, it determined that Dr Wakefield caused research to be undertaken on them without Ethics Committee approval and thus without the ethical constraints that safeguard research. Ethical constraints are there for the protection both of research subjects and for the reassurance of the public and are crucial to public trust in research medicine. It was in the context of this research project that the Panel found that Dr Wakefield caused three of these young and vulnerable children, (nos. 3, 9 and 12) to undergo the invasive procedure of lumbar puncture when such investigation was for research purposes and was not clinically indicated. This action was contrary to his representation to the Ethics Committee that all the procedures were clinically indicated. In nine of the eleven children (2,1, 3, 4, 9, 5,12, 8 and 7) the Panel has found that Dr Wakefield acted contrary to the clinical interests of each child. The Panel is profoundly concerned that Dr Wakefield repeatedly breached fundamental principles of research medicine. It concluded that his actions in this area alone were sufficient to amount to serious professional misconduct.

The results of the research project were written up as an early report in the Lancet in February 1998. Dr Wakefield as a senior author undertook the drafting of the Lancet paper and wrote its final version. The reporting in that paper of a temporal link between gastrointestinal disease, developmental regression and the MMR vaccination had major public health implications and Dr Wakefield admitted that he knew it would attract intense public and media interest. The potential implications were therefore clear to him, as demonstrated in his correspondence with the Chief Medical Officer of Health and reports which had already appeared in the medical press. In the circumstances, Dr Wakefield had a clear and compelling duty to ensure that the factual information contained in the paper was true and accurate and he failed in this duty.

The children described in the Lancet paper were admitted for research purposes under a programme of investigations for Project 172-96 and the purpose of the project was to investigate the postulated new syndrome following vaccination. In the paper, Dr Wakefield failed to state that this was the case and the Panel concluded that this was dishonest, in that his failure was intentional and that it was irresponsible. His conduct resulted in a misleading description of the patient population. This was a matter which was fundamental to the understanding of the study and the terms under which it was conducted.

In addition to the failure to state that the children were part of a project to investigate the new syndrome, the Lancet paper also stated that the children had been consecutively referred to the Department of Paediatric Gastroenterology with a history of a pervasive developmental disorder and intestinal symptoms. This description implied that the children had been referred to the gastroenterology department with gastrointestinal symptoms and that the investigators had played no active part in that referral process. In fact, the Panel has found that some of the children were not routine referrals to the gastroenterology department in that either they lacked a reported history of gastrointestinal symptoms and/or that Dr Wakefield had been actively involved in the process of referral. In those circumstances the Panel concluded that the description of the referral process was irresponsible, misleading and in breach of Dr Wakefield’s duty as a senior author.

The statement in the Lancet paper that investigations reported in it were approved by the Royal Free Hospital Ethics Committee when they were not, was irresponsible.

Subsequent to the paper’s publication, Dr Wakefield had two occasions on which he could have corrected the content of the Lancet paper yet both times he compounded his misconduct.

First, in a published letter in response to correspondents who had suggested that there had been biased selection of the Lancet children, Dr Wakefield stated that the children had been referred through the normal channels, a response which was dishonest and irresponsible. He provided an inaccurate statement which omitted relevant information when he knew that the description of the population in the study was being questioned by the scientific community.

Second, at a meeting of the Medical Research Council, the Chair, Professor Sir John Pattison referred to the seriousness and importance of the implications of Dr Wakefield’s research and its major public health implications. At that meeting and on the issue of bias in generating the series of cases, Dr Wakefield stated that the children had come by “the standard route”, a response which was dishonest and irresponsible.

Regarding the issues of conflicts of interest, Dr Wakefield did not disclose matters which could legitimately give rise to a perception of a conflict of interest. He failed to disclose to the Ethics Committee and to the Editor of the Lancet his involvement in the MMR litigation and his receipt of funding from the Legal Aid Board. He also failed to disclose to the Editor of the Lancet his involvement as the inventor of a patent relating to a new vaccine for the elimination of the measles virus (Transfer Factor) which he also claimed in the patent application, would be a treatment for inflammatory bowel disease (IBD).

Even before the publication of the Lancet Paper, eminent professionals had expressed concerns about the LAB funding to Dr Wakefield and potential conflicts of interest. Dr Wakefield rejected these views. With regard to non-disclosure to the Ethics Committee, Dr Wakefield did in evidence accept that the Legal Aid Board funding should have been disclosed, but said that his involvement in the litigation need not, especially because of his interpretation of the questions in the application form. He said no question was asked which related to that matter and therefore felt no need to disclose. In evidence to the panel he stated:

“The form is set out expecting certain answers to specific questions and no such question exists. Therefore, since it was not asked, it was not answered.”

However, given the importance of an Ethics Committee’s reliance on the probity of an applicant, the Panel determined that this was a failure by Dr Wakefield and his actions amounted to serious professional misconduct.

With regard to the non-disclosure to the Lancet the Panel accepted evidence from the Editor of the Lancet, as to the importance of this issue. The Lancet published clear guidance in relation to the conflict of interest test that the applicant should apply and the need to discuss any issues arising from it with the Editor. The Lancet test was: “Is there anything that would embarrass you if it were to emerge after publication and you had not declared it?” Dr Wakefield chose not to declare or discuss any conflict of interest with the Editor. He stated that he was able to reconcile his position, was not embarrassed by it, and was quite proud of the position he had taken on behalf of the Lancet children.

Dr Wakefield was insistent that his involvement with the new patent had not given rise to any prior need to disclose. Despite the clear terms of the patent, he did not accept that the invention was envisaged as an alternative vaccine to MMR. He acknowledged that he had envisaged the use of transfer factor for at least a proportion of the population and that he had a financial and career interest in its success, but he said that it did not cross his mind to disclose it, and even with hindsight he insisted that there was a reasonable argument, as he put it, for non-disclosure. The Panel considered that his actions and his persistent lack of insight as to the gravity of his conduct amounted to serious professional misconduct.

In relation to the administration of Transfer Factor to Child 10, the Panel noted the admitted background of Dr Wakefield’s involvement in a company set up with Child 10′s father as Managing Director, to produce and sell Transfer Factor. Around the same time, Dr Wakefield inappropriately caused Child 10 to be administered transfer factor. The Panel accepted that information as to its safety had been obtained and that the approval to administer Transfer Factor to one child was granted in the form of “Chairman’s approval”, “on a named patient basis” in a letter from Dr Geoffrey Lloyd, Chairman of the Medical Advisory Committee at the Royal Free Hospital. Nonetheless the Panel found that Dr Wakefield was at fault because the substance was given for experimental reasons, he did not cause the details to be recorded in the child’s records, or cause the general practitioner to be informed, and he did not have the requisite paediatric qualifications.

Dr Wakefield’s actions were contrary to the clinical interests of Child 10 and an abuse of his position of trust as a medical practitioner. The Panel considered these to be serious departures from the standards of a registered medical practitioner and concluded that these amounted individually and collectively to serious professional misconduct.

Dr Wakefield caused blood to be taken from a group of children for research purposes at a birthday party, which the Panel found to be an inappropriate social setting. He behaved unethically in failing to seek Ethics Committee approval; he showed callous disregard for any distress or pain the children might suffer, and he paid the children £5 reward for giving their blood. He then described the episode in humorous terms at a public presentation and expressed an intention to repeat his conduct. When giving evidence to the Panel, Dr Wakefield expressed some regret regarding his remarks. The Panel was concerned at Dr Wakefield’s apparent lack of serious consideration to the relevant ethical issues and the abuse of his position of trust as a medical practitioner with regard to his conduct in causing the blood to be taken. The Panel concluded that his conduct brought the medical profession into disrepute.

Dr Wakefield defended the ethical basis for the taking of blood at a birthday party contrary to the experts who gave evidence to the Panel and who strongly condemned this action. The Panel determined that his conduct fell seriously short of the standards expected of a doctor and was a breach of the trust which the public is entitled to have in members of the medical profession. It concluded that this behaviour amounted to serious professional misconduct.

The Panel has borne in mind the principles guiding a doctor as set out in the relevant paragraphs of 1995 Good Medical Practice which relate to providing a good standard of practice and care, good clinical care, keeping up-to-date, abuse of professional position, probity in professional practice, financial and commercial dealings, and the general principles of conflict of interest, followed by particular provisions as to the way in which research must be conducted. The 1998 Good Medical Practice, relevant to Dr Wakefield’s conduct at the birthday party, lists the duties of a doctor in providing a good standard of practice and care, keeping up-to-date and the issue of research and the absolute duty to conduct all research with honesty and integrity.

In all the circumstances and taking into account the standard which might be expected of a doctor practising in the same field of medicine in similar circumstances in or around 1996-1998, the Panel concluded that Dr Wakefield’s misconduct not only collectively amounts to serious professional misconduct, over a timeframe from 1996 to 1999, but also, when considered individually, constitutes multiple separate instances of serious professional misconduct.

Accordingly the Panel finds Dr Wakefield guilty of serious professional misconduct.

In considering what, if any, sanction to apply, the Panel was mindful at all times of the need for proportionality and the public interest which includes not only the protection of patients and the public at large, but also setting and maintaining standards within the medical profession, as well as safeguarding its reputation and maintaining public confidence in the profession. It bore in mind that the purpose of sanctions is not punitive, although that might be their effect.

The Panel noted the submissions of GMC Counsel that the appropriate and proportionate sanction would be erasure in light of his serious and wide-ranging misconduct. However the Panel accepted the Legal Assessor’s advice that this was only a submission on behalf of the GMC and it was for the Panel to make up its own mind. Dr Wakefield’s counsel did not make any substantive submissions on his behalf.

The Panel went on to consider whether it should, pursuant to Rule 30(1), postpone the case. It received no submissions in this regard and so went on to determine whether it was sufficient to conclude the case without making a direction or with an admonition.

The Panel made findings of transgressions in many aspects of Dr Wakefield’s research. It made findings of dishonesty in regard to his writing of a scientific paper that had major implications for public health, and with regard to his subsequent representations to a scientific body and to colleagues. He was dishonest in respect of the LAB funds secured for research as well as being misleading. Furthermore he was in breach of his duty to manage finances as well as to account for funds that he did not need to the donor of those funds. In causing blood samples to be taken from children at a birthday party, he callously disregarded the pain and distress young children might suffer and behaved in a way which brought the profession into disrepute.

In view of the nature, number and seriousness of the findings the Panel concluded it would be wholly inappropriate to conclude the case without making a direction or
with a reprimand.

It next considered under rule 31 whether it was sufficient to direct that the registration of Dr Wakefield be conditional on his compliance during a period not exceeding three years with such requirements as the (Panel) may think fit to impose for the protection of members of the public or in his interests. Conditions have to be practicable, workable, measurable and verifiable and directed at the particular shortcomings identified. The Panel concluded that Dr Wakefield’s shortcomings and the aggravating factors in this case including in broad terms the wide-ranging transgressions relating to every aspect of his research; his disregard for the clinical interests of vulnerable patients; his failure to heed the warnings he received in relation to the potential conflicts of interest associated with his Legal Aid Board funding; his failure to disclose the patent; his dishonesty and the compounding of that dishonesty in relation to the drafting of the Lancet paper; and his subsequent representations about it, all played out against a background of research involving such major public health implications, could not be addressed by any conditions on his registration. In addition, the Panel considered that his actions relating to the taking of blood at the party exemplifies a fundamental failure in the ethical standards expected of a medical practitioner. It concluded that conditional registration would not mark the seriousness of such fundamental failings in his duty as a doctor.

The Panel next went on to consider whether it would be sufficient to suspend Dr Wakefield’s registration for a period not exceeding twelve months. Dr Wakefield has demonstrated a persistent lack of insight and has insisted in many instances on his ethical propriety: in the context of the referral process and the treatment of the children in the research project in which he was engaged; in the context of the funding of the project; with regard to the terminology of the Lancet paper; with regard to his non-declaration of interests; with regard to not acting in the best clinical interests of the Lancet children and with regard to obtaining blood from children at a birthday party.

The Panel noted that the sanction of suspension may be appropriate for conduct that falls short of being fundamentally incompatible with continued registration; where there is no evidence of harmful deep-seated or attitudinal problems; and where there is insight and no significant risk of repeating behaviour. Although these points have been set out in the GMC’s Indicative Sanctions Guidance which was published subsequent to these events, the Panel considered that the guidance outlines the type of sanction appropriate to the gravity of misconduct and that the same principles are applicable to Dr Wakefield’s actions at the material times. The Panel considers that Dr Wakefield’s conduct in relation to the facts found falls seriously short of the relevant standards and that suspension would not be sufficient or appropriate against a background of several aggravating factors and in the absence of any mitigating submissions made on his behalf. Dr Wakefield’s continued lack of insight as to his misconduct serve only to satisfy the Panel that suspension is not sufficient and that his actions are incompatible with his continued registration as a medical practitioner.

Accordingly the Panel has determined that Dr Wakefield’s name should be erased from the medical register. The Panel concluded that it is the only sanction that is appropriate to protect patients and is in the wider public interest, including the maintenance of public trust and confidence in the profession and is proportionate to the serious and wide-ranging findings made against him.

The effect of the foregoing direction is that, unless Dr Wakefield exercises his right of appeal, his name will be erased from the Medical Register 28 days from when formal notice has been deemed to be served upon him by letter to his registered address.

Dr Wakefield is presently not subject to any interim order on his registration. The Panel will hear submissions on whether an immediate order of suspension should be imposed upon him pending the outcome of any appeal, first from Ms Smith on behalf of the General Medical Council and then from Mr Coonan on behalf of the doctor but will do that at the conclusion of the reading of all three determinations.

You know, it’s been pointed out that the enemies of Dr. Stephen Barrett of Quackwatch like to refer to him as “de-licensed,” because Dr. Barrett quite reasonably let his medical license expire after he retired from the practice of medicine. After all, it’s expensive for a non-practicing physician to obtain the required CME credits and pay for a new license every two or three years, and it makes little sense to do so if you’re not practicing anymore, particularly since some states even require physicians to carry malpractice insurance if they wish to remain licensed. Yet, none of this stops quackery supporters like Ilena Rosenthal or Tim Bolen from constantly calling Dr. Barrett “de-licensed.” Yet here we have a real de-licensed (as in having had his medical license taken away for misconduct) physician.

I wonder if quackery supporters will be referring to Wakefield as a “delicensed” doctor. I know I will be, and it will be interesting to see what sorts of defenses they come up with. In fact, I urge every blogger who cares about science: Whenever you mention Wakefield’s name, from this moment forward, preface it with “delicensed” or “delicensed physician.” It’ll be true.

Comments

  1. #1 Paul Browne
    May 24, 2010

    Good news indeed! It’s refreshing to see a dangerous crank pay the price for his dishonesty.

    As you say this will mean that the anti-vaxers wuill become all the more shrill in their claims of witch-hunts – shades of “Expelled” about them – but that’s certainly not a good justification for not initiating proceedings against him.

  2. #2 Pieter B
    May 24, 2010

    ‘Tis a pity that Lauer wasn’t briefed on the vaccine court. Just the fact that the three carefully selected omnibus cases were all found to be without merit would have been enough to keep Wakefield from scoring that point without opposition.

  3. #3 Scott
    May 24, 2010

    It’s refreshing to see a dangerous crank pay the price for his dishonesty.

    No, that would be when he gets locked up for murder.

  4. #4 augustine
    May 24, 2010

    Orac: “Is there a more arrogant and despicable physician out there right now?”

    Yes!

    scott: “No, that would be when he gets locked up for murder.”

    What Murder? There was NO MURDER. As anyone who champions the terms “evidence based” can attest there are no bodies let alone proof of causation. 18 died in the vaccinating period before Dr. Wakefield’s paper. 10 died in the vaccinating period after his paper. If anything one could say the same about his paper causing a decrease in MMR deaths.

    This is why the blood boils in the self proclaimed guardians of science. When protecting ideologies emotions and name calling rule. Objective “scientists” are not above this as evidenced in these blogs. Which then calls into question the objectivity. The mind is tainted with a priori.

  5. #5 nostrum
    May 24, 2010

    Wouldn’t it be nice if TV media did the slightest bit of research every once in a while? I’m tired of Jon Stewart being the best news journalist on the air.

  6. #6 Rene Najera
    May 24, 2010

    And, yet, if a foreigner from, let’s say, Mexico comes here with the very same arguments, he would surely find himself back in his country. Not so for Andy. I’m sure he’ll overstay his visa (if there is one), and no one will say a peep.

    DISCLAIMER: Peep!

  7. #7 superdave
    May 24, 2010

    I’m glad matt pointed out that wakefields study had 12 children and the major studies since have had hundreds of thousands. That’s the kind of fact that resonates with people.

  8. #8 Science Mom
    May 24, 2010

    Wakefield did drop one bomb–and a stinker it was, too–that I haven’t heard before. Apparently his new talking point is that the U.S. government has been settling cases of “vaccine-induced autism” on the down-low as early as 1991. He repeated it multiple times, in fact.

    I sense a new anti-vaccine talking point that defenders of science-based medicine will have to deal with. As usual, Andrew Wakefield didn’t present any evidence to support his unfounded assertion, but I bet that there will soon be something up on the anti-vaccine propaganda blog Age of Autism or on that repository of quackery and anti-vaccine nonsense, The Huffington Post (calling David Kirby!) to try to “prove” that what Wakefield said is true. My guess is that it will be more spin and dissembling along the lines of the Hannah Poling or Bailey Banks cases.

    And a new anti-vax internet meme is born. It’s already being commented on at AoA as though it were irrefutably true, albeit without any references to what he could have been talking about. Wakefield dropped that empty bomb for nothing more than give hope to his pathetic band of supporters and create interest in his book.

  9. #9 DayOwl
    May 24, 2010

    Accordingly the Panel has determined that Dr Wakefield’s name should be erased from the medical register. The Panel concluded that it is the only sanction that is appropriate to protect patients and is in the wider public interest, including the maintenance of public trust and confidence in the profession and is proportionate to the serious and wide-ranging findings made against him.

    “Delicensed” seems rather, well, tame for this category of professional shame. I mean, it just doesn’t convey the sort of outrage needed. I understand the desire to fling their terms back in their faces, but if that’s the best they can do, we must prove we can do far better.

    Perhaps we could all submit suggestions for a more appropriate term.

  10. #10 Lawrence
    May 24, 2010

    He seriously said that? Talk about getting into deep-deep conspiracy territory, and it is nearly impossible to disprove because AoA will just claim that the “Evil Government” is just covering up the evidence and hushing people up, like they always do.

    What a tool.

  11. #11 KWombles
    May 24, 2010

    There’s a vote being held over at Today, and right now the parents who think vaccines cause autism have 50%: http://community.todaymoms.com/_question/2010/05/24/4342399-do-you-think-vaccines-are-related-to-autism

  12. #12 sheldon101
    May 24, 2010

    http://www.gmc-uk.org/Wakefield_SPM_and_SANCTION.pdf_32595267.pdf

    http://www.gmc-uk.org/Professor_Walker_Smith_SPM.pdf_32595970.pdf

    http://www.gmc-uk.org/Professor_MURCH_determination.pdf_32597633.pdf

    The GMC panel disgraced itself when it let Murch off without any sanctions at all, which explains why the reasons for not sanctioning him are short and have a parallel universe view of what happened when compared to the Walker-Smith decision.

  13. #13 aravir
    May 24, 2010

    It’s perfect timing for Wakefield. After all, his book of martyology is due to be released on Wednesday. According to Amazon, it’s got a pretty hefty pre-order. That’s why he’s on with Matt Lauer.

  14. #14 D. C. Sessions
    May 24, 2010

    Good news indeed! It’s refreshing to see a dangerous crank pay the price for his dishonesty.

    I’m not persuaded that Wakefield is a crank. Cranks, after all, actually believe the snake oil that they peddle. There’s no evidence that Wakefield believes in anything but that Andrew Wakefield should have the best of everything — means be damned.

  15. #15 Calli Arcale
    May 24, 2010

    DayOwl: well, I do rather like the British term: erasure.

    I am suddenly picturing Doc Emmet Brown (“Back to the Future”) with a wild-eyed look saying “Erased . . . from medical practice!”

  16. #16 Anonymous
    May 24, 2010

    There’s some very compulsive, determined commenters in the Huffington Post’s report
    Andrew Wakefield Banned: British Doctor Behind MMR Vaccine Scare Struck Off Register (via AP)

  17. #17 a perfect circle
    May 24, 2010

    @Calli Arcale “For erasure you need 1.21 jigawatts of power! 1.21 jigawatts! “

  18. #18 ChrisKid
    May 24, 2010

    “his persistent lack of insight as to the gravity of his conduct…” This just floors me. It’s part of what I saw in the Today Show interview. He just has no clue that he has done anything wrong. It looks like his whole attitude is, “I did it, therefore it must be okay.” Callous disregard indeed.

    “Later, from 1 May 1997 he was a Reader in Experimental Gastroenterology and an Honorary Consultant in Experimental Gastroenterology at the Royal Free Hospital.

    The Panel has already found proved that Dr Wakefield’s Honorary Consultant appointment was subject to a stipulation that he would not have any involvement in the clinical management of patients.”

    Does this mean what I’m reading it to mean, that he wasn’t actually allowed to treat patients? Anybody know what that’s about?

  19. #19 DLC
    May 24, 2010

    For the GMC: ::: Polite applause:::
    For Orac : thanks for delivering the good news!

  20. #20 MC
    May 24, 2010

    Somehow that has a nice ring to it:

    Struck Off, Andy!

  21. #21 autiemum
    May 24, 2010

    chriskid @18

    Yes, he wasn’t allowed to treat any patients or arrange any treatment. But he did.

    his appointment was honorary ie unpaid and he was allowed to do research. Not diagnose or treat patients. This was not a slur on him. It was just the arrangement.
    The clinical decisions were the responsibility of Walker-Smith. Murch was a new, junior consultant guided by Walker-Smith. Murch actually stopped the research by refusing to nod through anymore lumbar punctures because he felt they were not clinically necessary. This plus his subordinate status is why he was not punished. I agree with this. It is proportionate.

  22. #22 dedicated lurker
    May 24, 2010

    And there was much rejoicing!

  23. #23 Journal Checker
    May 24, 2010

    The honorary part of his joint employment meant he was not paid for the ‘honorary consultant’ part, but he was also in salaried employment as senior lecturer and later as reader – these are paid academic posts. It’s pretty standard procedure in tertiary medical centres. He wasn’t working for no pay.

    It can work both ways – a salaried NHS consultant might have an honorary professorship at the university linked to the NHS Trust.

    Wakefield’s honorary NHS consultancy did not permit him treat patients – and that’s not so unusual either.

  24. #24 Der Bruno Stroszek
    May 24, 2010

    A good comment over at Ben Goldacre’s blog on this story raised an issue I hadn’t previously considered: if, as the standard Big Pharma conspiracy line goes, vaccines are such a money-spinner that the drug companies will cover up any evidence against them so they can keep selling, surely they would have supported a single vaccine instead of the MMR vaccine? If the Big Pharma of the crank imagination existed, it would have welcomed Wakefield’s research – telling your customers you should buy one instead of three isn’t terribly good business practice.

  25. #25 ChrisKid
    May 24, 2010

    autiemom, Journal Checker, Thanks for the information. Not knowing the system, it almost sounded as if he’d been prohibited for some reason.

  26. #26 Prometheus
    May 24, 2010

    Apparently his new talking point is that the U.S. government has been settling cases of “vaccine-induced autism” on the down-low as early as 1991.

    I suppose he is referring to the over-exposed Poling and Banks cases, although I don’t remember either of those being from 1991.

    I expect that we need to prepare ourselves for a more weeks and months of “teaser” press releases from Andy Wakefield’s public relations agent wherein we are told to expect “extensive documentary evidence” of a “massive government cover-up” (“Round up the usual suspects.”) “in the near future”, blah, blah, blah.

    And like all of his previous promises of “vindication”, these will also never, ever appear.

    If Andy Wakefield had any exculpatory evidence, he should have produced it at his hearing, not at press releases to be given at some vague and evanescent “future”.

    If he had evidence of “hushed up” government payments for “vaccine-induced autism”, he would have given it on Matt Lauer’s show.

    Are we to be endlessly bombarded by Dr. Wakefield’s vague and confused claims that he is the victim of a monstrous plot to suppress the knowledge of autism and vaccines that he alone is able to see? Will Dr. Wakefield never show us his evidence?

    It is well past time for Dr. Wakefield to either put up or shut up. He needs to show us the evidence or we should show him the door.

    Is there a process by which we can have Dr. Wakefield “struck off” the television talk show circuit?

    Prometheus

  27. #27 D. C. Sessions
    May 24, 2010

    Are we to be endlessly bombarded by Dr. Wakefield’s vague and confused claims that he is the victim of a monstrous plot to suppress the knowledge of autism and vaccines that he alone is able to see? Will Dr. Wakefield never show us his evidence?

    Is Prometheus addicted to rhetorical questions?

  28. #28 Calli Arcale
    May 24, 2010

    Prometheus @ 26:

    If Andy Wakefield had any exculpatory evidence, he should have produced it at his hearing, not at press releases to be given at some vague and evanescent “future”.

    Perhaps he thinks he isn’t just any doctor, but The Doctor?

    “I’ll explain later.”

  29. #29 Prometheus
    May 24, 2010

    D.C. Sessions,

    I confess – I do know the answers to those questions, so they are rhetorical. For those not as experienced in the ways of the wily Wakefield, the answers are:

    [1] “Are we to be endlessly bombarded….?” YES (unfortunately)

    [2] “Will Dr. Wakefield never show us his evidence?” YES (note the negative formulation of the question)

    Prometheus

  30. #30 Coryat
    May 24, 2010

    It’s sad that we actually have to celebrate small victories over unreason, but as a Brit I can certainly say I am elated at this news. Bye bye ex-doctor Fakefield!

    N.B Orac, I find it quite charming that you’re so enamoured with our term ‘struck off’. As I grew up with it I never considered how it would sound to foreign ears.

  31. #31 dedicated lurker
    May 24, 2010

    Cali – do not put the Doctor and Andrew Wakefield in the same sentence unless it involves the Doctor telling him off! Really now.

  32. #32 Matthew Cline
    May 24, 2010

    I have to ask: If there was so much evidence to support his defense that he had done nothing wrong, why didn’t Wakefield–oh, you know–actually present that evidence during the GMC hearings? He had, after all, ample opportunity, well over two years!

    The obvious answer: the GMC prevented him from presenting this evidence. Wakefield supports already claim that the parents of the children from his study weren’t allowed to testify in his favor, so from there it’s not that big a leap to say that Wakefield himself was gagged during his own trial.

  33. #33 Gr8GooglyMoogly
    May 24, 2010

    ‘Dr.’ Andrew Wakefield – Never will you find a more wretched hive of scum and villainy.

  34. #34 augustine
    May 24, 2010

    This must be how Ignaz Semmelweis felt when the status quo attacked him to conserve their ideology.

    “Doctor’s are gentlemen. And gentlemen can’t CAUSE disease.”

  35. #35 Johnny
    May 24, 2010

    On behalf of Dr Wakefield, no evidence has been adduced and no arguments or pleas in mitigation have been addressed to the Panel at this stage of the proceedings. In fact Mr Coonan specifically submitted:

    “……we call no evidence and we make no substantive submissions on behalf of Dr Wakefield at this stage.” “…I am instructed to make no further observations in this case”.

    Somehow, the pro-disease people think he was railroaded. He didn’t even *try* to fight. I guess “Doctor” Wakefield was saving all the evidence in his favor for the book, and not the proceedings. After all, if it was part of the public record, he public could read it for free, with out buying the book.

    Does anyone know if those proceedings are under oath, and do criminal charges of perjury apply to lying liars?

  36. #36 F. Andy Seidl
    May 24, 2010

    “I wonder if quackery supporters will be referring to Wakefield as a “delicensed” doctor. I know I will be…”

    I recommend using “delicensed for cause”, which can not even technically be applied to Dr. Barrett.

  37. #37 gpmtrixie
    May 24, 2010

    Ooh, that despicable unctuous voice! After seeing that interview, I just want to rip off Andy’s lips and slap him upside the head with them! He needs to just go away. What an ego!

  38. #38 Azkyroth
    May 25, 2010

    I wonder how many “Depraved Heart” murders it takes to add up to a capital offense…

  39. #39 eleanor
    May 25, 2010

    If you compare the ruling against Walker-Smith to that against Wakefield, Walker-Smith is ‘irresponsible but not dishonest’, while Andy is ‘dishonest’ over and over and over again. A fair assessment, I think (and bearing in mind this is a semi(?)-legal document; they aren’t doing to use ‘dishonest’ unless this is proven to be the case).

    I want Ansy’d next interview to start with “liar liar liar! Sue me for libel if I’m wrong – oh, you tried that and it didn’t work? Liar liar!” At least it would be a more intellectually satisfying exchange.

  40. #40 winegums
    May 25, 2010

    Does anyone know if there’s any truth to the statement that Saint Andy is still a registered doctor in America?

  41. #41 MartinM
    May 25, 2010

    AFAIK, he was never registered in the US in the first place.

  42. #42 Impostor
    May 25, 2010

    Can’t he be ritually stripped of his doctor-y regalia, like disgraced military cadets? Made to stand outside the GMC while a superior rips off his white coat and symbolically breaks his stethoscope over their knee, while a lone bugler mournfully plays ‘Taps’?

    Somehow ‘struck off’ always summons up for me the image of a giant Hogwarts-style register, with a grim-faced judge ruling a thick black line through the miscreant’s name with a huge old quill pen. Sadly, I think the Register is online now; technology takes all the poetry away…

    Oh, and can I be the first commenter to call him ‘Mr’ Wakefield? Feels very good to type that…

  43. #43 JohnV
    May 25, 2010

    @augustine #34

    What, was your Galileo reference in the shop or something?

  44. #44 gpmtrixie
    May 25, 2010

    In the US, each state is in charge of licensing doctors. I did a search and the State of Texas Medical Board website does not list Wakefield as a licensed physician. I guess he could be licensed in some other state(s). That doesn’t mean that desperate, uninformed parents won’t seek him out and continue to waste their money.

  45. #45 Science Mom
    May 25, 2010

    Andy Boy has never been a licensed physician in the U.S. and now, thankfully, never will be. Like it or not, he is still Dr. as his graduating institution has not stripped him of his professional title. That actually happens very, very rarely. It would be perfectly accurate to refer to him as de-licensed Doctor Wakefield.

  46. #46 Brian Deer
    May 25, 2010

    Here are some random notes of clarification and correction:

    (1) Wakefield has not, or ever had, a license to practise medicine in the US. Nor will he ever now get one.

    (2) On Age of Autism and the like, you see poorly informed parents talking about how Wakefield had “helped our children”. If Wakefield ever laid a hand on a child who was not his own, he would potentially be exposed to assault charges.

    (3) Any parent who has been given advice by Wakefield in circumstances where he is acting as, or holding himself out to be, a medical practitioner, might consider, if they wish, consulting a lawyer.

    (4) As a former trainee gut surgeon who became an academic researcher, he has at no time in his career ever had legal care of a patient. Contrast that with, say, paediatrician Paul Offit.

    (5) Wakefield has no relevant evidence that he didn’t submit to the GMC. All of his evidence was fully considered and rejected. Notably his claim that his research was ethically covered by a 1995 permission to the clinician Walker-Smith. This was a permission purely to take two extra biopsies for research purposes.

    (6) The GMC panel of three doctors and two lay members heard the case entirely independently of the GMC which presented the case.

    (7) There was no complainant in the case. It was brought by the GMC itself, responding to my investigation.

    (8) Wakefield was fully entitled to call anybody he wanted as a witness in his defence. He called none whatsoever.

    (9) Anti-vax loons who say parents were not allowed to take part are simply – and with malicious, deceitful intent – lying to the vulnerable.

    (10) The GMC called one parent of one of the children. She gave invaluable and devastating evidence for the prosecution, among other things that she was enrolled as a litigant before her child was referred to the Royal Free.

    (11) In addition to Wakefield calling no witnesses, none of the doctors called any witness from their institution to give evidence that any non-research “clinical protocol” ever existed (which was at the heart of their defence). Indeed, no evidence was adduced from any source (other than the defendants’ bald, unsubstantiated assertions, contradicted by their own previous documents, formal statements and writings) that there ever was any non-research clinical protocol.

    (12) When the UK government’s vaccine chief (David Salisbury) was called to give evidence, two days were scheduled for his appearance. However, at the end of direct examination by the GMC, Wakefield’s lawyer stood up and said he had no questions. The hearing then had to be adjourned and a day’s time was lost.

    (13) In case anybody missed point 12, Wakefield asked no questions of the government’s vaccine chief. The only possible explanation is that he feared the answers he might have got.

    (14) Following the liar-for-hire “writer” Martin Walker’s activities – rented by American anti-vaxxers to produce a false account of the proceedings – counsel for all three doctors, including Wakefield (obviously), formally submitted that the chairman of the panel had no conflict of interest.

    (15) At no time during the hearing was any suggestion ever made that the panel was anything other than independent.

    (16) Fearful of the facts coming out, Ms Isabella Thomas, known on the anti-vaccine circuit as “Betty Bonkers”, and other ex-MMR litigants, made repeated efforts to disrupt the proceedings with spurious behind-the-scenes complaints. They have also sought to disrupt publishing by the BMJ. Ms Thomas is now skating on the thinnest of ice.

    (17) Although, given the proven charges, clinician Walker-Smith was bound to be struck off, in my view his case was badly presented by his lawyers. Vain to the point of haughty, they basically took the view that he could do whatever he liked, and whatever he said must be correct. I don’t think they did him any favours with this approach. Wakefield’s and Murch’s cases, however, were immaculately presented.

    (18) I think the insurers, the aptly named Medical Protection Society, is by no means gagging to fund any appeal, whatever Wakefield says about it. They must be down about four or five million, including the million or so they lost in his lawsuit against me, and I think they would be reluctant to throw another million at the high court, with the risk that, either the judge will throw the case out (with more excoriating criticism of Wakefield from the bench), or, if there was any technical error, causing the entire GMC hearing to be run again. Still, we’ll see.

  47. #47 llasidog#87d47
    May 25, 2010

    Wakefield’s study was flawed… it wasn’t the MMR vaccine that causes autism, it is ALL vaccines cause autism. That has been the problem with all the vaccine/autism studies they have singled out one vaccine.

    The fat woman who eats chocolates, ice cream, and cookies all day long has proven over and over again that her diet does not cause her obesity. Every six weeks she gives up a different food and her weight stays the same. This last six weeks she gave up blueberry ice cream and she didn’t lose an ounce. – It’s the same with the vaccine studies.

    The so-called peer-reviewed scientific studies are a form of brainwashing. First, by insisting that ONLY peer-reviewed studies be given credence, you eliminate all of the studies that have not been financed directly or indirectly by Big Pharma. There are many articles on the web about the sad state of published research. The studies that are done that show the dangers of drugs are either never published or twisted to imply the opposite.

    The autism rate climbed substantially when the pharmaceutical firms got freedom from any liability, created the combination vaccines, lowered the ages of children getting vaccinated, and increased the number of recommended vaccines for children from 10 to almost 60 now.

    As the number of recommended vaccines climbed, our children became sicker and sicker. Food allergies are now potentially fatal. Highly refined peanut oil is GRAS and can be used by pharmaceutical firms without being listed on the package insert. There is a trace amount of peanut protein in the oil and when injected with an adjuvant = fatal food allergy. There is a new book on the topic “The History of the Peanut Allergy Epidemic” by Heather Fraser. Luckily, Heather is a historian so the Medical Mafia can’t take away her credentials. http://barbfeick.com/vaccinations

  48. #48 Chris
    May 25, 2010

    llasidog:

    ALL vaccines cause autism. That has been the problem with all the vaccine/autism studies they have singled out one vaccine.

    You obviously have not paid attention for the past dozen years or so, or you would not have left out Blaxill, Redwood, and friends. You also left out any real evidence for your silly claims that have been debunked multiple times here and elsewhere.

    Self published books by non-scientists do not count as real evidence.

  49. #49 Todd W.
    May 25, 2010

    @llasidog#87d47

    First, by insisting that ONLY peer-reviewed studies be given credence, you eliminate all of the studies that have not been financed directly or indirectly by Big Pharma.

    Bzzt! Wrong. There are plenty of peer-reviewed studies that are not financed directly or indirectly by Big PharmaTM. Of course, you would know that if you took the time to read some of them.

    The autism rate climbed substantially when the pharmaceutical firms got freedom from any liability

    What freedom from liability? They could still be sued by anyone that can show proximate cause and negligence. People can reject the ruling of the Vaccine Court and go after the manufacturer directly.

    lowered the ages of children getting vaccinated, and increased the number of recommended vaccines for children from 10 to almost 60 now.

    First off, the pharmaceutical companies did not do these things. AAP and CDC did, after reviewing the scientific literature, as they do every year. And there are not 60 vaccines. There aren’t even 16 vaccines. There are, at most, 11 vaccines preventing 15 different diseases by age 6. Or are you engaging in creative math and counting each dose of each part of a vaccine as 1 vaccine (e.g., counting 1 dose of MMR as 3 vaccines and the full series as 9 vaccines)? Also, there is a reason that there are more vaccines one: more have been developed!

    As the number of recommended vaccines climbed, our children became sicker and sicker.

    Citations, please.

    Food allergies are now potentially fatal.

    Not related to vaccines, but possibly related to over use of sanitizing agents like Clorox bleach and antibacterial soaps, combined with children spending less time playing in the dirt. In fact, there was a recent study suggesting that hook worms (parasites) may be responsible for keeping allergies to a minimum. Haven’t read the study yet, so I can’t say for certain, though.

    Highly refined peanut oil is GRAS and can be used by pharmaceutical firms without being listed on the package insert.

    Wrong. Peanut products, as a known allergen, are required to be listed in the ingredients of all products containing them.

    Perhaps you should obtain your information from reputable sources in the future.

  50. #50 Aka
    May 25, 2010

    “(7) There was no complainant in the case. It was brought by the GMC itself, responding to my investigation.” – Brian Deer

    I don’t get it. I thought you made three complaints to them, in specifically asking them to pursue fitness to practice investigations against Wakefield, Walker-Smith and Murch?

  51. #52 Chris
    May 25, 2010

    Aka, it can be assumed that you were wrong (or you got that information from an unreliable source). Perhaps the GMC was alerted to Wakefield’s shenanigans by actually reading the newspaper.

  52. #53 Calli Arcale
    May 25, 2010

    dedicated lurker @ 31:

    Cali – do not put the Doctor and Andrew Wakefield in the same sentence unless it involves the Doctor telling him off! Really now.

    Well, if Wakefield were to have delusions of grandeur, one might as well go all the way. ;-) Actually, there are some great Doctor Who quotes suitable for discussions involving Wakefield and his supporters:

    “Allow me to congratulate you, sir: you have the most totally closed mind I have ever encountered.” — 3rd Doctor

    “We start getting proof and we stop believing.”
    “With this proof, we don’t have to believe.” — Neeva & Tomas, “Face of Evil”
    (They were talking about religion, but hey, the anti-vaxxers run on belief. They have no proof, just their beliefs, and so they revile proof which could threaten their beliefs.)

    And of course my personal favorite for these situations:

    “What school of philosophy is this?”
    “I could easily teach him. All it takes is a cunning imagination and a glib tongue.” — 4th Doctor, Masque of Mandragora (he’s talking to a court astrologer)

  53. #54 Dedj
    May 25, 2010

    “I don’t get it. I thought you made three complaints to them, in specifically asking them to pursue fitness to practice investigations against Wakefield, Walker-Smith and Murch?”

    Complainant is a role within the complaints hearing.

    It does not, and cannot be applied to any person that makes a complaining letter, unless such a person is selected to act within that role by the GMC.

    This is fairly normal within legal and civic proceedures, as it allows gestalt or group concerns to be heard without having to go through each individuals’ concerns.

  54. #55 Brian Deer
    May 25, 2010

    Spot on Dedj.

    A GMC complainant is analogous to a civil litigation claimant: he or she is a party to the proceedings.

    In fact, I wrote a lot more to the GMC or its lawyers, met them I think twice and had several phone conversations. What I was doing was supplying them with any and all information I had in the matter, which I did as a matter of public duty. If you like, I was telling them where the bodies were buried, in the hope that they would go and dig them up. Which is pretty much what happened.

    For me, the GMC accomplished two things: firstly it broke though a deal between the Lancet and Wakefield’s former medical school, through which what he did was covered up, and the Lancet’s irresponsible publication of what was in fact (although they might not have known this) fraudulent research was defended. Secondly, the proceedings against Wakefield were an investigative tool for my journalism. Last year, for example, I was able to reveal, in summary, some of the ways in which Wakefield rigged his research to create the appearance of a link between MMR, bowel disease and autism.

    Journalists do this kind of thing all the time: sometimes even assisting, say, the army or the police, so as to advance an investigation. The real test is the public interest.

    If anyone’s really interested, my dealings with the GMC are described in my report on the proceedings, which I kind of did as it went along. I haven’t added the latest.

    http://briandeer.com/solved/story-highlights.htm#gmc

  55. #56 Aka
    May 25, 2010

    Ok…. but it’s right to say that the whole investigation against the three doctors was triggered by your complaint?

  56. #57 Just sayin'
    May 25, 2010

    Ok…. but it’s right to say that the whole investigation against the three doctors was triggered by your complaint?

    probably as right as saying the whole investigation against the three doctors was triggered by the doctors’ respective ethical and scientific miscoduct…

  57. #59 aka
    May 25, 2010

    “This explains what triggered the GMC hearing: a demand by Wakefield in February 2004″.

    Oh what nonsense!

    Come on fond tickletum… You think deep down it was Brian what triggered it too, don’t you? ;)

  58. #60 Chris
    May 25, 2010

    Why does this upset you so much, Aka? No matter how the investigation started, the outcome is the same: Wakefield got caught.

    Are you upset that there are people who actually read newspapers? Or that Wakefield got caught? Or that Brian Deer did the job that the Lancet should have done in the first place? (that paper should never have been published in the first place)

  59. #61 Journal Checker
    May 25, 2010

    It’s quite interesting that there seem to have been two Brians involved in trying to hold doctors to account for unethical research. Is this genetic or maybe just the mitochondrial bit?

  60. #62 Rogue Medic
    May 26, 2010

    @ 34 augustine,

    This must be how Ignaz Semmelweis felt when the status quo attacked him to conserve their ideology.

    “Doctor’s are gentlemen. And gentlemen can’t CAUSE disease.”

    For once you have stated something that is accurate. Ex-Dr. Andrew Wakefield is not causing disease.

    The current point man for germ theory denialists, Dr. Andrew Wakefield, is promoting the spread of disease.

    Promoting the spread of disease is what the earlier germ theory denialists were doing by opposing Dr. Semmelweis.

    They were able to treat patients without cleaning their hands after having their hands in cadavers. They claimed that the inconsistency of development of childbed fever meant that hand washing had nothing to do with the illness.

    Immunity is equally mysterious to current germ theory denialists.

    Dr. Semmelweis recommended hand washing to prevent the spread of disease. The germ theory denialists opposed him and continued to kill patients by spreading childbed fever.

    In the current century, the number of germ theory denialist physicians is a tiny proportion of physicians, since almost all physicians understand germ theory. The problem is disease being spread by people who do not understand germ theory and therefore do not vaccinate their children. How many more children will they sicken and kill before they become aware of their mistake?

    Almost all of the doctors opposed to Dr. Semmelweis eventually realized their mistake.

    What will it take for the anti-vaccinationists to realize their mistake?

    By denying germ theory, the anti-vaccinationists are spreading disease and killing children.

    Germ theory is science.

    Germ theory denialists (Anti-vaccinationists) oppose science.

  61. #63 Chris
    May 27, 2010

    New website for Augie to tout: Dr Andrew Wakefield, victim of evil conspiracy.

    I am imagining him reading it in a whiny little voice, but stumbling over any word with more than two syllables.

  62. #64 Aka
    May 27, 2010

    “Why does this upset you so much, Aka? No matter how the investigation started, the outcome is the same: Wakefield got caught.

    Are you upset that there are people who actually read newspapers? Or that Wakefield got caught? Or that Brian Deer did the job that the Lancet should have done in the first place? (that paper should never have been published in the first place)”

    I wasn’t aware I was coming across as upset, but anyway, nevermind.

    BD’s first complaint (I think) here:

    http://www.rescuepost.com/files/deer-letter-.jpg

    “Fearful of the facts coming out, Ms Isabella Thomas, known on the anti-vaccine circuit as “Betty Bonkers”, and other ex-MMR litigants, made repeated efforts to disrupt the proceedings with spurious behind-the-scenes complaints. They have also sought to disrupt publishing by the BMJ. Ms Thomas is now skating on the thinnest of ice.”

    Blimey… What facts is Isabella trying to hide, Brian?

    What complaints has she made?

  63. #65 Chris
    May 27, 2010

    So?

    Why does it matter? Why do you keep harping on it?

  64. #66 Chris
    May 27, 2010

    Also that badly scanned letter has numbers listed in front of the names. What are they, and why are they there? Are they case numbers? Like the process was already started?

  65. #67 Dedj
    May 27, 2010

    “Also that badly scanned letter has numbers listed in front of the names. What are they, and why are they there? Are they case numbers? Like the process was already started?”

    They look like Registration numbers for the professional register. All medical and health professionals should have such a number if they are on a register.

    The curious thing to notice about the letter is that:

    it post dates the announcement by John Reid
    it does not appear to have been submitted under any formal complaints proceedure
    does not contain any actual complaint
    presents itself as an ‘outline of evidence’ in the first paragraph and throughout.

    In other words, it looks exactly like a letter that would be written by someone who has got wind of an investigation and wants to submit evidence.

    This is exactly what the GMC and Deer have said it was.

    The best the Deer hunters can do is point to the lack of reference to prior communication, which is a weak point at best as the possibility of a GMC investigation was widely reported immediately prior to Deer’s submission.

  66. #68 Chris
    May 27, 2010

    So the time line according to Deer is:

    Five days after the meeting between Brian Deer and Richard Horton, and immediately upon publication of Deer’s first report, the GMC announced its own inquiry into the affair. On the day after Horton’s statement of Friday 20 February 2004, the government’s then-health secretary, John Reid, called for a GMC investigation, and on Monday 23 February, the GMC approached Deer and asked if, in the public interest, he would pass them the full findings behind his Sunday Times reports. In an email dated 25 February, he summarised his findings as of that date.

    That very badly scanned letter is dated 25 February 2004, exactly as stated in the above paragraph (and it is an email, something a decent screen shot would suffice for). Aka and friends do seem to get their panties in a twist about something that did not happen, nor does it matter.

    Wakefield was outed by an investigative journalist, and was caught. Though Wakefield’s paper was so bad, and the surge of measles is a real public health threat, that he would have been caught by someone else.

  67. #69 Aka
    May 27, 2010

    “Deer hunters”??

    I thought you chaps opposed paranoia and conspiracy theory? He’s a freakin’ hard-nosed investigative journo. He’s not going to break the second an easy question comes his way…

    All I’m trying to establish is

    1) Brian asked the GMC to launch an investigation into Wakefield Walker-Smith and Murch 25 February 2004
    2) The GMC launched an investigation into these three doctors and only these three doctors out of the research team who worked on the 1998 paper

    So the GMC decided to take Brian’s advice. Would that be a fair summary?

  68. #70 Chris
    May 27, 2010

    Um, dude… you really need to work on your reading comprehension. So in a report dated 23 February 2004 it says:

    On Saturday, Health Secretary John Reid urged the GMC to investigate “as a matter of urgency”. A spokeswoman for the GMC said: “We are concerned by the allegations and will be looking to see what action, if any, may be necessary.”

    Perhaps you should also work on your counting skills. Here on this planet, unlike Bizarro World, the 23th is before the 25th.

    How can you walk with such twisted panties? Really, why do you care? Wakefield’s research was so flawed he would have been found out eventually. It even came out in an American courtroom that his study was seriously flawed, and even fraudulent (Chadwick and Bustin testimony).

  69. #71 Dedj
    May 27, 2010

    “So the GMC decided to take Brian’s advice. Would that be a fair summary?”

    Yes and no.

    Yes, as they undoubtedly took at least some advice from Deer.

    No, as you clearly mean ‘Did they act upon his advice when they clearly would not have done so otherwise’. As pointed out above, Feb 25th is after Feb 21st/23rd.

    As others have pointed out in the wider literature (the name of the person who submitted the FOI request to the GMC escapes me) the GMC can and has launched several hundred investigations on the basis of press reports or articles.

    We have no evidence that the GMC did not investigate the other researchers. However, there is no evidence that they ever did anything other than act within their clinical and administrative roles.

  70. #72 David N. Brown
    May 27, 2010

    “BD’s first complaint (I think) here:

    http://www.rescuepost.com/files/deer-letter-.jpg

    Another document from GR, which also conveniently provided the mysteriously-obtained Aarhus “statement” about Poul Thorsen, and the documents that supposedly gave Paul Offit the entirety of an inventor’s share on a 1998 patent even though they were clearly dated 1992 and 1993.

    Rule of thumb: If a story uses a “rescuepost” as a source, it can and should be presumed a hoax until proven otherwise.

  71. #73 David N. Brown
    May 27, 2010

    Ah, and I just noticed that, while the printout clearly shows “Page 1 of 7″, the other 6 pages have curiously been ommitted.

  72. #74 aka
    May 28, 2010

    “the GMC can and has launched several hundred investigations on the basis of press reports or articles.”

    Ok… So (at the risk of tedium although we’ve perhaps now passed that point) you would say the Deer reports were the basis of the GMC investiagtion?

    “How can you walk with such twisted panties? Really, why do you care? Wakefield’s research was so flawed he would have been found out eventually.”

    Chris: Please save any speculation about my “panties” for the privacy of your own bedroom, you old perv.

  73. #75 Todd W.
    May 28, 2010

    @aka

    you would say the Deer reports were the basis of the GMC investiagtion?

    Perhaps a better way to think of it is that Deer’s reports were likely the impetus to start the investigation.

  74. #76 Chris
    May 28, 2010

    Aka, you are an idiot. You miss the fact that Wakefield’s research was so flawed, unethical and fraudulent. Your obsession with Deer is misguided, and you cannot seem to get your head around the fact that other people had pointed out that Lancet paper did not say what Wakefield claimed in the press report. Do you even know who Chadwick and Bustin are?

    Do you know who Ben Goldacre is? He wrote about the appalling science and media idiocy on the MMR in 2003. Which on this planet, and not on the Bizarro World you live on, is before 2004.

    Now go get yourself a decent tutor to work on both your reading comprehension and counting skills. That way you will be able to understand this review of Wakefield’s poor excuse for a book.

    I just wish we could deport the lying fraudulent liar.

  75. #77 Dedj
    May 28, 2010

    “Perhaps a better way to think of it is that Deer’s reports were likely the impetus to start the investigation.”

    Indeed. The investigation appears to have included concerns that were expressed almost immediately after publication of the initial report. Not only that, but no serious investigator would consider overlooking such a prime source.

    Of course, the main concern that has been thrown at Deer is that he is somehow involved in the GMC inquiry, and therefore should be disbarred from reporting on it. This is despite: no opponent of Deer ever citing any rule, law, code, policy, ruling or guidance document that would prohibit him from doing so.

  76. #78 Chris
    May 28, 2010

    Odd that they can’t find any law to keep Deer from reporting the inquiry. Isn’t at least one of them a lawyer? Though I would not call him a very bright lawyer, he was posting comments on various blogs claiming that Deer lied and had to retract an article (that was restored).

    I was reminded of another source of criticism of Wakefield that dates back to 2002 (which is also before 2004): http://ratbags.com/rsoles/comment/wakefield.htm

  77. #79 Aka
    May 29, 2010

    “Aka, you are an idiot. You miss the fact that Wakefield’s research was so flawed, unethical and fraudulent. Your obsession with Deer is misguided, and you cannot seem to get your head around the fact that other people had pointed out that Lancet paper did not say what Wakefield claimed in the press report. Do you even know who Chadwick and Bustin are?

    Do you know who Ben Goldacre is? He wrote about the appalling science and media idiocy on the MMR in 2003.”

    Oh now I’m “obsessed with Deer”? It looks like you’re too economical with the truth to have the authority to call others liars. Aswell as a pervert.

    I believe Goldacre is a psychiatrist who exposes what he deems to be medicine practised without a scientific basis. Where can I find his expose of the fact that SSRI’s don’t work?

    http://www.independent.co.uk/life-style/health-and-families/health-news/antidepressant-drugs-udontu-work-ndash-official-study-787264.html

  78. #80 Chris
    May 29, 2010

    You are not a very bright fellow are you? Trying to discredit a critic does not make Wakefield’s shoddy work any more real. Perhaps you can actually try reading Dr. Goldacre’s book Bad Science.

    There was lots of evidence that Wakefield was talking out of his butt before 2004. All of these papers are dated 2004 and before. :

    Relationship between MMR Vaccine and Autism.
    Klein KC, Diehl EB.
    Ann Pharmacother. 2004; 38(7-8):1297-300
    *Literature review of 10 studies

    Immunization Safety Review: Vaccines and Autism. Institute of Medicine.
    The National Academies Press: 2004
    (w w w . nap.edu/books/030909237X/html) *Literature review

    MMR Vaccination and Pervasive Developmental Disorders: A Case-Control Study.
    Smeeth L et al.
    Lancet 2004; 364(9438):963-9
    *Subjects: 1294 cases and 4469 controls

    Age at First Measles-Mumps-Rubella Vaccination in Children with Autism and School-Matched Control Subjects: A Population-Based Study in Metropolitan Atlanta.
    DeStefano F et al. Pediatrics 2004; 113(2): 259-66
    *Subjects: 624 children with autism and 1,824 controls

    Prevalence of Autism and Parentally Reported Triggers in a North East London Population.
    Lingam R et al.
    Arch Dis Child 2003; 88(8):666-70
    *Subjects: 567 children with autistic spectrum disorder

    Neurologic Disorders after Measles-Mumps-Rubella Vaccination.
    Makela A et al.
    Pediatrics 2002; 110:957-63
    *Subjects: 535,544 children vaccinated between November 1982 and June 1986 in Finland

    A Population-Based Study of Measles, Mumps, and Rubella Vaccination and Autism.
    Madsen KM et al.
    N Engl J Med 2002; 347(19):1477-82
    *Subjects: All 537,303 children born 1/91–12/98 in Denmark

    Relation of Childhood Gastrointestinal Disorders to Autism: Nested Case Control Study Using Data from the UK General Practice Research Database.
    Black C et al.
    BMJ 2002; 325:419-21
    *Subjects: 96 children diagnosed with autism and 449 controls

    Measles, Mumps, and Rubella Vaccination and Bowel Problems or Developmental Regression in Children with Autism: Population Study.
    Taylor B et al.
    BMJ 2002; 324(7334):393-6
    *Subjects: 278 children with core autism and 195 with atypical autism

    No Evidence for a New Variant of Measles-Mumps-Rubella-Induced Autism.
    Fombonne E et al.
    Pediatrics 2001;108(4):E58
    *Subjects: 262 autistic children (pre- and post-MMR samples)

    Measles-Mumps-Rubella and Other Measles-Containing Vaccines Do Not Increase the Risk for Inflammatory Bowel Disease: A Case-Control Study from the Vaccine Safety Datalink Project.
    Davis RL et al.
    Arch Pediatr Adolesc Med 2001;155(3):354-9
    *Subjects: 155 persons with IBD with up to 5 controls each

    Time Trends in Autism and in MMR Immunization Coverage in California.
    Dales L et al.
    JAMA 2001; 285(9):1183-5
    *Subjects: Children born in 1980-94 who were enrolled in California kindergartens (survey samples of 600–1,900 children each year)

    Mumps, Measles, and Rubella Vaccine and the Incidence of Autism Recorded by General Practitioners: A Time Trend Analysis.
    Kaye JA et al.
    BMJ 2001; 322:460-63
    *Subjects: 305 children with autism

    Further Evidence of the Absence of Measles Virus Genome Sequence in Full Thickness Intestinal Specimens from Patients with Crohn’s Disease.
    Afzal MA, et al.
    J Med Virol 2000; 62(3):377-82
    *Subjects: Specimens from patients with Crohn’s disease

    Autism and Measles, Mumps, and Rubella Vaccine: No Epidemiological Evidence for a Causal Association.
    Taylor B et al.
    Lancet 1999;353 (9169):2026-9
    *Subjects: 498 children with autism

    Absence of Detectable Measles Virus Genome Sequence in Inflammatory Bowel Disease Tissues and Peripheral Blood Lymphocytes.
    Afzal MA et al.
    J Med Virol 1998; 55(3):243-9
    *Subjects: 93 colonoscopic biopsies and 31 peripheral blood lymphocyte preparations

    No Evidence for Measles, Mumps, and Rubella Vaccine-Associated Inflammatory Bowel Disease or Autism in a 14-year Prospective Study.
    Peltola H et al.
    Lancet 1998; 351:1327-8
    *Subjects: 3,000,000 doses of MMR vaccine

  79. #81 David N. Andrews M. Ed., C. P. S. E.
    June 28, 2010

    @Sciencemom:
    “Andy Boy has never been a licensed physician in the U.S. and now, thankfully, never will be*. Like it or not, he is still Dr. as his graduating institution has not stripped him of his professional title**. That actually happens very, very rarely***. It would be perfectly accurate to refer to him as de-licensed Doctor Wakefield.****”

    Actually….

    * this is true… never has and certainly won’t ever be now.

    ** not quite true: his degrees (Bachelor of Medicine & Bachelor of Surgery) are the requisite minimum registrable qualification in the UK for practice as a medical practitioner or as a surgeon; he was a practising surgeon firstly, and then became an academic surgeon and – apart from his house year (6 months in medicine and 6 months in surgery, all supervised) – he never practised medicine and so was never really in a position to be called ‘Dr’ anything… and this means that his being struck off the medical register makes no difference to his title – except maybe that we call him ‘Mr’ for a very different reason now.

    *** this is true: universities and other learned bodies have the right to strip a person of their degree of membership of that body of which the membership is held; but they rarely do it.

    **** well…. I refer the honorable mom to the answer I gave in ** above ;) and the historical reasoning behind my assertion that he was never actually ‘Dr’ anything is given in this blog, in the comments section of a different post.

  80. #82 kerrie Waldron
    December 15, 2010

    to call you a dickhead is an insult to penises

  81. #83 Scottynuke
    December 15, 2010

    Well, apart from not specifying the “you” in the insult, the fact that it took almost six months to come up with the insult doesn’t speak very highly for kerrie’s Necromancer skills.

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