Andrew Wakefield and the GMC: A Badly Argued Defence

June 7, 2010 at 8:40 pm (Anti-Vaccination, Media) (, , , , , )

James Le Fanu has an article in the Daily Telegraph today regarding the GMC case against Andrew Wakefield, John Walker-Smith, and Simon Murch. It is very badly argued.

Here is the offending article. Here are the ‘highlights’:

It is not necessary to be a conspiracy theorist to recognise that the General Medical Council’s recent ruling to strike professors Andrew Wakefield and John Walker-Smith off the register had the fingerprints of the medical establishment all over it.

On the basis of the evidence before them, the GMC (whether they are the ‘medical establishment’ that James Le Fanu has in mind or not) were quite right to rule that there had been unethical behaviour with regard to the children in the retracted Lancet paper. You would probably have to be a conspiracy theorist to suggest otherwise.

But this charge against them, as everyone knows, cannot possibly be true. Professor Walker-Smith, who supervised the investigation, is, from personal experience and by common consent, the epitome of the saintly doctor. [Le Fanu goes on to refer to affidavits testifying to the saintliness of Walker-Smith.]

If the defence for Walker-Smith rests on the fact that Le Fanu and others consider him to be a good person and a good doctor, then it is easy to dismiss. Good people can do bad things.* People who are experts in their field can make misjudgements.

That a person is of previous good character may be a mitigating factor to be considered when the decision on that person’s fate is made. It is not, however, something that automatically precludes misjudgement or wrongdoing and Le Fanu is foolish to make this the basis of his defence of Walker-Smith.

We can find plenty of examples of people of previous good character who have appeared in court as “first-time offenders”. To pick out just one of these examples, there is this case, in which the judge stated that one of the defendants was of previous good character but had been badly influenced on this occasion by his peers. This person, as many others have been, was found guilty and sentenced despite being of previous good character.

It is probably reasonable for Le Fanu to assert that by reason of his character, Walker-Smith is unlikely to have behaved in a manner that warranted the action taken by the GMC, but he can not reasonably assert that the charge “cannot possibly be true”. [Apart from any other consideration, our natures may be less stable and less inherent than the natures of other things.**]

And so to the opinion of the parents of the vulnerable children whose best interests he had allegedly disregarded. […]

Actually, let’s not rely on the opinion of the parents of the vulnerable children to decide whether Wakefield and Walker-Smith behaved unethically. Here’s just one reason I would be wary of relying on their opinion as to what should have become of Wakefield and Walker-Smith: misplaced consistency***. As Stuart Sutherland writes in Irrationality, with house-hunters the example:

Apart from the time and effort expended in the search, they will have spent a great deal of money. If they are not to feel foolish, they must justify to themselves the commitment they have made… [they tend to exaggerate the good points and minimise the bad points].

Having made the decision to allow their children to be subjected to the investigations undertaken for the retracted Lancet paper, the parents have since had to justify their decision to themselves.

Le Fanu concludes:

It seems only sensible, given this moral confusion that would portray a decent and honest man as deceitful and exploitative, to reserve judgment about the GMC’s verdict and to speculate what lies behind it. Leaving aside the question of whether the MMR vaccine is implicated in this form of autism – as the parents’ accounts would certainly suggest – it is perhaps not unreasonable to detect the hidden hand of those powerful forces for whom the crushing of a professional reputation is a price worth paying for the continuation of the ever-expanding child immunisation programme.

This is utter nonsense. It is in no way sensible or reasonable to reserve judgement on the GMC’s verdict on the basis that Walker-Smith was a nice man who was good at his job.

Nor is it sensible or reasonable to imply that the anecdotes of the parents mean that MMR might be linked to autism, as Le Fanu does here. There is no good evidence to suggest that is the case. There is, on the other hand, rather a lot of evidence to suggest that it is not.

The suggestion that one can detect the hidden hand of sinister powerful forces determined to wreck careers in order to further the child immunisation program, meanwhile, is nothing but bullshit.

Plenty of doctors have expressed concerns about the vaccination program. Richard Halvorsen, to name but one. As far as I am aware, Halvorsen is still a doctor and a GP despite expressing his concerns about the immunisation program on his own clinic’s website. Why has Halvorsen’s professional reputation not been “crushed by the GMC”? Perhaps it is because he has not been guilty of unethical conduct. Compare his situation to that of Walker-Smith and Wakefield.

Then there’s Simon Murch, who I mentioned briefly earlier. In his case, the GMC did not find (despite his errors of judgement) that “the threshold of serious professional misconduct” had been reached – and the Panel found that Professor Murch was not guilty of serious professional misconduct. [PDF]. Why “ruthlessly crush” the professional reputations of two men for the continuation of the immunisation program and not the third? If the “saintly doctor” Walker-Smith can be found guilty, then why not Murch?

All Le Fanu provides are anecdotes, conspiracy theorising, and personal testimonies as to the previous good character of Walker-Smith. He uses the space allotted to him by the Daily Telegraph to imply (despite all the contrary evidence, not a bit of which is mentioned) that there might be a link between MMR and autism and to weave a sinister tale of good doctors ruined by sinister forces.

This really is shoddy journalism.

More

*Harry G Frankfurt writes, in his esssay On Bullshit, that:

there is nothing in theory, and certainly nothing in experience, to support the extraordinary judgment that it is the truth about himself that is the easiest for a person to know. Facts about ourselves are not peculiarly solid and resistant to skeptical dissolution. Our natures are, indeed, elusively insubstantial — notoriously less stable and less inherent than the natures of other things. And insofar as this is the case, sincerity itself is bullshit.

**A quote in this bench book, from Australia, is worth reproducing here:

The judge is at liberty to remind the jury that people do commit crimes for the first time and that evidence of previous good character cannot prevail against evidence of guilt which they find to be convincing, notwithstanding the accused’s previous character. This consideration may apply with particular force to certain types of crime and the judge is free to point that out to the jury if he or she sees fit: R v Trimboli (1979) 1 A Crim R 73 at 74.

***Robert Cialdini writes about consistency from a different perspective in Influence: Science and Practice. Cialdini discusses the work of Elliot Aronson and Judson Mills, who tested their observation that “persons who go through a great deal of trouble or pain to attain something tend to value it more highly than persons who attain the same thing with a minimum of effort”.

The parents of the children in the retracted Lancet paper, and their children, went through a great deal of trouble and pain to get answers. Having been provided with answers by Wakefield after going through the investigations performed for the retracted paper, some of the parents involved may feel a greater commitment to Wakefield and his ideas than they might otherwise have experienced.

Wakefield GMC determination PDF; Walker-Smith GMC determination PDF. Edited to add: Wakefield/Walker-Smith/Murch PDF.

Some of the evidence ignored by Le Fanu

This PDF presents a rough overview of the evidence on MMR and autism: here (note that 25 studies show no link and of the three that do, one has been retracted). This was in 2008.

Since then, more research has been published that has found “evidence against the association of autism with either MMR or a single measles vaccine” – but this was the news you didn’t read. Because newspapers like the Telegraph didn’t think it worth mentioning.

34 Comments

  1. Cybertiger said,

    You really are a twot, jdc523, admin worker from Bradford. Give me strength!

  2. Shabouwcaw said,

    Great post. Exactly what i was thinking. One of the wonderful things about finding blogposts that dovetail exactly with ones own train of thought is that a link will substitute for an explanation.

  3. Anne said,

    Excellent blog post, thank you.

  4. Dr Aust said,

    “…admin worker from Bradford”

    …and yet reaching levels of logic, understanding, analysis and (especially) expression that wholly elude you, Shabby. How about that?

    Congrats on another nice post, jdc.

  5. Michael said,

    As far as I can tell, this column is essentially saying “oh, c’mon guys, he’s my mate, leave him alone, he’s alright really” which in a sense is actually quite endearing.

    But… well, this guy says it better than me: http://www.youtube.com/watch?v=MOX9lDf-6go

  6. Chris said,

    I don’t know if the UK has had a similar financial scam recently, but would Mr. Le Fanu write the same stuff about Bernard Madoff? Everyone thought he was a really nice guy, until they found out they had lost their life savings in a Ponzi scheme… something between 10 to 17 billion dollars.

  7. Cybertiger said,

    “For every problem there is a solution: neat, plausible and wrong”

    The problem with Draust is that he’s wrong: the neat, twottish and plausible admin worker from Bradford seems to have wrongly pitched his nuance against this guy,

    http://www.jameslefanu.com/

    You have to larf: it seems that twottishness is both the problem …. and the solution.

  8. Teek said,

    This is blogging at its best – taking the frankly absurd opinions expounded in the so-called mainstream media (can’t exactly pinpoint the time that it became mainstream to promote conspiracy and hearsay over fact and ethics…) and subjecting them to rigorous scrutiny – well done!

  9. Cybertiger said,

    Frankly, this is blogging at its most vile … I shall have to up my doses of Prozac and Zyprexa.

  10. Dorothy Bishop said,

    Le Fanu may have a guilty conscience that he is trying to assuage.
    He has used his newspaper column to spread the anti-MMR message wide and far in the past, see
    http://tiny.cc/25g2i
    http://tiny.cc/pnf5w
    He seems to see himself as a fearless battler of the establishment, and has even taken on Charles Darwin: http://tiny.cc/hzl4r
    He clearly prefers instinct to evidence, and it is unfortunate to say the least that the Telegraph continues to let him promulgate his ill-informed views.

  11. Cybertiger said,

    Dot Bishop believes James le Fanu has ‘taken on the establishment’ by gently questioning the basic simplicity of Darwin’s evolutionary theory,

    “Darwin’s evolutionary theory generates the illusion that we know vastly more than we really do, while its too simple explanations drain the phenomena of life of the sense of the extraordinary. And there is nothing more extraordinary than ourselves.”

    I agree that there is nothing more “bizarre or extraordinary about the billionfold biological complexities of the living world” that could have produced something like Dot, in all her glorious dottiness.

    James le Fanu has written a fascinating book called ‘Why us?: How science discovered the mystery of ourselves’. However, I doubt he’ll take on the really big question of our existence, ‘Why Dot?’.

  12. sheldon101 said,

    I expected that none of the 3 doctors would have their names ‘struck off’. Why? Because the GMC doesn’t strike anyone off. They actually erase their names from the register. I asked the GMC if there was a ceremony or something and if it was open to the public. Unfortunately, they change just a field on the database. Ahh…for a simpler time.

    I predicted that all 3 would lose their license. Wakefield because he caused this disaster. Walker-Smith because he made it possible. Murch because he was a responsible consultant. If I had known that Murch was on the ethics committee at the time, I would have thought it was a slam dunk. That piece of info only came out in the sanctions decision. The rational conclusion is that Sally Smith for the prosecution had argued that it made his case worse.

    The GMC had 3 choices 1. nothing. 2. warn 3. erase his name.

    I’ve read their their sanctions reading and the fact finding reasons This is a case where normally the ‘hard cases make bad law’ rule applies. I’ve no doubt that Murch is an asset to the UK medical profession, but letting him off on the I was following orders excuse is intolerable. Yes, Walker-Smith was senior etc. I might even give him one unnecessary colonoscopy. But more than one? There won’t be a fuss because they got Wakefield for his lying unethical behavior. But it was wrong.

    As to setting a precedent (hard cases) , the circumstances are unlikely to arise again.

    I’ve got a lot more on Wakefield, especially the nonsensical argument at the heart of his defense at http://www.vaccineswork.blogspot.com.

  13. Cybertiger said,

    Q. Which rsole belongs in Room 101?

    A. Sheldon

  14. jdc325 said,

    I’d just like to apologise to anyone who is offended by Cybertiger’s remarks. He seems to be trying to test my support for free speech. If it starts to become vitriolic, I’ll do some disemvowelling.

  15. Cybertiger said,

    oooooh, u r a hoot! Go on, do a disemvowelling on that, jimmie!

  16. skepticat said,

    Superb post and at least Cybertiger’s funny with it.

  17. sheldon101 said,

    Cybertiger’s problem is that the comments are so lame. I mean, if you’ve got nothing worthwhile to say, at least say it with some style.

    This shows some style.”My simply complaint to you, Sheldon101, is that you tend to speak out of your arse than your mouth. It is fun to watch but distasteful.”

    That’s how you do it. That was Dana Ullman at Huffington-Post. I loved it.
    My simply complaint to you, Sheldon101, is that you tend to speak out of your arse than your mouth. It is fun to watch but distasteful.

    So Cybertiger, c’mon you can do better.

  18. sheldon101 said,

  19. softestpawn said,

    Good logical points there jdc, but I think it may miss the overall one: someone who is apparently good and nice and professional is being attacked by The Establishment, who probably wouldn’t have bothered if he hadn’t ‘taken them on’.

    Whether the attacks are fair or unfair is really the issue (which I think you had in a different post?). To me it looks a bit like getting Al Capone for tax evasion; it’s not what people really find bad about his behaviour, but it will do.

    Surely you have a standard reference now that you can link to every time you claim that there is evidence of no MMR/Autism link?

  20. softestpawn said,

    Oh, arse, you do have one at the end there. It was the bit inline in the text where you said “There is, on the other hand, rather a lot of evidence to suggest that it is not” I was expecting one.

    I shall go back to painting my ears.

  21. Cybertiger said,

    “I shall go back to painting my ears.”

    Yes, I would … and your tits too, twat!

  22. sheldon101 said,

    Re #19

    The cops were after Capone anyway they could get him. The ‘cops’ weren’t after Wakefield from 1998 to 2004.

    Wakefield’s paper came out in 1998. Almost immediately readers realized that Wakefield had connections with the lawyer doing the MMR lawsuit — that’s a conflict of interest concern.

    That raised a separate issue, were the children selected as described in the paper? That was raised in a letter to The Lancet. Wakefield said yes.

    There was an important scientific meeting on his paper. Wakefield was asked again about whether the children were routine consecutive referrals. Wakefield said yes.

    From then to 2004, Wakefield’s work got trashed as new studies were done. He and the hospital parted ways. He went to the US. But the cops weren’t after him. . He may have been sloppy, wrong and his ideas nuts — but that doesn’t get you investigated.

    In 2004, Brian Deer brought 3 issues to light.
    1. The children were treated terribly and unethically.
    2. Wakefield lied about the selection process.
    3. Wakefield had huge conflict of interest issues.

    One and two, meant that the GMC would investigate. Because medical doctors are required to be ethical and honest. Honesty is especially important when it comes to matters of public health.

    It should be added that Wakefield, typically, invited the GMC to investigate him. Only later did he complain about the investigation.

  23. Dr Aust said,

    The “important scientific meeting” Sheldon refers to was a meeting of the Medical Research Council and the Royal Free team that took place on March 23rd 1998. [Part of the minutes can be found on Brian Deer’s website here.]

    This was less than a month after the Wakefield paper came out – hardly evidence, of course, that the “establishment” ignored, or suppressed, the (apparent) Wakefield findings, as conspiracy theorists like Cybertiger, John Stone and the rest of the JABS Posse would have you believe. Quite the opposite, in fact -it shows the Royal Free paper was taken extremely seriously, to the point of the MRC calling an ad hoc meeting of all sorts of important folk within just a few weeks.

    A partial quote:

    “Members [of the committee] were interested in how the children had come to be referred to the RFHMS team, as this had a bearing on the issue of bias in the generation of the case series. Mr Wakefield explained that originally the parents of the children had come to the [Royal Free] group without any connection through any other organisation…. All patients who had been reviewed to date [which per se must have included the Lancet twelve] had been referred by their GP or paediatrician by the standard route.”

    Now, whether you could argue, Bill Clinton style, that those words were “not strictly a flat-out lie” (for instance, GPs and paediatricians had referred the children, but usually only after major arm-twisting by the parents, Wakefield or even Walker-Smith), the intent to deceive the MRC as to how the children had actually been recruited is blindingly obvious. And this was not after years of rancour and controversy – it was right at the start of the whole media farrago, in the eye of the initial storm.

    The GMC went over these events (Wakefield’s comments to the Lancet and to the MRC) and described Wakefield’s statements as “dishonest” and “irresponsible”, which is putting it mildly. See DeeTee’s summary here. The GMC say that Wakers:

    ““knew the statement [he made] omitted necessary and relevant information”.

    As DeeTee says:

    “Put simply, Wakefield was dishonest, he knew he was being dishonest, and he was repeatedly dishonest.”

    And that is even before you get to Wakefield’s two years of ties with the anti-vaccine lawyer Barr, the conflict of interest over funding from the Legal Air Board via the lawyers, and the patent applications for “alternative” vaccines.

    Quite how anyone can be arguing that Wakefield has been “persecuted”, as LeFanu is doing, is beyond me. Wakefield was treated absolutely seriously back in 1998, and his research ditto. He was taken at face value, as a honest researcher, and given every chance to be part of the discussion about MMR. And all he did was lie and deceive, repeatedly, to promulgate a fake scare. Twelve years on he is still at it.

  24. Cybertiger said,

    Who is this DeeTee fella – or fellarette? Are they what is known as an ‘anonymous whistleblower? Or is this someone who’s spineless identity is being protected by the medical establishment? Is this person a paper tiger?

  25. Cybertiger said,

    So many questions, so few intelligible answers!

  26. badsciencemonk said,

    Get help Cybertiger

  27. Cybertiger said,

    That’s not an intelligible answer, badmonkfishscience. Are you offering to help??

  28. Neuroskeptic said,

    “It is not necessary to be a conspiracy theorist to recognise that the General Medical Council’s recent ruling to strike professors Andrew Wakefield and John Walker-Smith off the register had the fingerprints of the medical establishment all over it.”

    Well no it’s not, the clue is in the name “General Medical Council” they are, by their own admission, the Establishment. And in this case they were right. As the scientific and medical Establishment almost always is, in fact. Establishment is a dirty word though, I prefer to call us “the qualified-people-who-know-stuff-and-think-carefully-about-it-ament.”

    Not quite as catchy.

    P.S. Cybertiger is sure to make some attempt at wit and I can tell I won’t be bothered to respond so I’ll pre-emptively say that he has just made a complete arse of himself as usual with his latest ridiculous comment.

    If he doesn’t I’ll happily retract that. Let’s see.

  29. Cybertiger said,

    septicneurotic said,

    “Well no it’s not, the clue is in the name “General Medical Council” they are, by their own admission, the Establishment. And in this case they were right. As the scientific and medical Establishment almost always is, in fact …”

    … but the medical Establishment didn’t get it right over Meadow and Southall, did they? What went wrong with them two rascals?

    PS. neuroseptic is not a very bright sparklet

  30. Cybertiger said,

    The Septic-Establishment-Neurotic provided us with this gem,

    “Establishment is a dirty word though, I prefer to call us “the qualified-people-who-know-stuff-and-think-carefully-about-it-ament.”

    The BMA is Medical-Establishment* and the BMJ is the Medical-Establishment’s house journal. Which is presumably why the the BMJ thought Professor Sir Deer-Dirty-Brian, Establishment journalist (God’s-Hack), was “the-qualified-person-who-knew-stuff-and-thinks-carefully-about-childish-crap-a-lot-ament”

    http://www.bmj.com/cgi/content/full/340/apr15_2/c1127

    PS. It’s rather painfully obvious that NeuroSeptic is a very-dim-Establishment-bulb. Twat!

    * That Deities are capitalised is an established rule

  31. Cybertiger said,

    I see 532jdc (unimaginative, inverted robot) is making a big prat of himself over at the Guardian …

    http://www.guardian.co.uk/science/2010/jun/09/genetics-autism-story-tracker?showallcomments=true#end-of-comments

    … with the usual sort of specious profundities like this,

    “These deaths aren’t purely hypothetical – since the MMR scare, people in this country have died from acute measles infection. This hadn’t happened since 1992. The vaccine damage to children (at least in terms of MMR and autism), however, is entirely hypothetical. Wakefield thought it might be true, but it turned out not to be. You have things entirely the wrong way round. Measles kills. MMR doesn’t cause autism. If we avoid the MMR vaccine because of fears about autism, we ignore a very real risk in order to avoid a non-existent one.”

    Arse!

  32. jdc325 said,

    There must be a law, somewhere, rather like Scopie’s Law, that dictates that as soon as CyberTiger joins in an argument on your side, you have lost. CyberTiger or Cybercat or Cybertwat, (grrrrrrrr!), will NEVER never debate and will always opt for personal insult and nutty insinuation

    Troll.

  33. Cybertwat said,

    Nuts, nuts, whole hazel nuts. Dontcha jus luv the nuttiness! Loon!

  34. Cybertwat said,

    Over at the Guardian (above), it looks like Clifford Miller is doing a first rate smear and paste job on the loopy automaton325. Nutter.

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