The transgressive medical genius that is Mark Geier

February 24th, 2007 by Ben Goldacre in bad science, MMR | 58 Comments »

Ben Goldacre
Saturday February 24, 2007
The Guardian

It’s hard to know how you’d react in a crisis, and so if there’s one group of people who can’t be blamed for the weirdness around autism, it’s parents. But academic journal editors have different responsibilities. The current issue of Lancet Neurology has a review of a book on autism: the book is for a lay audience, and it flatters the views of the growing fringe autism movement on speculative biological causes and treatments for the condition. The review is by a man with a long and worrying history of working on that fringe – and it’s certainly very flattering.

Now I’m not advocating censorship for one moment, but I do think that in a situation as extreme as this, it’s only fair to give the reader some background.

The reviewer, Mark Geier, is an American doctor, vaccine activist, and highly criticised expert witness in vaccine cases, who promotes the idea that mercury in vaccines causes autism, and that testosterone is somehow also implicated. He performs expensive, drastic, controversial, experimental and unproven treatments on children with autism, including “chelation” to remove this mercury (a procedure from which a child died in 2005, under the care of another activist doctor) and “chemical castration” of children using leuprorelin, a testosterone blocker.

Research on mercury in vaccines and autism suggests no link. And the evidence on chelation therapy and autism doesn’t support its use, nor does the evidence on “chemical castration”.

If you are going to use such radical treatments, then I would argue that you might want compelling evidence, rather than a theory, and also gold standard ethics committee involvement in every experiment you do.

Mark Geier does research with his son, David Geier, who is president of MedCon, a medical-legal consulting firm that helps vaccine injury claimants get compensation. Dr Geier (Mark) was a recipient in the multimillion pound MMR expert witness payout.

In more than 10 of his legal cases, particularly the more recent ones, Dr Geier’s testimony was either excluded, or accorded little or no weight, after it was found he was testifying beyond his expertise. He had “largely irrelevant” qualifications, and acted as a “professional witness” in areas for which he had “no training, expertise, and experience”. His “speculation” was directly contrary to the conclusions reached in well-respected and numerous epidemiologic and medical studies ranging over two decades”. He was “neither board certified nor [had] training in paediatrics and paediatric neurology”.

He was further criticised [PDF] by judges for his work not being “based on scientific validity, valid methodology, peer review or testing, and more than minimal support within the scientific community”.

My favourite of all was the finding that his testimony was “intellectually dishonest” and his affidavit was “nothing more than an egregious example of blatant, result-oriented testimony”.

A recent academic paper of the Geiers has been retracted by the journal without explanation – so far – and some of their published “scientific” work is so laughable you can explain the flaws in a jokey national newspaper column.

In 2003, they published a paper in the journal of a Miami hospital using data from a voluntary reporting system for adverse events. They compared the number of reports of autism after use of the vaccine MMR and the vaccine DTP, and found the MMR jab was more likely to be associated with autism.

But the DTP vaccine was a very odd choice for comparison as it is given to babies at two, four, and six months of age, whereas MMR is given to toddlers at 18 months on. You aren’t very likely to find autism in a four-month-old baby, since it is a developmental disorder affecting things like language – and not a lot of four-month-old babies can speak.

That didn’t stop the Daily Mail from giving the study a glowing write up, and the headline “MMR raises risk of brain disorders say researchers”.

As I say, I’m not hostile to people like Geier having a voice. And the idea that there might be a biological cause, or treatment, for autism is a seductive and interesting one. All I ask is that when you take someone as far out as Geier, and bung him in an academic journal reviewing a slightly maverick book, you owe your readers a tiny bit of a warning.

· Please send your bad science to science@guardian.co.uk


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58 Responses



  1. mcewen said,

    February 24, 2007 at 4:00 am

    Many people in the rather informal autism community, follow Mr. Geier’s career with interest. Thanks you for drawing attention to this.
    Best wishes

  2. jackpt said,

    February 24, 2007 at 6:23 am

    I’m not hostile to people like Grier having a voice, as long as we’re still allowed to tell them to fcuk-off.

  3. mikestanton said,

    February 24, 2007 at 10:47 am

    The Lancet has received a lot of flak over this review. Expect some serious back-pedalling in the next issue and a more accurate review. Geier and son are complete charlatans. Kathleen Seidel has chronicled their misdemeanours on her Neurodiversity blog. Coincidentally, the latest Geier paper was withdrawn from Autoimmunity Reviews after she wrote to the editor-in-chief about,
    “Dr. and Mr. Geier’s inadequate disclosure of conflicts of interest, inappropriate brand promotion, inadequate ethical review, excessive self-reference and reliance on suspect sources, misrepresentation of other researchers’ work, misrepresentation of research-related risks, and inadequate case documentation.”

  4. Ken Zetie said,

    February 24, 2007 at 11:40 am

    Re Autism, there is a brilliant page at isnt.autistics.org/ “Institute for the study of the neurologically typical” which includes a wonderful DSM-IV style description of normal social development disorder.

    To quote from the front page “Neurotypical syndrome is a neurobiological disorder characterized by preoccupation with social concerns, delusions of superiority, and obsession with conformity.

    Neurotypical individuals often assume that their experience of the world is either the only one, or the only correct one. NTs find it difficult to be alone. NTs are often intolerant of seemingly minor differences in others. When in groups NTs are socially and behaviorally rigid, and frequently insist upon the performance of dysfunctional, destructive, and even impossible rituals as a way of maintaining group identity. NTs find it difficult to communicate directly, and have a much higher incidence of lying as compared to persons on the autistic spectrum.

    NT is believed to be genetic in origin. Autopsies have shown the brain of the neurotypical is typically smaller than that of an autistic individual and may have overdeveloped areas related to social behavior.”

  5. Tolstoy the Cat said,

    February 24, 2007 at 1:22 pm

    Isn’t it just what the Lancet does? It publishes controversial nonsense to get itself a mention in the mainstream press.

    It published the original MMR paper, a brief viewing of which reveals that there was no evidence to suggest a link between the MMR jab and autism.

    It published the hugely controversial Iraq survey.

    It also published an editorial attacking AstraZeneca’s for putting Crestor on the market, as though the company hadn’t had to go through all the usual regulated processes – again, the story was followed up in the daily newspapers, including [url=http://business.guardian.co.uk/story/0,,1070789,00.html]the Guardian[/url] and [url=http://business.timesonline.co.uk/tol/business/article1101438.ece]the Times[/url] (which criticized the Lancet in turn).

    I’m sure there are others. It’s just a cheap and shitty way of getting publicity for a rag that the mainstream media mistake for a serious academic journal.

  6. Tolstoy the Cat said,

    February 24, 2007 at 1:26 pm

    Bollox. I thought this thing understood bb. The links are below.

    The text was

    It also published an editorial attacking AstraZeneca’s for putting Crestor on the market, as though the company hadn’t had to go through all the usual regulated processes – again, the story was followed up in the daily newspapers, including the Guardian and the Times (which criticized the Lancet in turn).

    business.guardian.co.uk/story/0,,1070789,00.html
    business.timesonline.co.uk/tol/business/article1101438.ece

    Anyway, I congratulated Ben in a different thread on his RSS award. It got buried, so here goes again. Congrats.
    www.rss.org.uk/main.asp?page=2721

  7. mikestanton said,

    February 24, 2007 at 1:58 pm

    Anyway, I congratulated Ben in a different thread on his RSS award. It got buried, so here goes again. Congrats.

    When I read that I thought Ben had won a blogging award for his news feed! Is that more or less geeky than knowing that RSS can also mean Royal Statistical Society?

    Is there a blogging award we can nominate Ben for?

  8. Andrew Clegg said,

    February 24, 2007 at 2:16 pm

    Plus it’s run by Elsevier, the arms dealer’s friend

    Andrew.

  9. Andrew Clegg said,

    February 24, 2007 at 2:17 pm

    Err, ‘it’ == the Lancet, obviously, not the Royal Statistical Society…

  10. pv said,

    February 24, 2007 at 5:49 pm

    More comment on the Geiers can be found on Orac’s blog. Here’s some comment pertinent to this blog entry.

    scienceblogs.com/insolence/2006/07/the_geiers_humiliated_1.php

  11. John R said,

    February 25, 2007 at 1:38 pm

    What I fail to understand about the mercury=autism collective is that they continue to say the same stuff, make the same assertions et al. as they have been for years despite the fact that no childhood schedule vaccines, and to my knowledge, no vaccines at all, used in the UK have contained mercury since 2004. MMR, IIRC, has never contained it.

  12. motmot said,

    February 25, 2007 at 2:38 pm

    Tolstoy: finding that climate change is mostly human-generated is controversial too: the Lancet paper on Iraq used the same methodologies used to count casualties in other war zones. Read up on it at en.wikipedia.org/wiki/Lancet_survey_of_mortality_after_the_2003_invasion_of_Iraq:a_cross-sectional_cluster_sample_survey; its conclusions were startling but evidence-based, and you shouldn’t be surprised at the outrage of those who should have been shamed by those conclusions.

    On the other hand, looking at the Wikipedia page for rosuvastatin (“Crestor”) seems to show that the Lancet did over-react, and Crestor is no worse than other statins on the market. I’m afraid neither of your two articles criticized the Lancet: both simply reported on criticism by the manufacturer, without taking a position themselves.

  13. Tolstoy the Cat said,

    February 25, 2007 at 5:31 pm

    “This criticism — timed to coincide with Astra Zeneca’s results — comes two weeks after The Lancet produced a Pfizer-sponsored edition promoting Lipitor, which had sales of $8 billion last year. The journal was published with a back and front cover promoting Lipitor.”

    Lipitor is a similar drug to Crestor. The quoted text is from the Times, not from the manufacturer. To me, it seems like criticism (or implied criticism, at least).

    I’m not surprised at the outrage expressed by those who are shamed by the situation in Iraq. But the estimates were far in excess of other estimates (and according to the Wikipedia article at least one piece of the published article was “erroneous and misleading”). Though I concede that referring to it as nonsense was too strong I can’t help but wonder if the Lancet would have published it if it was not controversial,

  14. Ben Goldacre said,

    February 25, 2007 at 8:31 pm

    Sun, Feb 25, 2007 at 8:16 PM
    To: bad.science@guardian.co.uk
    You should get your facts right before you go to press. the child who died , who was a doctor’s son was given the WRONG drug. This is the kind of accident that happens all the time, especially in the NHS. It’s people like you who know very little about the whole business who love to knock anything that seems on the fringe. 63% of French and Scottish children were found to have high levels of heavy metals, not just mercury in a recent published study.

    What a lot of flack the discoverers of helicobacter pylori got, but they were right – ulcers are caused by bacteria.
    you and your ilk are condemning people with autism to a life of misery. other countries are at least trying to find out i.e. USA and Canada. Here those within the NHS who try to help are frightened they may lose their jobs. Why don’t you right about that and do something useful for a change?

    Christine

    Mum of a 44 year old with heavy metal toxicity and the immune and other abnormalities that come with it.)

  15. apothecary said,

    February 25, 2007 at 10:05 pm

    Re the Lancet – it’s still one of the world’s ivy league medical journals. All journals print dodgy studies at times. I thought the editorial on rosuva was pretty good, actually. I’m sorry to dissapoint Tolstoy the cat, but the “well regulated processes” do occaisionally let unsafe products onto the market – I think the winner for the shortest time on the UK market was troglitazone (it was a matter of a month or two).

    There are no long-term safety data on rosuva (cf other statins such atorva or simva), it is not licensed for primary or secondary prevention of CVD because, most importantly, there are no published RCTs which have evaluated its effects in reducing the risks of CVD. Lancet was just pointing that out. Plus there are CHM warnings about use of high doses and use in Asians, and its being promoted to achieve cholesterol targets of 4&2 which are not NHS policy, have not been shown to improve mortality or make much difference to CV outcomes, and which would often necessitate use of high doses (which ceratinly carry risks). Oh, and it costs the NHS about four or five times as much as simva. Lancet was just pointing out AZ’s marketing strategy and taking issue with some aspects of it.

    I realise that all that is off-topic, but I feel better for getting that rant of my chest. Thank you, I feel better now.

  16. jackpt said,

    February 26, 2007 at 1:34 am

    Heavy metal is toxic. Particularly the big hair variety. I hope you tried to explain why that email is wrong, because I’m not sure whether it’s a well meaning, but wrong, or just insulting to all of those autistic people that have fulfilling reasonably happy lives. I was under the impression that a wrong drug wasn’t given (in the sense of achieving a pie in the sky outcome) but that it was administered in a risky way by an ENT doctor. An example of bad science taken to its logical conclusions.

  17. sockatume said,

    February 26, 2007 at 2:19 am

    I love that doctor’s decision. I took great pleasure in its addition to the Wikipedia article on the kook, especially the Referenced Quotes of Justice.

  18. sockatume said,

    February 26, 2007 at 2:21 am

    Doctor? I mean Judge.

  19. superburger said,

    February 26, 2007 at 8:38 am

    “Mum of a 44 year old with heavy metal toxicity and the immune and other abnormalities that come with it.) ”

    The ‘speaking as a mother’ argument is almost as bad an internet faux pas as the invoking Godwin’s Law.

  20. bumble bee said,

    February 26, 2007 at 9:16 am

    19.

    “The ’speaking as a mother’ argument is almost as bad an internet faux pas as the invoking Godwin’s Law. ” Superburger ????

    And this adds what to the debate?

    Perhaps she has a real life experience to bravely share rather than arguing as a hobby…………..

  21. superburger said,

    February 26, 2007 at 9:41 am

    In fact, it should be called Superburger’s Law:

    “As the length of an internet discussion on MMR and autism approaches infinity, the probability of someone mentioning their personal experience, “as a mother” of MMR and autism rapidly approaches unity.”

    “Additionally, whilst the same is true for fathers, the rate of approach to unity is considerably greater”

  22. Symball said,

    February 26, 2007 at 10:45 am

    @Bumble Bee
    Hi There
    The point superburger is making is that a mother is rather unlikely to be able to make a clear judgement on what is happening as they are (i hope) rather involved emotionally with the subject.

    Unless this theoretical mother is able to critically look at all of the factors that might be affecting this case as well as all of the other similar cases then their judgement can be skewed. This is why trials are designed to remove the possibility of bias and why these trials are reviewed by independent scientists to ensure the researcher conclusions are similarly free from bias and that they can be justified from the evidence found.

    You might find this a helpful summary of how the scientific method is supposed to work

    www.quackwatch.org/01QuackeryRelatedTopics/science.html

    I’m sure many mothers do have a wealth of experience relating to conditions such as autism, but this experience will only relate to a single case. it is impossible to find out the root causes behind these complicated conditions without looking at many cases together and finding a common and explainable root. This can take many years of study between hundreds of researchers to even get close to whittling away at the possible causes to get at the real trigger.

    Unfortunately there are many people who do get upset on sceptical sites like this on when anecdotes are presented as evidence. This is because you cannot control anecdotes, as you cannot remove the bias inherent in them. The scientific method may seem cold and dispassionate but this is why it is so good at what it does. By reducing everything to just numbers it can use statistics to analyse these numbers without including human fallibilities. This is done because (beleive it or not) scientists are human and fallible, and often are mothers and fathers too. Science understands that and tries to eliminate this to improve our understanding of the facts rather than our opinions.

  23. Dudley said,

    February 26, 2007 at 12:55 pm

    Good science is the only thing that will cure disease, find an environmental cause for autism or indeed disprove charlatans who feed off the misery of parents of autistic children.

    However, listening to parents and acting like a human being when confronted by people who are suffering from the sharp end of the condition is a prerequisite in all cases. Mocking someone for having an autistic child and mentioning that fact seems to be the action of someone with all the moral sense of pond slime: someone pretty much like the Andrew Wakefields and the Geiers, in fact.

  24. superburger said,

    February 26, 2007 at 12:57 pm

    being a mother does not qualify someone to investigate the relationship between mercury in vaccines and autism. Never has, never will.

    The fact that “as a mother” one is directly involved with the child, tends to cloud the judgment somewhat.

    The epidemiology of MMR and autism has been gone through and there is simply no proven link between MMR and autism.

    “Perhaps she has a real life experience to bravely share rather than arguing as a hobby………….. ”

    The real life experience is “I had a baby, the child is autistic, it may or may not have coincided with MMR injection and or increased Hg levels” That is the sum total of the experience to be shared.

    I happen to like arguing very much, thank you. And have done so since my last tetanus shot. The two must be realted…..

  25. bumble bee said,

    February 26, 2007 at 1:27 pm

    Thank you, Symball, I appreciate and understand your point. (Wikipedia also has useful
    information on the scientific method, perhaps slightly less “partisan”?) Quack seems a particularly emotive word to be employed in the service of science?

    And surely skeptic implies a degree of bias if it is unconvinceable and could be argued to shade into witch hunt?

    Of course I completely agree with Ben’s point that the magazine should have pointed out the failings (!) of the practitioners in question,

    but the point I was making was that the mother’s point (that the one death mentioned could not be regarded as typical as it did not follow the protocol under debate.) was so quickly dismissed without imhop sufficient scientific debate, switching instead to an attack on her internet skills, and perhaps, thus, non membership of this particular club?

    , I think that some times in the white hot excitement of debate, it is useful to remember the bottom line, the person who is now suffering, and can’t always wait for trials to complete?

    It has to come down to risk benefit analysis, doesn’t it, and you surely can’t establish that without examining the facts in an unbiased way.

    Personally (oo er missus) I think it’s doubtful that chemical castration would be justified, but know nothing about chelation therapy, so wouldn’t venture an opinion one way or another.

    I listened to the radio 4 obituary of Dr ? whose work still has not proved the efficacy of “Lorenzo’s Oil” . It was fascinating. You can probably listen to it again if interested.

  26. Dudley said,

    February 26, 2007 at 1:29 pm

    Superburger, your spelling and haphazard punctuation indicate that you don’t look over your comments before posting them. Maybe you should try doing so.

    You might also look for moments where you’re being a self-satisfied offensive boor, thus actually detracting from the argument for in rational enquiry that Symball believes to ascribe to.

  27. Dudley said,

    February 26, 2007 at 1:30 pm

    Sorry, I have no idea what happened to the last sentence there. It should read “You might also look for moments where you’re being a self-satisfied offensive boor, thus actually detracting from the argument for rational enquiry that Symball believes you ascribe to.”

  28. Dudley said,

    February 26, 2007 at 1:32 pm

    Gah! “…SUBSCRIBE to”!!!

    That was lesson #1 in how to undermine one’s own point.

  29. Delster said,

    February 26, 2007 at 1:36 pm

    As far as i can make out, the only thing that being a parent of somebody with autism will teach you is how to care for the affected child.

    Unless you already have a back ground in a number of sciences, or go out afterwards and pick up a couple of degrees to gain the back ground, you are not qualified to speculate on the causes.

    I have a broad education of science (but no degree in one) having done physics, chemistry and biology but i don;t consider myself qualified to say this or that caused something.

    What i can do is take a look at a study and estalish (within broad limits) if it has been well designed or not. Possibly i could do a statistical analysis of the data, but all that would allow me to say is that the study did or did not show the connection that the study was aimed at showing.

    I would still not have the knowledge of the why… just of the stats.

  30. Martin said,

    February 26, 2007 at 1:48 pm

    Actually, reading Christine’s email again, she doesn’t say that she’s a mother of an autistic child, she’s the mother of a 44 year old with heavy metal toxicity.

    Christine may have a 44-year old with autism and heavy metal toxicity (in which case she’s had a bloody hard life) but she hasn’t stated that; we appear to have implied it.

    Unfortunately, her email jumps around a lot – there’s a lot of statements, but little linking between them. For instance, “63% of French and Scottish children were found to have high levels of heavy metals, not just mercury in a recent published study.” Then, two sentences later, “you and your ilk are condemning people with autism to a life of misery.” There is no link between the two in her email; the sentence between them is about ulcers.

    The only instance of a recurring theme is heavy metals, and the statement that “63% of French and Scottish children were found to have high levels of heavy metals” is odd. It may well be true, but are all 63% ill? Is it 63% of children with a specific illness? What is a ‘high level’? Why French and Scottish? (The French and Scots have very different diets.) Is it 63% of Scottish children and 63% of French children? Who else was involved in the study (Germans, Irish, Swedes, Morrocans, Japanese, etc)?

    Unfortunately, we may never know exactly what Christine was on about, just that Ben’s column roused her ire sufficiently to cause a reaction.

  31. Andrew Clegg said,

    February 26, 2007 at 2:49 pm

    Martin — we inferred it, she may or may not have implied it.

    Andrew.

  32. superburger said,

    February 26, 2007 at 3:13 pm

    “Superburger, your spelling and haphazard punctuation indicate that you don’t look over your comments before posting them. Maybe you should try doing so.

    You might also look for moments where you’re being a self-satisfied offensive boor, thus actually detracting from the argument for in rational enquiry that Symball believes to ascribe to. ”

    Did you ever consider that I may be dyslexic?

    Point is, anecdotes are easy to come by, and even for ‘self satisfied offensive boor’ (I prefer the term “tosser” ) myself. And when it comes to autism there’s no end of nice middle class parents to tell their own tragic stories.

    None of which actually help in the investigation of the causes of autism save for providing an initial hypothesis.

  33. Symball said,

    February 26, 2007 at 3:31 pm

    Bumblebee- I am glad I could help. The site was chosen deliberately as it is a great starting point for anyone who wants to see a scientific take on most ‘new age’ and alternative treatments.

    The word quack is unfortunately very apt. The Geiers and their ilk do not use science, fact or any other rational thought in promoting their businesses, they simply try and trick vulnerable people into using their expensive (and often dangerous) treatments. They are also easily hired to act in frivolous lawsuits against drug companies, and not on a no win, no fee basis either.

    Finally superburger might be a tosser, but his problem is the way he gets his message across and not the message itself.

  34. BrickWall said,

    February 26, 2007 at 3:47 pm

    Bumble Bee, post 25

    The notion that someone suffering should try anything because they can’t wait for completion of trials opens lots of doors for a wide variety of quacks and charlatans to sell their wares.

    Whilst it is understandable that someone in the position of suffering might be open to TRY anything it is not justifiable for those offering help to OFFER “anything” without some sort of evidence. The best that one could hope for in this circumstance might be to be involved in a formal trial of whatever new therapy was being offered so that you may, if you are lucky benefit, and so that others will definitely learn for the future.

    But as has been recounted in Ben’s columns so many times many people offering these new studies/therapies aren’t doing the studies properly and so no discernible learning outcome is achieved – but someone somewhere starts to quote said ineffective study as fact.

    I too felt that some of the reaction here was a little strong in response to this letter until I re-read both the letter and the initial responses. Note the letter wasn’t actually part of the forum it was posted by Ben having been received directly, and also notice Ben’s perfectly sensitive point made at the beginning of the original article.

  35. Dudley said,

    February 26, 2007 at 4:25 pm

    > Did you ever consider that I may be dyslexic?

    farnkly, aftir my own postes went so rong i’m woeirrd i mihgt be dyslexic myslef,

    > None of which actually help in the investigation of the causes of autism save for
    > providing an initial hypothesis.

    Yes, but strangely enough I don’t think that the causes of autism will be uncovered either by Ben Goldacre or by people arguing in the comments section of his blog. It was the rudeness of your comment that seemed pretty disgusting.

    I’m not entirely sure about the ethics of Ben Goldacre reposting the email on a public forum, either. Did the email’s author give permission? I know that her email address and full name have been kept anonymous, but if she looks at this forum and sees remarks like superburger’s (which were pretty inevitable) I doubt she’ll be super-thrilled. Of course she emailed the Guardian first, but on a private email address rather than a public forum.

  36. superburger said,

    February 26, 2007 at 5:40 pm

    If you email a journalist and don’t mark it ‘in strictest confidence’ or whatever, then you haven’t got a proverbial pot to piss in if those comments end up in the public domain I’m afraid.

    My comments may be up there with Fungus the Bogeyman in the disgustingness stakes, but what is more disgusting, in my opinion, is that there is an industry built up out of giving distraught parents false hope that MMR / Hg / Whatever might be the cause of their child’s misfortune – long after the evidence has been shown to suggest otherwise

    And what is more disgusting is that uptake rates of MMR have dropped leaving many more children at risk of catching diseases which are known to cause blindness, deafness, infertility and can kill.

  37. pv said,

    February 26, 2007 at 6:30 pm

    www.badscience.net/?p=372#comment-11085
    4:25 pm

    “Yes, but strangely enough I don’t think that the causes of autism will be uncovered either by Ben Goldacre or by people arguing in the comments section of his blog. It was the rudeness of your comment that seemed pretty disgusting.”

    And, strangely enough, you won’t find Ben Goldacre pretending to have a “cure” for autism spectrum and extracting money from vulnerable individuals, nor making money by appearing as an “expert” witness in spurious legal cases against “Big Pharma”.

  38. Dudley said,

    February 26, 2007 at 6:54 pm

    Erm, way to take a comment out of context. Nice one!

  39. pv said,

    February 26, 2007 at 7:45 pm

    www.badscience.net/?p=372#comment-11088
    6:54 pm

    “Erm, way to take a comment out of context. Nice one!”

    Glad you liked it.
    I’m definitely with superburger (and Fungus the Bogeyman) on this. The real obscenity is the charlatan(s) who preys on the vulnerable and produces a situation where the uptake of vaccines like MMR have declined with the inevitable and wholly predictable, tragic consequences. In every sense except one the activities of the Geiers and everyone like them are criminal. The exception is the law doesn’t explicitly prohibit what they do, more’s the pity. The real harm isn’t in the activities of conventional medicine, Doctors or the pharmaceutical industry, rather in the activities of the Geiers, Wakefield and that whole army of professional quacks currently occupying the space reserved for “darlings of the media”. And one mustn’t forget or understate the complicity of the news media in this criminal activity. This is what’s disgusting.

  40. Ben Goldacre said,

    February 26, 2007 at 7:53 pm

    i think what this argument shows is that its very difficult to know what to do with letters like that, i (personally) don’t want to be mean to parents, or indeed anybody, and i certainly wouldnt encourage anyone else to be. these letters are, however, often very angry and accusatory.

    in some respects i see it in the same terms as the personal ad hominem attacks of people like max clifford (“ben’s just jealous of mckeith’s money”) and holford (ben is pro-drug and too cowardly to debate me (he asked, i said yes!)).

    the message is clear: do not challenge these ideas, or these powerful figures, if you do, we will attack you as a person, abuse you, and accuse you of doing great harm.

  41. evidencebasedeating said,

    February 26, 2007 at 10:57 pm

    The Emperors New Nutritionists?

    Bens post #40 serves to remind that the nutritionally/ medically inferior use the ‘red-top’ (or Tonite with T McD) approach of personalising critical statements about their practice, always justified by supportive anecdotes, obligatory tutillage under now-dead teacher (Linus will do) or famous pupil (Diana is always a hallowed name to drop) to attack the messenger.

    Yet post #14 – serves to illustrate the ease with which the medically desperate – and their family members – cling to the persuasive musings of the nut-nutritionists and mock-docs, even if their suggestions are biologically implausible. Sure, ‘alternative’ approaches occasionally throw up unusually beneficial results, but this is a rare occurrence. Almost as rare as the individual being informed that alt.musings are randomly generated, dependent on the dupability (Dudley, is this a ‘real’ word?), disposable income and willingness to continue with futile practices (‘but at LEAST they have HOPE!)

    And Dudley – you are taking yourself too seriously! Rest assured we Badsciencers are all used to, and enjoy, Superburgers clear take on issues. It’s what makes this forum the interesting read it is. No ‘bleeding-heart’ posts here – we don’t do palliation, just active discussion!

  42. Andrew Clegg said,

    February 27, 2007 at 11:47 am

    Ben, re what to do with the angry brigade letters — maybe every few months you should have a follow-up column where you mention and respond to some of the feedback you’ve had from readers of the paper on controversial subjects you’ve recently covered?

    “I’ve had several letters about , many of which contain misconceptions typified by this message from Mrs. Trellis of North Wales:” etc.

    Not exciting investigative journalism but maybe a good way to set the record straight.

    Andrew.

  43. Andrew Clegg said,

    February 27, 2007 at 11:48 am

    That meant to say “about [subject X]” but I used angle brackets so of course it got mistaken for HTML…

  44. Michael Harman said,

    February 27, 2007 at 4:51 pm

    Three points.

    1 There’s an analogy between medicine and law. In law, we generally want our judges to be disinterested in the cases before them. (Interested rather than uninterested, but disinterested – not having a (financial or emotional) interest in the cases before them.) Indeed, we require them not to have even the appearance of an interest. It is generally agreed that if judges have an interest in the cases before them, the judgements are less satisfactory. And there’s a lot to be said for having the same kind of distancing between medical researchers and the topics they are researching.

    2 With AIDS, I gather that there is widespread interest in the AIDS community in the details of new drugs and treatments being developed. The view that it is improper (unethical) to withhold treatment merely in order to satisfy experimental protocols, when it is becoming clear that a treatment is clearly looking good, is (I gather) fairly widespread. So new drugs become self-prescribed and widely used. The drawback to this is that it can then be difficult to run proper trials. And therefore the evidence in favour of new drugs is tainted. We don’t have the same level of confidence in anti-AIDS drugs as we do in drugs for less emotive conditions. Probably most of the new drugs do do more or less what we think and hope they do. But a few of them won’t do what we think they probably do, or won’t do it as well as we think they do. So if we’re being honest, we should dish out the drugs but say “These drugs will probably help you. But they may not, and that chance is significantly higher because we’ve been unable to do the proper tests, because a considerable proportion of your fellow AIDS sufferers have made it impossible for the proper tests to be done.”

    3 A historical example – blindness among premature babies. It was found that sufficiently premature babies benefited greatly from an atmosphere enriched in oxygen. Within a year or two of that treatment being started, an increase in blindness in young children was discovered. Someone thought that the blindness might be caused by the elevated oxygen. So an investigation was started into how much oxygen really needed to be supplied. Apparently the nurses involved were so confident that high oxygen was essential that some were creeping into the wards at night to turn up the oxygen levels. (“I don’t want babies in my care being killed by too little oxygen because of some wild and fanciful theory.”) But it was found that too much oxygen *did* tend to produce blindness, and it is now accepted that careful control of the oxygen levels is necessary.

  45. raygirvan said,

    February 28, 2007 at 1:07 am

    a 44 year old with heavy metal toxicity

    How, I wonder, was this diagnosed?

  46. manigen said,

    February 28, 2007 at 10:42 am

    I don’t know much about heavy metal toxicity. Is it easy to diagnose? Are there tests?

  47. raygirvan said,

    February 28, 2007 at 11:28 am

    Well, that’s the trouble. There’s the real thing, and there’s the situation when someone gets a mess of ill-defined symptoms that conventional medics fail to diagnose, gets terribly resentful that the establishment can’t do anything, so they go to an alt therapist who diagnoses heavy metal toxicity on the basis of iffy tests, in particular hair analysis and live blood cell analysis.

  48. raygirvan said,

    February 28, 2007 at 6:01 pm

    she holds a lock in her hand, concentrates and the hair ‘tells’ her what is wrong! (she does emotional freedom technique as well)

    Just so. Vega testing and applied kinesiology are other favourites.

  49. Symball said,

    March 1, 2007 at 11:26 am

    One of my recent favourites was her getting a horse chiropractor out (the horse has never had problems) who told her the horse had emotional tension in his jaw.

    nothing to do with being poked and prodded by a stranger then!

  50. CaptainKirkham said,

    March 1, 2007 at 12:08 pm

    If I may say so, as a disinterested observer, perhaps the best way to deal with a distraught parent whose child has autism is NOT to insult her grammar, intellectual capacity and lack of scientific education. Perhaps instead education, trust and communication might be appropriate.

  51. manigen said,

    March 1, 2007 at 1:04 pm

    @52

    Absolutely, they are the best responses. However you do need to make some allowances; I have trouble not getting angry when I read letters like the one above, and I’m not alone in that.

    I feel sympathy for her, but she is dangerous, and her whole approach to an immensely complex and difficult subject threatens to destabilise the good work done by others. It’s not her alone of course; by herself she’d be harmless. It’s her and all the others. All the others who make sweeping assertions about medical conditions without any evidence, and who shout down anyone who dares to question them.

    It’s really difficult to be sympathetic and angry at the same time. Most of the people on this thread seem to be doing their best.

  52. generaltapioca said,

    March 1, 2007 at 7:28 pm

    CaptainKirkham

    I think it’s unlikely that Christine is the mother of a child with autism. Given the context, I’m sure she would have said it explicitly.

    Also, the comments aren’t made at her, but about her.

  53. helensparkles said,

    March 3, 2007 at 1:04 am

    The experience of having an autistic child is one of loss, see Kubler Ross for details, but my experience of their parents is that empirical evidence is extrapolated from personal circumstances which is entirely misrepresentative. There is actually little one can do once the narrative of the MMR (or whatever) is to blame, except wait, because it to will pass.

    I don’t think anyone had really got to grips with causes, only symptoms, which are a useful framework in terms of statementing & other practical issues. I do wonder though, why the fathers of autistic children can often be found on the continuum, that is the autistic spectrum. Genes would be a biological cause right? & I’m not a doctor in case that last bit worried anyone!

  54. three tigers said,

    March 5, 2007 at 2:34 pm

    If her son is 44 he was born in ’63/’64. MMR surely wasn’t available as a vaccine then combined or otherwise and is therefore not a source of “heavy metal poisoning”. As vintage ’61, I certainly had all 3 diseases as a child, and distincly remember measles as the particularly nasty one. Not something you would wish on your kids, so “as a mother” I had both my kids vaccinated against everything I could ‘cos I didn’t want them to go through the same misery and risk of blindness/deafness, sterility (boy) or dying as I had.
    Home video evidence of autistic kids indicates they often show subtle symptoms as young as 3-6 months and these can be distingushed from mental retardation and unaffected kids by both child psycologists and lay people. This runs counter to the “my child was developing normally until (s)he had the MMR jab” argument. I’ll dig out the refs if anyone is interested. Gives mostly a genetic cause lots of support.

  55. hrb said,

    March 6, 2007 at 10:34 am

    i do find it disgraceful how these people feed off the misery of others.

  56. CaptainKirkham said,

    March 6, 2007 at 3:02 pm

    Such amazing excuses for such nasty words.

  57. Antonia said,

    March 9, 2007 at 12:36 pm

    With (any) due respect, Christine’s assertion is incorrect. She opined that Ben should get his “facts right” because “the child who died , who was a doctor’s son was given the WRONG drug.”

    Assuming the Pennsylvania Board of Registration in Medicine doesn’t pull things out of thin air, the Order to Show Cause issued in the Kerry case shows the deceased child was not given the “wrong” drug, but rather was deliberately dosed with Endrate, the disodium salt of EDTA, by IV push: www.circare.org/pd/kerry_ordertoshowcause_20060908.pdf

    And never mind absence of indication for use, or that infusion over less than 3 hours is specifically contraindicated due to the risk of hypocalcemia, the condition the state coroner determined to have been the cause of the child’s death: www.circare.org/foia2/endrate_ppi.pdf

  58. Roger Cornwell said,

    May 7, 2011 at 5:43 pm

    Mark Geier has had his medical license suspended by the State of Maryland. This was apparently an emergency action, odd given the number of years this has been going on, but welcome never-the-less.

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