Here’s a very brief piece I bashed out for the Guardian newsdesk today on the Wakefield finding, the further reading below will be more helpful if you’re interested in the story.
Ben Goldacre, The Guardian, Thursday 28 January 2009
In medicine, “untoward incident inquiries” tend to look for systems failures, rather than one individual to blame.
It’s certainly clear that Andrew Wakefield and his co-defendants failed to meet the high standards required of doctors in research. The GMC have found he was “misleading” “dishonest” and “irresponsible” in the way he described where the children in the 1998 paper came from, by implying that they were routine clinic referrals. As the GMC have also found, these children were subjected to a programme of unpleasant and invasive tests which were not performed in their own clinical interest, but rather for research purposes, and these tests were conducted without ethics committee approval.
These tests were hardly trivial: they included colonoscopy, where the child is sedated, and a long tube with a camera and a light passed through the anus and deep into the bowell; lumbar puncture, where a needle is placed into the spine to get cerebrospinal fluid; barium meals and more. It’s plainly undesirable for doctors to go around conducting tests like these on children for their own research interests without very careful external scrutiny.
But there is the wider context: Wakefield was at the centre of a media storm about the MMR vaccine, and is now being blamed by journalists as if he were the only one at fault. In reality, the media are equally guilty.
Even if it had been immaculately well conducted – and it certainly wasn’t – Wakefield’s “case series report” of 12 children’s clinical anecdotes would never have justified the conclusion that MMR causes autism, despite what journalists claimed: it simply didn’t have big enough numbers to do so. But the media repeatedly reported the concerns of this one man, generally without giving methodological details of the research, either because they found it too complicated, inexplicably, or because to do so would have undermined their story.
As the years passed by, media coverage deteriorated further. Claims by researchers who never published scientific papers to back up their claims were reported in the newspapers as important new scientific breakthroughs, while at the very same time, evidence showing no link between MMR and autism, fully published in peer reviewed academic journals, was simply ignored. This was cynical, and unforgivable. Then, after Tony Blair refused to say if his son had received the vaccine, the commentators rolled in. Experts from Carol Vorderman to Fiona Philips from GMTV have all shared their concerns about MMR with the nation. Less than a third of all broadsheet reports on MMR in 2002 mentioned that the overwhelming evidence showed no link between MMR and autism.
The MMR scare has now petered out. It would be nice if we could say this was because the media had learnt their lessons, and recognised the importance of scientific evidence, rather than one bloke’s hunch. Instead it has terminated because of the behaviour of one man, Andrew Wakefield, which undermined the emotional narrative of their story. The media have developed no insight into their own role, and for this reason, there will be another MMR.
I talk about this stuff at much greater length in the last chapter of the book:
And more importantly, because it’s free, here:
The Cardiff ESRC report is good (and I don’t want to incite copyright theft or anything, but for god’s sake, someone put it on Scribd, this is good publicly funded research, but Cardiff and ESRC change their web address for it every five minutes, I don’t think they really understand how the internet works):
Lastly, I recommend reading the GMC’s findings for yourself, if you’re interested in this stuff, as the details of what they got up to, the ethics committee dodginess, and the mis-statements around who the children were, is pretty bad. The document annoyingly hasn’t appeared on the GMC website – even though this is a massive news story today – but someone has resourcefully uploaded it for free public access here: