Monday 24 May 2010

Why Wakefield became a cause célebre

So, Andrew Wakefield has been struck off by the GMC. Brian Deer has covered the story extensively and uncovered details about the trials that proved to be Wakefield's downfall - details about payments from the legal aid fund, a patent for a vaccine, and the questionable way in which the trials were carried out. His determined investigations show how good journalism can function as a counterbalance to poor judgment by a whole host of agencies from ethics committees to the Lancet which unintentionally promoted the spread of the MMR-autism belief.
But a great deal of blame has also been directed at the newspaper stories that covered the initial findings (based it has to be said on a press conference at the Royal Free Hospital chaired by its professor of medicine, and then on a paper in the Lancet, - both of which most journalists would regard as reasonable sources).
While it would be impossible to defend all the coverage, it is worth noting the historical context.
The UK had recently emerged from the BSE crisis. The medical establishment had been found to be over-sanguine about the threat, ministers had dissembled, and the chief medical officer chose not to correct unfortunate ambiguously reassuring statements. It took much longer than it should have for the real risks to be identified and for preventive action to be taken.
In this context, the pursuit of the MMR-autism hypothesis, in the face of establishment opposition, looks less contrary, and more like the pursuit of the public interest against an orthodoxy that had recently been found to be less than open. What is not defensible is the subsequent highly selective reporting of studies that gave some weight to the hypothesis while ignoring the numerous, better, bigger, more statistically significant studies that did not.
The 'swine flu' pandemic last year shows that an open attitude and a recognition of uncertainty is the right response to take. Most people are sympathetic to the 'damned if you do, damned if you don't' tightrope of a response to a potential health threat. What they find less forgivable is the realisation that information, albeit imperfect information, is being concealed, or finessed.
BSE was a bad enough scandal by itself. The bad taste it left in the mouths of journalists and others was a contributory factor in the wildfire spread of the belief, however unsupported by evidence, that MMR might contribute to autism.

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