Wednesday 3 February 2010

HuffPo: blame Lancet, not Wakefield, for paper deceptions

So, Andrew Wakefield has finally had his comeuppance, with the GMC taking him to task for hiding conflicts of interest, lying about the study itself, performing research on children without approval or competence, and other staggering violations of basic ethics. The Lancet has, correspondingly, retracted the infamous paper, as "the claims in the original paper that children were 'consecutively referred' and that investigations were 'approved' by the local ethics committee have been proven to be false". Jay Gordon, MD[1] ("Nationally renowned pediatrician on the faculty of UCLA School of Medicine. Soccer Player.") at the Huffington Post chimes in:

This prestigious journal is now forced to cover their own embarrassment at having done virtually no rigorous due diligence of Dr. Wakefield's methodology, data gathering and conclusions before they published the paper in 1998.

Whether or not you believe that Andrew Wakefield is a savior, a misguided researcher with "his heart in the right place" or an attention-mongering, unethical "biostitute" the real blame must be shared by the world's most-respected medical journal, The Lancet, for allowing the flaws and potential conflicts of interest to go unnoticed. The self-righteous attitude they now assume serves no one, least of all families affected by autism.

I have to wonder how Jay Gordon, MD expected the Lancet to find "flaws and [...] conflicts of interest" which Wakefield actively concealed. Likewise it's hard to use "rigorous due dilligence" in assessing how someone performed a study when their description is not the experiment which was actually performed.

It's true that the Lancet did not dig into Wakefield's supposed ethical approval, which might have revealed his deceptions. However there is nothing unusual about this. Medical research is published under the assumption that the researchers will act with their patients' and test subjects' best interests in mind, and furthermore that any breaches will be the result of error and not malice. To operate under the opposite assumption, that all research is unethical and flawed until conclusively proven otherwise, would be practically fascistic. In exploiting the trust placed in him by the medical community for his own ends, Wakefield has taken us on a step down that horrid path.

Gordon continues:

A large leap was made in assigning any sort of "proof" from the small Lancet study. I'm not certain that Dr. Wakefield, himself, feels that anything was proven.

This statement boggles the mind. Wakefield is not one of the many innocent scientists probing the edge of knowledge, whose found their work blown out of proportion by a hungry press. He is unrelenting in his defense of his research, long after it has been discredited by further study, and actively promoted the vaccination-autism link in every available venue. Even if his research were performed ethically and honestly - and it's now clear that it was not - he has continued to promote his hypothesis to the media in spite of a staggering volume of evidence to the contrary. It's pure, Frankenstein-grade hubris.

As I wrote this post, Jim Carrey and Jenny McCarthy published this conspiracy theory in defense of Wakefield's research, likening it to Fleischmann and Pons's cold fusion publication. (One wonders whether Carrey and McCarthy will be funding cold fusion research, considering the obvious value the place in it.) It's clear that this single study and its lead author, found technically and ethically lacking, are too important to the vaccine-autism movement for them to be discredited. (More on that here.)

[1]Actually, Carrey and McCarthy's son's physician. It'll be interesting to see whether his stance on the proof level of Wakefield's study changes now that his clients have issued a statement.

Update: A follow-up post is available here.

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