If you go to the web-site of the British Medical Association you will find the BMA’s tag line prominently displayed: “Standing up for doctors.” It’s a position most notable for what they do not stand up for: not patients, not science, not health, just the doctors who join the association. The home page elaborates what this means more directly, “We are … an independent trade union dedicated to protecting individual members and the collective interests of doctors.”
In other words, The BMA is an unabashed economic entity: a trade union. And its primary purpose is to defend the money and power of its members. It’s that simple. Who does the BMA stand against? The adversary of the day might vary a bit. But on a day to day basis, the biggest conflicts British doctors face are with patients. When patients comply with what doctors tell them to do and generate income for them, they are useful to the BMA. When they want to take control of their own families’ health, or worse, suggest that member doctors may have caused harm, well that’s a different matter. When patients' interests conflict with “standing up for doctors,” It’s pretty clear what the BMA’s job is.
The BMA attacks critical patients as if they were their enemy.
One of its instruments for defending doctors’ interests is “science,” or more accurately, propaganda masquerading as science. Notably, the BMA publishes the British Medical Journal, the journal that earlier this year disseminated Brian Deer’s accusations of fraud against Andrew Wakefield. Despite Wakefield’s lengthy and Byzantine trial on allegations surrounding his medical ethics and research design in front of the General Medical Council (GMC), allegations of scientific fraud were not part of the GMC proceedings. Until January 2011, freelance reporter Brian Deer, and Deer alone, had accused Wakefield of lying about data and falsifying evidence. That is, until the BMJ entered the mix, effectively certifying the validity of Deer’s 2009 accusations in The Sunday Times with a dramatic flourish that proved even more devastating to Wakefield’s reputation than the GMC trial. How devastating were these accusations? In a press release, BMJ editor Fiona Godlee claimed to be “struck by a comparison between researcher Andrew Wakefield’s fraud and Piltdown man, that great paleontological hoax that led people to believe for 40 years that the missing link between man and ape had been found.” Sadly, these extravagant allegations were picked up by the global media, spread like wildfire, and, despite their manifest implausibility, the charges stuck.
For any doctor or scientist who might ever have been inclined to support a critical patient the message was clear: when the BMA and its flagship journal the BMJ go after you, they will be ruthless.
Lost in the frenzy over Wakefield’s alleged scientific fraud, however, is the fact that the origin of the evidence in the 1998 Lancet article never came from Wakefield. Rather, the Royal Free Hospital's investigation (which included many others beyond Wakefield) was launched based on the collection and reporting of observations originally made by parents. These parental observations included varying forms of regressive autism or encephalitis, inflammatory bowel disease and a temporal association between exposure to the measles-mumps-rubella vaccine (MMR) and the onset of symptoms. As time has passed (and in every one of the cases reported in The Lancet paper), the parents’ continuing reports support Wakefield’s original account. In addition, many thousands of parents have subsequently reported an identical sequence of events. At kitchen tables all over the world, the MMR has become known as “the autism shot.” The heart of the matter, therefore, is the tension between the British medical establishment on one hand and the Lancet parents on the other.
So in accusing Wakefield, the BMJ is really doing something else; they are accusing the Lancet parents of committing an elaborate fraud.
Why would the BMJ condone such an aggressive attack? Sadly again, in publishing Deer’s accusations, the house organ of the BMA was advancing the interest neither of science nor the truth. Instead, they were “standing up for doctors”: for the income doctors gain from frequent visits to the doctor to receive vaccination; for doctors’ freedom to avoid costly minutes with skeptical parents during their well-child visits; and for the power of doctors to force parents to comply with the recommended vaccination schedule.
As for Deer’s reporting, while Wakefield provided the proximate target, not far under the surface lurked an aggressive attack on parents who have the temerity to question the mandates of the BMA and public health officials. It’s quite a ruthless attack: Parents who question vaccine safety are a danger to the public health; Parents who allege vaccine injury are liars; Parents who take offense to intimidation and coercion are anti-vaccine campaigners; Parents who seek resources to support a vaccine-injured child are cheating the system to get rich.
This kind of attack is not delicate work. But in making the decision to tie its reputation to Deer’s, the BMA made a risky choice.
One need not look very far to find evidence of Deer’s boorishness. It’s most plainly exemplified by his unvarnished contempt for noncompliant parents. One widely circulated example was provoked following on-line challenges to Deer’s reporting by three autism parents: Lancet 12 mother Isabella Thomas, Age of Autism Contributing Editor John Stone and a third unnamed blogger. Jumping into the fray in a Pharma-friendly blog, Deer had this to say about the critical parents (see HERE)
And they wonder why their children have problems with their brains.
Apparently not content with just this brief insult, Deer elaborated further (see HERE )
I genuinely think that the three individuals I was criticising – and I know who all three of them are – do need to question whether their personal behavioural issues are indicative of a better explanation for their children’s issues. Certainly a lot better explanation than MMR.
The festering nastiness, the creepy repetitiveness, the weasly, deceitful, obsessiveness, all signal pathology to me
Deer has reserved special antipathy for Isabella Thomas, the mother of two of the twelve Lancet cases. Mrs. Thomas has most publicly opposed Deer, so his public comments about her plainly demonstrate his bias: Deer’s presumption that in a dispute between BMA members and unsatisfied parents, the parents are always guilty and the doctors are always right. (see HERE)
There was the case of one mother, for instance, whose story is now in the public domain and entirely reportable, who had two children. Her GP gave evidence that he believed she obsessively sought unnecessary treatment for the children, to their detriment. He said he felt she was harming their interests. She fell out with her local hospital, and with a previous GP, who were not convinced by her...
There is a reckoning coming, I think. Skulking behind medical confidentiality, legal privilege and hapless kids won’t do it forever. There is a public interest here, and that, I think, will eventually prevail.
Deer’s thinly veiled threats aren’t limited to Isabella Thomas. He has also criticized Lancet 12 parent Rosemary Kessick, another parent who has criticized Deer’s methods and refused to back down. Deer’s interactions with Kessick included an outright lie about his identity, an interaction my Age of Autism colleague Dan Olmsted described last week (see An Elaborate Fraud, Part 2: In Which a Murdoch Newspaper’s Deceptive Tactics Infect the British Medical Journal ). The ultimate intent of Deer’s narrative was to accuse Kessick of lying (see HERE).
I interviewed Mrs Rosemary Kessick… and, in four hours of recorded material, found her account of events surrounding her son's vaccination and history to be unsatisfactory. It is my belief that a great deal of material placed before the public is also of a misleading nature.
In these and other intemperate statements, Brian Deer remains unrepentant, and as long as the medical industry protects him against the consequences of his actions, he feels secure, even triumphant, in his position. Our series “An Elaborate Fraud” began last week and will continue to demonstrate that it is Deer’s account of events that is the only unsatisfactory and misleading material being placed before the public.
But as far as the BMA goes, it should be concerned about something more threatening to its long term mission of representing doctors: guilt by association with Brian Deer and his unethical methods. As we’re beginning to learn, Deer’s work was deeply enmeshed with the “anything goes,” “the ends justifies the means” culture of News International, Rupert Murdoch’s criminally corrupt British newspaper empire. As the News International saga unfolds, many more people of conscience will begin to ask the question, what did the BMA condone in their assault on patients who didn’t pay proper fealty to the sovereignty of British doctors and who needed to stand down?
There are signs that the BMA is already concerned over its accountability for the Wakefield Inquisition. A few months ago, Age of Autism’s John Stone was successful in extracting an admission of conflict of interest from the BMA. This concession was made grudgingly in an essay titled, “In response to John Stone” by BMJ editor Fiona Godlee. Godlee wrote (BMJ Content)
“we should have declared the BMJ Group's income from Merck as a competing interest to the editorial (and the two editor's choice articles) that accompanied Brian Deer's [MMR] series... We should also, as you say, have declared the group's income from GSK as a competing interest in relation to these articles....We didn't declare these competing interests because it didn't occur to us to do so.”
The formal (but as John Stone points out, merely partial) concession followed (see Age of Autism: Farce at British Medical Journal as Double Standards Persist Over Undeclared Competing Interest)
“The BMJ should have declared competing interests in relation to this editorial by Fiona Godlee and colleagues...The BMJ Group receives advertising and sponsorship revenue from vaccine manufacturers, and specifically from Merck and GSK, which both manufacture MMR vaccines.”
In most businesses, service providers understand that going to war with their customers rarely ends well. So far, the medical industry and its partners in the public health bureaucracies have managed to sell the media the line that the controversies in autism pit “parents vs. science.” Sadly, true science is the casualty in this narrative, one in which the real battle is defined by economic and political difference between doctors and their powerful trade associations on one hand and critical, determined parents on the other. And the BMA is revealing itself as part of a long line of economically interested parties—from tobacco companies to the leaded gasoline industry—that put their own bottom line ahead of the health of children.
We’ll have more on Deer and his sponsors at the British Medical Association in the days and weeks ahead.
Mark Blaxill is Editor-at-Large of Age of Autism. He is the co-author, with Dan Olmsted, of The Age of Autism – Mercury, Medicine, and a Man-made Epidemic, to be published in paperback in September by Thomas Dunne Books.