The conflicting views of Dr Ben Goldacre and the Wakefield affair: dumbing the public down.
By John Stone
Photo: Ben Goldacre receiving the 2003 GSK/ABSW award for his Guardian article on MMR,’Never mind the facts’, posing between Pallab Ghosh, science correspondent of the BBC, and Dr Alistair Benbow of GSK.
Not so familiar in the North American world Ben Goldacre, author of the Guardian’s Bad Science column, is perhaps the most prominent and prestigious scientific opinion leader in UK journalism, and at least since 2003 – when his career was effectively launched – he has carried a brief to defend the reputation of MMR vaccine. Essentially, this has consisted of a different strategy of that of Times Newspapers and Brian Deer, focussing on trying to damage Andrew Wakefield’s scientific reputation without the all-out assault on his integrity. Until the GMC brought in its verdict against Wakefield and his colleagues John Walker-Smith and Simon Murch this might have looked like a clever insurance policy, but now it has led to problems.
In his article ‘Don’t Dumb me down’ which won the 2005 Syngenta/Association of British Science Writers’ award Goldacre wrote something remarkably interesting (and accurate) (HERE ):
"...people periodically come up to me and say, isn't it funny how that Wakefield MMR paper turned out to be Bad Science after all? And I say: no. The paper always was and still remains a perfectly good small case series report, but it was systematically misrepresented as being more than that, by media that are incapable of interpreting and reporting scientific data."
Remarkably, too, there sat on the panel of judges for the award, Brian Deer’s associate and Liberal-Democratic member of parliament Dr Evan Harris. This nevertheless brought Goldacre into conflict with Brian Deer, or certainly led to Deer expressing public annoyance in an interview the Press Gazette last year.
On the other hand when the GMC panel announced its decision on 28 January Goldacre was hit by a sudden attack of amnesia, failing to recall anything of his earlier reasoned objection to the central charge of the GMC hearing. Even if for some reason he had changed his mind, the only mainstream journalist who had sufficient grip on the case to explain what was at issue held his tongue in his “expert view” comment in the Guardian on-line that evening (HERE).
The reality was that the panel had swallowed an astonishingly tenous case from the prosecution that the “Lancet study” was not “a perfectly good small case series report” – in Goldacre’s words – but a botched attempt at the protocol of what looked like a completely different study. The panel in fact found that the doctors were in breach of the terms of the protocol which had been granted ethical permission as project 172-96 (HERE):
“The Panel has heard that ethical approval had been sought and granted for other trials and it has been specifically suggested that Project 172-96 was never undertaken and that in fact, the Lancet 12 children’s investigations were clinically indicated and the research parts of those clinically justified investigations were covered by Project 162-95. In the light of all the available evidence, the Panel rejected this proposition.”
However, if the claim that the study was bungled version version of Project 172-96 was perverse they border on deception by claiming 162-95 as a “project” at all: 162-5 was nothing other than code for the ethical permission granted to Prof Walker-Smith, when he arrived at the Royal Free Hospital the previous year, to order biopsies according to his own clinical judgment: he was, after all, recognised as the leading paediatric gastroenterologist in the country at the time (HERE).
Of course, if the panel had explained what 162-95 was, instead of passing it off as an alternative “project” perhaps even the press room at the GMC might have worked out that something was amiss. The panel would have had to have explained why or how they had managed to retrospectively disable the discretion granted to John Walker-Smith to use his clinical judgment for the apparent purpose of bringing in a guilty verdict. Moreover, it is fairly hard to see how there was anyone present at the hearing who had the expertise or experience to second-guess Prof Walker-Smith’s clinical judgment anyway.
It is quite apparent Ben Goldacre did not originally announce his reservations abou
t this prosecution out of the sympathy for the predicament of the doctors or for the children injured by MMR vaccine. Infamously, his Bad Science blog site used to bear the advice (HERE):
".. personal anecdotes about your MMR tragedy will be deleted for your own safety"
Goldacre, plainly adopted this line because he and many people like him in the medical establishment believed the prosecution would unravel. Well, it hasn’t yet, but he may live to regret his silence. That same Thursday evening his colleague Sarah Boseley wrote in the Guardian (HERE):
“Opinion is divided in the medical establishment on the wisdom of pursuing Wakefield – and particularly his colleagues who played a lesser role in the drama – at the GMC. Some say there was a clear case to answer and that the GMC had no other option but others believe that no good can come of it.”
Her choice of tense: “no good can come of it” is interesting.
John Stone is UK Editor for Age of Autism.