GMC Hearing Update
There is one consolation that I will bring to that house of misery
- a clear conscience, a heart whose still small voice
tells me that I have done no wrong to upbraid myself with.
This is the consolation that I have - that my conscience is clear.
Augustine E. Costello in1867
Speeches from the Dock, M.H.Gill & Sons
By Martin Walker
On Tuesday 13th April and Wednesday 14th April, its 200th day, the hearing sat in order to hear mitigation and assess 'sentencing' arguments on behalf of Professor Murch and Professor John Walker-Smith. Dr Wakefield, disgusted by the clearly biased 'findings on fact' in January, had decided to have no more to do with the hearing. Mr Miller, counsel for Professor John Walker-Smith, presented his case on Tuesday and on Wednesday, Mr Hopkins for Professor Murch presented evidence to their character and integrity while arguing the words 'serious', 'professional' and 'misconduct'.
So essentially, all parties having been found guilty on most if not all the charges, the tribunal was about to pick the carcass clean arguing politely about who received which internal organs. Although from the perspective of the legal profession, perhaps even from the perspective of the medical profession, one can understand the defence attesting to the good character of the defendants, over a single day after the prosecution has spent over two and a half years attesting to their dishonesty and unethical behaviour, from my perspective and perhaps that of other survivors of the nineteen sixties, this situation might have appeared absurd.
Frequently over the time of this trial, my mind has slipped back to the sixties and early seventies when a whole generation, or so it appeared, undermined the pastiche ritual and the theatrical authority of the governing class, when a whole generation suddenly became their own people. It wasn't so much that they went head to head with authority; some of them slipped round the corners of it, almost ignoring it and began independent lives.
Unfortunately, governments and states, corporations and the ethos of shopping are now back in the driving seat and the first response of many in today's post-managerial society is to doff their hats and pay homage to the new ministerial class that now patrol our political and regulatory malls. So it comes as little surprise that the counsel presenting the defence of the three doctors at the GMC, continue to clack along the tin tracks like model trains on the drawing room floor, without a hint of disrupting the proceedings even by hooting their whistles.
What might have been the outcome of this case if, on the first day, counsel for the three doctors had said that they would first present the character evidence on behalf of the doctors and then withdraw from the hearing, forcing the GMC to continue alone or negotiate a wholly new ground plan? However, the law is like diplomacy, war by more civilised means and the lawyers were no more likely to disrupt the proceedings than they were to wear kaftans to court or light-up spliffs during the proceedings.
Yet there were times, when I could see that the presentation of the defence cases only obscured and confused to a much greater degree, the honesty, kindness and ethical principles of the three accused men. And another thought returns time and again: the lifetime's work, the good name and the public conscience of these three doctors, whatever the juridical process mutters, has now been almost completely razed, they lie still and bleeding in the gutter, carried there by the crash bars of a juggernaut as they idled across the road earnestly talking about how they might make safe the health of vaccine damaged children. Nothing will raise these doctors to their feet or to wholeness their dreams or careers.
Tuesday was a relatively quiet day at the GMC; there were no demonstrations outside the building in support of the doctors. Inside the long white hearing room, the alert charcoal clad figures watched Mr Miller as he began presenting a series of letters in support of Professor John Walker-Smith. Some of these are quoted, below. In the public seats, JWS had the support, as he has had on other occasions throughout the hearing of his wife, daughter, son and grandson.
The session began at 10.00 after the long practiced morning delay, with Mr Miller confirming that Professor Walker-Smith's submissions would be completed in one day. He mentioned that he would read some, but not all the testimonial letters, that the Panel had before them. It was Mr Miller's case that it was important that the Public should know that these letters underpinned their submissions.
The language of mitigation is a nightmare language; again, by definition diplomacy, a language that disguises intent rather than explaining it. How does counsel or indeed the innocent defendant who has been found guilty phrase his profound belief in the wrongness of the prosecution? How does a defendant found guilty of fifty odd charges, retain credibility enough to express his overwhelming contempt for the prosecution.
Does counsel read out and endorse testimonials that say, 'I think my friend was well fitted-up by you bastards, people who aren't good enough to hold his hat', or, 'To be honest I think that Big Pharma and Public Health power players are behind this charade and I don't believe for a second that my dear friend has done any of the things that you have accused him of, this whole trial was a get up during which the prosecution and their witnesses lied through their teeth'. Or do you depend upon friends and colleagues who want to throw you on the mercy of the court? 'I can see that my colleague has done something quite terrible, and I would like on his behalf to ask for your everlasting forgiveness', or 'terrible as the offences of my colleague are, I hope that you can find it within your hearts to forgive him'.
It was, however, on a safer very English side of the road that most of those testifying on behalf of professor Walker-Smith veered. The witnesses on behalf of Professor Walker-Smith and Professor Murch spoke mainly in euphemisms and an ancient coded language, containing expressions such as 'My colleague is one of the greatest gastroenterologists in Europe and what he has done seems completely out of character' or 'It is difficult for me to accept that my colleague did the things you say he did, however, having heard the evidence, you must be right'. How do you express complete faith in your colleagues' integrity while allowing that he must have committed at least 50 ethical blunders. The avoidance of the political and the personal at all costs, exhibits the practice of diplomacy at its highest.
But this semantic quagmire is, like most things created and governed by lawyers, a creature of the game introduced and played by the prosecution. What a marvelous weapon, a mitigating statement, or testimonial could be in the hands of a truly radical lawyer; a real chance to go beyond the box. 'When you see my colleague and old friend Doctor Wakefield, you see before you a man who has fallen amongst thieves, callous and heartless people. Mercenary prosecutors who have turned the truth on its head and pursued three completely innocent, hard working doctors whose only interest were in their young patients. I will continue to use all the powers of my office to campaign for a public enquiry into this matter and to bring to justice those who planned and perpetrated this cruel conspiracy'.
Alas, in most of the testimonies Mr Miller read out prior to the mid morning break nothing came close to this radicalism. Although all the testimonies mentioned how confused, astonished, surprised even amazed were the witnesses, none of them were outraged or propelled to take up arms. One peculiar testimony even spent sentences claiming the writer's bourgeois heritage of rationality and civilized behaviour. In defence of her courteous testimonial, reassuring the GMC the witness wrote proudly 'I am not an activist'. To which my only heartfelt reaction was 'Well, you should be ashamed of yourself.'
* * *
Mr Miller read out 16 testimonials before the morning break and 17 following the morning break before the appearance in person of the two character witnesses for Professor Walker-Smith. I have quoted some of these testimonies, at the very least they show a striking solidarity from the medical profession with Professor Walker-Smith and at the most between the lines they message the hypocrisy and stupidity of the GMC's fraudulent prosecution.
'I am a Consultant Paediatric Gastroenterologist ... I was very soon impressed by Professor Walker-Smith’s immense knowledge in the field of Paediatric Gastroenterology as well as by his kind and compassionate attitude towards his patients.'
'I am aware that Professor Walker-Smith has recently undergone a GMC hearing following allegations on his professional conduct. The above allegations came to me as a surprise, since I have always considered him as a model to emulate for integrity, honesty, skills and knowledge'.
* * *
'I am writing in deepest support and solidarity of Professor John Walker-Smith, who has been involved in the publication of the Wakefield et al Lancet paper in 1998.'
'He has an enviable international reputation with more than 300 published scientific and medical papers and publications in the field of paediatric gastroenterology.'
* * *
'I first met Professor Walker-Smith in 1978 when my daughter was in his care. He is a highly professional yet caring man, very gentle and reassuring.
I have the utmost respect for him and placed all my trust in him when it came to my daughter’s treatment.'
* * *
'I have known John Walker-Smith for almost thirty years, having met him first in 1981, when I was embarking on my career as a paediatric gastroenterologist ... I have been dismayed to learn of the GMC’s findings and distressed to see the effects of these and the very long and drawn out process that led up to them, on Professor Walker-Smith... While I am aware of, and accept, the findings of the Fitness to Practise Panel, the purpose of this testimonial letter is to state my belief that I have never seen evidence, nor do I believe, that John Walker-Smith acts, or has acted, without the highest professionalism, integrity, and clinical ability.'
* * *
'It is a mystery to me, on the basis of experience of relationship with scores of other colleagues, that someone as dedicated, honourable and highly regarded as Professor Walker-Smith has proved to be over the many years that I have known and worked with him should suddenly become a pariah in the eyes of others ... John Walker-Smith is to me, to all his immediate associates known to me and to the international medical fraternity, the very embodiment of professional integrity and humanity, a saintly and truly honest person with the highest ideals.'
* * *
'I am a consultant paediatric gastroenterologist and work at Southampton General Hospital. I have known Professor Walker-Smith since the early 1980’s ... He is, in my opinion, a man of the highest calibre in terms of his integrity, professionalism and clinical ability. During his distinguished career as an academic and practising clinician he was recognised nationally and internationally as a pioneer in paediatric gastroenterology. This included pioneering work in the recognition and management of inflammatory bowel disease in children, diagnosis and management of coeliac disease, recognition diagnosis and management of gastroenteritis including its complications. His work had a massive impact on the care of children with gut problems, including both awareness and clinical care nationally and internationally.'
* * *
'I am a consultant paediatric gastroenterologist and I was initially appointed to a consultant post in 1978 at Westminster Children’s Hospital, London... I first came to know Prof Walker-Smith in 1978. He is a highly regarded colleague, a man of integrity and honesty... The allegations which have been the subject of the GMC hearing have created surprise and consternation amongst his peers.'
* * *
'We were patients of you and your team during the now infamous period on 1998/9. We had been under Great Ormond Street epilepsy team for the 5 years preceding and their view was ‘just diarrhoea and no need to worry ... What we learnt from the investigations that followed with you and your team changed the course of our lives and especially the effect on [T]. Your work gave us a meaningful agenda from which to work. It also gave us the understanding of the extent of the damage to [T’s] colon and bowel and the huge degree of impaction that followed. From this knowledge we could now at last begin to address these matters, for [T’s] benefit ... we are forever grateful to you for helping us to improve the abilities of our children through your work. You have changed our son’s life beyond all our expectations.'
* * *
'I have been a Consultant Paediatric Gastroenterologist in Manchester for over 17 years ... I have been saddened to read the findings of the Fitness to Practise Panel but I remain convinced that Professor Walker-Smith would not subject any child to unnecessary investigations if he did not believe that there may be a potential benefit for that child.'
* * *
Although the testimonials above showed considerable support and some critical puzzlement with respect to Professor Walker-Smith, it was as is always the case, the parents of damaged children who addressed the question of how the professor had arrived before the tribunal and the injustice of it. The first testimonial below is from a number of the parents whose children were cited in the Lancet paper and the second from Isabella Thomas, an indefatigable campaigner on behalf of her children and the accused doctors:
'We are writing to you as parents of the children who, because of their symptoms of inflammatory bowel disease and associated autism, were seen at the Royal Free Hospital Paediatric Gastroenterology Unit by Professor Walker-Smith and Dr Simon Murch with the involvement of Dr Andrew Wakefield on the research side of their investigations. Our children became the subjects of a paper published in The Lancet in 1998.'
'We know these three doctors are being investigated by the General Medical Council (GMC) on the basis of allegations made to them by a freelance reporter. Among the many allegations made are the suggestions that the doctors acted inappropriately regarding our children, that Dr Wakefield ‘solicited them for research purposes’ and that our children had not been referred in the usual way by their own GPs. It is also claimed that our children were given unnecessary and invasive investigations for the purpose of research and not in their interest ... this was not so. All of our children were referred to Professor Walker-Smith in the proper way in order that their severe, longstanding and distressing gastroenterological symptoms could be fully investigated and treated by the foremost paediatric gastroenterologists in the UK. Many of us had been to several other doctors in our quest to get help for our children but not until we saw Professor Walker-Smith and his colleagues were full investigations undertaken. We were all treated with the utmost professionalism and respect by all three of these doctors. Throughout our children’s care at the Royal Free Hospital we were kept fully informed about the investigations recommended and the treatment plans which evolved. All of the investigations were carried out without distress to our children, many of whom made great improvements on treatment so that for the first time in years they were finally pain-free.'
'We have been following the GMC hearings with distress as we, the parents, have had no opportunity to refute the allegations. For the most part we have been excluded from giving evidence to support these doctors whom we all hold in very high regard. It is for this reason we are writing to the GMC and to all concerned to be absolutely clear that the complaint that is being brought against these three caring and compassionate physicians does not in any way reflect our perception of the treatment offered to our sick children at the Royal Free.'
'We are appalled that these doctors have been the subject of this protracted enquiry in the absence of any complaint from any parent about any of the children who were reported in the Lancet paper.'
* * *
'I just wanted to tell you how dismayed I am that Professor Walker-Smith is in the position of being attacked over the care he gave to my boys. I believe all those tests were indicated, especially with the symptoms the boys had. He was one of the best doctors the boys had ... The problem with the GMC is that they have not asked how the children are now. Because of the GMC hearing doctors are afraid to treat our children and I had to take them for treatment to the USA.'
'... I would like to thank Professor Walker-Smith with all my heart. If he and the others had been allowed to continue treating our children then Michael and Terry may not be suffering so much pain now and their other problems would have been picked up much earlier.'
I am saddened that I was not allowed to give evidence on behalf of my boys and was upset to hear the lies about my family from the other side. I felt we did not have a voice and my boys were not protected in this.'
The testimony above from the parents was to raise serious questions in the hearing later in the day, which goes to show that throwing stones does create ripples and that it is more effective sometimes to use strong words and shout rather than whisper your case.
Following the mid morning break, after everyone had filled back into the hearing room, Smith strode stern-faced up to Mr Miller's table and entered into a seemingly angry exchange with him. One observer in the public gallery with exceptional hearing said she definitely heard Mr Miller say 'I am not going to recant'. Clearly Smith wasn't happy about something and it seems more than probably that Isabella's statement, that including the word 'lies', could have offended Smith's professional sensibilities.
If it was this, one can't help but wonder at the preciousness with which these people see themselves, they legally assault three notable, hard working and honest doctors, ruining their reputation and careers; they infer that thousands of badly injured vaccine damaged children do not exist, while intimating that their parents have at the best misjudged their children's illnesses and at worst been untruthful to doctors in order that they might make money from a legal claim against pharmaceutical companies; then appear mortally hurt when someone says that they have lied. These marauding legal mercenaries carrying arms for corporations live in a mirror world where the right people are wrong and the wrong people are always right.
Later in the morning, seemingly after some matters had been brought to his attention, the Legal Assessor made a two-part intervention that grew out of the parents' testimonial. First he made the exacting grammatical point that when Mr Miller read out testimonials which disputed the 'carved in stone' factless facts endorsed by the panel in their findings, he should be careful to always qualify, as he had done in this case, testimonial statements with the word 'they say' - meaning the writer of the testimonial - in case the panel were of the opinion that Mr Miller himself endorsed such a disagreement with the panel's findings. The assessor used this point to address the panel on the fact that as far as the hearing went, the panel's truth was an indisputable truth and no other truth held weight.
But it was the next part of his intervention that related directly to Isabella's letter and cast an interesting light on the enclosed way that the prosecution thinks.
'Mr Miller', the Legal Assessor said, 'before you move on ... I have been asked a question and I just want to indicate what I have said. One of the Panel members asked me where it says in the previous document, about which I made comment (the testimony of the parents of the Lancet paper children), "For the most part we have been excluded from giving evidence, whether the panel is entitled to know who excluded us." I have advised no. How witnesses come to be called is not a matter for the panel and who is or is not selected is not a matter for the panel.'
Of course, no one could argue with the Legal Assessor in his judgement of this matter. Why should the prosecution be made to explain to the panel why the parents were not called to talk about the health of their children? This would be as patently absurd as suggesting that the defence to explain why they didn't call the parents to support the case of the doctors. It would have been interesting to hear the Legal Assessor's proof of this ruling; perhaps he might have alluded to Smith's much earlier statement in the Hearing that what everyone was involved in was an 'enquiry' and not a trial.
But on the whole, one has to agree wholeheartedly with the Legal Assessor, no jury should be allowed under any circumstances to know or even question such things as: who made the initial complaint about the doctors to the GMC, this should always be hidden; why Brian Deer, whose hack writing provided the basis for the charges, was not called to give evidence; or why parents who appear in the prosecution case as being to some extent victims of the doctors unethical action were never called to give evidence. The answer to this last question should naturally be kept a complete secret. For the GMC to give any such information to the jury would be to clearly encourage a contempt that might lead the panel to make a wrong finding.
After the break, Mr Miller read out another eleven testimonials, including those from a Professor citing John Walker-Smith's skill and devotion. Listening to all this praise heaped upon Walker - Smith one was forced to wonder who will write such testimony in favour of Ms Smith, come the day in the not too distant future of the Vaccine Truth and Reconciliation Hearings. If I had to hazard a guess I don't think even her milkman would find time to pen her praises.
* * *
The first character witness Mr Miller called was Professor Sir Christopher Booth, who had first got to know Professor Walker-Smith after Walker-Smith arrived in London from Australia. This was at the beginning of 1960’s, 1962.
'At St Bartholomew’s Hospital I knew from discussions with colleagues and friends how very highly he was regarded in respect of his work. He was, in my experience, a man of the highest integrity. He is a very committed Christian and utterly devoted to his church. He is a man I would trust completely with the treatment of my children, a man who I do not think would ever harm anybody. The idea that he should be in any way held guilty of anything of any sort which is discreditable is to me completely unbelievable.'
Sir Christopher mentioned Walker-Smith's writing; 'Writing a textbook is a hard job and he wrote his book on diseases of the small intestine some years ago. It has now gone through four editions. It has had a major impact on teaching of the subject internationally. It is the only book in the world to do with that particular area and it is beautifully written and an extremely good book.'
Surprisingly, Sir Christopher made it absolutely clear that he did not believe that Professor Walker-Smith had been conducting research and made a call for consultants to play the primary role in decisions about clinical work.
'I think the other problem that comes out of that is if you want to do, say, an endoscopy in a child, who makes the decision that it is appropriate? It should be the consultant physician in consultation with the parents themselves and that is how it should work. The idea that ethical committees interfere with that relationship is, I think, wrong.'
* * *
Dr Heuschkel from Cambridge was the next character witness and the hearing managed to squeeze him in before the lunch break so that he could return to an afternoon clinic. Dr Heuschkel is a member of the Royal College of Paediatricians and Child Health. Dr Heuschkel gave evidence to professor Walker-Smith's collective approach to work in a hospital. Although Heuschkel's evidence didn't appear to do that much for Walker-Smith, in terms of the case as a whole it was considerably pertinent. Between the lines he was casting doubt on the suggestion deeply embedded in the prosecution case that Wakefield, or Wakefield, Murch and Walker-Smith had sneakily conducted research in dark corners at the Royal Free. 'One of the striking things about John Walker-Smith was the importance that he put on running the unit within a team, within what we now take for granted, within paediatrics as part of a multidisciplinary team. Complicated patient decisions were discussed as a team, management decisions were carried out by a team. He interacted openly and fairly on a regular weekly basis with all members of the team, from the most junior to the most senior, in discussing research, in discussing patient care, and his approach to patients in clinic was one that I still follow now. We all see patients independently in the afternoon and we will come together after a clinic to share the decisions that we have made, to discuss those decisions, and to ensure that we all are making decisions in the best interests of the patients.'
Dr Heuschkel's single statement on behalf of Professor Walker-Smith was pointed. When asked if he could see Professor Walker-Smith putting the clinical interests of a patient, a child patient, secondary to research? He answered determinedly, 'In no way whatsoever.'
* * *
Following lunch, Mr Miller introduced Professor Allan Walker who suggested that Walker-Smith was considered an expert on a global basis. 'John is one of the most revered paediatric gastroenterologists in the world. Finally, and I believe you may already be aware of this because it was in the letters that you got, John has been given a distinguished achievement award by the European Society for Paediatric Gastroenterologist and Nutrition and, to my knowledge, this is the first time that it has ever been given, a lifetime achievement award, to a paediatric gastroenterologist. I think that underscores the view of John Walker Smith as a paediatric gastroenterologist on a world wide basis.'
* * *
Professor Sir Nicholas Wright, was the final witness to appear in person, the Chairman demoted Sir Nicholas into a common doctor and Mr Miller had to retrieve his reputation: 'It's Professor Sir Nicholas Wright, I think', Miller said to the Chairman. Perhaps it was the case that the chairman thought this devolution of Sir Nicholas's professional position would rub off on the Panel. But Mr Miller was quick to show that Sir Nicholas was right at the top of medical tree; Warden of The Barts and London School of Medicine and Dentistry after having been the Deputy Principal of Imperial College School of Medicine, and prior to that, Dean of the Royal Postgraduate Medical School at Hammersmith.
Sir Nicholas's evidence was straight to the point. 'I think Professor Walker-Smith has an extremely high reputation. He really is one of the founders of the paediatric gastroenterology specialty. He was held in the highest regard, and I think anybody who has known him will regard that as a privilege because he has a reputation of the highest standards, both of intellectual behaviour and integrity. He has been particularly praised by the European Society in them giving him a lifetime distinguished achievement award for his care of his patients and the care he takes with looking after them, so I have always regarded him as being an extremely worthy individual.'
* * *
Wednesday the 14 April 2010 was the 200th day of the hearing. Like that on behalf of Professor Walker-Smith, the pleading on behalf of Professor Murch was fairly short, beginning and ending on that day. As well as the reading of testimonials, Mr Hopkins called three character witnesses, who appeared in person, on behalf of Professor Murch: Edward Piele, Robert Green and Allison Rodgers.
The first testimonial read for Professor Murch came from Professor Carter, the former Dean of Warwick medical School where Professor Murch is now employed as Professor of Paediatrics and Child Health. Unfortunately, Professor Carter died not long after writing the testimony in September 2009. One was reminded of how short human life was, and how much damage the GMC prosecution had done to the three defendants lives and careers. Professor Carter's testimonial described Professor Murch as a man with 'a kind and gentle nature, ideally suited to working with students and teachers. Despite the intense pressure of the GMC proceedings, the time-commitment required and the effect on his self-esteem, he remains conscientious about his patient lists and academic responsibilities'.
Professor Edward Basil Piele was next sworn in and examined by Mr Partridge, Mr Hopkins junior. Piele was a fellow of the Royal College of Physicians, a fellow of the Royal College of Paediatrics and Child Health, a fellow of the Royal College of General Practitioners, a fellow of the Higher Education Academy, a fellow of the Academy of Medical Educators and the former Associate Dean for teaching at Warwick Medical School. His current title was that of Professor Emeritus of Medical Education at University of Warwick.
Piele was one of the people who interviewed Professor Murch for his present job at Warwick, but despite have an interesting name, Piele said perhaps slightly less than your average family Labrador would say in favour of its master.
'I think the things that impressed me most were the degree of rigour and care that Professor Murch gave to appraising the appointment coming to the Medical School. At that level it is usual for candidates to make preliminary visits but I think Simon Murch stood out because he had prepared his questions very searchingly'.
Mr Partridge then read the testimony of Dr Diana Rutter, consultant paediatrician:
'I have known Simon Murch for more than 10 years as a respected paediatric gastroenterologist. He has been a speaker at many meetings both national and international on clinical and academic topics associated with gastroenterology ... I have also undertaken some of his out-patient clinics when he was unavoidably absent with the requirement that he attend the GMC hearings. At these clinics I, of course, saw patients that he was already managing. Many of these families were able to make quite long journeys to ensure that their child remains under Professor Murch’s management.'
The next witness in person to be examined by Mr Partridge was Dr Michael Robert Green. Green, a consultant paediatrician and gastroenterologist at the Children’s Hospital, Leicester Royal Infirmary, for almost twenty years, said that Professor Murch was clearly a very committed clinician ... 'I have certainly never had any concerns. In fact, the very opposite: he is clearly hugely committed. What is very clear from seeing his patients is that he listens to the histories that are being given to him and tries to interpret them, I think in a much more careful way, I think I could honestly say, than I have ever come across before ... Professor Murch, I think – and you see this when you do his clinic – has a hugely analytical mind and will try and find causes for symptoms that others might ignore.'
It was always the case throughout the hearing that medically lay observers could learn a great deal from those who gave evidence. Although Smith and the lay individuals on the panel are unlikely to have been listening hard enough to pick up the intonations in Green's evidence, what he was saying was of great concern to this case. While the likes of Smith and Deer and a whole army of pragmatic material skeptics dismissed the defendants as quacks, here was an uninvolved consultant bringing to the fore the post-modern concept of 'interpretation' of signs, symptoms and the patient narrative. Dr Wakefield had mentioned this with the discussion of the histology samples, but it had never been explored. Yet it was in some respects the key to the defendants' complete innocence of the charges.
Parts of two testimonials were then read out on behalf of Professor Murch, from Professor Levin, the Professor of International Child Health at the Imperial College in London.
'I am aware of the findings of fact from the Fitness to Practise Panel concerning Professor Simon Murch. I am writing to convey to the panel the extent to which their findings in relation to Professor Murch’s participation in the investigation of patients included in the discredited Wakefield research, contrasts with his professional activities in both care of patients, research and teaching in the rest of his career.'
'I have the highest regard for Professor Murch’s integrity, honesty, long-term commitment to providing the highest professional standards to the patients under his care as well as to their families and the medical and nursing staff with whom he works. From my long familiarity with Professor Murch’s work I am happy to confirm that his interactions with both professional colleagues and patients are conducted with the highest degree of kindness, sensitivity and decency. His care of patients is always administered with compassion, sensitivity and commitment to the patients and their families. I believe his scientific work has been conducted with a commitment to research being used for the benefits of patients.'
'Having read the findings of fact from Fitness to Practise Panel, it seems clear that the conclusions of the panel in relation to Professor Murch’s involvement in the investigation of patients included in the Wakefield study, stands in complete contrast to his dedicated and committed care of patients and commitment to ethical conduct of research which has characterised the remainder of his clinical career.'
Good for Murch but gratuitously bad for Dr Wakefield. During my twenty years of para-legal work, especially on behalf of those wrongfully arrested and wrongfully imprisoned, I learned to take very exacting statements. In fact, statements - the defendants or witnesses narrative are at the very heart of the judicial idea. During these years I learnt that statements were always taken and never given, in case the untutored mind of the witness or defendant might inadvertently say something that was true but contextually detrimental. I would never have let Professor Levin state that, 'Professor Murch’s participation in the investigation of patients included in the discredited Wakefield research'. Clever as it is might be to kick Wakefield under that table, the statement was not true from the defence perspective and anyway it blew back on Murch as well.
One of the things which comes across very clearly about Professor Murch is his kindness and his liking for his patients and their children. 'Professor Murch upheld high ethical standards and always dealt kindly and compassionately with patients and staff.' The following is a good example of the semantic gymnastics employed by colleagues of Professor Murch:
'I have read the findings of the GMC decisions on Professor Murch and I am aware that he has been found guilty of performing a number of colonoscopies on children for research purposes, without ethical permission. I would regard these findings as an unfortunate departure from a career, which in my observation, has been exemplified by a character of highest ethical standards, together with the highest academic standards.'
One's answer to all the testimonials read on behalf of Professor Murch was the same and very straightforward, at least in my case. If this man was as principled and as ethically correct, as gentle and kind as everyone said he was and from my observations and contact with him, he clearly was, why did he allow his lawyers to inveigle him into this gross and ugly process of apologia?
After lunch Mr Partridge examined Alison Jane Rodgers, a senior lecturer in infectious diseases at University College London, who had taken her son to see Professor Murch when he was a baby.
'It was an astonishing relief for both my husband and I, even from the first consultation with Simon. He took a very careful history, he examined my son, he listened to our concerns and he said immediately, “Your son has severe food allergies which are probably causing inflammation within his intestine”. The difference in my son’s health within a matter of weeks was truly astonishing.'
* * *
In his closing submission, on Tuesday, Mr Miller went back over the areas of charges against Professor Walker-Smith. Although there was some shifting of blame to Dr Wakefield, it did tend to be in areas where there had been a real disagreement between the two doctors, such as over the Press Briefing, that Professor Walker-Smith refused to attend. However, one could not but be struck in the case of Walker-Smith and that of Simon Murch that it often appeared convenient for both men to shift blame onto Dr Wakefield. It would seem important to me that we put both their cases in context and understand that for a couple of years after the Lancet paper, all three doctors were continuing to work clinically on cases which came to the Royal Free. Only when Brian Deer hit the fan in 2004 and the GMC began preparing charges, did everyone appear to turn on Dr Wakefield.
Mr Miller made the point that when the Panel announced their findings in January, most people would have been hard pressed to find any mention of Professor Walker-Smith or Professor Murch in the report of the proceedings. He made the point that the Panel must not bracket all or any of the doctors together when you consider the seriousness of the findings that have been made.
As Mr Hopkins was later to do on behalf of Professor Murch, Mr Miller began with a couple of points that severed connections between Wakefield and Walker-Smith. Professor Walker-Smith was first and foremost a clinician. 'His motivation – and again what you have heard this morning testifies to this – was to alleviate the suffering of children suffering from bowel problems, and that has been his concern virtually for the whole of his medical career.'
Secondly Miller asked the Panel to dismiss from their minds the implied suggestion that Professor Walker-Smith became involved in investigating the Lancet children because he wanted to prove that MMR caused autism and bowel disease. Mr Miller made it clear, as again Mr Hopkins was to do, that Professor Walker-Smith was an old school paediatrician who was absolutely in favour of vaccination in general and MMR in particular. He constantly shied away from publicly raising any alarm about the role of MMR.
It was while listening to mitigation for Professor Murch and Professor Walker-Smith with Dr Wakefield missing, that one realised just how deep was the divide between the two professors and Dr Wakefield. And both counsel and the other defedants seemed to play on these differences, almost as it were, blaming Dr Wakefield for having pulled the case down on everyone.
Mr Miller drew attention to the “press briefing”, and suggested that it was then, not with the publication of the Lancet paper that 'everything went wrong'. The real damage was caused when Dr Wakefield took it upon himself to promote the adoption of monovalent vaccines, which was nothing to do with the paper. While this was an accurate reading of the situation that separated his client from Dr Wakefield, it went no way to reiterating the fact that the chain started with Zuckerman, who had set Wakefield up to pronounce on the single vaccine and actually farmed out a journalist's question to him.
Mr Miller moved on to the point that there has been no formal complaint made to Walker-Smith by any patient or his or her family (not only from the original Lancet parents but also from the tens or hundreds that followed them). He mentioned the one Lancet parent that had been called yet still referred to her as Mrs 12. Other parents might have wondered why he didn't tell the panel that she had been duped by the prosecution to attend the hearing, after being told that she would be giving evidence for the defence. And, of course, he could have chosen this time tell the panel why the defence themselves had not called the parents.
Mr Miller shed a sudden light on a matter that, I have to admit, I had missed. He told the hearing that the reason the prosecution had given for not calling the parents was that it was the child who was the patient and not the parent. Not only is this a growing trend in Britain of state loco parentis - the state assuming rights over the child while depriving the parent of those same rights - but fortunately for the GMC the cited in the Lancet paper were either non-verbal or anyway too young to be able to give evidence. From the point at which the law took responsibility for the children, everyone was expected to believe that Smith and the GMC had a greater concern for their welfare than did their parents.
When it came to criticising expert witnesses, Mr Miller's submission also served Dr Wakefield. Of Professor Booth Mr Miller suggested that it was wholly inappropriate to rely on Booth's evidence that parents may lose objectivity when the panel had not seen or heard the parents. It was clearly the case, said Mr Miller, that parents of damaged children knew those children better than anyone.
Not only had none of the parents of the hundreds of children who had passed through the hospital complained, but there had been no complaints either from Professor Walker-Smith’s employers or colleagues that he behaved unethically, with duplicity or contrary to the interests of his patients.
If Professor Walker-Smith had 'jumped the gun' in starting a research project without ethical approval, said Mr Miller, then so did everyone else, all the authors of the paper and anyone who had examined the children. Mr Miller stressed not only this but the point that what he had then begun to call 'a research project' - despite it not actually existing - was not secret and did not take place behind closed doors.
'We say that the correspondence reflects Professor Walker-Smith’s genuinely held view that the only investigations which would be carried out in his department would be those which would offer some clinical benefit of whatever type to the children.'
'Second, there is no evidence to suggest that any other clinician within the Royal Free believed that Professor Walker-Smith’s department was not offering normal clinical care: quite the contrary.'
'Fourth, the testimonials demonstrate that it would have been wholly out of character for Professor Walker-Smith to subordinate the interests of one of his patients to a simple research agenda. When I asked that question of Dr Heuschkel, he said he could not see it happening.'
At this stage, Mr Miller began to argue a second hand case, that the only investigations that had taken place were clinical and for diagnostic reasons. But what can you do when the jury has been led to the fuzzy end of the lollipop and are determined to believe a completely unevidenced prosecution case? Mr Miller pointed out the fallacy in the fact that children seen clinically also had biopsy material taken under Professor Walker-Smiths ethics committee approval 172/96.
'Finally, we note that you found many of the Lancet children were investigated under 172-96 despite the fact that they did not meet the inclusion criteria for that project. Such inclusion criteria would include the manifestation of disintegrative disorder or the fact that they had been vaccinated with MR rather than MMR vaccine. However, sir, we fail to understand the real gravity of this allegation.'
Following the afternoon break, Mr Miller found himself arguing the relative safety of the processes carried out or instructed to be carried out by Walker-Smith. On colonoscopy he said, 'we ask you to bear in mind the abundance of evidence that you have heard concerning the safety of colonoscopy. It is clear from the literature and the oral evidence, first that the objective risk of complications is extremely low; secondly, in this unit, the complication rate was zero in 1996 to 1997 when the colonoscopies took place; thirdly, the most important factor, is the skill and experience of the endoscopist who carries out the endoscopy.'
Finally, said Mr Miller, Professor Walker Smith had in Dr Murch and Dr Thompson two of the most highly skilled paediatric colonoscopists in the country. On the issue of lumbar puncture, Mr Miller repeated to the Panel another of their absurd decisions. 'You have found that Professor Walker Smith caused two of the children to have a lumbar puncture which was not indicated. Again, we invite you to bear in mind the evidence of Dr Thomas, the only paediatrician neurologist called in these proceedings on the safety of lumbar punctures. He said: 'Yes, I think it is considered to be a safe procedure.'
Mr Miller again addressed the question of transfer factor that appeared to have been given to child 10 with the full permission of his parents as an experimental treatment. 'It is difficult', Mr Miller said, 'to see how this could be a serious allegation laid at Professor Walker-Smith's door, because the treatment was not given by him and he was unaware of the circumstances in which the child got it'.
Mt Miller ended with a run-down of professor Walker-Smith's career.
'It is striking to see quite how influential he has been. I say that because you see – and to some extent I have seen – a modest man giving evidence before you – and in my case he is my client but I say a modest man – and yet from what we have heard this morning it is a truly astonishing set of reminiscences and kind words from so many people from so many different parts of the world.'
I do think if the choice had been mine that I would never have subjected myself to this almost humiliating excusing of the role that I had played in the heroic diagnostic work done at the Royal Free. It isn't simply that the whole chimaeras case is a creation of Big Pharma, it is also the fact that I would know that I and the other defendants were public spirited National Health Service workers and our careers, even our lives had been ruined by mercenary profligate prosecutors whose interest in the case was driven by meanly motivated private interests.
* * *
The rumour around town is that Brian Deer is going through considerable mental turmoil at the moment. Certainly when he appeared at the Hearing briefly on Tuesday looking like a trailer park resident in grey jogging bottoms and trainers, it did look as if the three year Hearing had taken it's toll on any sense of the sartorial, he might originally have had. When he jogged out of the glass building, it was rumoured that he was just about to launch other possible three year cases against other doctors and he was in training for this, others said that listening to the wonderful testimonials given to JWS by great medical figures, had finally tipped him into insanity as he tried to deal with immense damage he had done to a great physician.
* * *
The introduction to Mr Hopkins concluding submission on behalf of Professor Murch on Wednesday was strong and determined yet completely undermined by the fact that the stable door had been open for almost three years and the horse had already bolted and the thought upermost in my mind, was that Mr Hopkins should have been out on the fells looking for it and supporting evidence rather than excusing his client in this tomb of a hearing room.
It was clear from the beginning of the day, that Pofessor Murch being the youngest and least advantaged of the defendants, would not be able to draw upon the same stature of character witnesses as had Professor Walker-Smith. It was relatively clear also, that Professor Murch would even more be enticed into a scratch-face defence.
Mr Hopkins, began his submission by going through all the areas within which Professor Murch had been found guilty, he then argued each area outlining general reasons why and how these findings might be explained and in some ways excused. Mr Hopkins went over much of the defence case again, presenting it this time as a mistake, that did not come within the realm of 'serious' or 'professional misconduct'
For example, he argued that if the Panel had found that errors were made by the defendant, those errors were shared ones across the team - even across the whole hospital staff - working on the children's cases. There was a sharing of advice, a sharing of clinical work, even a sharing of decision making on the diagnostic research and consequently there had to be a shared responsibility. Wrestling with this argument for a moment, I was tempted to believe that Mr Hopkins was suggesting that all the authors of the Lancet paper should perhaps have been brought before the GMC to be pronounced guilty.
'So we say', Mr Hopkins said, 'In these circumstances it is understandable that Dr Murch was reassured by and acted on the advice of his peers and more experience colleagues.' So, professor Murch was led astray by his elder and more experienced colleagues. I must admit to very slightly tearing-up at this point.
And, as silly as this seems, it has undoubtedly been one of the GMC's major problems throughout this protracted trial, that the Experimental Gastroenterological Unit at the Royal Free Hospital, was staffed by a large number of medics and during their clinical work, especially the diagnostic work they called on many specialists in surrounding departments of the hospital. The question of whether these professionals, camoflaged the wrong doing of Dr Wakefield, Professor Murch and Professor Walker-Smith or whether either openly or subliminally they struck deals with the GMC prosecution, not to be charged themselves, has to be raised.
'Even if you conclude that Dr Murch made an error of judgment' hammered on Mr Hopkins, 'about the clinical rationale for the colonoscopies on five out of the six children referred to him for this procedure, the context for his decision-making was a department that made frequent use of this investigation to enable a secure tissue-based diagnosis to be reached for the benefit of the individual patient.'
This is of course what is so hateful about the bogus legal procedure at the GMC, in order to get back to work, or to be able to work ever again in the face of a Big Pharma get-up, the defendants have to agree with the ruling of the Panel, however grossly wrong it might be, however criminal might have been the ignorance with which it was informed.
Mr Hopkins defended Professor Murch as a large bosomed woman at a blood- doners-charity cake stall might have defended her hyperactive grandchild. 'If', he said, 'You find this was an error of judgment by him, then you may think it is understandable how it arose.' Covered quickly with the fact that 'any such misjudgement is not in the ballpark of serious professional misconduct.' Mr Hopkins presented professor Murch's case as part mistake, part ethical stumble, part poor boy naiveté.
Some of the excuses offered by Mr Hopkins on professor Murch's behalf were as they say, almost 'cringe-making'. Professor Murch, as Professor Walker-Smith had, raised the matter of Professor Murch's heroic defence of MMR and public health policy following the publication of the Lancet paper. 'Dr Murch took a responsible position in public to support the continued use of MMR. Mr Hopkins drew our attention to Professor Zuckerman's evidence in relation to Dr Murch’s statements at the press briefing :
Q: And you have told us that he strongly supported the continued use of MMR; is that right?
A: Yes, very strongly; indeed, vigorously.
Of course it might be that any man would have another stand up in front of him and slip him out of a hanging, but isn't 'strongly supporting the continued use of MMR' selling ones soul, even in mitigation, at slightly too high a price.
* * *
It has to be realised, inevitable that this two day scramble for sainthood, is in a sense a virtual and not a real matter, a little like having 'friends' on facebook. On the other hand I couldn't help but be reminded of the beaten faced professional criminals I had watched at Old Bailey trials as they sat in the dock listening to their local vicar speak in their favour, 'And I remember the occasion when Billy was much younger and he helped Mrs Arbuthnot across the road outside the church and I can't help but feel that it is quite unbelievable that he should more recently, have threatened to throw acid in the face of the three security guards and then set one on fire with lighter fuel, sadly failing to put him out even when he did open up the security van'. Not that these cases were in any manner similar, just that the dissembling indulged in defeat, though all a part of the Grand-Guignol, is somehow demeaning when adopted on behalf of professional men who have done great work, and who should not only have not been found guilty in the first place but should in the second have refused arguments in mitigation on the grounds that their consciences were clear.
Mr Hopkins went on at some length about the nature of Professor Murch and then veered into the argument that the hearing had gone on for far too long and how this was relevant to any discussion over 'sanctions'. I am pondering whether to send him a request that he donate at least half of his earnings from the case, to Cry Shame the parent's organisation.
It wasn't long, before Mr Hopkins arguments in this final submission, slipped into the maudlin. He told the panel how much the farrago had cost Professor Murch and then segued into the toll that the hearing had had on his family life and was clearly going to have on his professional commitment and his identity. Then Mr Hopkins threw another log of sentiment on the fire with his own anecdote about Professor Murch's condition.
'I want to give you another quote of something he said to me when I asked him to reflect on what impact this case had had. He told me: “I am not the same person I used to be. It is going to take me years to pick up my life again. I feel the prime years of life have been robbed from me'.
For a moment I thought I heard the strains of a violin rising from the pavement below where a one armed violinist was busking. A small cardboard notice at his feet told his sad story in a hardly readable scrawl 'doctor left for destitute by the GMC'.
But why didn't Mr Hopkins on the instructions of Professor Murch state clearly that his lamentable psychological condition was caused entirely by unprincipled people who had conspired against him, in a cruel and unjust world where Big Pharma and politicians covert money more than they feel for life.
* * *
The Legal Assessor addressed the Fitness to Practise Panel, sitting as the Professional Conduct Committee, saying that they were now required to:
'consider and determine whether, in relation to the facts proved in proceedings under rule 27, and having regard to any evidence adduced and arguments or pleas addressed to you under rule 28, you find the practitioner to have been guilty of serious professional misconduct.'
He reminded the Panel that no evidence has been adduced and no arguments or pleas in mitigation have been addressed on behalf of Dr Wakefield,. 'In fact' he told the Panel, Mr Coonan specifically said to you:
'... we call no evidence and we make no substantive submissions on behalf of Dr Wakefield at this stage.” “... I am instructed to make no further observations in this case'
Clearly, whether or not this 'turning his back on the court' has affected in any way the already determined path of the GMC, Brian Deer, the government or the pharmaceutical companies, to totally destroy Dr Wakefield, is a very mute point, however it is entirely clear that this was the most principled thing that a defendant in such a trial might do.
The Panel will next sit on Monday 24 May 2010 at 9.30 a.m. although it was completely unclear as to whether this was a public session or one in camera.
Martin J Walker is an investigative writer who has written several books about aspects of the medical industrial complex. He started focusing on conflict of interest, intervention by pharmaceutical companies in government and patient groups in 1993. Over the last three years he has been a campaign writer for the parents of MMR vaccine damaged children
covering every day of the now two year hearing of the General Medical Council that is trying Dr Wakefield and two other doctors. His GMC accounts can be found at www.cryshame.com, and his own website, where you can purchase Silenced Witnesses Volumes I and II, is www.slingshotpublications.com.
Thank you for the comment about my work. I do feel very appreciated on AOA.
Yes, an out of focus and poor sound quality 'home' video of the 1998 press briefing that coincided with the publication of the Lancet paper does exist. It was played by both the defence and the prosecution during the hearing but I have no idea of how it might be possible to gain its release by either party. Because the quality of the film was so bad, a transcript was made for the Hearing and this might be of interest.
Best Wishes, Martin W.
Posted by: Martin Walker | April 27, 2010 at 09:40 PM
This article is a amazing, even by the standards we have conme to expect from you. Thank you for your hard work.
Question, I am curious to see video or a transcript of the famous 1998 press conference attended by AJW and Prof. Zuckerman. Does that exist? Has it been posted here on AoA? Does it exist anywhere?
Posted by: JonGH | April 27, 2010 at 06:50 PM
I have already purchased Silenced Witnesses Vol 2. Still, I would like to thank you for your kind and charitable offer.
Posted by: Donna K | April 27, 2010 at 12:19 PM
Dear Donna K, Yes of course you are right, the fall-out from this case has been enormous and continues to proliferate, but there at the very centre are two clear warnings to physicians.
First, don't get seriously involved in the investigation, diagnosis or treatment of pediatric gastrointestinal problems if there might be an environmental trigger - especially vaccination - involved.
Second, always deny all kinds of vaccine-damage.
In the UK this three year trial of three of the most important figures in gastroenterology has bewitched the media and the medical profession to such a degree that the cases of vaccine damaged children are now invisible.
This is why I organised, edited and published two volumes of Silenced Witnesses: The Parents' Story. Two volumes of eight chapters each written by the parents about their children post MMR vaccination. You can obtain both these volumes from my web site: http:www.slingshotpublications.com
I don't know what your financial position is Donna, but if the books and postage are too expensive for you and you want them, just send a message to my web site saying I said you could have complimentary copies of both books, with your land address and e-mail address.Martin.
Posted by: Martin Walker | April 26, 2010 at 06:09 PM
Thank you for further elaborating on the dynamics of the relationships between the three doctors in this case. For me, it is now even more apparent that Walker-Smith and Murch are being raked over the coals just for clinically investigating the children's gastrointestinal symptoms, no matter their resistance to MMR involvement. Even though I live far removed from the U.K. the chilling effect on clinical investigations, for purposes of diagnosis and treatment only, of any gastointestinal symptoms in children with autism where I live is plainly evident.
My daughter, who developmentally suffered a severe regression and was subsequently diagnosed with autism, has suffered from a myriad of gastrointestinal symptoms including chronic constipation, persistent vomitting, intestinal distress, etc. that screamed for investigation and treatment. One particular symptom, please excuse the graphic nature in my description, was that she would pass large cement-like stools covered in sand. This is completely abnormal, but the pediatric medical doctors we visited for help over the years refused to help, always the excuse, "there's nothing I can do for her." Like most of us parents of affected children, I could go on listing more intestinal-associated problems that have ensued over the years, but my point being, Drs. Walker-Smith and Murch are being held up as examples for any physician who dares help these children even if they hold an opinion in support of MMR. There will be absolutely no exceptions for anyone attempting merely to ease these children's pain. It's despicable.
Thank you for your professional diligence in the matters of fact-finding, as I can imagine it has come at great financial sacrifice to yourself (at the very least) in your tenacious tracking of the events on this issue.
Posted by: Donna K | April 26, 2010 at 12:36 PM
"one day a bright student will write a PhD thesis..."
We are full blown into the era of media manipulations at behest of industries/government in control. I wonder if even a bright student will consider that writing such a paper will still be "career ending suicide".
Posted by: michael framson | April 26, 2010 at 12:53 AM
Dear Donna, This was probably just pure laziness. Journalists see the GMC hearing out of the corner of their eyes and think that the three defendants are solid with each other against the Royal Free, against the medical and pediatric establishment, when in fact the defendants were actually not in tune from the beginning. Having attended every day of the hearing bar one or two, I know that from the time of the publication of the 1998 lancet paper and the press briefing about it, Dr Walker-Smith was heavily opposed to Dr Wakefield's view and unwilling to attend the press briefing while Dr Murch, although he attended the press briefing carefully defended MMR.
Probably in the minds of lazy journalists, and no journalist could have been more lazy than the ones who have failed to cover this three year hearing, the three defendants were imagined to be the original dissenters who were standing together in solidarity and this was why they were defendants.
One day some bright student will write a PhD thesis on the way that the international media dealt with this hearing and we will be able to gain an insight into how our perceptions of it were manipulated.
Posted by: Martin Walker | April 25, 2010 at 02:31 PM
To Martin Walker,
I really wasn't questioning your accuracy as much as bringing up an observation that I've made from reading a large number of MSM reports on the Lancet paper retraction. Where I live the media reports I have read only mentioned Wakefield, Murch and Walker-Smith regarding the Lancet paper etraction, implying that they were of the three authors that refused to sign it. Not a stretch by any means to imagine their report iss just more of the same disingenuous stories with the purpose to misled concerning the who/what/when/why of this case. Thank you for helping clear this up.
Posted by: Donna K | April 25, 2010 at 12:18 PM
Thank you for this update. From my perspective any damage in reputation as result of this "hearing" has been sustained solely by the GMC and those trying to prevent true informed consent with vaccine administration and those trying to avoid the inherant responsibility to help those who are or may have been harmed by such administration.
Posted by: JenB | April 25, 2010 at 03:11 AM
All I can do Donna K, with respect to your confusion, is give you the facts about those who signed and did not sign the 'retraction of the interpretation' of the Lancet paper. Your question, however, gives me the chance to reflect on this 'retraction'.
On April 17 2004, under considerable pressure from Dr Richard Horton the editor of the Lancet, ten of the thirteen authors of the original Lancet 'case series review' paper, signed a 'retraction of an interpretation'. The three individuals who did not sign the retraction were Dr Wakefield, Dr Harvey, and Dr Linnell. Both Dr Murch and Professor Walker-Smith signed the retraction. The retraction did not retract any of the material facts in the paper.
The retraction was a bizarre document, for it retracted only what Horton claimed was one of the conclusions of the paper; a link between MMR and autism. In fact no such link was posited in the papers conclusions, quite the reverse, the paper actually stated that none of the data reproduced constituted evidence of an association between MMR and autism. The paper was clear, that while it reported anecdotal suggestions from some parents of a temporal link between MMR and regressive autism, further research would have to be carried out before any conclusions were reached. The retraction stated:
'We wish to make it clear that in this paper no causal link was established between (the) vaccine and autism, as the data were insufficient. However the possibility of such a link was raised, and consequent events have had major implications for public health. In view of this, we consider now is the appropriate time that we should together formally retract the interpretation placed upon these findings in the paper...'
This retraction if read according to it's grammar, clearly states that the ten authors were retracting an interpretation placed on the papers findings by others, this was of course a real and philosophical impossibility, even under the most dippy of New Age tenets.
The retraction, however, did make one thing clear, while the conflict over the paper had nothing to do with the facts presented in the case series review, or the ethics of any of the authors, it had an enormous amount to do with maintaining the chimera of 'public health' and 'herd immunity'. Pharmaceutical science at its very best!
Posted by: Martin Walker | April 25, 2010 at 12:54 AM
To Martin Walker,
You wrote, "Murch and Walker-Smith recanted on the Public Health issue of MMR safety. So not only did they join in the retraction of the interpretation of the Lancet paper, they also gave full blooded public support to MMR."
I believe I have read elsewhere that Murch and Walker-Smith, along with Wakefield, did "not" join in the retraction of the interpretation of the Lancet paper. Please clear up my confusion if you will.
Posted by: Donna K | April 24, 2010 at 08:00 PM
I think there is misunderstanding here. I don't think there was anything in the representations made to the panel over sanctions that precludes Profs Walker-Smith and Murch appealing over the High Court on the Findings on Fact. I may be wrong but I would suppose that even if they were allowed to continue practicing by the GMC they could still challenge the Findings on Fact in the High Court, and I guess they probably will.
Posted by: John Stone | April 24, 2010 at 12:54 PM
My point about the GMCs tactics is that they seemed to be trying to drive a wedge between Murch and Wakefield when they suggested Murch show 'contrition'. From your account, they failed to do so. They may still offer Murch a short suspension - shorter than the length of time it would take to go through court; which might take him our of the fight, with the implicit suggestion he accepted some culpability.
That is just speculation of course, as was my prediction of Wakefield's intentions (I certainly don't want to give the impression I have inside knowledge), but everything that Dr. Wakefield has said recently, and has not said, suggests he has his sleeves rolled up ready.
With, as I understand it, the potential for appeals going all the way to Strasbourg, you would have to hope justice would be found eventually.
Posted by: GH | April 24, 2010 at 11:22 AM
Dear GH, The reason I have not discussed the appeal, is twofold. First, I really don't know what the position is with any of the defendants with respect to an appeal in the High Court. Lets say that Professors Murch and Walker Smith both get suspended rather than struck-off they might decided to cut their loses and sit out the suspension, on the other hand they might already be discussing with their counsel going to the High Court to challenge the whole hearing. As for Dr Wakefield, I have no information, we have to take into account that twelve years of his life have gone down the pan and he might not consider another however many years following them, in an appeal, to be productive. He might be thinking that when the science wins the day, he will be exonerated.
However, this matter aside, I don't agree with your argument that the 'other side' would be better off focusing solely on Dr Wakefield, when it comes to the High Court. I did spend a long time thinking about why there were three defendants and I concluded that it was because, 13 doctors authored the Lancet paper and all of them worked within the context of a major hospital coming into contact every day with higher and lower staff. Had the GMC prosecuted Dr Wakefield alone - a man who did not clinically examine any of the children nor carried out any exploratory procedures - the Panel would never have believed that he could have committed the ethical infringements cited by the prosecution, without them being noticed.
I think that this holds true for the High Court, perhaps even more so. An intelligent judge - if he doesn't have a brother on the board of GSK, or has himself undeclared shares in the company - would think very hard about this matter of Dr Wakefield being presented as a loner.
You have also to consider the fact that the GMC can not possible give Murch or Walker-Smith no sentence at all, because that would seriously undermine the whole case. So on this understanding however long a suspension is for either men, could well see them going to the High Court.
Amanda, I don't entirely follow your reasoning, my fault I'm sure. there are two matters of government knowledge of the safety of MMR. First there is the question of the two Urabi strain mumps MMR brands. The British government continued to vaccinate with these between 1988 and 1992,when they stopped using it, even though it had been rescinded by the Canadian government and found to be unsafe. However, the adverse reactions from Urabi were related to meningitis and not inflammatory bowel disease and regressive autism.
If you are referring to Dr Wakefield alerting the head of the department of Vaccine and Immunisation and other politically appointed functionaries and NHS staff about an impending possible public health crisis, from the triple vaccine, which he thought could be related to the measles aspect of MMR. Then Dr Wakefield began informing the NHS and the government around 1993/4 and continued to inform them over the next five years until 1998.
But the government and the GMC prosecution and everyone on the 'other side', has never given credence to Dr Wakefield's view and would still say that they 'knew' nothing, having simply heard Dr Wakefield's scientifically unsound personal opinion.
This in fact is the nub of the whole matter, the UK government has decided to make all vaccine damaged children and their parents invisible. Besides the science, the political campaign of the parents is primary - to make them and their children real to the public and shame the politicians into facing up to their their crimes.
Posted by: Martin Walker | April 24, 2010 at 08:53 AM
Martin - the aspect you have not discussed is that the GMC must know from Wakefield's response that this will be fought again in a real court.
Neither Walker-Smith nor Murch seem to have given them much ammunition against Wakefield, so the GMC will now have to decide whether it is better tactically to fight the next round against all three or to single out the main target.
Posted by: GH | April 24, 2010 at 05:20 AM
My grandson was not one of the original 'Lancet twelve' children; he was a later identical case, treated at the Royal Free Hospital by Profs Murch and Walker Smith.
My grandson was properly referred by his GP for investigation and treatment for his bowel pain and symptoms.He was treated appropriately and with sympathy and kindness by these two outstanding clinicians and we are all very grateful to them for their professional care. How can Profs Murch and Walker Smith possibly be criticised far less 'struck off' for doing their jobs and doing them well??
We are OUTRAGED by this GMC medieval style inquisition. If this is 'justice' then we have gone back to the dark ages.
Posted by: Jenny Allan | April 24, 2010 at 02:37 AM
Doing the math, I see that the MMR jab was known to be dangerous before my son received it, thereby losing his previous burgeoning verbal skills. Like many other Big Lies, this one is almost too horrible to contemplate. I appreciate Age of Autism continuing the arduous and complex task of bringing the truth to light. I will continue to read all posts about this subject--probably for decades, as the Big Liars aren't going to let go easily.
Posted by: Amanda Blinn | April 24, 2010 at 01:20 AM
"I think that you might be wrong to use the word 'outcome' as if the hearing has been a process which came to a logical and real conclusion. I think the whole matter must already have been decided upon in 2004, before the charges were even drawn up."
I agree, sort of. It is clear that there were attempts in 2006 to call the whole thing of with editorials in the Independent, New Scientist, BMJ, and even Michael Fitzpatrick in Spiked-online. People were obviously getting cold feet, and even now I believe they had lots to have cold feet about. Indeed, even Goldacre for a long time seemed to have a rational take on the protocol business whch he silently abandoned when the findings on fact came in. But I agree the spirit of the show trial hovered over it from the beginning. Everyone stuck to the script, didn't take any notice of the defence, and now we have the absurd and horrific result.
Posted by: John Stone | April 23, 2010 at 07:59 PM
Dear Seonaid, I think that you have got it almost right but you need to factor in some information that is not in my last account. There is the fact that Dr Wakefield was looking at the cases of vaccine damaged children from around 1993 and was concerned about the measles component of MMR from this time. Although he wrote on a number of occasions to the head of NHS vaccination and immunology, it took almost six years before this functionary arranged a meeting. What is important here is that it is evident that Dr Wakefield was well ahead of the curve before he was joined by professor Murch or Professor Walker-Smith in dealing specifically with children damaged by MMR.
Then there is the crucial matter of the Press briefing during which Dr Wakefield was pressed into answering a journalists question about the triple vaccine. In suggesting that perhaps parents might like to continue with the single vaccines (an answer he had been tutored in by Professor Zuckerman) until diagnostic research at the RFH had come to conclusions about the safety of MMR, Dr Wakefield committed career suicide.
When looking at the three defendants, there is something else we must be very aware of, something that comes with the prosecution propaganda in the case; that it would have been impossible to try Dr Wakefield on his own. In fact it was hard enough with only two other defendants, when it was obvious that a whole hospital department knew that nothing illicit was going on.
But if these two stalking horses had been added to the prosecution, it would appear only sensible to not actually 'erase' them from the Medical Register. In not so doing, this would make it look as if the GMC was fair minded - especially if they pretended as they did last week that they were about to erase him. Also, it would leave the one defendant they really wanted to eradicate as the person receiving the most extreme punishment.
Finally, there is the point that you make very well and which I drew attention to in my post, that both Murch and Walker-Smith recanted on the Public Health issue of MMR safety. So not only did they join in the retraction of the interpretation of the Lancet paper, they also gave full blooded public support to MMR.
I think that you might be wrong to use the word 'outcome' as if the hearing has been a process which came to a logical and real conclusion. I think the whole matter must already have been decided upon in 2004, before the charges were even drawn up.
Posted by: Martin Walker | April 23, 2010 at 05:39 PM
I wonder if I have got this right?
Professor John Walker Smith was responsible for final decisions made about the tests and treatments for the children – after discussion with and agreement from his colleagues and team members – but is too well know and respected to be penalised.
After discussion with and agreement from his colleagues and team members, Professor Simon Murch carried out the agreed procedures, but youth and the effect on his career must be taken into consideration.
And Andrew Wakefield, as a researcher was directly responsible for neither, other than as a team member whose views would of course be taken into account and agreement sought.
It sounds as if the outcome will be based solely on the fact that it was Andrew Wakefield made the statement implicating the triple vaccine. And in today’s climate, the Establishment of course deems this totally unacceptable. Nothing must damage the reputation of MMR vaccine. That is the nub of the matter.
Posted by: Seonaid | April 23, 2010 at 02:23 PM
Men occasionally stumble over the truth, but most of them pick themselves up and hurry off as if nothing ever happened. - Winston Churchill.
Posted by: GH | April 23, 2010 at 06:31 AM