By John Stone
Nearly a year after the United Kingdom’s General Medical Council (GMC) brought in its findings on fact against Andrew Wakefield, John Walker-Smith and Simon Murch, one of Wakefield’s principal adversaries, doctor and Guardian newspaper journalist Ben Goldacre, has published comments in IrishHealth which challenge the basis of the GMC’s central finding against the three doctors at its foundations. Goldacre, who initially welcomed the verdict has reverted to the views he expressed in an award winning article in 2005, in which he expressed the opinion that the Lancet paper was a legitimate study. He told the Irish on-line publication:
“But you have to remember this paper didn’t actually say MMR causes autism, it didn’t even speculate on that. It was accompanied by an editorial that said by the way people should be very clear that it doesn’t mean that MMR causes autism.
“Also, this was a 12 subject case series report - it was a description of only 12 children’s clinical anecdotes, and while this is not good evidence to say MMR causes autism, it is a perfectly legitimate thing to publish.”
This is at variance with the GMC finding that rather than being “a 12 case series report” it was an ill-conducted version of a protocol sponsored by the United Kingdom’s Legal Aid Board (now Legal Services Commission), and a totally different kind of study. The lack of correspondence between the Lancet paper and the LAB protocol led in turn to the panel finding the three doctors were in detailed breach of the protocol despite their representations that they had never been doing it, and also to the single most distressing finding against Wakefield that he was dishonest because he had failed to account for the LAB’s sponsorship.
The GMC panel stated (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, the panel never explained what specific “available evidence” had led them to disregard the evidence presented by the defence on this matter, and their statement was additionally misleading because ‘162-95’ was not “a Project” at all but simply the generic permission granted to Prof Walker-Smith to retain biopsies for further research, thus avoiding having to explain in front of the media why this permission did not pertain in the instance of the Lancet paper.
Goldacre originally stated his views in an article in 2005 (HERE) in which he wrote:
"...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."
And remarkably when the article won an Association of British Science Writer’s award the following year Evan Harris the Liberal Democrat politician who first made these allegations against Wakefield with Sunday Times journalist Brian Deer was on the panel of judges (HERE). Whatever Harris’s private views the article seems to have led to bad feeling between Goldacre and Deer (HERE).
It is apparent that Goldacre’s views, stated first of all in 2005 and then again last month are incompatible with the findings of the GMC hearing against the three doctors, and that he must consider that a grave and prolonged injustice has been done. If this is the case he surely has a moral obligation to say so.
Then, when the legal prejudice has been removed from this matter we can get back to considering the science on a level playing field.
Ben, the ball is in your court.
(With thanks to Jake Crosby who drew my attention to the IrishHealth.com article.)
John Stone is UK Editor for Age of Autism.