Brian Deer on the Wakefield Autism Scandal

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I’m really pleased Russ Roberts stepped outside of his usual economics beat, to talk with Brian Deer on Autism, Vaccination, and Scientific Fraud about the Andrew Wakefield controversy. It’s a real public service.

Before Deer’s inquiries, Wakefield had appeared to all the world to be an independent, if controversial, researcher. Tall and square-headed, with hooded eyes and a booming voice, he was the son of doctors (a neurologist and a family practitioner), had grown up in Bath, a prosperous, west-of-England spa town, and joined the Royal Free in November 1988, after training in Toronto, Canada. His demeanour was languid – he was privately educated – and, born in 1956, he was a lingering example of the presumed honour of the upper middle class.

I’m really pleased Russ Roberts stepped outside of his usual economics beat, to talk with Brian Deer on Autism, Vaccination, and Scientific Fraud about the Andrew Wakefield controversy. It’s a real public service.

Before Deer’s inquiries, Wakefield had appeared to all the world to be an independent, if controversial, researcher. Tall and square-headed, with hooded eyes and a booming voice, he was the son of doctors (a neurologist and a family practitioner), had grown up in Bath, a prosperous, west-of-England spa town, and joined the Royal Free in November 1988, after training in Toronto, Canada. His demeanour was languid – he was privately educated – and, born in 1956, he was a lingering example of the presumed honour of the upper middle class.

But the investigation discovered that, while Wakefield held himself out to be a dispassionate scientist, two years before the Lancet paper was published – and before any of the 12 children were even referred to the hospital – he had been hired to attack MMR by a lawyer, Richard Barr: a jobbing solicitor in the small eastern English town of King’s Lynn, who hoped to raise a speculative class action lawsuit against drug companies which manufactured the shot.

Unlike expert witnesses, who give professional advice and opinions, Wakefield negotiated a lucrative and unprecedented contract with Barr, then aged 48, to conduct clinical and scientific research. The goal was to find evidence of what the two men called “a new syndrome”, intended to be the centrepiece of (later failed) litigation on behalf of an eventual 1,600 families, mostly recruited through media stories. This, publicly undisclosed, role for Wakefield created the grossest conflict of interest, and the exposure of it by Deer, in February 2004, led to public uproar in Britain, the retraction of the Lancet report’s conclusions section, and, from July 2007, the longest-ever professional misconduct hearing by the UK’s General Medical Council.

Barr paid the doctor with money from the UK legal aid fund: run by the government to give poorer people access to justice. Wakefield charged at the extraordinary rate of £150 an hour – billed through a company of his wife’s – eventually totalling, for generic work alone, what the UK Legal Services Commission, pressed under the freedom of information act, said was £435,643 (about $750,000 US), plus expenses. These hourly fees – revealed in The Sunday Times in December 2006 – gave the doctor a direct, personal, but undeclared, financial interest in his research results: totalling more than eight times his reported annual salary, and creating an incentive not only for him to launch the alarm, but to keep it going for as long as possible.

In addition to the personal payments was an initial award of £55,000, applied for by Wakefield in June 1996 – but, like the hourly fees, never declared to the Lancet, as it should have been – for the express purpose of conducting the research later submitted to the journal. This start-up funding was part of a staggering £18m of taxpayers’ money eventually shared among a group of doctors and lawyers, working under Barr’s and Wakefield’s direction, to try to prove that MMR caused the previously unheard-of “syndrome”. Yet more surprising, Wakefield had predicted the existence of such a syndrome – which he would later dub “autistic enterocolitis” – before he carried out the research.

This Barr-Wakefield deal was the foundation of the vaccine crisis, both in Britain and throughout the world. “I have mentioned to you before that the prime objective is to produce unassailable evidence in court so as to convince a court that these vaccines are dangerous,” the lawyer reminded the doctor in a confidential letter, six months before the Lancet report.

And, if this was not enough to cast doubt on the research’s objectivity, The Sunday Times and Channel 4 investigation unearthed another shocking conflict of interest. In June 1997 – nearly nine months before the press conference at which Wakefield called for single vaccines – he had filed a patent on products, including his own supposedly “safer” single measles vaccine, which only stood any prospect of success if confidence in MMR was damaged. Wakefield denied any vaccine plans, but his proposed shot, and a network of companies intended to raise venture capital for purported inventions – including a vaccine, testing methods, and strange potential miracle cures for autism – were set out in confidential documents. One business was later awarded £800,000 from the legal aid fund on the strength of now-discredited data which he had supplied.

Yet, as grateful as I feel for this podcast and cognizant that so many suffered for Wakefield’s greed, the issue of useless theorizing and bad science education recurred at the end of the podcast.

My lesson–what I try to teach my children–is to be skeptical of scientific findings. Hard for us. A lot of us are vulnerable. We like good stories. We like to be scared. We like to think the scientists have the answer. A lot of us in the street think: well, if scientists don’t have the answer, what’s the point of them? That’s what we have them for. To discover that scientists actually don’t have the answers but are all just putting forward ideas for testing and maybe eventually one or two of them will prove to be correct is kind of a bit of a dispiriting view of the nature of science. A lot of romance about it

We are this fallible animal whose brain looks for stories and possesses certain capabilities and limitations. But, humans are also remarkably sociable, and our evolution depends on it, and has depended on it. If anything this Wakefield scandal demonstrates why we need to develop those social mechanisms for protecting ourselves against our worst limitations. When it comes to the interconnection between business and science, I think we need to be more regulatory, erring more in the direction of science than commerce or convenience. We need more consumer protection with lay participation, but also with professional support. And, of course, we need more effective education.

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Filed under: Europe, Law, Podcasts, Politics, Science Tagged: andrew wakefield, autism, brian deer, mmr, the lancet, vaccines



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