GMC brands Dr Wakefield 'dishonest, irresponsible and callous'

[Guest guest]

my comments interspersed.............

http://www.telegraph.co.uk/health/7095145/GMC-brands-Dr--Wakefield-dishonest-irresponsible-and-callous.html

GMC brands Dr Wakefield 'dishonest, irresponsible and

callous'

As the GMC announce their findings that Dr Wakefield " failed

in his duties " , he talks to Cassandra Jardine.

By Cassandra Jardine

Published: 7:00AM GMT 29 Jan 2010

Standing outside the General Medical Council yesterday, surrounded by

crowds of supporters, Dr Wakefield appeared shell-shocked by the

GMC’s damning findings that he had been “dishonest, irresponsibile and

showed callous disregard for the distress and pain of children.” Rallying

some of his usual bravado, he then declared himself “resolute and

determined” in the face of disgrace.

“I still had a naive belief in justice, I didn’t believe it could be

quite like this,” he told me when the hubbub had subsided. “I feel so

sorry for the children and their parents, it’s desperate for them. But

the struggle goes on. The chap who discovered Thalidomide said this

always happens and fifty years later he received an apology.”

For two and a half years a panel has been listening to arguments about

whether Wakefield, and two erstwhile colleagues from the Royal Free

Hospital in London – Professor - and Professor Simon

Murch – were guilty of unethical behaviour in the way they conducted

research. At the heart of the case lies a 1998 paper, published in the

medical journal The Lancet: a study of 12 patients with autism and

bowel disease which might have been linked to the MMR

(measles/mumps/rubella vaccine. Its publication, and the views expressed

by Wakefield, a gastroenterologist, at the press conference afterwards,

led to widespread panic about the safety of MMR.

The conduct of the study – not its conclusions – has been the subject of

the hearing, but the paper was a landmark in the debate surrounding the

safety of vaccines. It created the panic that led to a drop in uptake of

the MMR, which now stands at 78 per cent, and a subsequent rise in cases

of those diseases. Last year in England and Wales there were 1,143 cases

of measles, which can lead to brain damage and death.

Long before the GMC concluded that Wakefield had “failed in his duties”,

he was a villain to many within the medical establishment – an arrogant

doctor who published his findings too soon, a man whose reputation

mattered more to him than public panic and herd immunity. In 2004, 10 of

the 13 authors dissociated themselves from a paper which the editor of

the Lancet, Horton, described as “fatally flawed”. [no,

they only dissociated themselves from an interpretation not the

study............sheri]

But to the parents who wept outside the GMC today, Wakefield is a

hero, a wronged man. Among them was Polly Tommey, founder and editor of

The Austim File, a magazine whose readership of 40,000 consists of

parents whose children have autism combined with bowel problems. They are

looking for explanations and cures. Wakefield, to them, represents hope,

and it is in Tommey’s west London home that Wakefield invited me a week

ago, because he wanted to explain his case.

His mood then was considerably more bullish than yesterday. Far from

feeling contrite, or admitting to nerves, he was on the attack. His

targets were the Government, Public Health supremos (with capital

letters he later emails to make clear), the press in general and

Deer in particular – the journalist whose three letters of complaint

to the GMC had led to the longest, and most costly, trial in that

organisation’s 148-year history.

For a man who has been under intense pressure since 1998, he appeared

unlined for his 53 years. In 2001, he lost his job at the Royal Free, and

moved to America while his wife Carmel, also a doctor, and their four

children, currently aged from 21 to 12, stayed behind in England. They

joined him three years later, once he had established Thoughtful House, a

research and treatment centre, in Austin, Texas. “It has been pretty

terrible,” he admits and his face briefly takes on a vulnerable look, but

he does not wish to dwell on personal matters.

Wakefield is a man who says what he wants to say, not what others may

wish to hear. His agenda is to vindicate himself. “The GMC might find

fault,” he believed before the findings were handed down. “They might

find misconduct, but they won’t find serious professional misconduct.”

How seriously the GMC views yesterday findings of fact will be decided in

a few months’ time, together with sanctions against the three doctors.

They are likely to be struck off the medical register. Although Wakefield

no longer works in England, he may find it hard to attract patients to

Thoughtful House, although he believes the findings to be “unfounded and

unjust” on all but one count – taking blood samples from children at one

of his own children’s birthday parties. [i doubt he will

have any problem attracting patients to Thoughtful

House......sheri]

It was a strange thing to do, without approval from the Royal

Free’s ethics committee, but he wanted a control group to contrast with

his sick patients. He continues to believe it was not unethical. “I had

fully informed parent and child consent. The ethics committee is there to

protect NHS patients, and these weren’t NHS patients.”

More seriously, he was charged with causing pain to sick children by

painful, intrusive diagnostic treatments. But the researchers had

ethical approval, he argues, producing a letter, dated 27 Februrary 1997,

from Professor -, the head of the department of Paediatric

Gastroenterology at the Royal Free, noting approval for biopsies and

organising further approvals. Wakefield believes the letter is his

smoking gun. “For some bizarre reason the GMC do not seem to have had

this document. My barristers didn’t have a copy because their job is to

respond to the documents presented to them.”

Other charges related to whether the research team was receiving money

for the study as part of a legal action which sought to show a link with

MMR. Although some of the children in the study subsequently become part

of the legal action, he says they were not involved when he first

examined their symptoms, and wrote the report. He saw no conflict.

“The Lancet rules then were: ’What do you, the author, think

determines conflict of interest?’ A year or two later the definition was

changed to 'what others might perceive as conflict of interest’ " .

Behind his cool manner, and soft voice, lies rage. He believes he has

been the victim of a media campaign. “Repeat after me: 'Wakefield

discredited, Wakefield discredited,’ if you say it often enough it will

stick.” But why? “There was a huge political will to prosecute. Don’t you

dare challenge vaccination, was the message. The motive was not always

financial. It was a belief system. I am, of course, deeply concerned with

public health, but not with the structure of Public Health. I’m

interested in the individual who comes in and sits down at the table and

says: 'This is what happened to me or my child.’ That’s why I came into

medicine.”

Between 1996 and 2000 more than 1,000 pateints were referred to the

paediatric gastroenterology team at the Royal Free because -,

now retired, was the leading light in the field. “Many of the letters

from parents and doctors said the same story, that shortly after

vaccination these children had suffered some kind of event that left them

with autism and bowel problems. It seemed to be a new kind of autism.” As

well as studying patients referred to him from all over the world, he

trawled the literature on the safety of vaccines and wrote a 250-page

report in which he expressed his horror at the inadequate research.

He regrets the downturn in vaccination that resulted form his work,

because lack of compliance “creates a dangerous situation” but feels the

Government is responsible. “We added this line to The Lancet

paper: 'We do not prove an association between the MMR vaccine and the

syndrome described.’ Any drug, especially one that involves three live

viruses, must be considered dangerous until proven otherwise. At the

press conference I said that I supported the use of single vaccines until

any causal link with MMR had been investigated. But the single vaccines

weren’t made available.”

Since then many studies have found no link. He remains unconvinced.

“There are studies from six countries which show a link. In the US,

there have been a number of court cases in which the link has been

acknowledged.”

As for the epidemiological studies, he says that you can achieve any

result you want by manipulating statistics. “We are not up against

science, but interpretation.”

His hope now is that he can continue researching and treating children

whose autism seems be at least partially alleviated through managing

their gut problems, whatever the cause. “Thousands of children are

presented with these problems every day. We can do a huge amount to help

them. The more we can understand this disorder, the more impact we can

make by practising straightforward simple medicine – and not treating

these children as an anomaly or an inevitability. I’m a scientist. I ask

questions, I don’t know the answers. The science will tell the story in

the end.”

If so, one day, he may be vindicated. But for now he is no hero, only a

maverick who put lives at risk because he did not conduct his research

properly. [he is still a hero to those whose opinion

matters..............Sheri]

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Sheri Nakken, R.N., MA, Hahnemannian

Homeopath

Vaccination Information & Choice Network, Washington State, USA

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