Turning a blind eye to the truth

Here’s a sentence I never expected to read: ‘Private Eye got it wrong in its coverage of MMR.’ Of course, even a degree of contrition over its egregious record of support for Dr Andrew Wakefield, whom the General Medical Council recently judged guilty of dishonesty and irresponsibility, is welcome. But the Eye’s apology falls far short of acknowledging the true scale of its failure – which is symptomatic of the wider failure of the media in relation to the MMR/autism controversy.

‘So when should the Eye have bailed out?’, asks MD, the Eye’s medical correspondent, in the current issue. After much huffing and puffing and citing of scientific references, MD finally concedes that in 2005, after a second review of the evidence by the Cochrane foundation, the Eye ‘should have conceded the argument’ (this is the extent of its apology). MD claims that in 2001, ‘when the Eye joined the controversy’, there were ‘plenty of specialists willing to support the possibility that Wakefield might be right’ – indeed ‘27 expert witnesses’ were supporting the campaign to sue the MMR vaccine manufacturers. In fact, as was comprehensively exposed in the Omnibus Autism Proceedings in the USA last year, in which many of the same specialists appeared, few had relevant expertise or current experience, many were professional expert witnesses and several claimed academic and professional qualifications to which they were not entitled. Not a single paediatrician, child psychiatrist or gastroenterologist in the UK has ever endorsed the Wakefield theory.

By 2001 the balance of scientific evidence was already clear. In the three years since his 1998 Lancet paper had advanced, without any evidence whatsoever, a highly implausible hypothesis, Wakefield had failed to produce any credible evidence in support of this hypothesis (this is still the case a decade later). In 1999, the former Royal Free paediatrician Brent Taylor, working with vaccine specialist Elizabeth Miller and others, had produced powerful epidemiological evidence against the suggested MMR-autism link. The Medical Research Council had conducted three inquiries – in 1998, 2000 and 2001 – and had found no basis for Wakefield’s claims. In the USA, the Institute of Medicine and the American Academy of Pediatrics had come to the same conclusion.

Here it is important to emphasise that the Eye did not merely offer routine ‘coverage’ of the controversy. In May 2002 it published a 32-page ‘Special Report’ – MMR: The Story So Far – which was, in an extraordinary and unprecedented gesture, distributed alongside the regular edition. This report presented a comprehensive account of Dr Wakefield’s case against MMR, providing the campaign with a new manifesto to succeed the one produced in 1998 by the solicitor Richard Barr to attract clients for his anti-MMR litigation (see MMR and Autism: What Parents Need To Know, by Dr Michael Fitzpatrick). Supporters of the Wakefield campaign were sympathetically portrayed while its critics were gratuitously smeared by specious claims of conflicts of interest (gleaned from publicly available declarations). Though Private Eye’s anti-MMR propaganda pamphlet provided the template, both in form and content, for much subsequent media reporting of the MMR issue, it goes without mention in MD’s apology.

Private Eye’s anti-MMR special report was written by Heather Mills, a journalist lacking any background in scientific or medical reporting. Yet, as the US autism specialist Laura Schreibman writes, ‘one need not be a scientist in order to know how to evaluate information critically: one just needs to be appropriately critical’. What is striking about Mills’ report is that it is utterly uncritical of Dr Wakefield, taking him and his supporters entirely at their own estimation. The Eye special depicted Dr Wakefield as a ‘caring, listening’ doctor (though he never had any clinical responsibility for children), as a pioneering researcher who had already discovered the cause of Crohn’s disease (a discovery not recognised in gastroenterology), and as a heretical genius (whose insights into autism remain unrecognised).

The significance of the Private Eye special report lies in the way in which it both reflects and appeals to the particular constellation of anxieties, resentments and prejudices underlying the popular impact of the campaign against MMR. One feature of this outlook is an irrational fear of environmental threats to health, including not only diverse forms of radiation and chemical toxins, but also therapeutic agents such as antibiotics and vaccines. Another theme in the anti-MMR worldview is cynicism towards scientists and doctors, often accompanied by credulity towards different schools of alternative medicine. Additional features are distrust of official and medical authority and hostility towards the pharmaceutical industry (attitudes not generally accompanied by any wider questioning of the state or capitalist enterprise). Among some campaigners these attitudes assume a level of intensity approaching paranoia, expressed in belief in conspiracy theories linking big pharma, big government and the medical establishment. The fact that Private Eye – as well as the Daily Mail and the Daily Telegraph – took up the anti-MMR cause gave it an aura of radical legitimacy, confirming the resonance of these sentiments across familiar political and social boundaries.

With some deficit of irony, MD insists that the Eye was ‘right to keep asking questions on behalf of parents’. But the problem was that the Eye never asked any questions of Dr Wakefield – and, in my capacity as a critical parent, I provided a list in response to the Special Report back in 2002. Apparently following the familiar Wakefield tactic of first painting himself into a corner and then proceeding to dig, and keep digging, MD continues that the MMR story ‘could have been’ a medical scandal, ‘but it wasn’t’. But, of course, it was a scandal – the scandalous attempt to blame an effective child vaccine for causing autism – and one which was first exposed by a real investigative journalist, Brian Deer (a name entirely absent from the Eye account) in 2004, in terms comprehensively endorsed by the General Medical Council last month.

Since the General Medical Council verdict, Dr Wakefield (who still awaits what now seems the inevitable sentence of removal from the medical register) has found himself abandoned by many of his former supporters. He has been expelled from the private clinic which he helped to found in Texas; his Lancet paper has been formally withdrawn (as has another, more recent, paper); he has even been rejected as a potential client by publicist Max Clifford. Two of his leading US supporters – Arthur Krigsman and Jeffrey Bradstreet – both of whom have appeared at his side at conferences in the UK, are also under a cloud. Both were severely criticised in the Omnibus Autism Proceedings for the poor quality of their expert evidence and for their clinical care for litigants. Following earlier disciplinary proceedings in both New York and Texas, Dr Krigsman has also left the Texas clinic. Dr Bradstreet, notorious for his Bible-bashing exorcisms as well as for promoting his own line of vitamins to patients at his Florida clinic, has filed for bankruptcy.

Meanwhile in the UK, the lawyer Richard Barr has long abandoned the 1,500 families he led in a futile quest for compensation. Heather Mills joins a long list of journalists who once lionised Dr Wakefield in a self-imposed silence.

In the Eye, MD sagely concludes with the comment that ‘there have been plenty of medical scandals exposed by investigative journalism, and plenty more to expose’. Well here’s a suggestion. Journalists in the USA, notably Trine Tsouderos of the Chicago Tribune, have begun to investigate the scandals surrounding the treatment of children with autism in private clinics. Perhaps journalists in the UK could make some amends for their uncritical coverage of the campaign against MMR by investigating the conduct of similar clinics in Britain.

Dr Michael Fitzpatrick is the author of MMR and Autism: What Parents Need to Know (buy this book from Amazon(UK)) and Defeating Autism: A Damaging Delusion (buy this book from Amazon(UK)).