Thursday, 17 October 2013

The debate is over on vaccination and smoking both!

Two articles in one day declare as much. A Guardian writer bemoans the need for editorial coverage of the vaccination issue to cover the anti-vaccine position. And the BMJ decides it won't cover any research funded by the tobacco industry – a decision I thought it had taken years ago.

I actually understand the Guardian writer's position about false balance. Something of the kind occurs regularly on news broadcasts when two spokespersons from major parties face each other in discussion. Deciding the parameters of the discussion is something editors have to do on all subjects and I suspect many are quite lazy some of the time – such are the pressures of broadcasting – and break down the debate into something like a false dichotomy.

However I disagree with her, as I do with the BMJ on tobacco, that the best course is to take the view that the 'other side' is incapable of making a valid contribution to the debate. The mere fact that a researcher is funded by big tobacco, for example, does not invalidate the conclusions of the study. All major corporations engage in activities with adverse health effects, but I cannot think of any other whose intentions are so reviled. The justification is that tobacco companies set out specifically to injure their customers (surely their purpose is to satisfy a market desire for a popular product), and everything they do must contribute to this murderous intent.

In my view, tobacco companies make a consumer product with known health risks. Some of these they have sought to cover up. Pharmaceutical companies make products that carry significant health risks (there are plenty of cover-ups here too), and are arguably more dangerous, because they don't declare this on the tin. You expect to be cured by pharmaceutical companies, yet there is an alarming list of medical injuries running into hundreds of thousands. For every tobacco CEO scheming how to recruit teenage smokers, there is a pharmaceutical salesman wondering how to dump unapproved drugs in some far flung corner of the world to reduce losses.

I have no direct experience of the debate on vaccinations – I don't have children so have never had to take the decision whether to vaccinate them. But I have taken an interest in the debate on autism because it seems to me that there does have to be some explanation for the stupendous jump in autism rates that we have seen in the last 30 years, beyond an improvement in diagnosis methods.

But there is more to this debate than whether autism is caused or triggered by the MMR vaccine. There is the issue of the way autistic children are treated. Dr Andrew Wakefield, known primarily for his position on vaccines,* treated children with gut problems that had been associated with an MMR vaccine, putting them special diets to improve gut flora and achieving significant health improvements. As I understand the story, his assertion of a link between autism and gut problems has also been challenged by journalist Brian Deer.

It seems to me that Dr Wakefield and those who follow him have sought to understand the problem of children in chronic pain who have lost their communication skills following autism jabs. Whatever the cause of their autism, the duty of doctors is to treat their symptoms. In the short video below, this duty is completely by-passed, as doctors treating Alex concluded that there was no physical condition to treat, even following the results from an endoscopy. Autism, to them, is a psychiatric condition, and they did not cooperate with any attempt to show them otherwise; the story starts when a doctor advises his mother to stop the special diet designed to help the gut flora.

Whatever the cause of autism in this case, it demonstrates a failure at every level to pursue reasonable treatment options for the young man concerned, with the exception of specialists who could not influence events, in spite of their best efforts.

This is just one example of why I oppose censorship on the lines suggested by the BMJ and in the Guardian. Polarizing the debate helps no one except those who, for their own reasons, want to suppress information.

The video is also a fundraiser for the purpose of producing a full documentary on this case. Please share and donate if you can.

*Dr Wakefield, contrary to popular belief, is not anti-vaccine as such. A gastroenterologist, he supported parents who were convinced of a link between MMR and autism and whose children also suffered from gut problems. His paper in the Lancet, withdrawn by the paper some time after publication, did not claim an explicit link, but described the case studies of a small number of children whose autism had followed MMR jabs. In the course of his work he discovered that proper safety trials for combined vaccines had not been carried out. At the outset his fear was that improper use of vaccines would imperil legitimate vaccine use by losing the confidence of the public. He has explained his case many times publicly and is easily found on Youtube.  

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