“Followers of Jesus are required to pursue truth wherever it leads them.”
Dallas Willard
Then you will know the truth, and the truth will set you free.
John 8:32 (NIV)
Yesterday’s British Journal of Medicine detailed the specifics of how Dr. Andrew Wakefield and his colleagues in England misrepresented data in his 1998 paper (subsequently retracted by The Lancet) claiming a link between the MMR vaccine and rapid onset of symptoms of autism.
After posting the link to the article earlier today on the Key Ministry Facebook page, I caught some flack from one of our followers who has two boys with autism who found the tone of the post a little insensitive…it probably was. I thought I owed her a little more than the standard brief response to a Facebook comment as to why I was so bent out of shape about this study, so here goes:
Truth is absolutely central to our Christian faith. Truth invariably points us back to the person of Jesus Christ.
I don’t see any disconnect at all between my identity as a physician/researcher and my identity as a follower of Christ. When I was at the child psychiatry meetings a couple of months ago sitting in on the presentations of preliminary neuroimaging and genetic research into conditions like autism and ADHD, I couldn’t help but marvel at the extraordinary complexity with which we were made. The intricacy of the human brain could only have come about under the influence of an incomprehensible intelligence. I can’t not think about God and His magnificence as I learn more about the design of His creation!
I had the honor of serving for six years (2001-2007) on the Program Committee and New Research Subcommittee of the American Academy of Child and Adolescent Psychiatry (AACAP). The Program Committee reviews all of the research submitted for presentation at the Annual Meeting and makes determinations as to the scientific merit and relevance of the information presented to 5,000 physicians and researchers from around the world. Under the leadership of Dr. Bennett Leventhal, Dr. Larry Greenhill and others, the Academy very intentionally “raised the bar” in terms of the quality of research in the child and adolescent mental health field. I learned more about critical thinking in my first weekend on the Committee than I had in med school, residency and fellowship put together. I’ve witnessed firsthand how the processes in place for vigorous peer review of research with appropriate disclosure of potential conflicts of interest leads to discoveries that guide us in helping kids with serious emotional, behavioral and neurodevelopmental disorders and their families. Vast improvements have occurred in the quality of the studies being conducted, transparency of funding sources and availably of study data, especially studies in which the hypothesis tested wasn’t proven to be true with an appropriate degree of certainty. If I’m committed to seeking truth, the truth, when I find it, is going to reflect something about the character or glory of God, or have some use in restoring his Kingdom through providing comfort or healing.
By accepting the incredible privilege of calling myself a follower of Christ, I also recognize the responsibility to present myself to others in a a way that reflects positively upon Him. In practical terms, that means reflecting excellence in the quality of assessment and treatment I provide to the kids and families served through my practice, the research we do, the interactions I have with other professionals, the manner in which I serve in our church and hopefully, in the quality of the resources and services Key Ministry provides to church staff and volunteers. As a result, the work I did with AACAP, the work we do in our practice (teaching/research/clinical care), work peer-reviewing studies…the work I do should be worship…participating in God’s plan to make things right again and redeem His creation.
I become intensely frustrated when I see Christian parents and families accept unproven theories and treatments, investing time, money and hope in approaches that less likely to be of benefit to their kids when proven alternatives are available. The reasons for this are complex and beyond the scope of this post, but I’m angered when kids and families who are my brothers and sisters in Christ settle for second best. After all, we’re the children of the King!
So…if Jesus is “the way, the truth and the life,” what’s the nature of something that’s demonstrably not true?
Coming back to Wakefield’s study, there were major problems with the methods used in recruiting patients to participate in the study, described in the retraction to the Lancet article. There appeared to have been attempts to obscure the source of funding for the study (trial lawyers) or the potential for financial gain for Dr. Wakefield and his co-authors by providing services to lawyers based upon the results of the study. The paper in BMJ suggests that this study was plagued by more than poor design and study methods, but represented a deliberate attempt to deceive readers.
Fiona Godlee, editor in chief of the British Medical Journal, summed it up in her editorial:
“Clear evidence of falsification of data should now close the door on this damaging vaccine scare.”
Continuing with the editorial:
“The Office of Research Integrity in the United States defines fraud as fabrication, falsification, or plagiarism.13 Deer unearthed clear evidence of falsification. He found that not one of the 12 cases reported in the 1998 Lancet paper was free of misrepresentation or undisclosed alteration, and that in no single case could the medical records be fully reconciled with the descriptions, diagnoses, or histories published in the journal.
Who perpetrated this fraud? There is no doubt that it was Wakefield. Is it possible that he was wrong, but not dishonest: that he was so incompetent that he was unable to fairly describe the project, or to report even one of the 12 children’s cases accurately? No. A great deal of thought and effort must have gone into drafting the paper to achieve the results he wanted: the discrepancies all led in one direction; misreporting was gross. Moreover, although the scale of the GMC’s 217 day hearing precluded additional charges focused directly on the fraud, the panel found him guilty of dishonesty concerning the study’s admissions criteria, its funding by the Legal Aid Board, and his statements about it afterwards.14
A purposeful deception occurred that led to widespread resistance to child immunization in cities and towns through the UK. (Rates of immunization in the US never dropped to levels associated with a significantly increased community risk). As a result, it appears that hundreds of kids experienced symptoms of a highly preventable illness, some are likely experiencing chronic disabilities because of the effects of measles, and at least one kid died. Can you think of anywhere else you might have read about a purposeful deception leading to death?
When most of us experience adversity, either personally or through the experience of someone we love, we desperately want to know WHY. As a physician, understanding why guides me in developing a plan to address the problem. Because of our human nature, we’re wired with a need for control. As a parent, knowing why helps us to take steps to protect our kids from bad situations or outcomes. Knowing why gives us a framework for interpreting or understanding the meaning behind the daily struggles we experience or the struggles our kids experience.
Consider the story of Job. Much of the book centers around the process Job went through trying to identify a reason for his suffering, with the assistance of some well intended, but insensitive friends who were clearly challenged in their capacity for discernment. In Job’s case, he never found out why. It’s unsettling for families today when their understanding of why is subsequently shown not to be true. This happens all the time when families come to our practice and leave with a different diagnosis and treatment approach than the one they’d been working with for years. No doubt it also happens when families leave our practice in search of a new answer.
Just because I want something to be true doesn’t mean that it’s true. As Christians, many of us try to put God in a box by picking and choosing the attributes of God that we like and dismissing or ignoring the attributes that make us uncomfortable. For example, I’d like to believe that everyone is going to be in Heaven with Jesus someday, but that’s not what Jesus taught.
In some ways, it would be pretty cool if Dr. Wakefield’s claims had been true. It would be nice if we could identify a preventable cause for autism associated with an environmental toxin manufactured by companies with very deep pockets to compensate families of kids affected with the disorder for the costs of effective treatments. It’s just not true.
Admittedly, I’m not as knowledgable about autism as I am about ADHD, mood disorders and schizophrenia, but as best as I can tell, we’re likely to find at least 300 genes linked to specific traits associated with autism spectrum disorders, with hundreds of environmental factors/toxins impacting the expression of individual genes that in turn influence traits. There won’t be an “autism gene”…that wouldn’t appropriately reflect the magnificent complexity of the brains God created for us.
When we stop seeking the truth, we stop seeking God. While I failed in reflecting grace in my Facebook post, I was angered by Dr. Wakefield’s deliberate attempt to misrepresent truth, and the harm that resulted to kids and families loved by God in the process.
Our work at Key Ministry is done with the hope that the churches we serve will be equipped to welcome, serve and include families of kids with disabilities with the intent that the local church will be the instrument of God’s healing and restoration.
Church4EveryChild 
Here’s a link to a well-designed study, involving 256 kids and 752 controls, conducted by the U.S. Centers for Disease Control, published this past September in Pediatrics, demonstrating no between vaccines containing mercury and autism spectrum disorders:
http://pediatrics.aappublications.org/cgi/content/short/peds.2010-0309v1
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Dear Dr. Grcevich,
Thank you for this very thoughtful post. I’ve included it in the list I’m keeping of positive responses to the BMJ (Yes Wakefield is a fraud, and here are the implications…) and negative responses (Wakefield’s research IS TOO valid and vaccines cause autism anyway) at A roundup of responses to the BJM & Wakefield’s research was motivated by fraud.
Some observations
1. The positive responses come from a broad range of sites — politically left and right; people who are skeptics/ people who have heretofore (to my knowledge) never commented on vaccines or autism before, and so on. The negative responses are from a predictable set of sites and people.
2. The news coverage in the US has (perhaps inadvertently) perpetrated the idea that all parents of children with autism believe in the vaccine causation myth. It is a complete falsehood. Many parents of children with autism and adults with autism robustly reject the myth.
3. Kev Leitch, whose daughter has intense autism, has a moving post on how Wakefield’s actions have damaged everyone affected by autism.
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drgrcevich, did you even READ the *paper* in question?????????????????????? by the words you have written, i don’t think so. the truth will set you free, my friend. quit relying on headlines and look into the allegations for yourself.
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Please read, “Callous Disregard,” Dr Wakefield’s carefully documented account. Deer is ignorant of how the scientific method works; Wakefield’s paper is the first step in introducing a medical problem to science. Thalidomide was introduced to science exactly the same way, with a paper of case studies chosen exactly the same way. Why was it okay to create a paper of cases of children born without limbs but not a paper of cases of children with severe, suddon onset bowel disease following an MMR (along with developmental regression after the MMR)? Why is one okay and the other not?
The media headlines, the editorials are not the truth.
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Dr. Grcevich,
I am the mother of a child who regressed into autism following his 18 month vaccinations, I hold an MS in Clinical Counseling from Johns Hopkins University, I am a co-author of the new book “Vaccine Epidemic” coming out on Feb. 9th (of which Andrew Wakefield is also a co-author) and most importantly I am a disciple of Jesus Christ. I blog on autism at AdventuresInAutism.com and on critical thinking in Christianity at DailyDiscernment.com.
I have not read the first piece you reference above, but after reading this one, I am happy to find a Christian Physician whose stated goal is to find the truth of this matter. I have often lamented that the church does not take up this matter, as that is the place that believers are to work out conflicts, with mutual respect, humility and love. I truly believe that if that were the case, the ‘two sides’ would not be so far apart and children would not be getting hurt in the cross fire.
I am hoping that you will be willing to engage me on this issue in a serious and thoughtful way. Reading this, God’s admonition not to make judgments after hearing only one side of the story springs to mind. I have been writing about vaccine/autism issues for more than five years, and I can report to you that many of the people that are the sources of your information have undisclosed conflicts of interest themselves and have been caught in dishonesty. While this information makes the rounds in autism circles, mainstream medicine routinely ignores these problems. When physicians like yourself only seek testimony from those in the establishment who are being accused by other physicians and parents like me of serious malfeasance, how can you be sure that what you are discerning is actually the truth? Andrew Wakefield has produced documents that he says exonerates himself. Have you reviewed them or read his book or looked at his defense against these charges? If you were in the position of being scape goated by a medical industry because you said something that caused them difficulty, would you not hope that earnest Christians would listen to your defense before taking their word at face value? Have you even read the paper in question in the first place?
And take a look at what we are being asked to believe. That Andrew Wakefield is suddenly discovered to have committed fraud that was undetectable by his 12 co-authors on the paper, the parents of these children who stand by him, the GMC investigators, prosecutors and judges during a six year/three million dollar hearing (the longest in GMC history) and the entire vaccine community/autism community/medical community, over the course of 13 years? And this discovery was suddenly made by a “journalist” who was aided in his “investigation” by a firm whose sole client is Pharma and whose sole purpose is to go after doctors and researchers who disparage their products? And that he was writing about these things several years ago, while the Wakefield trial was under way, and yet he was never actually charged with any of this in the GMC? And this journalist published almost all of his attacks on Wakefield in the Sunday Times of London whose CEO is on the board of GlaxoSmithKline, who makes the MMR? This is only a smidgen of the craziness that we are expected to swallow in this story being handed to us about this dangerous doctor. Does any of this give you pause?
And let’s say Andrew Wakefield is completely guilty of all he is accused of and more. I put to you that it has absolutely no impact on the vaccine/autism causation question, because the revelations in that paper, that autism is associated with gastrointestinal distress, is now not only widely replicated, it is the position of the US Centers for Disease Control. You will note that their “Autism Alarm” one sheet for pediatricians on Autism recommends that children diagnosed with autism be screened for associated illnesses including seizures and GI problems. And the federal Vaccine Injury Compensation Program has ruled in at least one case that MMR “caused in fact” ADEM which caused a little boy named Bailey Banks to develop and ASD. So throwing out Wakefield does not, by any stretch, end this discussion. I have compiled a list of more than 45 studies that support vaccine/autism causation and this paper has never even been on my list.
When my son regressed, I asked my pediatrician if it was his vaccines. He said no. But as I tried those interventions you mentioned, and my son made amazing gains, sometimes in hours of administration, I had to check my doctors opinion. So I got on pubmed and started looking for autism research on the vaccines my son was given that day. He got DTaP, Polio, HIB, Heb B, and Pnumo. There was not one single study that examined the relationship between any of these vaccines and autism. There was not one single study on what administering these seven vaccines at once might do to a child or if it was a safe practice. I did find thimerosal research, but my son got thimerosal free vaccines that day. I found MMR research, but my son never got the MMR. That was six years ago, and since then I have found only ONE study that can be applied to his case. One that found that the triple series of the Heb B vaccine, started in the first month of life, triples a boy’s chance of developing autism.
So whether or not Wakefield is actually the devil in disguise has zero impact on my son’s case and pretty much no impact on the vaccine/autism question. Erase him from history and all the same questions remain.
Tim Keller is someone whose preaching I really respect. In challenging unbelievers to take seriously the existence of God, he made the point that there are many things that you can be wrong about, that won’t cause that big of a problem. But that there are a few things that are so important, the consequences of which are so dire, that you can’t just THINK they aren’t true, you have to KNOW that they aren’t true.
One in 100 children in this country has autism. That does not include the epidemic numbers of other children with neurological and immune disorders. Vaccines DO cause neurological and immune disorders. This is not disputed. Those born between the late 1960s and the mid 1980s received around 25 doses of vaccines. The current CDC recommended schedule is 70 doses of vaccine, and a baby born today will get more doses of vaccine by the time he is six months old that his mother got by the time she went to college. Whether or not vaccines are a causal factor in autism is one of those things that is so important, the consequences of which are so dire, that you can’t just THINK it isn’t true, you have to KNOW that it isn’t true.
I put to you that you CANNOT know that it isn’t true because the science required to make that assessment has never been done. The claim that “vaccines don’t cause autism” is not a scientifically supportable statement.
What if you are wrong? What if you are trusting the word of the wrong people? What if there is more information on this topic than they are offering you? Restating, I have been following and writing about this story for more than five years and I can attest to you that many of them are lying and it is my belief that a few of them belong in jail. Because vaccine damage has been removed from the civil courts, the machinations of Pharmacutical companies and public health officials has been removed from public view, as they cannot be made to testify in court and no court can force them to turn over internal documents via the disclosure that every other company in the country is subject to. Because of this, the corruption in the vaccine program is very deep. There is literally no way for the public to challenge them or hold them to account. Everyone from the researcher to the maker to the public health official who recommends it to the doctor who orders it to the nurse who administers the vaccine can commit outright malpractice with malice of forethought, and even if it kills a child or ten or one hundred, there is no way for those families to hold any of them accountable. They cannot even begin an investigation. They have no power.
Add to this that CDC and NIH are themselves vaccine patent holders, and I have to ask, why are you just believing what these people are telling you? If they lie to you there is nothing that can touch them. Well congress. But congress is not usually up for shining a light on governmental abuses or putting their wealthy pharma doners in a difficult position. So it doesn’t happen.
For the vaccine program NOT to become corrupt after 25 years of liability protection would be a complete miracle. Impossible really.
I have just scratched the surface here. I am hoping that you are a woman of your word, that you will carefully contemplate what I have taken the time to present you with here, that you truly are seeking the truth in this because you have the sincerely belief that it is our duty before God to do so and that you will engage me in a dialog on this. Test my claims and measure them against the claims that are being made to you by those whose opinions you are trusting at the moment. Be a Berean.
Will you talk with me about this?
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Hi Ginger and Michelle,
Before I respond to your comments, I want to focus first on what’s most important here. I’m delighted that both of you are passionate followers of Christ and live in a part of the country where we’re aware of a number of churches and church leaders who are passionate about wanting to see kids with autism and other hidden disabilities along with their families welcomed into the church. Our ministry team would very much like to come to Houston and talk about how we can train and equip more churches to welcome, serve and include families like yours. I’ve heard wonderful things about Denise Briley from several members of my team who met her at a conference she helped organize in the fall of ’09. I don’t want this discussion to distract from that goal…helping more kids and more families to come to know Jesus Christ. Let’s agree on that.
In response to Michelle’s question, yes, I did read Dr. Wakefield’s original paper. I would hope that I do have some understanding of scientific method, having served as a peer reviewer for several journals as well as my professional society. I’m also very aware of the influence of the pharmaceutical industry on the objectivity of many academic physicians considered to be thought leaders in their fields. I was part of the group appointed to develop conflict of interest guidelines for members of the American Academy of Child and Adolescent Psychiatry. I can also share that the only paper I’ve ever submitted as a lead author that was rejected for publication raised significant safety issues about a class of medication that have been replicated in a number of studies since that time. I also made a decision to walk away from an opportunity to make six figures annually as a drug company speaker because that’s what I believed God wanted me to do, so as not to compromise the integrity of my witness or the integrity of Key Ministry.
Let’s start with Tim Keller’s statement…(I know we sent some info to one of their key volunteers, and I’d love to help Redeemer Pres do some great things in NYC)…Jesus Christ represents absolute truth and once we get beyond Christ, things get shaky.
In science, it’s nearly impossible to “disprove” a hypothesis with absolute certainty. One of the challenges I face every day as a physician is that there are risks associated with the treatments I offer, but there are also risks associated with the decision NOT TO TREAT, and I’m often in the position of having to help parents make those decisions in the face of insufficient data.
One of the problems we face in this situation is the risk of being wrong, as Ginger eloquently described in her post. For some proposed interventions in kids with autism (some dietary interventions, for example), there’s not much downside for being wrong. If we’re wrong about vaccines as a cause for autism, kids will die of preventable diseases. There’s evidence to support that’s already occurred in areas where large numbers of parents have chosen not to vaccinate their kids.
There are other consequences to being wrong in this situation as well. Having sat through hours of research presentations this past fall, there’s some tremendously exciting work going on in the field. I’d suggest that there are likely multiple environmental factors interacting with many different genes that contribute to traits associated with the autism spectrum. I suspect that we’d also agree that the funding allocated to autism research is grossly inadequate. When we have to spend money in attempts to disprove a link that doesn’t appear to exist, that’s money that’s NOT spent examining other more promising hypotheses as to autism prevention or treatment, resulting in more kids and more families suffering needlessly.
There’s a flaw in the argument you make about the pharmaceutical industry. Check out this article from the chief of infectious disease at Children’s Hospital of Philadelphia from 2005.
http://content.healthaffairs.org/content/24/3/622.full
The money involved in manufacturing vaccines is chump change to these guys and the legal liability too great. As a result, most of the companies have left the market, and the NIH and CDC have stepped in out of necessity.
Ginger…I’d be delighted to talk to you about this further. Send me an e-mail to my Key Ministry address (steve@keyministry.org) and we’ll exchange numbers and set up a time. Michelle…It would be really cool if we could meet at a Key Ministry event in Houston where the subject will be how to help more churches welcome more families of kids with autism, ADHD, anxiety, bipolar disorder and other hidden disabilities. After I post these comments, I’ll make a point of praying for each of you and your kids…that somehow, God will use your circumstances to bring Him honor and glory, and that your families be used to do great things for His Kingdom.
When we come (unless invited as part of a larger conference), there will be no charge to attend, and I won’t be paid. I’ll also pay my own expenses. Our staff will be paid by donations from individuals and churches. Those donations will cover the cost of our volunteers. One reason we give everything away is that it’s important to me that our motives are clear.
For purpose of full disclosure, all research funding I’ve received since 2006 has originated with NIMH (passing through CAPTN/Duke Clinical Research Institute). All pharmaceutical industry payments for consulting in 2008 and 2009 were donated directly to Key Ministry. I did no pharmaceutical consulting in 2010. I resigned from my last drug company speakers’ bureau in the Spring of 2006.
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I am really happy to hear that you will discuss this with us. And VERY happy you have turned away from those ties that bind.
I have to get off to bed but I wanted to address one thing that you said. I am not sure you took in what I wrote about vaccine liability. You wrote:
“There’s a flaw in the argument you make about the pharmaceutical industry. Check out this article from the chief of infectious disease at Children’s Hospital of Philadelphia from 2005.
http://content.healthaffairs.org/content/24/3/622.full
The money involved in manufacturing vaccines is chump change to these guys and the legal liability too great. As a result, most of the companies have left the market, and the NIH and CDC have stepped in out of necessity. ”
There is no legal liability to vaccine manufacturing. These companies CANNOT be sued when their products kill or maim children. The 1986 National Childhood Vaccine Injury Act (http://en.wikipedia.org/wiki/National_Childhood_Vaccine_Injury_Act) removed almost all rights from individuals to sue vaccine makers. This law is currently being tested in the Supreme Court in Bruesewitz v. Wyeth. Arguements were heard last fall and a ruling is expected this spring. (http://ebcala.org/index.php?option=com_content&view=article&id=60:the-supreme-court-takes-bruesewitz-v-wyeth-is-there-justice-for-vaccine-injury-victims&catid=1:latest-news&Itemid=58)
Additionally, the source you are citing, Paul Offit, is the most notorious man in this debate. He is a vaccine patent holder of RotaTeq with Merck, Merck sponsors his 1.5 million dollar research grant at CHOP (also vaccine patent holders) and he admits that his patents have earned him at least six million dollars. He admitted, that is, after several years of failing to disclose his vaccine ties at all. It is estimated that his patent could make him in the ballpark of 30million in future profits, and Rotateq is arguably the LEAST important vaccine on the US schedule, so if the schedule gets paired down, his is the first to go. In fact when parents decide to selectively vaccinate, his vaccine is rarely chosen. Further, he sat on the ACIP and voted to add another rotavirus vaccine to the schedule as he was developing his, would would guarantee his vaccine would immediately go into every peds office in the country as soon as it was on the market. (note he actually writes about the approval of the now pulled RotaShield with out disclosing he was on the ACIP and voted to add it to the schedule in the first place) After doing so he was actually reprimanded by Congress.
Finally, he is most famous in our community for saying that a baby could theoretically get 100,000 at once. Safely. I contacted him to verify because I assumed it was a misprint, and he replied “no 100000 is correct. It is probably a conservative estimate”.
He lied about the head of Jenny McCarthy’s charity in his book about autism, was sued and had to pay Jenny McCarthy’s charity several thousand dollars.
And this is just scratching the surface of his baggage.
This guy is the undisputed king of undisclosed conflicts of interest. He is Merck’s boy. When you see his name, just replace it with “Merck”.
Further:
“Unfortunately, three important weaknesses in the NVICP discourage vaccine makers. First, if dissatisfied with the outcome, people can always opt out of the NVICP and take their case to a jury. Parents claiming that their children were harmed by thimerosal (an ethylmercury-containing preservative in some vaccines) have sued vaccine makers; about 300 separate lawsuits are now pending in U.S. courts.”
I am glad you drew my attention to this article because five years ago he was claiming that people COULD opt out of the VICP and go to court. You should know that no family has been able to do this since the law was passed. All families have been told that the law precludes them from doing so. Which is why it is now with SCOTUS.
The fact that Offit is claiming here, five years ago, that they can, is note worthy. That is not the talking points any more and I plan to call attention to this to those currently trying to get their cases heard in civil court.
You should know that one of our contentions is that vaccine makers claim to us that their vaccine divisions don’t make much money, while the investment prospectus of these divisions claim huge profits and even bigger future profits. So either they are lying to us or they are lying to their investors. That’s fraud.
I hope you see why I encourage you to speak to us directly and not to take at face value what you are reading that is not just influenced by pharma, it is pharma.
Have a good night.
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