Law and Magic Blog

Piltdown Men?

The British Medical Journal has deemed Andrew Wakefield's 1998 Lancet paper "fraudulent" after a researcher, Brian Deer, carried out a lengthy investigation. Dr. Wakefield defended himself on CNN's Anderson Cooper show last night. The 1998 paper had asserted a link between MMR and autism, which created fear in many parents over the wisdom of child vaccinations, an increase in interest in alternative medicine, and demands for more research into the causes of autism. 

Brian Deer, the journalist who carried out the detailed investigation of Dr. Wakefield's 1998 paper compares the MMR study to the Piltdown Man hoax.

Wakefield fraud had sat in plain view for six years before serious challenge.  Journals, the BMJ included, had fretted over epidemiology and viral studies without giving pause to the remarkable, now fully retracted,  fundamentals.  Did the scientific community ever really believe that 12 families had turned up consecutively at one hospital, with no reputation for developmental disorders, and make the same highly specific allegations – with a time-link of just days – and that there was not something  fishy going on?

Piltdown Man offers the salutary lesson.  Polite society could not harbour such thoughts.  Even as the skullcap, jaw, and tooth were first laid out for public inspection before the Great War’s outbreak, some among the audience were muttering fraud.  But they were urged not to rock the establishment’s boat with the implication that a gentleman could not be trusted.  “He was a delightful colleague in scientific research,” Woodward said later of the fossil-hunter Dawson.

“We all rely on trust,” Walker-Smith told the GMC panel, in words for which he will be remembered.  “I trusted Dr Wakefield.”

People's reputations have been ruined. Children may have died as a result of non-vaccination. Has anything good come out of this mess? Well, yes. One outcome is good--more research into the causes of autism, since we know what probably doesn't cause it. The media is trying to assess the impact of the BMJ's report already.

This story has magic written all over it, from its beginning, in which Dr. Wakefield and his colleagues offered the magic answer--that MMR is linked to autism--to the ending, in which Brian Deer asks the magic question--why did they do "it," the "it" being why did they publish a study that would eventually turn out to be so flawed. Mr. Deer and the BMJ might offer one explanation if we asked them (or they might not). Dr. Wakefield might offer a different one. I can hear cell phones ringing and see fingers flying over keyboards, and I fully expect within a year to see at least one book in the bookstores about this whole affair. Maybe there'll be a movie. Will Jenny McCarthy play herself?

Placebos: The Magic Cures?

From Boston.com, an article on the history and use of placebos in medical care. Says Rebecca Duhos-Dubrow in part:

You’re not likely to hear about this from your doctor, but fake medical treatment can work amazingly well. For a range of ailments, from pain and nausea to depression and Parkinson’s disease, placebos--whether sugar pills, saline injections, or sham surgery--have often produced results that rival those of standard therapies.clinical trials, they won’t get approved by the FDA. Patients who benefit from placebos might understandably wonder if the healing isn’t somehow false, too.

But as evidence of the effect’s power mounts, members of the medical community are increasingly asking an intriguing question: if the placebo effect can help patients, shouldn’t we start putting it to work? In certain ways, placebos are ideal drugs: they typically have no side effects and are essentially free. And in recent years, research has confirmed that they can bring about genuine improvements in a number of conditions. An active conversation is now under way in leading medical journals, as bioethicists and researchers explore how to give people the real benefits of pretend treatment.