Wakefield GMC Hearing 2007

Naked Intimidation: The Wakefield Inquisition is Only the Tip of the Autism Censorship Iceberg

“That’s baseless conspiracy-mongering”, some might counter, contending that any anecdote I might dig up is simply the normal process of scientific quality control. “Welcome to the real world”, I respond, because this is something entirely new and disturbing. The deep and profound censorship occurring around autism science reaches depths that few casual observers can imagine.

I have proof.

January 29, 2010

By Mark F. Blaxill   http://www.ageofautism.com

There are no words to describe the findings of the General Medical Council (GMC). All I can say is that none of us should be surprised. The stakes had escalated far too high for the British medical establishment to countenance any other outcome. In the face of this parody of real justice, the only thing for the autism community to do now is stand by Andy Wakefield. Like him, we must not be intimidated; which is why I am proud to call Andy my friend. He is all of our friends.

We must also not forget two other fine men, John Walker-Smith and Simon Murch, men who have devoted their professional lives to healing the guts of sick children, and whose public reputations stand in tatters before the world, assaulted by the public health propaganda machine, victims of a modern day show trial. The GMC proceeding is a frightening and thoroughly modern form of tyranny. It makes you shudder to think what Stalin or McCarthy might have accomplished if their public relations had been more skillful and better organized.

The extremity of the GMC’s verdict--all three men guilty on all counts—lays bare any pretense that the British medical establishment cares one whit about the welfare of its patients. Let’s put in perspective the actions at issue here. No children were harmed and no parent or guardian has complained about the care these three men provided. In fact, the procedures involved were routine, the resulting treatments standard and the careful attention to gastrointestinal illness in autistic children has recently been endorsed by a consensus statement published in the journal Pediatrics (no friend of the autism community). Considered in this light, the GMC hearing process stands exposed for what it is. It was not about medical standards. It was not about evidence. It was not even civilized.  It was, rather, a naked exercise in intimidation, a fateful moment of moral decision in which the medical industrial complex exposed its ruthless, repressive essence. They are a frightening bunch and their conduct here raises issues well beyond autism.

There are others who can and will speak to the particulars of the case: the accusations, the evidence, and the integrity of the witnesses for the prosecution (see HERE and  HERE ). But it’s important to remember that this trial has never really been about the three doctors. If it were, it would never have consumed so many millions of dollars and thousands of hours over more than two years. The real goal of this proceeding, what I have called The Wakefield Inquisition (see HERE ) is to send a clear message to anyone--clinician or scientist--who dares step out of line like Wakefield did. And as parents and citizens, we all need to understand one thing: that message has been received loud and clear.

Over the last ten years I’ve had the privilege to interact with a wide range of scientists in several different fields. Many of them are wonderful people and first-class professionals. And in the course of those interactions I have observed common patterns. A few, like Jon Poling and Mark and David Geier, who have worked openly on behalf of our children, have suffered harsh public recriminations. But for every public example there are countless more private examples of intimidation, coercion and censorship. It’s like an iceberg; the vast majority of the scientific censorship occurring in autism takes place below the waterline, invisible to the broader public.

“That’s baseless conspiracy-mongering”, some might counter, contending that any anecdote I might dig up is simply the normal process of scientific quality control. “Welcome to the real world”, I respond, because this is something entirely new and disturbing. The deep and profound censorship occurring around autism science reaches depths that few casual observers can imagine.

I have proof. 

 Over the last ten years I have collected a number of private examples--some via conversation others via email--of individual scientists who have felt the cold hand of censorship when dealing with autism. They comprise a modest sample (my interactions are necessarily episodic) of what I believe to be a pervasive pattern of suppression. But it’s an extensive sample nevertheless and in all instances the good-citizen scientist on the other side of the interaction has been troubled by it. In order to give some visibility to this mass of bad behavior lying below the waterline, I have decided to share a few of these examples here (I’ve observed many more than just this selection). In all cases, I have thoroughly disguised the identities (including name, age, gender, specialty and affiliation) and materially altered the words in order not to violate confidences and to protect the careers of the scientists involved.

But every single one of them is real.

Below the surface: scientific institutions behaving badly

Not every inquisition takes place in public. One researcher who has investigated the environmental causes of autism was brought up before a university panel on charges of misconduct. This charge was raised for blatantly political reasons by someone hostile to the environmental model of autism causation. The defense against the charges consumed months of this researcher’s time and has had career threatening implications. Here is an excerpt from that researcher’s discussion of this private proceeding.

Have been sidetracked/consumed with preparing my defense for the research misconduct proceedings instigated by X, but am looking forward to the opportunity to clear my name at least in this academic sphere. Unfortunately, the process has been less than transparent so that it is completely unclear as to how the charges came about (in acting to exclude X as a complainant, and thus the origin of these charges, the university failed to appreciate that a new committee not privy to what was provided might falsely assume that the original committee saw a problem), why I am being charged now, or even what specifically I am being charged with...but the noise from one individual has been clanging very hard looking for support for me to be fired.

Sanctions against non-compliant researchers need not reach the extreme outcome of a research misconduct action. Instead of overt punishment for past action, future career opportunities can be the vehicle for intimidation, and researchers who have published on a controversial autism issues can find themselves newly unwelcome in the grant review process. Since the National Institutes of Health (NIH) hold a virtual monopsony (“a sole or predominant buyer” in a particular market) on scientific research in the United State, NIH grant reviews are one prominent place where researchers can be effectively intimidated. One scientist, who authored a sensitive, previous publication, when asked to join in the effort to draft a review paper, demurred with the following explanation.

I have had two rejections of NIH grants in the last two weeks.  This is most remarkable, in that the grants were not deemed good enough to even be scored.  In my X years on the faculty, I have never had an unscored grant.  Moreover, in one grant it is clear that there is a personal vendetta ongoing.  This is not totally surprising but nonetheless disturbing.  I am not ready to throw my career away, and I don't look at how Andy Wakefield has handled such problems as a good model for me.  It is vital that the science of this problem get out, and this is where I want to focus my attention.  Therefore, I have decided that I do not want my name on [this new review publication], for I don't need more persecution right now, and as good as the paper is (and I think it is extraordinary), it is not going to be a definitive scientific publication.  I am enclosing a section I wrote-some of this is already included-feel free to use any of it. 

If an intrepid researcher goes so far as to submit a paper for publication, that’s where the more overt forms of censorship can enter in, all in the guise of “peer review.” Admittedly, rejection at the point of peer review is a common part of science, but the autism problem is especially radioactive and is a place where have seen the unmistakable cold hand of censorship take many forms: some unwelcome research can be headed off at the pass, with journal editors making clear that papers on certain autism topics are unwelcome and won’t even be sent out for review; or unwelcome papers can be sent to anonymous reviewers the editor knows to be hostile to the topic of environmental influences;  in other cases, papers are rejected even in relatively progressive journals’  peer review process for reasons that have little to do with scientific merit. Given the nature of peer review, there is little effective recourse if one or two selected reviewers make critical comments that are simply wrong or biased. Here’s how one researcher described a recent rejection.

My paper was rejected today from the [Journal]. While some of the reviewers’ comments could have been addressed in a revision, most of them revealed the reviewers obvious bias and purposeful efforts to suppress this paper. Having gone over the comments, most of them are simply gibberish.

Another form of intimidation can come more directly from colleagues, in the social network of “mainstream autism researchers.” If a respected researcher takes the risk of making honest public comments about the possible role of environmental factors in autism, they can find themselves receiving “career advice” from their “friends” to keep their mouths shut. Here’s an example of one such communication.

I am concerned that you may be perceived as a strong supporter of the environmental influence on the developmental of autism ….  I am afraid this attribution to you will tarnish your reputation and your credibility in the mainstream autism research community...This is the second time that what you had to say came back to me and astonished me (what you said was perceived as supporting the influence of toxins as causes of autism), even though I consider it likely that what you actually said was probably distorted. I hope you will accept this missive as the result of my concern for you as investigator and clinician… as your friend I truly feel impelled to give you the perspective of an outsider who fears that such statements are going to harm you. 

Even when a paper from a brave and principled researcher succeeds in ushering useful research through the hurdles of peer review, the uniquely treacherous terrain in autism can (and almost always does) affect the drafting process, editing choices and the interpretation placed on evidence that might be viewed in multiple ways. In numerous cases I have observed (without any inside connection) that published evidence has been interpreted so as to downplay environmental factors. In a number of cases where I have been able to hear the inside story from researchers on what took place in the editing process, it’s clear how widespread biases and peer pressure can censor the interpretation of more open-minded members of a research team. Here’s one example from a researcher who was asked about how evidence that clearly could have been interpreted to implicate environmental factors was downplayed.

On the other hand, some of the 'downplay' of environmental factors probably reflected differences in emphasis between the lead author and myself, and even more, the pressures of the reviewers (which influenced the lead author), who thought the paper showed that environment played a negligible role. Like my [topic X] paper of last year, this paper went through innumerable reviews. 

The collapse of civil discourse in a closed society

As we organize ourselves as an autism community to call attention to the injustice done by the GMC decision, we must make clear that Andy Wakefield is not alone. He, Simon Murch and John Walker-Smith are simply the most prominent and visible victims of an increasingly ruthless and doctrinaire campaign by the medical industrial complex to suppress a long overdue revolution in autism science. Autism can no longer be explained through the orthodox lens (as a rare, brain-centered, inherited psychiatric disorder), but those who would attempt to offer alternative explanations (how rising rates might reflect environmental influences that provoke whole body developmental injury in vulnerable children) are facing a rising tide of intimidation and censorship. The GMC verdict, that honest scientists like Andy Wakefield have “failed in their duty”, makes a mockery of the value of civil debate in an open society.

The medical industrial complex is closing ranks. It’s time for responsible citizens--health consumers and principled scientists alike--to raise their voices in opposition.

Mark Blaxill is Editor-At-Large for Age of Autism.