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Re: Dick Taverne's competing interests
 

Dick Taverne is Chairman of Sense about Science. Sense about Science is funded by GlaxoSmithKline, a defendant in the MMR case. [1]

[1] http://www.senseaboutscience.org.uk/about.htm

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Re: MMR KIDS - LIVING SCIENTIFIC PROOF MMR CAUSES AUTISM
 

Dear Sir,

MMR KIDS - LIVING SCIENTIFIC PROOF MMR CAUSES AUTISM

I challenge the Honourable Lord, Dick Taverne, to a scientific duel on his view ('The legal aid folly that damages us all' BMJ 2004;329:239 (24 July), doi:10.1136/bmj.329.7459.239).

For credibility he leans on chairmanship of a charity claiming to promote an 'evidence based approach'.

Evidence? It is before him and the entire medical scientific community. The MMR children are living proof of challenge-dechallenge- rechallenge reactions. Challenge-dechallenge-rechallenge is well established science and accepted as the strongest scientific proof existing of a causal connection between a pharmaceutical preparation and an adverse drug reaction (‘ADR’) (1).

A major omission from the published scientific papers which are cited as purported evidence of no link between MMR, autism and other ailments is the absence of any attention to test/re-test or challenge/de-challenge/re -challenge tests as a drug research and development tool. United States Congressman Dr Dave Weldon MD heavily criticised the US Institute of Medicines’ partisan 2004 report on vaccination. Congressman Weldon specifically raised the issue (2) that challenge-dechallenge-rechallenge studies have been ignored and studies in that regard went unheeded:-

“In 2001 you found that cases of MMR “rechallenge” would provide evidence in favor of causality. It is my understanding that Dr. Wakefield has developed such a case series. The lack of an invitation is puzzling.”

If challenge-dechallenge-rechallenge were to be applied to the two medical case histories which the noble Lord can read in detail in Hansard (3) (4) they should be recognised as living scientific proof of a causal connection between their ailments and the MMR vaccine. The pharmaceutical companies have failed to apply this scientifically valid study of cause and effect which is used particularly in the psychopharmacological world. Instead, most drug companies focus on the controlled clinical trial and epidemiological studies. It is well known the latter, in particular, can be highly limited and not necessarily strong or good evidence and the former have been shown to be susceptible to manipulation, such that fraud is alleged by the US New York Attorney-General in a prosecution undertaken currently in the US.

The case histories of all the MMR children are repeatedly and wrongfully dismissed by pro MMR science as valueless ‘anecdotal’ evidence whereas direct oral parental evidence supported and corroborated by documentary, photographic and video evidence is the gold standard of our legal system (5). Because of the high standard of proof science sets, viz, irrefutability and the failure of scientific method to have any mechanism to test this kind of evidence, it dismisses it as unverifiable. The consequences of this are that science can only be relied on to prove a fact positively: the absence of scientific evidence in science is not evidence of absence, especially when there is other strong evidence available which should not be but is ignored.

And the MMR childrens’ real sin? Being such powerful living proof that vaccination is dangerous and a deadly medical practice applied en masse to the human population. These children threaten a pharmaceutical market grown over the past twenty years to be worth billions and a blindly followed conventional wisdom that vaccination is generally something the evidence shows it is not, a ‘good thing’ and safe. Is the entire medical community intent on putting these children down and sweeping this shameful issue under the carpet, even to the extent of continually relying on scientific papers based on very shaky ‘evidence’ (6)?

This does not happen just in relation to vaccines. It is a scandal across the board, that even sweeping the Augean Stables of the MHRA would still not correct (although that is not an excuse for not getting the broom out).

It is troubling to see, as here, such a view expressed by a Peer of the Realm, former barrister and Queen’s Counsel. I entreat the noble Lord to be so kind as to consider heeding the admonition I set out on a previous occasion (7).

The questions the noble Lord might consider asking himself and the government are ‘what kind of government poisons its own kids’, why are Liberal Democrats so involved, as MP Evan Harris also is, and exactly what was going on between Whitehall and the LSC when legal aid was withdrawn?

___________________________________________________________________________

(1) Edited extracts from Professor David Healy’’s evidence in the US Forsyth SSRI litigation in the US Courts - another of many other pharmaceutical scandals:-

“Pharmaceutical companies focus on the controlled clinical trial and epidemiological studies. This ignores a scientifically valid study of cause and effect used particularly in the psychopharmacological world, known as test/re-test or a challenge/de-challenge/re-challenge test. This is well established science and strong scientific proof of a causal connection between a pharmaceutical preparation and an ‘‘adverse event’’. A major omission in all of the papers published as purported evidence of no link between MMR, autism and other ailments is the absence of any attention at all on rechallenges as a drug research and development tool. If this were to be applied to the MMR children, then each and every one of them could well be recognised as the conclusive living scientific proof of a causal connection between their ailments and the MMR vaccine.

The literature discussing the tools available for the development of drugs refers to rechallenges as one of the most effective, most persuasive, most cost-effective means for determining the side effects of drugs.

The Guide to Clinical Studies and Developing Protocols, published in 1984, states on page 163:-

"In evaluating whether an adverse reaction is related to a specific test drug, one should consider the following points: ... 6. Rechallenge, i.e., what happened if the drug was restarted after the adverse reaction had disappeared? ... Definitions are given below for a five-category system that may be used to classify the relationship between adverse reactions and drug. These are adapted from Karch and Lasagna (1975). 1. Definite. A reaction that follows a reasonable temporal sequence from administration of the drug or in which the drug level has been established in body fluids or tissues; that follows a known or expected response pattern to the suspected drug, and that is confirmed by improvement on stopping or reducing the dosage of the drug, and reappearance of the reaction on repeated exposure (rechallenge)."

Drug Epidemiology and Post-Marketing Surveillance, contains several references to the value of rechallenges in determining the relationship between drugs and their side effects. In Drug Development, Regulatory Assessment, and Postmarketing Surveillance, the author also refers to the value of rechallenges, citing a work by Irey and Karch and another by Lasagna.

The Detection of New Adverse Drug Reactions has a full chapter describing the importance and the use of rechallenges as a tool to investigate drug reactions. On page 208, the text describes the positive rechallenge as "probably the strongest proof of a causal relationship," despite its shortcomings.

A pharmaceutical company’’s own research scientists have validated the use of test-retest designs for the determination of cause and effect relationships in regards to adverse effects. Dr. Charles Beasley, an Eli Lilly senior scientist wrote in the British Medical Journal in a letter to the editor on November 9, 1991, "Healy and Creaney's suggestion of using rechallenge to determine causality of rare events is scientifically appropriate." (Charles M. Beasley, Fluoxetine and Suicide, British Medical Journal, Col. 304, November 9, 1991, p. 1200).

In December of 1991, Anthony J. Rothschild published a report of three rechallenges which established a link between akathisia caused by Prozac and emergent suicidal tendencies (Anthony J.Rothschild, et al., Reexposure to Fluoxetine After Serious Suicide Attempts by Three Patients: The Role of Akathisia, Journal of Clinical Psychiatry, Vol. 52, No. 12 (1991), pgs. 491-493.). The authors described a series of cases wherein Prozac caused emergent suicidality associated with akathisia. In order to test whether the emergent suicidality was coincidental or was associated in a cause and effect way with Prozac, the researchers first withdrew the Prozac, then re-administered it (the re-challenge step). All three cases who were re-exposed to Prozac after having made a previous serious suicide attempt on Prozac experienced the exact same effect on rechallenge. "All three patients developed severe akathisia during treatment with fluoxetine and stated that the development of the akathisia made them feel suicidal and that it had precipitated their prior suicide attempts." The emergence of the same side effect upon rechallenge is powerful evidence of cause and effect.

(2) Statement of Rep. Dave Weldon, M.D. Member of Congress Before the Institute of Medicine February 9, 2004

(3) Health Select Committee Sixth Report 1998/99 - David Thrower's Memorandum Appendix I — Degeneration of Oliver Thrower Into Autism — Case History http://www.publications.parliament.uk/pa/cm199899/cmselect/cmhealth/549/99072718.htm

(4) Hansard 19th November 2003 - Norman Baker MP - debate regarding MMR and the effects on Michael and Terry Thomas, two of the four sons of Isabella Thomas:- http://www.publications.parliament.uk/pa/cm200203/cmhansrd/cm031119/debtext/31119 -42.htm#31119-42_head0

(5) ‘UNRELIABILITY OF SCIENTIFIC PAPERS AS EVIDENCE’ http://bmj.bmjjournals.com/cgi/eletters/328/7440/602-c#52948

(6) see, eg http://bmj.bmjjournals.com/cgi/content/full/322/7284/460 ‘Mumps, measles, and rubella vaccine and the incidence of autism recorded by general practitioners: a time trend analysis’ BMJ 2001;322:460-463 ( 24 February ) and, ‘CLARIFICATION SOUGHT FROM AUTHORS TO ESTABLISH EVIDENTIAL VALIDITY OF THIS PAPER’ http://bmj.bmjjournals.com/cgi/eletters/322/7284/460#56882

(7) ‘TIME FOR POLITICIANS TO ACT RESPONSIBLY AND ADDRESS THE ISSUES’ http://bmj.bmjjournals.com/cgi/eletters/328/7442/726-a#54697

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Re: Distress deserves apology not money
 

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Re: Well said but watch out for the outcry on rapid responses
 

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Re: Naming Peter to blame Paul
 

Stone is a very common name. If we had a few more contributors like John Stone (not to mention Peter Morrell), the world would take a big sigh of relief.

Dr. Sangell, have you really taken the time to read these comments?

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Re: Re: MMR KIDS - LIVING SCIENTIFIC PROOF MMR CAUSES AUTISM
 

I agree totally with Clifford Miller's response. Many of the children with autism have measles in the gut and/or elevated measles antibody titers in the blood. Recently, in the Journal of American Physicians and Surgeons, there was an article about measles virus detected in the spinal fluid of children with autism. (1)

There has never been any independent, long-term safety studies done on any of the vaccines. When a person is prescribed a prescription medicine they are asked if they have any allergies but yet when a baby is vaccinated, allergies are not considered. The baby is vaccinated without considering allergies. The question is why? When it comes to vaccines, one size fits all.

On a personal note, our son was born normal and regressed into autism after the MMR vaccine. We have video tapes of Eric besides medical information concerning his elevated measles antibody titers, T-cell abnormalities, colitis and testing positive for myelin basic protein antibodies.

Eric is 19 years old, 6'2" tall and 200 pounds. In the last two years he has aggressions where he bites, head-butts, kicks, scratches and pulls hair of family members and others. He has seven different medications including adivan and haldol and presently has tremors and drools. He is being rehabilitated in a hospital out-of-state for his aggressions and will be released to an out-of-state residential school. The school will cost $160,000.00 a month.

Eric will never be a productive member of society because the medical establishment doesn't recognize there is a problem with vaccines like the MMR vaccine. Therefore, no research will turn up treatment modalities that could help Eric get better. So Eric and thousands like him will not experience the potential that we were all afforded by being healthy individuals. The autism epidemic will continue and that will be the tragedy we will all have to face. God have mercy on us all.

References:

1. Detection of Measles Virus Genomic RNA in Cerebrospinal Fluid of Children with Regressive Autism: a Report of Three Cases

J.J. Bradstreet, M.D.; J. El Dahr, M.D.; A. Anthony,

M.B., Ph.D.; J.J. Kartzinel, M.D.; A.J. Wakefield, M.B. Journal of American Physicians and Surgeons Volume 9 Number 2 Summer 2004 http://www.aapsonline.org/

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Re: Fiat justicia, but can we afford it?
 

The programme to acquaint judges with the main provisions of the Human Rights Act 1998, which put on a statutory footing certain Articles of the European Convention on Human Rights, cost £4,500,000. The Act states that Article 2 of the Convention should have effect. Article 2 requires that everyone's right to life (health) should be protected by law. The jurisprudence of the Convention in Association X v. UK (1978) presents a case which should be familair to all those considering the legal implications of MMR. In the Association X case it was argued by the plaintiffs that the UK had violated Article 2. It was contended that a vacination programme which had damaged or killed children was government sponsored. The Commision of the Convention stated, "there exists a general common knowledge that vaccination schemes involve certain risks". However, and this may be the pertinent point per claims arising from MMR, it was shown that the UK system of control and supervision of such vaccination scemes was sufficient. Accordingly, it may be that the Wakefield research suggested that such control and supervision may not have existed in the implementation of MMR inoculation.

It has never been the case that courts prove truths, be they medical or otherwise. Rather, with regards to Article 2 it is a question of finding whether the defendant acted reasonably in the defence of life (health). Within tort law more generally the classic definition of negligence has it as "the omission to do something which a reasonable man, guided upon those considerations which ordinarily regulate the conducy of human affairs, would do, or doing something which a prudent and reasonable man would not do". (Blyth v. Birmingham Waterworks Co. ( Ex. 1856)).

The observation of Lord Taverne QC that links human rights with primitive rituals strikes me as being poorly construed. The cause of action in the majority of the Alder Hay case needs to be understood. Most of the cases were for negligence causing psychiatric harm due to the NHS trusts's misleading response to disclosure about organ retention. Parents were given organs piecemeal, the returns were at times insensitive and information was given without compassion. Can it really be said that such distress deserves only appology and not quantum. After all financial penalties may be most effective!

The "public",it seems to me, suffers more when it is denied access to accountability. Modern jurisprudential theory and practice seems willing to tear down the walls of silence that once dominated the response of the professions to good cause allegations of negligence.

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Re: Really, Mr Miller?
 

But is Clifford Miller, lawyer and physicist, really serious when he states, in this context, that "direct oral parental evidence supported and corroborated by documentary, photographic and video evidence is the gold standard of our legal system"?

Those evidences may help prove that autism exists in a child, but proving the existence of autism says nothing about its cause.

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Re: Lord Taverne: an impersonal view
 

1) Lord Taverne remarks regarding the plantiff's legal team: "This team was quite clearly not adequately qualified to investigate possible causes of autism", and unusually for the BMJ this sentence is separately set in large letters as in a newspaper story. He makes a specific claim that legal team only had three members with basic science degrees, but he does not document the specific claim or the general one.

2) This disregards the fact that the core research was obviously carried out by experts.

3) It is not clear what the alleged inexpertise of the plaintiff's team has to do with the merits of the case or otherwise.

4) Whatever the potential cost to the tax payer through Legal Services Commission, the money is a fraction of the resources available to pharmaceutical manufacturers in defending their corner. This in itself makes any such action hazardous, but presumably even Lord Taverne would agree that some sanction should in principle be available to the public if something goes wrong with a product? Or perhaps he does not (which would be interesting). Perhaps he could elucidate.

5) Some may feel that it was made excessively hard for the plaintiffs to prove their case. As for instance reported by Robert Sandall in his Sunday Times Magazine article 'MMR RIP' in which he describes the difficulties set for families in trying to obtain cerebral spinal fluid [CSF}samples of their children. The defendants also never tried to replicate the positive results obtained from the samples by Prof. John O'Leary choosing to use a different viral tracker[1]. Andrew Wakefield with colleagues has recently published further evidence regarding measles virus in the CSF of affected children, evidence which might have made a difference if the case had not already been effectively terminated [2].

6) Lord Taverne cites the fact that the Committee on the Safety Medicines (CSM) reviewed the safety of the MMR in 1998 at the request of the claimants and found no evidence for a link with autism. It would evidently help public perception if there was a clear separation of public and private interest on the committee with members not being allowed to have professional or financial links with the drug companies. The Sunday Telegraph reported on 25 August 2002 that 15 of the 36 members of the CSM had links with the manufacturers of MMR and 9 of the 20 on the Vaccine and Immunisation Committee [3].

[1] Sunday Times Magazine, 14 December 2003: www.timesonline.co.uk/article/0,,10009-941849,00.html

[2] Bradstreet et al, Detection of measles virus genomic RNA in CSF of three children with regressive autism, Journal of American Physicians and Surgeons, Vol 9 No 2 (2004).

[3] Lorraine Fraser, 'Parents unhappy with MMR safety experts' links to drug firms:

"Documents produced by two Department of Health committees responsible for reviewing the safety and efficacy of the vaccine, the Committee on Safety of Medicines and the Joint Committee on Vaccination and Immunisation reveal that significant numbers of members have links with the manufacturers of the MMR jab.

"Fifteen of the 36 members of the CSM have declared personal or non- personal links with companies cited in a class action being brought by parents who believe that the measles mumps and rubella vaccine has harmed their children.

"Six committee members have personal shareholding and/or consultancy posts with MMR manufacturer GlaxoSmithKline and nine have past or present association such as receiving research funding from companies involved. Two members have declared interests in both categories.

"Among the 20 members of the vaccination and immunisation committee, two have declared consultancy work, again with Glaxo, and six have recorded personal interests relating to relevant companies. One member has interests in both categories.

"Although there is no evidence that their opinion on MMR have been influenced by their links, the extent of them has caused disquiet."

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Re: Public Funds Must be protected at all Costs!
 

Perhaps if Dick Taverne, Liberal Democrat peer is so concerned about the issue of public funds, then he must be be looking at the rising numbers of children diagnosed with the current autism epidemic and the costs to the taxpayer with horror!

Cost estimate for education/support/loss of revenue from parents unable to work and benefit claims ie DLA (lifetime) for a severely autistic child like my son estimated (today) at £3 million pounds. A higher functioning child estimated to be £500,000!

Figures released from National Autistic Society estimate there now to be 1 in 110 children with a diagnosed form of ASD. This rises to 1 in 80 in primary school children! Cases of "atypical" or "late onset" autism now outnumbering the class "Kanner" from birth syndrome by 5 to 1!

At the moment there are estimated to be 500,000 autistic individuals in the UK and these numbers are rising.

Perhaps if Dick were to do his sums - he would reconisder that perhaps the funding for the legal aid may be value for money or money well spent (what is the vaccine strain of the measles virus doing the gut and brain stem of these children???). When this research "scientitcally" proves a link (as I parent I know the link exists - I have seen it happen to my my own children) DoH could implement a policy to halt the numbers of severely damaged children and therefore save the taxpayer a fortune!

We would all be happy then, including Mr Taverne.

These parents are not in it for compensation! They want research and acknowledgement of the damage done to their children. I know the parents have signed any potential awards away - THEY WANT RECOGNITIION FOR THE DAMAGE DONE TO THEIR CHILDREN!

Perhaps if Dick is that concerned he could offer to save the LSC money and offer to mind these kids whilst their parents attend the Royal Courts of Justice tommorrow (Monday 26th July), and save the taxpayer money for creche facilities!

I am not personally involved in the UK litigation but I wish the parents involved all the best of British for tomorrow!

Yours

Carol Johnston

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Re: MMR KIDS - LIVING SCIENTIFIC PROOF MMR CAUSES AUTISM
 

Dr Fitchett questions whether parental evidence corroborated by video and suchlike can prove causation between MMR and autism. Challenge- dechallenge-rechallenge is scientific proof (not evidence but proof) of causation.

The parental and associated evidence establishes the MMR children are challenge-dechallenge-rechallenge cases.

Hence, MMR causes autism, and this is demonstrable and demonstrated quite clearly on a scientific basis.

Come on medical guys, head up now please. Start paying close attention.

This is all very clearly stated in my original piece 'MMR KIDS - LIVING SCIENTIFIC PROOF MMR CAUSES AUTISM' (http://bmj.bmjjournals.com/cgi/eletters/329/7459/239#68276). However, it does no harm to restate it.

Whilst there is plenty of evidence, the truth and facts are that no one actually knows on a scientific standard of proof how much serious and long term harm is being done by vaccines. This is because 1) no one is counting either properly or at all and 2) adverse drug reactions ('ADR's) to vaccines are not being accepted as such, as the MMR kids prove. 1500 UK deaths per annum from asthma and 400 UK SIDS deaths per annum versus 100 postulated from measles as and when there might be an epidemic? What about other serious long term harm being caused. Life threatening food allergies? Diabetes? Repeated susceptibility to infection? Shaken Baby Syndrome ('SBS'). Come on Doc, the public may not all be medically trained but they sure ain't dumb bums.

Does anyone else want to add to the list?

I hope Dr Fitchett might find further reading of assistance in:

1. ' UNRELIABILITY OF SCIENTIFIC PAPERS AS EVIDENCE' http://bmj.bmjjournals.com/cgi/eletters/328/7440/602-c#52948

2. 'TIME FOR POLITICIANS TO ACT RESPONSIBLY AND ADDRESS THE ISSUES' http://bmj.bmjjournals.com/cgi/eletters/328/7442/726-a#54697

3. 'SCARIER VACCINE STORIES TRUMP MUMPS' http://bmj.bmjjournals.com/cgi/eletters/329/7458/132-a#67642

4. 'JAIL NEEDED FOR HEALTH OFFICIALS - FITZPATRICK NO LONGER RELEVANT' http://bmj.bmjjournals.com/cgi/eletters/328/7455/1571#67305

5. ''FATALLY FLAWED' YELLOW CARD SCHEME' http://bmj.bmjjournals.com/cgi/eletters/328/7448/1095-b#58730

If anyone else has further recommended reading, perhaps they might be so kind as to respond with it?

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Re: Our world is totally irrational now
 

If this extraordinary use of flawed logic was not so tragic for millions of children across the world, it would be farcical.

How on earth can a GP talk about there being no causal links between a vaccine and subsequent never before seen problems, even when one shows evidence from video, photographic, parent opinion etc. pre and post vaccine?

How does he progress each day in his practice?

Say someone comes in with serious stomach problems. The GP would ask a series of common sense questions, undertake an examination, maybe take some samples for lab testing and will come up with a good enough opinion of cause - if he is any good as a clinician.

From this position he is then better placed to provide some sort of appropriate long term intervention. It may be that the patient ate something nasty, it may be connected to associated illness, it may be a drug reaction. He'd want to rule all that out before he progressed to thinking of other factors and to appropriate intervention - and of course to advise the patient whether he should avoid certain `triggers` again to prevent re-occurrence of the problem - as part of his Duty to the patient.

To rule out causal factors they must first be ruled in, that is, consider the differential diagnosis methods.

It is obviously not always possible to know what causes illness and disorder, but we as clinicians must at the very least surely be interested in all the possibilities which make sense.

He would formulate his opinion on the symptoms and the patient's record, the examination, his own common sense and his medical and scientific knowledge.

Now, in this Brave New World, we are being invited to apply tunnel vision to our medical and scientific knowledge, to include only the politically acceptable. For example, the epidemiological outcomes in relation to adverse reactions to vaccine, must now replace clinical good practice as we are encouraged to forget all our knowledge and training, to ignore what is staring us in the face, to bypass common sense.

In another post - `To the Point` - I used the example of people becoming ill in a restaurant after eating, say, lemon sole. Doctors would look at the patients, take the history and quite reasonably conclude that the cause of the illness was the lemon sole they had just eaten.

They would not say 'there is no evidence to link lemon sole with gastric problems. Thousands of people all over the world eat it and are perfectly well therefore there is no link at all. Its a complete mystery why these people are ill'

If a person was knocked over by a bus in a quiet street, it would be quite reasonable to conclude that the injuries found on the person were linked to the bus hitting him.

We would not say 'we've checked all our records on accidents in this street and accidents with this bus and there are no statistically significant links between this street and accidents of this nature or between this bus and accidents of this nature - therefore, the injuries cannot be linked to the bus hitting this person in this street'.

They may go a couple of steps further down the black rabbit hole and say that, given the latter, the person must have made his injuries up, or maybe did them to himself for attention. Or maybe even deny they exist at all. Then make a referral to psychiatry.

That is the impossibly illogical route being taken by all those who emphatically deny even the possiblity that some children could have been/could still be, made ill/made autistic/regress after multiple vaccinations despite all the common sense evidence from clinical good practice looking directly at the children affected? Isn't this akin to what the Holocaust deny-ers did for decades?

How can it be sensible, that years ago, when these temporal links with adverse reactions to single vaccines were recognised in some cases, and when the world was rational, that compensation was given to the victim from a vaccine damage fund?

How can it be that multiple vaccines cannot be seen to be causing problems in some children when just one used to? Haven't we multiplied the chances of such reactions occurring, not reduced them?

Are we not being duped into applying reverse and oppositional logic?

The question is - why?

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Re: Re: Really, Mr Miller?
 

Anthony Fitchett, General Practitioner says that I consider coincidence rather than causation with regard to our son's autism because of oral evidence supported by video documentary evidence.

I would like those like Anthony Fitchett, GP to give us some science as to why measles in the gut (1), elevated measles antibody titers in the blood (2), and measles virus in the spinal fluid are found in children with autism. (3)

It is up to those like Anthony Fitchett, GP to provide clinical science that shows us if it isn't the MMR vaccine doing this to all those children with autism, then what is?

Show us the clinical science! We don't need denials grounded in conjecture and personal opinions. Clinical science, not Voodoo science!

Denials will not make the autism epidemic disappear and we will be there every year to document this.

Five years ago, autism was 1 in 500.

Two years ago, autism was 1 in 250.

Now, autism is 1 in 166. (4)

References:

1. http://www.puterakembara.org/archives4/00000021.shtml

2. http://www.autismautoimmunityproject.org/singhsresearch.html

3. Detection of Measles Virus Genomic RNA in Cerebrospinal Fluid of Children with Regressive Autism: a Report of Three Cases

J.J. Bradstreet, M.D.; J. El Dahr, M.D.; A. Anthony,

M.B., Ph.D.; J.J. Kartzinel, M.D.; A.J. Wakefield, M.B. Journal of American Physicians and Surgeons Volume 9 Number 2 Summer 2004 http://www.aapsonline.org/

4. http://autismautoimmunityproject.org/A.L.E.R.T..htm

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Re: Re: Our world is totally irrational now
 

As a parent of an 3-year-old autistic kid, I really do not have time right now for a fight with big pharm and their cronies. But, pretty soon, hopefully in less than 3 years my son will recover fully (thanks to all "non-scientifically proven" techniques such as CFGF diet and ABA therapy). Then I will have all the time and energy for that. I will not rest until all of the culprits are in jail for genocide against 3 or 4 generations of kids worldwide. What they dont understand is that their denial and their stalling until enough "research" is fabricated by geneticians showing a link between genetics and autism (e.g. nobody is to blame) is making unfortunately more kids autistic. At the rate that autism is increasing, even some of their kids or grand kids are at risk of becoming autistic. The number of outraged parents they are going to deal with in the future is swelling and some of these parents might be their own kids. Their ego does not let them see the big 20 feet wave that is going to sweep them and their masters really soon.

Saadedine Tebbal, Ph.D.

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Re: IT IS TIME FOR LORD TAVERNE TO START ANSWERING
 

Lord Taverne should either substantiate his headlined comments about the plaintiffs' legal team in the MMR case or withdraw them. I believe the BMJ also has a responsibility in this matter.

Perhaps Lord Taverne would also agree with me that people who have been keen to point the finger at Dr Andrew Wakefield over alleged non- disclosure of interest should be open and frank about their own.

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Re: YOUR OWN DO-IT-YOURSELF KIT - RELIABLE PROOF MMR CAUSES AUTISM
 

Here, in two simple steps below, are references for you in the medical profession to look up for yourselves and see from reliable and official sources some of the evidence and examples of some of the science showing MMR causes autism.

This information has been available on the internet, but unknown to the general public. This is even whilst Lord Taverne, chairman of Glaxo funded Sense About Science has published in the BMJ this advertorial diatribe putting down the cases of these seriously damaged kids. Glaxo is, as noted already, a defendant in the MMR litigation (another hearing taking place today). In addition to this kind of misinformation about the morality and truth of the MMR kids cases, our government, medical heirarchy and legal system are in the process of crushing them.

The information about the justice of these children's cases has been available all the while drug company funded scientists have been busy publishing papers on epidemiology and the like telling us all there is no evidence to support a link between MMR and autism and all the while our government has been repeating the same mantra, regrettably, hiding behind questionable 'science'. That is science which stands today heavily criticised and questioned in the US by George Bush's White House appointee and Special (legal) Counsel and George Bush's Republican colleague and medical doctor Representative David Weldon MD. (See for references http://bmj.bmjjournals.com/cgi/eletters/329/7459/239#68276)

Now, when US Republicans express concern about these issues, you can be sure of one thing ...... there really is something to be concerned about. But wait a moment .... So, ..... what kind of government poisons its own kids? ...... Tony Blair's New Labour, aided by the Liberal Democrats, Lord Taverne and Dr Evan Harris MP. Yes medical boys and girls, the world is upside down, you are not standing on your heads.

This is all yet again proof that the MHRA and our system of pharmacovigilance not only does not work, but operates to protect the interests of the drug companies against a backdrop and history of (literally) deaths and serious injury caused to our kids in which pharmaceuticals are implicated.

Who is next? Your kids, your grandchildren? Your nephews? Your neices? And maybe you have not realised, not given it a second thought, that your ASD little brother or sister is a victim?

Please come back to these Rapid Responses and confirm you are concerned about what is going on or write in confidence to your local MP or, if outside the UK, to your local political representative. You can print out and copy them with this or other Rapid Responses to support your concerns.

THE DO-IT-YOURSELF KIT - RELIABLE PROOF MMR CAUSES AUTISM

As you will see below, and as admitted by Novartis in published documentation available on the internet, the minimum challenge dechallenge rechallenge requirement is for just one example. So, putting to one side the evidence of 1000 plus kids in the MMR litigation:-

STEP ONE:- Here are just two of those case histories available on the internet from Hansard, the UK Parliament's official record of proceedings: -

1. Health Select Committee Sixth Report 1998/99 - David Thrower’s Memorandum Appendix I — Degeneration of Oliver Thrower Into Autism — Case History

http://www.publications.parliament.uk/pa/cm199899/cmselect/cmhealth/549/99072718.htm

2. Hansard 19th November 2003 - Norman Baker MP - debate regarding MMR and the effects on Michael and Terry Thomas, two of the four sons of Isabella Thomas:-

http://www.publications.parliament.uk/pa/cm200203/cmhansrd/cm031119/debtext/31119 -42.htm#31119-42_head0

(if the immediately above link does not work remove the space before ' -42.htm#31119-42_head0' which the BMJ software introduces erroneously).

STEP TWO: Now just do a simple Google search just entering 'challenge dechallenge rechallenge' such as:-

http://www.google.com/search?hl=en&ie=ISO-8859- 1&q=challenge+dechallenge+rechallenge&btnG=Google+Search

(if the immediately above link does not work remove the space before ' 1&q=challenge+dechallenge+rechallenge&btnG=Google+Search' which the BMJ software introduces erroneously).

And look at what we get. The following are just some quick (but very important) examples:-

1. Look at the Novartis Cyclosporine Drug Interaction Manual on challenge dechallenge rechallenge (www.novartis-transplant.com/medpro/pdf/DrugInteraction2000.pdf second Google page - headed 4.75x10 DrugInteraction2000.MAN) in which it is said:

"The minimum criteria used to establish well-substantiated status are that the reported agent must have clear documentation in at least one patient of the effect, resolution and return of effect on challenge, dechallenge and rechallenge respectively.

Alternatively, the described interaction is considered well-sub- stantiated if at least three patients are clearly documented to have exhibited the interaction followed by resolution upon withdrawal of the interacting agent (rechallenge not required). Either criterion assumes the absence of equal or stronger conflicting data. Where any conflicting reports exist, these have been noted."

(if the immediately above link does not work remove the space before ' medpro/pdf/DrugInteraction2000.pdf' which the BMJ software introduces erroneously).

2. See Prof. Healy's paper in which Healy notes 'Far less consistent evidence led the Medicine’s Control Agency in Britain in 1988 to state unambiguously that benzodiazepines can trigger suicide.' stated in ANTIDEPRESSANTS & SUICIDE: RISK-BENEFIT CONUNDRUMS David Healy MD ... www.healyprozac.com/GhostlyData/JPCNDHealy2.pdf

3. See eg. the 'Challenge Dechallenge Rechallenge' heading in '“Suicide and Neuropsychiatric Adverse Effects' http://www.oism.info/teoria_prassi/2002_03_gb.htm

This was cited in the BMJ in http://bmj.bmjjournals.com/cgi/eletters/328/7440/602-c#53591

And amongst the important and useful information on challenge- dechallenge-rechallenge, there is also comfort and moral support in the same presentation at the end for all those battling to establish the truth and also a explanation of why medical professionals ignore it (at first):-

"All Truth passes through Three Stages:

First, it is Ridiculed...

Second, it is Violently Opposed...

Third, it is Accepted as being Self-Evident.

Arthur Schopenhauer (1778-1860)

In Friedson’s account, moral entrepreneurs in medicine are commonly part-time practitioners who crusade in health matters. The thrust of their activity is towards political power as they seek to implement measures designed to improve what they see as public health. They give press interviews and try to give testimony in court.

They are often responsible for legislation. They want to place jurisdiction for their concerns in the hands of health professionals rather than leave them with society. Freidson identified lay interest groups, sometimes led by, and always including, prominent physicians, whom he described as ‘the most flamboyant moral entrepreneurs of health, untrammelled by professional dignity, crusading against the menace of a specially chosen disease, impairment or disease-producing agent’

Such moral entrepreneurs, essential players in any moral panic, are ubiquitous. Professional entrepreneurs are creating panics about the consequences of child sexual abuse, others about failing to have professionals attend immediately on persons involved in traumatic events and about depression which had become the greatest scourge of modern society.

They advert to cases of undiagnosed and untreated post-traumatic stress disorder and depression, which medication would surely cure. They attribute to these evils a status of being important causes of personal failure and society’s epidemic ills.

Physician moral entrepreneurs are likely to see the environment as more dangerous to health than does the layman, and to emphasise the seriousness of the health problem preoccupying them by estimating the cases probably undiagnosed and therefore untreated.

They are disposed to see mental illness where the layman sees nervousness, to see illness where the layman sees variations within the broad range of normality, to see a serious problem where the layman sees only a minor one. They are biased towards the creation of sick roles and press their licence as physicians to manage the newly defined sick within their relevant speciality frameworks.

In brief, the medical profession is more prone to see illness and the need for treatment than it is to see health and normality. This selective perception is both self-confirming and self-sustaining. "

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Re: IT IS TIME FOR LORD TAVERNE TO START ANSWERING 2
 

What redress does Lord Taverne, Liberal Democrat peer, think ordinary citizens should have against private industry or the state if things go wrong? Surely we cannote separate his scorn for the parents and legal team in the MMR case, and the parents in the Alder Hey scandal from the implicit view that they should not have rights anyway. You might expect a Liberal Democrat spokesman to be concerned about over-powerful industrial conglomerates exerting their muscle against ordinary citizens through courts. Well, actually, he seems to want deny access for ordinary citizens to the courts altogether - placing the state and the conglomerates finally above the law and rendering them completely unchallengeable. If this is not his view he should say so, but it is the only sense I can make of it.

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Re: One law for all.
 

Sir,

I note that Lord Taverner (1) makes the claim that:

“As long ago as 1994 legal aid was granted to a group of parents who were opposed to immunisation (and who were strong believers in homoeopathy)”

If indeed these parents were initially and fundamentally opposed to allopathic medicine and vaccination, they would not be pursuing a claim through the legal system of vaccine damage to their children in the first place.

In summation, Lord Taverner comments that:

"Both cases demonstrate that we live in a climate of increasing irrationality, as the fashion for alternative medicine confirms. They also show that the law promotes this trend"

How might that be? I beg to differ. It would seem that Lord Taverner would ask that relatively modern (fashionable?) science and medicine ought not be party to or bound by the same principle of duty of care that guards the safety and interests of all members of society.

Fundamentally placing one above or beyond the realms of accountability to another?

I would hope for Modern science and it's rational, practical application to be seen as an intelligent, responsible feature of society, leading innovation with prudence, but not transcending it or it's laws of redress.

(1) BMJ 2004;329:239 (24 July), doi:10.1136/bmj.329.7459.239

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Re: Fiat justicia - er just wait a minute.....
 

I am quite flattered that Latin has made it back into the columns of the e-BMJ,having been banished (or even out-lawed from the paper version a few years ago) and in the mouth of a lawyer Mr M Luck, see above. But I do feel the context of ’Fiat justicia….’ could usefully be rehearsed. My starting point was the program from last year, Law and Order which has ‘fiat justicia ruant coeli’ R v Wilkes in one of the flash frames of the opening credits. Eighteenth century cases are reprinted in the All England Law Reports – because some of them are still good law: Dyer v Dyer 1767 and Lord Nottingham’s case 1676 in Trust, spring to mind.

Fiat Justicia ruat coelum was one of Lord Mansfield’s dicta. It came up in 1769 when John Wilkes – the famous one – was seeking to have his outlawry reversed (1). Even thought there was public acclamation that Lord Mansfield ought to reverse it, he alluded to this and refused to do so with the words:

“Unless we have been able to find an error which will bear us out to reverse the outlawry; it must be affirmed. The constitution does not allow reasons of state to influence our judgments: God forbid that it should! We must not regard political consequences how formidable soever they might be: if rebellion was the certain consequence we are bound to say, “fiat justicia, ruat coelum.”” (2)

Contemporary commentators immediately piled in. There is even a letter from Junius about Mansfield that Mr Woodfall's Public Advertiser carried. Modern commentators will spot a variety of other things. Mansfield uses the singular – (let justice be done though the heaven fall in) thought most modern quotes have the Latin in the plural. Also the plural of coelum is coela and not coeli.

There is a rare grammatical occurrence of something called tmesis.

Also, Mansfield then Lord Chief Justice, did not have an index linked judges’ pension to keep his mind on the political ball. But this does not prevent him from finding for the Establisment at the time.

Mansfield is saying that judges (rather than the executive – his next paragraph) are not open to outside pressures. Now if this applied to the MMR case, the outside pressures would be the focus groups supporting the autistic children who are claimants – and Mansfield is saying that they should be ignored, the Law should be decided according to the Law. This is 1769, mind you.

Readers will see therefore that Mansfield dictum militates against their case and doesn’t support it.

Fiat justicia seems a wonderful idea – one has to be careful how one uses it.

I just thought people would interested

Oliver R Dearlove FRCA

Refs 1. 4 Burrows 2527 2 at 2567

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Re: Re: MMR KIDS - LIVING SCIENTIFIC PROOF MMR CAUSES AUTISM
 

Like Ray Gallup, my children suffer in silence too. Though we have irrevertable proof of the viruses of MMR, Stealth Polio SCMV pumping through my children's veins, CNS and Brain, hypofusion-encephalitic damage, Myelin Eating, Lyme disease, Autistic enterocolitis etc, this is not proof that autism is not caused by vaccines? Let's break that down shall we?

I believe vaccines are the last trigger in our children, the irrevertable truth is, it is the major trigger. This along with use of antibiotics lowering Metallothionein at key times, a birth process that damages the BBB and gut via hypoxia on speech centers and aerobic centers of the brain as well as gut, then following that through with antipyretics which lowers glutathione, selenium, TNF, IGF-1, Metallothionein and lowers IL-6 in ALREADY compromised immune tendancy to autoimmune reaction (www.rollingdigital.com/autism ), this is the set up if you will to make an autistic child. But I can make another scenario just as clear from other stories of families with autism. Though they are varied and different, they all have various trigger events, and the final wallup is the vaccines.

First of all, you have parents who have lyme disease, who are congenitally passing the bacteria to their children via semen and breastmilk. Then maybe mothers have amalgam fillings, filling the birth environment, or flooding it with mercury disrupting brain circuits and growth of the brain. Then, you birth with less hypoxia, but pitocin is pumped in you or your C-sectioned, and then you give them a HEP B mercury shot, which along with that, will have billiburin stain in the brain (a sure sign of Immediate Cord Clamp), then you get autism very early.

Or, another scenario. A mother takes the "pill" for many years, disrupting her zinc, copper and iron balance. She is high testosterone now (a poor energy metabolism too), and has very little zinc stores which makes for collapsed metallothionein. She may have high histmines and absence of copper regulation which triggers a total shut down of Metallothionein and a slow autism onset, becuase the child is dumped with MSG and IRON in his diet (formula, Poly-vi-sol), and now you have no methylation and pump them with mercury. Again, autism onset regression around 18 months.

Or, you have a family history of Hemachromatosis, and your child has an underlying cerouloplasmin deficiency and Mt problem. You have a family history of schizophrenia and depression in your family, and included in that, sure signs of mycoplasma infection via a husband with GULF WAR history or VIETNAM, and even other TORCH symptoms at birth. The mother had a virus in utero (simple flu) and while she had it, she had a fever and took antipyretics, but then finally, got the full course meal of vaccinations...whala, you have a child with autism.

Or, you have a family history of pyrlorria and high oxidative stress. And talk of stress, you have that too. You have extraordinary high norepinephine and adrenaline levels, and signs of thyroid problems, a little mercury here or there in the mouth or fish eating, and then you wallup your child with vaccines, and they react with a high fever, and then you give them fever suppression drugs, but then your rememberence is that the child was on ear infection antibiotics for many months previous, wallup, your child has autism.

The point I am making is harsh, and a little cartoonish, but it is making a point. Just what makes a pediatrician think that a "healthy looking child" is ready for vaccination, WHEN IN FACT HE IS NOT ASKING THESE QUESTIONS!? We never were asked if we had a viral process, if I had mercury in my mouth or a MELISA allergy to thimerosol, if I had an iron disorder, lyme disease, SCMV or other markers that suggest, my children will not do well. No one is ready in these paragraphs above, yet we IGNORE the biological code of ethics which states, you cannot inject people with a biologic if they can't handle it.

The question is never asked, nor the question answered, if vaccines are a one size fit's fall, and, if some must wait, split, or never be vaccinated based upon these principles of health, and if anything, pure science, what has our medical cartels really done? They have made stories like Eric, like my son Ryan and Stacy...who to them, are acceptible losses in their disease wars. Disease is frightening either way, both either maim or injure, and the two sides offer plenty of sorrow. However, in my mind, it is preventable, due in part to the fact, that we are not asking SERIOUS questions in a SERIOUS epidemic.

Case in point, my son with ZERO complement C4B. Not measured in routine bloodwork, my son is in essence a sitting duck for viruses, fungals and toxins. He had VERY LITTLE ear infections, or use of antibiotics. He was for all purposes of the argument, the best looking child around, yet, he had an underscore of "don't mess with me". All three of these lovely ingredients above are produced in vaccines in one vial. Every succeeding vaccine he received dumped him into the landfill of autism.

UNLESS WE START ASKING THESE PRECONCEPTUAL, BIRTHING, and FAMILY HISTORY Questions and LESSONS-while avoiding products, medicines, and birth practices which are known to be harmful (www.cordclamping.com ), we shall continue autism, due to our mindset that they are IRRELEVANT in the entire picture. They are in fact the things we have changed in policy and scope and amounts, which have developed into problems for the average american family who for all intents and purposes are just as oxidatively stressed and immune deficient as a biafra child. Our immune systems are constantly being degredated, yet there are never new and improved vaccinations, or safety regulations, due to the fact that there is no icentive to look at such changes in policy and making vaccines safer, or enlarge the contraindication tables becuase "profit margins" matter, not our children.

If 30 percent of the american people are in fact sitting ducks with vaccines, this would still maintain herd immunity. Perhaps those thirty percenters will have a chance of a whole life, free from autoimmune autism, or other autoimmune diseases and or decades later, a life free of myeloma, lymphoma, MS or other neurological diseases that have also proof's of vaccination histories and damages (proven).

It is entirely clear to me, just how evil the whole paridigm is. There is no free agency, when it comes to this choice, unless your informed, and for those who are not, pay a bitter price. I wonder how long however, that will be, until an administration finds it necessary to vaccinate or pay up or go to jail, becuase terrorism small pox attacks are eminant? What lengths will these people go through, and how they can sleep at night, is my question? That's why the legal system is so important, becuase that is the only avenue parents have left to make sure their rights are protected, which in the first place, was not even protected due to our lack of ignorance and or our buy into the hype, media, and lies that vaccines are inocuous.

The same kind of lies are being told the Lyme infected. That it is not prevelant, that it is perfectly monitored. But we all know, the CDC, NIH and other minions, have a buy into the thought pattern of not waking up the american people, and ensuing anarchy that our government has us under wraps with a lot of things. WAG THE DOG.

Kathy

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Re: Re: Fiat justicia - er just wait a minute.....
 

I have no doubt this motto has been invoked from time immemorial (and way before the 18th century) in support of some humanly catastrophic legal decision. Perhaps in times past justice was not quite so expensive, though I have no doubt it was often just as arbitrary. If John Luck meant to adapt the phrase to mean that we should be allowed to seek justice irrespective of the financial cost I am not sure it was the occasion for some clever remark.

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Re: Making heavy weather of justice
 

Oh mischievous Dr Dearlove. "Let justice be done" despite the financial costs was my simple refrain. If I had wished to refer to a dictum I would have explicitly made reference to case law and context. Yes, of course what is just in law depends upon the application of the law by an impartial judge to the facts without reference to external political, social or economic predjudices etc; we would not wish it otherwise.

Let us rehearse the context of 'fiat justicia'. Lord Mansfield was a stickler for Roman law and indeed the dictum 'fiat justicia etsi coelum ruat' was well known to students of Latin from Seneca's discusion on Piso. Piso's law could have positive as well as negative consequences; since it all depends on the law at hand. It is probably best not to get sidetracked as to whether or not the judiciary discovers or makes law. Nevertheless, my favourite use of the ancient dictum is to be found in a later judgement of Mansfield LCJ, Somersett v. Stewart (Kings Bench 22 June 1772) 1. Lord Mansfield ruled that James Somersett, as escaped slave, could not be shipped to Jamaica. It was found that slavery was so odious that nothing but positive law could support it. As no such legal backing existed (Eg An Act of Parliament) then there was no such support in law for slavery. Somerset could not therefore be removed from England without his own consent to it. An example of law being applied despite the protestations of conservative mercantalists.

A case needs to be proved by the application of law to admissable evidence; there is no other way!

1) 98 Eng Rep 499-510.

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Re: Public Funds Must be protected at all Costs!
 

Since Mr T. has expressed grave concerns regarding the MMR Litigation costs and the perceived waste of public funds, he must be choking on his cornflakes over this latest article that appeared today in The Scotsman[1]. The Commons Select Committee on Constitutional Affairs warned excessive spending on legal aid for asylum seekers was swallowing up resources that could be spent elsewhere. In England, the Legal Services Commission spent £204m on advice on immigration in 2003-2004.

Although I support all "just" causes - justice it seems is not available to all, especially those innocents unable to speak for themselves - who have been severely disabled or even killed!

Although mathmatics was never my strong point - the £10m or was it £15m that was needed to conclude the MMR Litigation trial - is small change compared to £204m spent in England alone on immigration advice!

Regards

Carol Johnston

[1] http://news.scotsman.com/index.cfm?id=909942004 - Sun 8 Aug 2004 Asylum legal aid bill hits £1m by KATE FOSTER

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Re: Science or Sentiment?
 

Dr Blakemore - Brown's response of 25 July seems most incongruous with her rapid response of 17 July to the topic of Sally Clark’s miscarriage of justice. In the case of Sally Clark, she advocates that we seek clear, evidence-based thinking, free of associationist pseudo-logic and the emotional reasoning that blocked any challenge to the expert testimony. In the MMR debate, she suggests that because someone is ill on a quiet street, it must be an external injury and must be caused by a passing bus! Distressed families are regarded as “proof”. I regularly see people who are convinced that their relative’s psychosis is caused by displeased ancestors, bad star signs, or the evil eye cast by jealous neighbours. They, too, are convinced, and offer associationist evidence. It comforts them to assign blame on something specific and demonise something powerful, but it does not help us to treat, cure, or prevent mental health problems.

I am perplexed by her application of rigorous logic in one case and emotional reasoning in another. The only common denominator seems to be a cry for the underdog against “the establishment”.

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Re: Re: Science or Sentiment?
 

What surprises me - or perhaps does not - is not Dr Blakemore-Brown's alleged illogicality but Dr Laube's capacity for doublethink. In every case that we are talking about there is a documentented medical incident, ie the vaccination. The comparison of parents who report or document adverse drug reactions with people who put their faith in astrology or talk about the "evil eye" is deeply telling. Vaccine safety will remain a 20/21st century superstition if we systematically do not monitor, record or investigate adverse reactions. Trashing the intellectual capacity of patients is not a substitute for ethical practice.

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Re: Re: Re: Science or Sentiment?
 

When John Stone says that "trashing the intellectual capacity of patients is not a substitute for ethical practice," [1] he might be interested to read about similar observations in the literature. Patients do of course have legitimate recourse to “attempt to assert some control,” [2; 185] over all medical interventions concerning their own health. Such would seem self-evident if not axiomatic. That doctors too often fail to appreciate these points reveals “important differences in the perspectives and goals of doctors and their patients.” [2; 185] Patients tend to “have a broader notion of health and illness…concerned with all aspects of their life,” [2; 186] compared with the somewhat narrow view taken by medical practitioners.

One might contend that the biomedical attitude towards sickness encourages doctors’ “inattention to the sick person’s whole situation,” [2; 205] such that even “extremely caring physicians can lose sight of the socio-structural roots of patients’ suffering,” [2; 205] for it is often “the patient’s larger predicament,” [2; 205] that characterises more fully their state of ill-health, than mere numerical data and diagnostic techno- speak. Certainly, such can be construed as an endemic form of ‘medical blindness’ to the wider situation of the patient. For example, a major problem with modern scientific medicine is that “illness can be reduced to disordered bodily…functions.” [2; 213] Such “physical reductionism…excludes social, psychological and behavioural dimensions to illness,” [2; 213] and how one’s “social and emotional life might impinge on physical health.” [2; 213] Indeed, such exclusion seems inherent to the predominantly narrow biomedical approach, preferred today, and it endorses a “general inattention to social conditions…that contribute to illness or could aid in healing.” [2; 213]

All such problems can be legitimately traced to the power dynamics of the patient doctor interaction, an important aspect of which involves the doctor “controlling the flow of information to the patient.” [2; 219] To be candid, control here means restricting. The ‘good patient’ is often construed as one who meekly and submissively “accepts the doctor’s judgement and complies with doctor’s orders,” [2; 220] never questioning his/her authority or judgement. There is often an implicit assumption that “patients are generally ignorant and child-like, unable to comprehend explanations…or expected outcomes,” [2; 220] and yet repeated studies have shown that physicians “markedly underestimate their patients level of comprehension.” [2; 220] Arguably, this again reflects the gulf between patient and doctor.

In the “constrained, pre-structured talk,” [2; 220] that constitutes a medical consultation, communication can be “strained or adversarial,” [2; 224] and the physician viewed as “evasive, non-supportive, insensitive, uncaring, or dishonest.” [2; 224] Such unpleasant interactions can obviously serve to deter patients from visiting their doctor at all, and erode their “trust in the doctor-patient relationship.” [2; 224] There is no doubt that some patients do feel intimidated by their doctor, who they feel rides roughshod over their views and this feeling “is enhanced by their control over minute parts of their interaction with patients.” [2; 226] Clearly, feeling intimidated does not exactly encourage the patient to deliver an accurate and honest account of their problems—upon the basis of which the doctor will prescribe.

Doctors’ domination of the consultation is evident in their “frequently interrupting their patients, whereas they are seldom interrupted.” [2; 227] The relationship is clearly tilted in the doctor’s favour and in “subtle ways…dominance is asserted,” [2; 227] and a “one- sided familiarity serves to remind the patient that the doctor is dominant.” [2; 227] They can also “appear to be more oriented to the patient’s objectified record or chart than to the patient,” [2; 227] as a unique human being. This depersonalisation of the patient into ‘just another case’ is another example of the general process of disempowerment that characterises many medical consultations. This is enhanced by the doctor controlling many aspects of “space, posture, and gesture,” [2; 227] by the patient “waiting to see the doctor, rather than the reverse,” [2; 228] and the doctor often interrupting or discarding “information the patient wishes to communicate.” [2; 228] One study found that “doctors cut off patients’ descriptions of their complaints within the first 18 seconds.” [2; 228] In a ten minute consultation that represents only 3% of the time.

In conclusion, then, I would say that the comments John Stone made combined with the above quotes serve as clear examples of the fundamentally skewed, asymmetrical power dynamics of most doctor-patient interactions. Patients can try to be more assertive and dominant, if they choose, and challenge the doctor’s authority and decisions more, but we all know where that tends to lead—a swift exit, being labelled as a difficult patient and an invitation to register at a practice elsewhere.

Sources

[1] John Stone, Re: Science or Sentiment? BMJ e-letter, 17 August 2004

[2] Peter E S Freund & Meredith McGuire, Health Illness and the Social Body - a Critical Sociology, New Jersey: Prentice Hall, 3rd edition, 1999

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Re: Re: Re: Re: Science or Sentiment?
 

Without wishing to detract from the comments by Peter Morrell in his recent rapid response(1a), I would add that the practice of discrete boundaries of investigation and treatment, be it Bio-medical or Psycho- social is in some instances entirely dependant on fashionable and perhaps arbitrary diagnostic criteria separating mind and body. In the case of Autism, some recent suggestion (2) has been made to breach that boundary and access the tools of the Bio-medical approach in standardised diagnostic techniques, but is not reflected in an otherwise excellent suggestion for a care pathway. As has been noted by many respondents on this particular topic over the past year, adequate investigation requires diligent attention to each individual child.

In his discussion, Mr Morrell goes on to quote the passage:

“…All such problems can be legitimately traced to the power dynamics of the patient doctor interaction, an important aspect of which involves the doctor “controlling the flow of information to the patient.” (1b)

I would refer to a somewhat earlier work by Gervase Markham (3) his paternalistic attitude reflected his environment and may still be unwittingly marked in many an interaction in surgeries across the land when one considers the dynamic of dissemination of information and practical application in immediate patient care.

“Of Her virtues in Physic:

To begin then with one of the most principle virtues which doth belong to our English Housewife; you shall understand that sith the preservation and care of the family touching their health and soundness of body consisteth most in her diligence,”(3)

So if it all goes horribly wrong, it’s my fault for not being diligent enough?

“…… it is meet that she have a physical kind of knowledge; how to administer many wholesome receipts or medicines for the good of their health, as well as to prevent the first occasion of sickness as to take away the effects and evil of the same when it hath made seizure upon the body.”(3)

AHA! primary healthcare resides in the home, a little bit of knowledge is not a dangerous thing, on to the NHS Direct website I go!

“Indeed we must confess that the depth and secrets of this most excellent art of physic is far beyond the capacity of the most skilful woman, as lodging only in the breast of the learned professors;”(3)

I know my place, O yes, not for me the inner mysteries of the Pub-Med index.

“….. yet that our housewife may from them receive some ordinary rule and medicines which may avail for the benefit of her family, is (in our common experience) no derogation at all to that worthy art. Neither do I intend here to load her mind with all the symptoms, accidents and effects which go before or after every sickness, as though I would have her to assume the name of practitioner, but only to relate unto her some approved medicines and old doctrines which have been gathered together by two excellent and famous physicians……” (3)

Right, well, that’s me told then, I’ll ask a Pharmacist instead (4)

In conclusion to his response, Peter Morrell notes ”Patients can try to be more assertive and dominant, if they choose, and challenge the doctor’s authority and decisions more, but we all know where that tends to lead—a swift exit, being labelled as a difficult patient and an invitation to register at a practice elsewhere” (2b)

For a parent/caregiver, the repercussions of outright dissension may be far more damaging than seeking another practice to register with and at the very least leaves them in isolation.

MCF

(1a) Morrell P. Rapid Responses BMJ re:re: Science or Sentiment 20/08/04 (1b) Quote from: Peter E S Freund & Meredith McGuire, Health Illness and the Social Body - a Critical Sociology, New Jersey: Prentice Hall, 3rd edition, 1999 Cited by Morrell P (1a)

(2) Diagnosis of Autism, Clinical Review. Care pathway and service needs for children and young people with autistic spectrum disorder (Posted as supplied by author, Gillian Baird) BMJ 2003;327:488-493 (30 August), doi:10.1136/bmj.327.7413.488

(3) Gervase Markham “The English Housewife- containing the inward and outward virtues which ought to be in a complete woman…” First Edition circa 1615 Ed: Michael R Best Pub: McGill_Queens University Press

(4)University of Sunderland Autism Research Unit

http://osiris.sunderland.ac.uk/autism/index.html

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Re: Re: Our world is totally irrational now
 

Sorry Dr Laube, I am at a loss to understand why you don't understand me. Also I am not a `Dr`. Maybe that's why you and I think differently?

I have given the most simplistic examples of very obvious causal links in my examples on 17th July 2004 to reveal the absurdity of what is being missed in terms of temporal associations in vaccine damaged cases - and indeed in other cases in which medical interventions such as the use of experimental drugs may have been used ...this is what I wrote:

"If a person was knocked over by a bus in a quiet street, it would be quite reasonable to conclude that the injuries found on the person were linked to the bus hitting him.

We would not say 'we've checked all our records on accidents in this street and accidents with this bus and there are no statistically significant links between this street and accidents of this nature or between this bus and accidents of this nature - therefore, the injuries cannot be linked to the bus hitting this person in this street'."

Your reading of and interpretation of what I wrote is way off beam - you don't diagnose MSBP do you?

I don't see any reference to distressed families, and certainly no reference to this being used as part of the audit trail which good practitioners should develop.

I did do a talk on MSBP being a Pseudo Science in Sydney earlier this year so maybe that is something to do with your post.

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Re: Medical folly damaging us all with support from an "ass"
 

I agree with Mr Taverne that sometimes the “law is an ass”, however, I differ in the details: I think that the law was an ass in the case of the MMR class action of about 1000 parents, whose children were damaged by these dangerous and useless vaccine, by the fact that the legal aid was withdrawn. I also differ in saying that these parents were definitely not “strong believers in homoeopathy” because if they were they would not have vaccinated their children and would not had taken any legal action. Instead they were indeed and mistakenly strong believers in orthodox medicine and the judicial system which repaid them by tragic consequences to their children’s health and withdrawing the legal aid for their much needed legal action in the interests of all children.

Moreover: What a NAZI-style rhetoric!

The causal link between the administration of a variety of vaccines and including MMR, has been demonstrated and proven!

As Mr Miller wrote in his Rapid Response to Dick Taverne, autistic children are the living proof of the causal link. The parents’ video records of their children’s behaviour before and after are the superior proof in the eyes of the law, and, may I add, also in the eyes of science.

People should stop taking seriously the inconsequential ramblings of pro-vaccinators about lack of evidence of vaccine damage allegedly based on epidemiological studies. Ignorance is not bliss, ignorance these days is painful. However, I also strongly believe that parents can stop all this vaccination damage and nonsense about deadly infections diseases, which are in reality not just quite manageable but beneficial for their children, by simply exercising their legal right not to vaccinate.

As far as medical doctors are concerned, I have coined a new legal term, “criminal ignorance”, which applies when medical professionals have a lack of knowledge that is essential for proper performance of professional duties, resulting in grievous bodily harm and/or death of the client/patient.

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Re: Unaccountable
 

Revisiting this article by the (unacknowledged) chairman of Sense About Science [1] I was struck by this remarkable statement:

"The first was a claim against manufacturers of the MMR (measles, mumps, and rubella) vaccine. As long ago as 1994 legal aid was granted to a group of parents who were opposed to immunisation (and who were strong believers in homoeopathy), for an action claiming that MMR causes brain damage, epilepsy, arthritis, and autoimmune disease."

On what basis could Taverne claim either that this was a group (some may have known each other, but others not) or that they were "strong believers in homeopathy". One thing that is fairly certain about all of them is that they had their children vaccinated: that some may have become disaffected with mainstream medicine might perhaps be a factor of their experience, but if he was saying that collectively the litigants were adherents of homeopathy this is without foundantion and the purest nonsense.

What is disturbing about this article after all this time is the way it targets people rather than provides any scientific argument for its position, and is substantially propagandistic. Sense About Science list as its sponsors:

"the ABPI, AstraZeneca plc, BBSRC, The Biochemical Society, Blackwell Publishing, BP plc, British Institute of Radiology, Dixons Group plc, Elsevier, Engineering and Physical Sciences Research Council, The Esmee Fairbairn Foundation, Garfield Weston, GE Healthcare, GlaxoSmithKline, Halifax Bank of Scotland, Health and Science Communication Trust, Institute of Physics, Institute of Physics and Engineering in Medicine, John Innes Centre, John Innes Trust, Medical Research Council, NESTA, New Scientist, Oxford GlycoSciences plc, Pfizer plc, The Physiological Society, Royal Academy of Engineering, Royal Astronomical Society, Royal College of Radiology, Royal Pharmaceutical Society of Great Britain, Royal Society of Chemistry, Science Careers.org, Social Issues Research Centre, The Society for Applied Microbiology, The Society for Endocrinology, The Society for General Microbiology, Unilever plc. Help with equipment, facilities and services has been received from: AXA Investment Management, Horticultural Research International, Institute of Biology, The Natural History Museum, Lord Stevenson of Coddenham, and WPP." [2]

Now that the ABPI have a code of practice [3] it is also an interesting question whether influencing public perceptions through such lobby organisations fits either within its spirit or its letter.

[1]http://www.senseaboutscience.org.uk/index.php/site/about/7

[2] http://www.senseaboutscience.org.uk/index.php/site/other/130/

[3] http://www.bmj.com/cgi/eletters/335/7618/480#176540