Autism Bioethics Medicine Quackery

Arthur Allen on conflicts of interest in the mercury militia movement

Those arguing the “conventional” view that sound science and epidemiological studies have failed to find a link between vaccines and autism are often tarred with the “pharma shill” brush. Meanwhile, researchers who have ever taken drug company money (particularly if it’s from a drug company that makes vaccines) are castigated for having a serious conflict of interest, even to the point where conflicts of interest are invented or exaggerated beyond any reasonable recognition to tar the investigator with the dreaded “pharma shill” label.

Don’t get me wrong. Possible conflicts of interest should be aired whenever research is reported. Indeed, it’s happening more and more, both in journals and at scientific conferences, and this is generally a good thing. At conferences, for example, we now routinely joke about the mandatory conflict of interest statement at the beginning of a talk that each speaker must make. My personal favorite variant (and the one that I usually use) is something along the lines of: “I have no conflicts of interest to report because, alas, no one wanted to hire me as a consultant and no drug company wanted to give me money for my research.” Whatever the past transgressions of “conventional science” in not being adequately transparent about funding sources and conflicts of interest, a serious effort is under way to correct the problem, sometimes with comical results at various conferences.

But what about less conventional “scientists”? What about the anti-mercury activists who, against the growing preponderance of evidence, continue to cling stubbornly to the discredited hypothesis that mercury in vaccines causes autism? Arthur Allen, author of Vaccine: The Controversial Story of Medicine’s Greatest Lifesaver (an excellent book that I heartily recommend), wants to know in an article at the Huffington Post entitled Autism, Mercury and the Anti-Merc Activists: Whose Conflicts?:

There has been increasing public scrutiny of scientific conflicts of interest in recent years, no doubt a good thing. In the scientific culture, scientists are expected to acknowledge biases. In the “comments” section of their papers, for example, most scientists are in the habit of playing the devil’s advocate by explaining how their results may have been skewed by the structure of their data or data collection; this is a recognition of the fact that many a scientific result can’t be reproduced. Scientists are also obliged by most journals to describe any financial or relational bias that may impact the work, such as funding from a pharmaceutical company.

Public advocates have no such demands on them, and that was what was disturbing about the IOM workshop. Many of the scientists in this field and at the workshop table were drawn into it by the fact that they have autistic-spectrum children; that’s a bias, of sorts, but it’s also a strong motivation to find real causes and treatments of the disorder. But there were others at the meeting who were there simply to further pester the government and scientific community about their own pet theory for autism, which is that it was caused by toxins, particularly the mercury-based preservative thimerosal. The demeanor of people who buy this theory ranges from ranting and profane to reasonable. At the table last week were three groups–Autism Speaks, SafeMinds and the National Autism Association. As someone who entered the debate about this theory, in 2002, with an open mind, but h as come to the strong conclusion that there is no basis for blaming vaccines for an “epidemic” that may not even exist, I find some of the individuals in these groups, especially in SafeMinds, to be disingenuous. They are playing at scientific seriousness while refusing to acknowledge the data.

Here I would differ with Mr. Allen somewhat. They are not even playing at scientific seriousness. They have an agenda, and they twist the data to fit the agenda, not the agenda to fit the data. One only has to look at the incredibly poorly designed and executed “studies” of mercury miliitia luminaries like Mark and David Geier, whose “research” involves using chemical castration plus chelation therapy to “treat” autism and gone as far as using bogus institutional review boards packed with mercury militia and cronies to “approve” such “studies.” Meanwhile, they serve as “expert witnesses” who aren’t in legal action after legal action for parents suing the government for alleged “vaccine injury” due to mercury.Their pseudoscience and shoddy studies provide tactical air support to the parents who, unaware of how easy it is to see correlations where none exist, believe that chelation has helped their children, unwilling to realize that most autistic children’s symptoms improve as they get older and unaware of concepts that bedevil scientists trying to determine if a treatment works, such as regression to the mean qne confirmation bias. As Ben Goldacre put it so well, they feel the p-values in their souls:

You cannot sense whether a pill improves intelligence, or cures the common cold, or whether MMR causes autism. Your tiny, beautiful ingot of human experience in the world does not present you with sufficient information to spot patterns on that scale: it’s like looking at the ceiling of the Sistine chapel with one eye through a very long cardboard tube.

Mr. Allen does get it, however, when he notes the inherent conflict of interest in these groups, a conflict every bit as potent as that of any researcher who accepts drug company money–perhaps even more so, given the added emotional component overlaid onto the financial incentive, combined with the groupthink that provides support and validation to the members of the mercury militia and ostracism to any member who publicly question whether mercury causes autism:

Many of the people in the “mercury” camp (including SafeMinds’ Lyn Redwood, and NAA’s Laura Bono, both participants in the IOM workshop) are or were involved in lawsuits charging that their children were made autistic by mercury. And as Blaxill himself has pointed out (for example in a 2005 meeting at the CDC), you don’t have to have a financial conflict of interest to cling stubbornly to a flawed position. It’s enough to have too much professional pride, or to belong to a community of belief that will heckle or ostracize you if you step out of line (Blaxill, at the time, was talking about what he perceived as the pediatrics community’s unwillingness to face the fact that it had been poisoning kids for years).

After you’ve spent years shouting at the government, participating in flawed Congressional hearings, writing junky “investigational” books and reports, ginning up gigantic legal claims that cost the courts, the public, and the drug companies hundreds of millions of dollars, and spreading unfounded slander against government scientists on the Web, it’s pretty darn hard to step back and say, “Whoops, I was wrong.” I just wish I could find someone–anyone–willing to do that.

Good luck finding someone like that among the mercury militia. They’ve drunk so deeply of the Kool Aid that no number or quality of studies failing to find a link between thimerosal in vaccines and autism is likely ever to sway them. (Don’t believe me? Check out the comments after Mr. Allen’s post.) It is only fair and proper that scientists should be forced to acknowledge their conflicts of interest. Activists and the “scientists” who support them should not get a pass on the same transparency. It’s only fair.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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