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Autism Complementary and alternative medicine Medicine Quackery

Silencing the opposition over autism

Now here’s something you don’t see every day. Nature Neuroscience has weighed in about the pseudoscience that claims that mercury causes autism. Based on British experience with animal rights activists, it points out a parallel that I hadn’t considered before:

The idea that autism is caused by vaccination is influencing public policy, even though rigorous studies do not support this hypothesis. Legislators are right to take into account the concerns of parent groups and others directly affected by autism, but policy decisions should be based on hard evidence rather than anxiety. More worryingly, some proponents have adopted tactics reminiscent of certain animal rights groups, which are aimed at shutting down the views of opponents.

The hypothesis is based on the observation that the number of autism cases increased in the 1980s, coinciding with a push for greater childhood vaccinations, which increased above recommended levels children’s exposure to mercury in the vaccine preservative thimerosal. However, autism diagnosis continued to rise even after thimerosal was removed from US childhood vaccines in 2001. A review by the Institute of Medicine (http://www.nap.edu/catalog/10997.html) of over 200 studies concluded that that there was no causal link between thimerosal-containing vaccines and autism. Autism is no more common among vaccinated than unvaccinated children, and its incidence has not covaried with the presence of thimerosal in vaccines across different times and locations.

Indeed. I first discovered the antivaccination lunacy that is fueled by the scientifically untenable hypothesis that the mercury in thimerosal in childhood vaccines is a major cause of autism back in 2005. You may recall that around then the mercury militia (as I and others like to call antimercury warriors like Mark and David Geier who don’t let lack of evidence or research ethics stop them from pursuing their bête noire, even if they have to force the evidence to show what they want it to. Sadly, dupes like Robert F. Kennedy (for whom I’ve totally lost all respect) fall for this, hook, line, and sinker, as do credulous reporters like Dan Olmsted (who’s busy parroting canards about how the Amish “don’t get autism” and how alternative medical practitioners in Chicago who don’t vaccinate claim on the basis of zero objective evidence that unvaccinated children don’t get autism), and, of course, David Kirby, the less said about whom, given his guzzling of the Kool Aid in his book Evidence of Harm was a major force for popularizing the “thimerosal causes autism” pseudoscience, the better.

The question of whether pseudoscientific doctors like Dr. Mark Geier feed the belief in parents of autistic children that vaccines caused their children’s autism or whether the belief that has spread among these parents, desperate to find a cause for their children’s condition, has attracted such pseudoscientists, some of whom see money to be made serving as “expert witnesses” in litigation alleging “vaccine injury” is very much a “chicken-or-the-egg” sort of a question. However, there is no doubt that they feed upon each other. Similarly there’s no doubt that a not insignificant number of parents have become so convinced that mercury in vaccines cause their child’s autism, despite all the epidemiological and scientific evidence that has failed to find a link between mercury and autism, that it seems that nothing will convince them otherwise. Indeed, the belief that mercury causes autism has led parents to fall for outright quackery like chelation therapy to “remove” the nonexistent mercury, plus a cottage industry of laboratories that exist to provide “evidence” that their autistic children have elevated mercury, even though it is a procedure that can result in death. On the far toxic end of the spectrum is someone like John Best (a.k.a. “Fore Sam”), who has been a frequent commenter on this blog and whose utterly irrational and toxic diatribes represent the looniest of the loons. Best is so far off the deep end that he’s beyond reach. The sort of rhetoric that emanates from the mercury militia movement tends to lead to absolutism:

These findings have not dissuaded supporters of the mercury-autism link, whose strategies have become more extreme as the evidence against the hypothesis mounts. People who oppose the idea have been harassed with repeated calls, whether they have written a letter to their local paper (http://tinyurl.com/3dba3c) or an editorial for The Wall Street Journal (http://tinyurl.com/2obgfg). The harassment includes parents of autistic children who do not align themselves with the anti-vaccine movement. Kevin Leitch reports, “I have personally been told that because I am not chelating my daughter, I am a child abuser. That I am a murderer. I have had threats of violence made against me, and a few people have even sent personal hate mail to my seven-year-old autistic daughter.”

Yes, it’s that Kevin Leitch who was interviewed for the Nature Neuroscience editorial, and he’s commented further, stating that it’s not just him who has been subjected to harassment for speaking out against the mercury concept:

I know of four scientists whom I have exchanged emails with who have been targeted by this same extreme group and who had:

  1. Threats of property damage made against their homes and property.
  2. Threats of physical violence made against them.
  3. Been the victims of concerted email and telephone harassment campaigns to the point where security services have had to get involved.
  4. Had their associations with entities that merely sound like Pharma organisations misrepresented.
  5. Been accused, on no basis at all, of fraud.

These scientists are staggered that merely performing accurate science has led them to having to (in three cases I know of) inform Campus Police of the places they work at of their movements in order to remain safe.

I’ve also spoken with several paediatricians and doctors in general practice who report belligerence and fury when the doctor tells the parent in question that the ‘test’ the parent has had performed by Doctors Data or some quack lab – at no small cost – is worthless and means nothing. One GP told me xe felt intimidated to the point of pressing the panic button under the desk.

The Nature Neuroscience editorial likens such behavior to that of animal rights extremists. I’m not sure how apt a comparison that is, although I can see signs of incipient tactics similar to animal rights loons. Indeed, Autism Diva points out similar incidents and rhetoric. It’s easy for me to forget that radical animal rights extremists are much more of a problem in the U.K. than they are in the U.S. Thus far, in the U.S., they are an occasional and mostly minor nuisance, although they have recently indulged in intimidation and threatened violence. In contrast, in the U.K., animal rights terrorism is far more prevalent, to the point where scientists are much more afraid than they are in the U.S., as documented by Brian O’Connor in his now-defunct blog Animal Crackers. Fortunately, in both nations, the mercury militia has lived up to its name in rhetoric only.

However, there is one difference, I think, between animal rights activists and the mercury militia. In general, most scientists doing biomedical research now recognize the threat represented by animal rights extremists. Kevin and the editorial rightly point out that, for the most part, scientists studying autism are either unaware of the mercury militia or do not consider them a force to bother with. Several years ago, even though the hypothesis that mercury causes autism seemed unlikely, it was just plausible enough that it caused some concern. Over the last few years, multiple studies have been performed to try to find a link between mercury and autism, and none have succeeded. It is quite clear that mercury in vaccines is not a major cause of autism and that it probably has nothing to do with autism. It’s marginally possible that mercury may have an influence in very uncommon susceptible individuals, but even that’s unlikely, given that the size of the multiple epidemiological studies would probably have picked up any such association. In the unlikely event that such an association does exist, it is clearly extremely weak indeed.

I’ve been fortunate in that, although I’ve been “outed” on the Evidence of Harm e-mail list, I’ve had little in the way of harassment from mercury militia devotees. I rather suspect that, because I am not autistic myself or a parent of an autistic child, parents who do have autistic children and have bought into the mercury militia line for the most part dismiss me as irrelevant, although why they do not do the same with David Kirby, who is also neither autistic himself nor the parent of an autistic child , I have yet to figure out. They also accuse me of “not understanding,” which to some extent is true; I have no personal experience of the day-to-day struggles of raising an autistic child, although contacts like Kev have opened my eyes as much as they can be opened not being in his shoes. However, I do know science and epidemiology. I do know that the science has shown that mercury, whatever else it might do, does not cause autism. I do know that subjecting autistic children to chelation therapy at best will do them no good and at worst might kill them. Such dubious treatments are the outgrowth of the whole “mercury causes autism” concept.

In any case, the first harassment I suffered, before I got into the mercury debate, came from the likes of William O’Neill of the Canadian Cancer Research Group. Indeed, Mr. O’Neill holds the “honor” (such as it is) of being the only person ever to e-mail vacuous legal threats to my Division Chief, Department Chair, and Cancer Center director beginning almost exactly two years ago. Indeed, that is how they all found out about the existence of my blog. Fortunately, none considered my online antics a problem as long as it was done on my own time. I also never write directly about where I work, only about academic medicine and surgery in general, which probably helped. Amusingly, my department chair was particularly contemptuous of Mr. O’Neill and his antics. Since then, any time I’ve gotten such idiotic threats, I’ve made it a point to forward them to my Department Chair, who seems bemused by my hobby, and my Division Chief, among others. It’s been several months since the last one. I have little doubt that, sooner or later, Mr. O’Neill will find this post and reactivate his campaign. He does seem to obsessively Google himself and links to Peter Bowditch’s webpage. At least that’s the only way I can imagine that he finds out about mentions of him so rapidly.

Following in Mr. O’Neill’s footsteps in the fall of 2005 was a member of the aforementioned Evidence of Harm mailing list, who obviously must have spent a lot of time Googling through Usenet posts from the late 1990’s, which at the time was the only place online where it was possible to connect my ‘nym with my real name. Equally odd, she made a claim that I was into seriously nasty racism because she found posts by me on alt.revisionism and various white nationalist newsgroups. Apparently this woman was too stupid or too drunk with hate to note that the reason I posted on such newsgroups was because of my interest in combating Holocaust denial, and the content of my posts was entirely critical and devoted to the rebutting of Holocaust denier lies. Following in this woman’s footsteps was one of the Big Kahunas or the mercury militia himself, J.B. Handley, who decided to cybersquat on my previous blog’s name. More recently, an HIV denialist named Casey Cohen (which, I suspect, is also a pseudonym) did the same thing and challenged me to a “debate” with Christine Maggiore, the HIV-positive mother and HIV denialist who refused to take AZT during pregnancy and the death of whose child from AIDS she and other denialists attribute to bizarre and improbable things like reactions to amoxicillin or to unlikely viral infections. Finally, “intelligent design” creationist crank, global warming denialist, and supporter of self-experimentation with non-FDA-approved cancer treatments DaveScot (also a pseudonym; his real name is David Springer) did the same thing, while our old buddy John Best is over at his own blog trying to out people left and right with whom he doesn’t agree.

Based on my experience, I’ve come to the conclusion that at least one true mark of a crank, particularly medical cranks but certainly not limited to them, is that they are obsessed with who the opposition is. Pseudonyms drive them crazy. When they find someone posting material refuting their pseudoscience to Usenet, discussion boards, or a blog under a pseudonym something that criticizes their views, their first reaction is to try to unmask that person, not to refute their criticism. Because their position is so tenuous and because there is no legitimate scientific rationale for it, their only fallback it to attack the person, which is why they obsess on who I am and to find any way they think they can embarrass me or even (at least in their minds) threaten my career. On the other hand, I’m fairly fortunate. I’m not worried about my life (at least not from the mercury militia). At the worst, if I happened to work at an institution less tolerant and for a boss who didn’t want to be bothered even once every several months (the usual rate of Mr. O’Neill’s appearances), I could be in trouble from these people–although my ability to obtain outside funding for my laboratory certainly goes a long way to immunize me from such problems for now. If I were not fortunate (and sufficiently talented enough as a scientist) such things might be more of a concern to me.

Given that background, I tend to agree with Kevin:

For the scientists still trying to do studies that touch on the autism/vaccine hypothesis, the issue hasn’t gone away. For the millions of autism parents around the world who find themselves having to compete for funding with a set of threatening bullies the issue hasn’t gone away. For GP’s and nurses who have to listen to the threats and screaming fits the issue hasn’t gone away.

The only way to defeat a bully is to stand up to him. I plead with the larger scientific community to come back to the fray where we can be united and face down these enemies of science and autism.

Indeed. I’m only starting to realize this, which is one reason that for a few months now I’ve been toying with the idea of losing the ‘nym. On the other hand, I’ve become quite attached to it. I don’t know what I’ll ultimately decide to do. Orac is my alter-ego; getting rid of him would be almost like killing off an old (albeit cantankerous) friend, and it would almost seem like an admission of defeat if I had to do it.

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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