Monday, February 09, 2015

The cracks in trust continue to grow ...

Healthcare providers and patients have placed great trust in researchers (both private and public) to provide data (information) and solutions to health problems based upon good data. Once trust is broken it is not easily regained. 

Over the last decade there have been seminal articles sounding the alarm that the trust we have placed in those providing us with information and products we use to either protect or repair our health may have some growing cracks. 

In 2005 John Ioannidis published an essay "Why Most Published Research Findings Are False" in which he reviews problems with published research that lead to a foundation for skepticism toward much of the results and what to do about it.

In 2009, this quote from Marcia Angell, MD, writing in the NY Times Review of Books, "Drug Companies and Doctors: A Story of Corruption" caught the attention of many: 
"The problems I’ve discussed are not limited to psychiatry, although they reach their most florid form there. Similar conflicts of interest and biases exist in virtually every field of medicine, particularly those that rely heavily on drugs or devices. It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of TheNew England Journal of Medicine."
Even with just a cursory read of Dr. Angell's writing one would recognize she has no love for free-market medicine or market-based solutions in healthcare, and here she and I would disagree, as I think this would provide the best solutions for many problems in healthcare.  The brilliance of the free market is that it reflects the collective expression of individual economic choices, and good ideas, good products do well because people demand more of them - the "mandate" grows from a groundswell of consumers requesting more of, and being willing to pay for a product rather than it being forced upon them in an authoritarian fashion. 

In 2010 a qui tam lawsuit was filed against Merck by 2 of their scientists alleging Merck provided fraudulent proof of efficacy for the mumps portion of the MMR vaccine. A ruling was issued in Sept 2014 allowing the lawsuit to proceed.

In August of 2014, Dr. William Thompson (of the CDC) came forward alleging a major 2004 study reporting no association between vaccines and autism was gerry-rigged to achieve desired results. He is reported to have been granted formal "whistleblower" status, and this story continues to develop.

And today, in 2015, Charles Seife published two articles (concurrently, in lay and professional press) alleging tolerance of fraud at the FDA. 

Not all research is corrupt, but it is prudent to be discerning, and no one should be vilified for asking reasonable questions. Science is seldom settled, and has a long history of reversing itself, whether the domain is medicine or physics or any other aspect science. 

Because science is not settled, and because of disclosures reviewed above, it is reasonable for people to determine for themselves what risk/benefit ratio with which they are comfortable in regards to vaccines (or any other medical intervention). We don't have all the data regarding vaccine safety, nor efficacy - much of this remains undisclosed, guarded by the companies that make a product that is mandated by the same government that has provided a virtually impenetrable liability shield, whose use is determined by professionals who may have undisclosed personal financial conflicts of interest with these same manufacturers! 

It isn't transparent to stategize management of the crisis of a cluster of infant deaths following vaccination by ensuring no large batches of any one lot of a vaccine go to a particular geographic area (Wyeth 1979) and here for Wyeth's internal memo

It is impossible to eliminate all risk of disease, even if there were 100% compliance with all vaccines - and we may well be trading temporary illness for long-term chronic ill health. There are many who would love to have studies looking at that very riddle, and what role, if any, vaccination may play in it. 

None of us is unbiased, and neither is science as it is conducted by humans, who quite clearly, find it difficult to set aside their personal views in pursuing new knowledge. All of us live with the consequences of each others choices ... whether that is smoking, what we eat or whether we exercise, with whom we have sex and how we have sex ... and of course, whether we do or do not choose to be vaccinated (or have our children vaccinated if we are parents). It is wrong to demand people use a product whose safety and efficacy are unknown, in particular when there is so much apparent conflict of interest embedded in the very system making recommendations for said product ... when those who receive the product bear all risk with essentially no recourse when they are injured by the product they were required to use even against their will! 


  1. I just now read your blog post about why people begin to question vaccination. You did a nice job writing it and giving examples.

    I remember how furious I was several months ago when I read about what you mentioned, about Wyeth in 1979 when it was found that certain lots of the DPT vaccine were being recalled. I was angry because that is about the time (in 1978) that my first child had received the DPT vaccines and had severe reactions to it. At the same time, though, my child had been given the oral polio vaccine along with the DPT shot, at age 2 months and again at age 3 months. The third dose of DPT was given at age 4 months but not with another dose of oral polio vaccine.

    The first two (at 2 and 3 months) resulted in brain swelling, which I could tell because of the poochy fontanelle (soft-spot on the head) and screaming for hours. I'm thankful that I was breastfeeding; otherwise the damage could have been much worse than it was. As it was, we later found that this child had a learning disability.

    1. Susan - thanks for your comments.

      Part of what I find so appalling is that this issue of dodgy data and squishy science certainly isn't limited to vaccines.


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