In 37 years in the news business, I’ve never seen anything like it.
The stunning collapse of the British Medical Journal's allegation of fraud against Dr. Andrew Wakefield, less than a year after it was made with so much fanfare, raises an inevitable question: when is the mainstream media going to realize they've been had, and what are they going to do about it?
When will they notice that not only were the allegations recycled from a two-year-old account produced by the Murdoch media empire's disavowed methods, but that the whole tangled mess has landed right on the doorstep of the BMJ in Trafalgar Square?
NOW would be a good time to notice -- now that the central premise of the paper has been shown by the BMJ itself to be a "matter of interpretation" -- not an elaborate fraud perpetrated by Wakefield in plain sight of his 12 well-respected co-authors at one of the top medical clinics in the world. And now that "multiple discrepancies" claimed as the remaining evidence are turning out to be the journal’s, not Wakefield’s.
"A syndrome necessarily requires at least some consistency," author Brian Deer wrote in January in "How the Case Against the MMR Was Fixed," attacking the Wakefield paper's claim that a consecutive series of children arrived at the Royal Free Hospital in the late 1990s with signs of regressive autism and bowel disease, and that some of the parents blamed the MMR. "But, as the records were laid out, Wakefield's crumbled."
What's crumbling now is the credibility of the British Medical Journal.
Like Gaul, the allegation of fraud is divided into three parts. According to BMJ Editor Fiona Godlee, speaking at the U.S. National Institutes of Health, the fraud was constituted of Wakefield’s statements about "inflammatory bowel problems, regressive autism, and the parental claim that MMR was the underlying cause. What these articles [by Brian Deer] also say [is] that when those three things didn't come up trumps on the twelve children included, and the subsequent series of children, Andrew Wakefield altered the data to make those three things emerge."
Altered the data on those three things? That seems clear enough. A sidebar titled "How the linked was fixed" – fixed as in faked as in fraudulent -- makes the same claims:
"--Three of nine children reported with regressive autism did not have autism diagnoses at all. Only one child clearly had regressive autism.
-- Despite the paper claiming that all 12 children were 'previously normal,' five had documented pre-existing developmental concerns.
-- In nine cases, unremarkable colonic histopathology results -- noting no or minimal fluctuations in inflammatory cell populations -- were changed after a medical school research review to 'non-specific' colitis."
And who made these fraudulent changes? "It had to be Wakefield," Godlee wrote. He was the one who "altered the data to make those three things happen."
But hold on. Godlee is now taking that back without saying so. In fact, she says she never said it. The reason she's slithering away from those clear assertions is that this month, an independent microbiologist named David Lewis presented the BMJ with the actual gut pathology "grading sheets" created by another member of the research team, Dr. Amar Dhillon. Godlee rustled up experts to claim that the pathology did not appear to be as problematic as the paper claimed, but also quoted an outside expert saying there was no evidence of fraud!
Lest you think I'm doctoring this, let's just quote from Scientific American:
"Before publishing Lewis's letter, the BMJ asked Ingvar Bjarnason, a gastroenterologist at King's College Hospital, London, to review the materials. Bjarnason says he doesn't believe they are sufficient to support claims in the Lancet paper of a new disease process. He also questions whether "non-specific" on the grading sheets refers to colitis, saying it could refer to any kind of gut changes. But he says that the forms don't clearly support charges that Wakefield deliberately misinterpreted the records. "The data are subjective. It's different to say it's deliberate falsification," he says."
Yes, doctor, it's different to say it's "an elaborate fraud" and "it had to be Wakefield" who committed it. Now Dhillon himself has weighed in, defending the process by which the pathology slides were evaluated. Deer and the BMJ didn't understand what they were talking about, Dhillon said. The last sentence of his letter to the BMJ is the dynamite: "The designated diagnosis of colitis seemed to me to be plausible."
Godlee is now calling for a parliamentary inquiry, and tarring anyone who got near the paper, including Dhillon, as complicit in shoddy work. Deer says that he “never accused Wakefield of fraud over his interpretation of pathology records," Scientific American reports. "But he says that records read to him from the Royal Free pathology service clearly stated that the children's gut biopsies were within normal limits, even though they were reported in the Lancet paper as having enterocolitis."
Deer's backing and filling is no more convincing than Godlee's. In the BMJ article, Deer wrote: "My investigation of the MMR issue exposed the frauds behind Wakefield's research."
What remains now that Godlee is stipulating one-third of the three-part fraud is just a matter of interpretation? She says it was always about "multiple discrepancies" -- that Wakefield changed crucial facts to suit his purposes.
But as we've already shown in this series, the BMJ report is marred from the get-go by false statements that undercut this claim against Wakefield.
We already reported on the story that began the BMJ series, Deer's encounter with the father of Child 11, the only parent in the case series who is actually hostile to Wakefield and sympathetic to Deer's attack. If anyone were going to make an open-and-shut case for Wakefield's fraud, this would be it.
Nonetheless, when I tracked down the father and he saw the BMJ piece for the first time, he immediately said it was wrong on the decisive point. Deer claimed that Child 11's symptoms began before the administration of the MMR -- a deathblow to any association between the shot and autism. He said the father was deeply upset by that "fraud."
"That's incorrect," the father told me bluntly of Deer's assertion. The shot came first, and it was well documented that it did. The father continues to believe the MMR caused his son's problems, which soon followed, and he wrote that the article made him "appear irrational" for saying otherwise. I presented this evidence to Godlee and the BMJ months ago, but they have declined to acknowledge it or correct the record.
Any journalistic code -- Deer was named Specialist Journalist of the Year by the British Press Association for his BMJ reports -- requires prompt correction of such a material fact. Yet Deer and the BMJ remained mum. Worse, Godlee has repeatedly said the article was fact-checked and peer-reviewed, that no errors have been brought to her attention, and that she stands by Deer’s reporting unreservedly.
I also reported that Deer's questioning of Child 11's autism diagnosis -- second of the three pillars of "fraud" -- was bogus. The father, contrary to Deer, included independent documentation of regressive autism when he first approached Wakefield at the Royal Free in January 1997. The father showed me the letter. There is no basis to question it and try to manufacture doubt about the diagnosis.
Along with the now non-fraudulent pathology reports, such "multiple discrepancies" in the BMJ paper raise questions that journalists who trumpeted the fraud allegation have an affirmative duty to ask. How did this happen? Why wasn't it corrected? What other mistakes are there? "Extraordinary claims require extraordinary evidence," as Carl Sagan said, a maxim that mainstream doctors and scientists are fond of wielding. What's extraordinary here is the absence of evidence in the presence of such a devastating claim.
Media outlets that swallowed whole the “elaborate fraud” ought to be developing intestinal problems of their own right about now. It’s essential work, because not just Wakefield's reputation is at stake. At issue is the way in which the medical industry handles unorthodox and threatening information, how the media reports it, and whether Wakefield's questions remain to be answered-- whether a link between regressive autism and unusual bowel disease is real; whether children can be helped; whether parents really do believe, as Wakefield said they did, that an environmental trigger like the MMR has played a meaningful role in some cases of autistic regression.
When people have attempted to challenge the BMJ's fraud claim, they've been met with withering personal attacks that are well out of the mainstream of journalistic conduct. That also should arouse the skepticism of journalists who understand the profession's norms. Deer has called Wakefield a “charlatan” and “slippery as condom lube.”
Or take David Lewis's recent "rapid response" letter to the BMJ. He presented the grading sheets and wrote a letter to the BMJ on what he believed their significance to be.
Deer went ballistic. He wrote:
"Using this guy Lewis, who was essentially bought by the anti-vaccine lobby in much the same way that the drug industry buys up doctors and scientists (foreign travel and luxury accommodation), Wakefield advances the same kind of deception.
"Through Lewis, he places the lie that our reports alleged that the fraud lay in pathology (when, since we didn’t have the reports now disclosed we could hardly have divined the intent involving their use), then he says (following his discovery that we have had the forms assessed) that these are ambiguous, and that therefore there was no fraud."
Elsewhere, in seeming contradiction to that, Deer writes: “I’m grateful for the forms, which further illuminate how the appearance of a link between MMR and autism was manufactured in an elaborate fraud.”
As Lewis says: "How can anyone take Deer seriously when he just goes around spitting out false allegations left and right without bothering to check any of the facts?"
Dan Olmsted is Editor of Age of Autism and co-author, with Mark Blaxill, of The Age of Autism -- Mercury, Medicine, and a Man-made Epidemic.