Sep 21 2009
Crank “scientific” conferences: A parody of science-based medicine that can deceive even reputable scientists and institutions
If there’s one thing that purveyors of pseudoscientific medical modalities crave, probably above all else, it’s legitimacy. They want to be taken seriously as Real Scientists. Of course, my usual reaction to this desire is to point out that anyone can be take seriously as a real scientist if he is able to do science and that science actually shows that there is something to his claims. In other words, do his hypotheses make testable predictions, and does testing these predictions fail to falsify his hypotheses? That’s what it takes, but advocates of so-called “complementary and alternative medicine” (CAM) or “integrative medicine” (IM, or, as I like to refer to it: “integrating” quackery with scientific medicine) want their woo to be considered science without actually doing the hard work of science.
There are several strategies that pseudoscientists use to give their beliefs the appearance of science, a patina of “science-y” camouflage, if you will. One, of course, is the cooptation and corruption of the language of science, which has been a frequent topic on this blog, particularly in posts written by Drs. Atwood and Sampson. Another is to produce journals that appear to be science, but are anything but. I’ve discussed one example, the Journal of American Physicians and Surgeons and Medical Acupuncture, but others include Homeopathy, the Journal of Alternative and Complementary Medicine, and Medical Hypotheses, which recently was forced to retract a horrible paper by arch-HIV/AIDS denialist Peter Duesberg. What’s worse is that some of these journals are even published by what are considered major publishers, such as Mary Ann Liebert, Inc., and Elsevier.
There is, however, a third strategy. How do scientists communicate their findings to other scientists, as well as meeting and mingling with other scientists? Why, they hold scientific meetings, of course! These meetings can be small or even as large as the American Association for Cancer Research meeting, which is attended by around 15,000 cancer researchers each year. So, too, do cranks hold meetings. These meetings often have all the trappings of scientific meetings, with plenary sessions, smaller parallel sessions, poster sesssions, and an exhibition hall, complete with exhibits by sponsoring companies. Sometimes these meetings can even appear so much like the real thing that they take in legitimate researchers and legitimate universities. Here, I present two examples of such conferences.
THE UNIVERSITY OF TORONTO: DUPE OR WILLING ACCOMPLICE?
The first such conference that comes to mind when I think of fake scientific conferences is the autism quackfest known as Autism One. Autism One is a conference of believers in two things: (1) that vaccines cause autism and (2) that “biomedical” and CAM/IM therapies can treat and even reverse autism. This conference, heavily promoted on anti-vaccine websites like Age of Autism, is held every year in Chicago near or on Memorial Day weekend. It is generally held in a hotel near O’Hare International Airport (downtown locations must be too expensive), and in general features the “luminaries” of the vaccines-cause-autism underground giving talks on the “science” of the vaccine-autism link and all manner of “biomedical” interventions, the vast majority of which are, in my opinion, pure quackery. For instance, the 2008 Autism One conference featured Boyd Haley, the father-son team of autism woo-meisters Mark and David Geier, Mayer Eisenstein, and a number of others. Examples of the talks at that conference included “Over 50 years of known toxicity! (Unsafe at any Concentration)” by Frank Engley, who said this: “NOT GRAM- NOT MILLIGRAM – NOT MICROGRAM- BUT NANOGRAM!” Its keynote speaker was–surprise! surprise!–Jenny McCarthy, whose ignorance of science is beyond belief and has led her to become, in essence, the celebrity face of the anti-vaccine movement, even leading marches on Washington against vaccines.
In 2009, Autism One made a bit of a splash, but not in a good way. Basically, what happened is that the Chicago Tribune noticed the Geiers’ Lupron protocol for autism. Specifically, Mark and David Geier have been subjecting autistic children to a drug that is a powerful suppressor of sex hormone production because they actually think that testosterone somehow binds mercury and that lowering testosterone concentrations will make chelation therapy work better. Truly, this is some of the most despicably off the wall woo that I’ve ever encountered. it combines bad biochemistry with anti-vaccination pseudoscience of combining testosterone-lowering treatments with the dangerous quackery that is chelation therapy for autism. Then there was Dr. Mayer Eisenstein, founder of the crunchy and “alternative” HomeFirst practice. This is the same guy who said that he had never seen a case of autism in an unvaccinated child in his practice, a case of data-free selective memory so blatant that later the story morphed into his practice having a huge computer database to back up his claim. He is a master of anti-vaccine rhetoric, including his beliefs that vaccines cause autism, that the government is covering it up, that the American Academy of Pediatrics is hopelessly in the thrall of big pharma, and that “every doctor now essentially in this country has done something as heinous as the Nazis did, unknowingly” because they give vaccines to children.
And, of course, Jenny McCarthy was the keynote speaker in 2008 and then again in 2009. Any one want to make any bets against her being the keynote speaker for Autism One 2010? I don’t.
As annoying as Autism One in Chicago is, however, there is one thing that very obviously distinguishes it from real scientific conferences, specifically the lack of a university or academic organization sponsoring it. It’s held out in a hotel near the airport, far from downtown Chicago, and there is very little pretense of academic endeavor. The patina of a scientific conference is thin indeed.
I wish I could say the same thing about an offshoot of Autism One, namely Autism One Canada:
If you live in Canada, the Northeastern United States, the Great Lakes area, or beyond, you will not want to miss this conference from Autism One, Autism Canada, and the University of Toronto’s Dalla Lana School of Public Health. The 2-day main conference will be held Saturday, October 31 and Sunday, November 1, preceded by a 1-day training program for practitioners on Friday, October 30. This conference features two dozen of the most highly respected names in the autism community and provides the most up-to-date information to help your child. From implementing the best biomedical treatments to realizing the benefits of educational therapies to adolescence and adulthood issues, the conference brings you the answers to be your child’s most effective healer and powerful advocate.
The flier then advertises that it is sponsored by the SickKids Foundation, Spectrum Supplements, and Ontario Hyperbaric Oxygen Therapy Centre Inc. A scan of the actual pamphlet advertising the conference can be found below:
Autism One Canada doesn’t appear quite as bad as the Mothership Autism One in Chicago usually is. At least, “scientists” like the Geiers don’t appear to be speaking there. But there’s still plenty of dubious science there to go around, starting with the keynote speaker, Dr. Martha Herbert. She shares one characteristic with at least a couple of “luminaries” of the anti-vaccine “biomedical” movement. As Autism Diva and Kevin Leitch pointed out, like Dr. Mark Geier and Dr. Boyd Haley, Dr. Herbert has been slapped down by the courts, which used the Daubert standard to reject her testimony claiming that a child was made autistic by a reaction to mold growing in the condo she was living in. The court found:
Dr. Herbert’s publications indicate that she is an outspoken advocate of increased attention to the possibility of environmental influences. Even she, however, despite that acknowledged perspective, speaks in her published work of possibilities and potentialities, rather than of the ‘reasonable degree of medical certainty’ to which she offers to testify under oath in this case.10 Neither Dr. Herbert’s publications, nor any others cited, identify mold exposure as even a suspected, still less a known or proven, trigger of autism……Dr. Herbert’s method, to the extent the Court can discern it from the materials offered, is a series of deductions based on possibilities…..*Clearly, Dr. Herbert’s method is not generally accepted in the scientific community*. Dr. Herbert’s theory of environmental triggers of autism may some day prove true. It has not yet. Her proffered testimony does not meet the standard of reliability required by the case law, and cannot be admitted in evidence at trial.
Dr. Herbert is, it turns out, a big fan of the idea that autism has something to do with neuroinflammation. Unfortunately, none of her publications persuasively presents evidence for this hypothesis, and lately she’s publishing in bottom-feeding alternative medicine journals articles with titles like Learning From the Autism Catastrophe: Key Leverage Points. Suffice it to say, Dr. Herbert is big on “biomedical” woo, so much so that anti-vaccine propagandist David Kirby likes to cite her and Age of Autism loves her. Unfortunately, for all her grandiose claims that neuroinflammation is a major cause of autism and that mold and other environmental influences trigger it, Dr. Herbert’s publication record does not support these assertions. Go ahead. Head over to PubMed and look at Dr. Herbert’s publication record. I’ll wait. She has listed 15 publications about autism, of which:
- six are review articles
- two are in alt-med journals, and one of these is an interview
- one is a paper with dozens of authors reporting the results of mapping autism risk loci using genetic linkage and chromosomal rearrangements. (Dr. Herbert is solidly right in the middle of the huge pack of authors.)
Of the remainder, Dr. Herbert only appears to be first author or senior author on four publications on autism containing original research, and these appear to be all imaging studies of the brains of autistic children. In other words, Dr. Herbert is making claims far beyond what her publication record in the peer-reviewed literature can, even under the most charitable interpretation possible, support. Nothing in her publication record appears to support her concept of autism being a systemic, rather than brain-based condition. There’s nothing there to support a link between autism and gut disorders; nothing to support a link between autism and immune dysfunction; and nothing to support a link between “environmental influences” and autism. That’s not to say that there aren’t environmental factors that influence the development of autism; it’s just that there’s nothing in Dr. Herbert’s publication record to support such a hypothesis or to identify what, if anything, those environmental factors might be.
This is the “keynote speaker.” She is, however, faculty at Harvard University.
The other speakers aren’t much better. I’ll admit, the woo-to-normal ratio isn’t as high as it was in Chicago last May, but it’s still pretty high. It’s just that this is mostly second tier “biomedical” stuff. It’s the second stringers, for the most part. For instance, there’s Dan Rossignol, who’s big on hyperbaric oxygen as a treatment for autism with very little data. There’s Amy Yasko, who’s known for somehow thinking that one can treat autism (and lots of other disorders) with orally administered RNA solutions. I work with RNA all the time. It’s damned unstable. It would not survive even the saliva without being broken down into its components. Actually, RNA won’t survive long in aqueous solution without being frozen at at least -20° C, preferably -80° C. Yet this Dr. Yasko claims that “we have found that by using highly specific solutions of RNAs we are able to enhance our cells natural ability to communicate with one another.”
I’d call Yasko’s woo homeopathic RNA therapy, except that apparently there are real yeast nucleotides in her concoction. Speaking of homeopathy, there’s a real homeopath there called Rudi Verspoor, HD(RHom), DMH, whose presentation is described thusly:
Autism spectrum disorder (ASD) is a complex disorder with multiple causes, and each case presents its own unique and distinct challenges. The key is to treat the causes and not just the effects. Treating symptoms may provide some improvement but does not provide a permanent solution. Heilkunst, which includes homeopathy, is a comprehensive approach to addressing the multiple deeper underlying causes of a case in a given sequence over time, while using energetic, homeopathic medicines. It provides a clear map of the problem and of how to get out of the swamp of autism spectrum disorders that is safe, non-toxic, and effective even in complex seemingly non-responsive cases.
Well, two out of three ain’t bad, I guess. There’s no doubt that homeopathy is safe and nontoxic. After all, it’s water. But effective? Not so much. Come to think of it, I take back what I said about Autism One Canada not being as bad as Autism One Chicago. Advocating homeopathy definitely ups the ante to anything the mothership could come up with. But other forms of woo rule too: For instance, there’s Bryan Jepson, who comes straight from Andrew Wakefield’s Thoughtful House. His talk will be:
Treating Autism: Understanding Biomedical treatment options
Dr. Jepson will describe the multiple organ system involvement of the autism spectrum including the brain, the gut, the immune system and the detoxification/metabolic system. He will discuss the mechanisms for disease in each of these areas and then talk about treatment options that are being used by clinicians in order to try to correct the underlying biochemical abnormalities that are contributing to the behavioral presentations of the disorder.
Whenever you hear anything about “detoxification” and “biomedical” in the same talk, run, don’t walk. You’re almost certainly hearing only the finest anti-vaccine and environmental woo. If the speaker is someone like Dr. Jepson, who is currently working with the Dark Lord of the Anti-vaccine Movement himself, the man who, while on the payroll of a lawyer who sues vaccine companies, produced an incompetently done and fraudulent study that launched a thousand anti-vaccine quacks in the U.K., in the process producing a scare that the MMR causes autism so great that vaccination rates fell to the point where the measles has become pandemic again, you’re certain to hear anti-vaccine nonsense.
Finally, let’s not forget that Dr. Bob Sears will be speaking there, too. Dr. Bob craves respectability and wants his “alternative” vaccination schedule to be taken seriously as a viable alternative, but he can’t marshal one bit of science to support his beliefs. Worse, lately he’s been writing for Age of Autism and that repository of all things anti-vaccine, The Huffington Post. I refer readers to Dr. Snyder’s excellent post Cashing In On Fear: The Danger of Dr. Sears for a more detailed deconstruction of his “alternative” vaccine schedule and why he has gravitated closer to the anti-vaccine movement.
When I first heard of Autism One Canada, I wondered if this was a case of Autism One and Autism Canada simply renting space at the University of Toronto and trying to coopt its good name, much as creationists tried to coopt the name of the Smithsonian by showing The Privileged Planet there. I’d like to hope that it’s the same sort of deal at the University of Toronto, where such events have to be listed as “co-sponsored” by the host institution in order for the event to occur there. I’ve searched the Dalla Lana School of Public Health at the University of Toronto and haven’t been able to find a single mention of this conference. Alternatively, what may have happened is that someone at the University of Toronto confused anti-vaccine pseudoscience for “cutting edge” and somehow was thus fooled into cosponsoring this conference. What it is is half and half.
First the good half. A reader at my other blog has informed me that the Dana Lana School of Public Health has completely disavowed any involvement in the conference other than that one of its junior faculty, Dr. Marianna Ofner, Assistant Professor of Epidemiology, is giving a talk there, entitled The Epidemic of Autism in Canada, which does not sound encouraging, as it sounds as though she may buy into the concept of an “autism epidemic” so beloved by the anti-vaccine movement. Be that as it may, it’s unclear why or how Autism One Canada thought it could get away with listing the Dalla Lana School of Public Health as one if its sponsors.
Now the bad half. A number of people, myself included, upon learning that the SickKids Foundation was listed as having sponsored Autism One Canada, wrote e-mails and letters of complaint and concern. They received in response a canned reply from the Grants Officer at SickKids Foundation, Pam Gilliland:
Dear Mr. [suppressed],
Thank you for your email concerning the conference: Changing the Course of Autism in Canada, organized by Autism Canada Foundation in collaboration with the Dalla Lana School of Public Health University of Toronto and Autism One.
The goal of this conference is to provide a respectful forum for parents, therapists, doctors, researchers and individuals with Autism Spectrum Disorder to share, learn and work collaboratively to expand knowledge of treatment interventions for Autism. There will be a cross section of speakers.
As part of SickKids Foundation’s National Grants Program, support is offered for conferences, workshops or symposia which are relevant to the health of Canada’s children. The purpose of the conference grants program is to support events which are organized by and/or for families with children with health challenges.
The review process is competitive and funding is limited, with a maximum of $5,000 per grant. Each conference grant application is assessed in terms of its relevance to the health of Canadian children up to 18 years of age, as well as for its fit with the conference grants program goals.
The Foundation sees value on information sharing between medical staff, community organizations, and families. It is important for families to have opportunities for open dialogue with health professionals in order to get an understanding of current research and practices.
The Foundation takes a neutral stance on complementary and alternative health care. We actually have a history of funding research on complementary and alternative health care for paediatrics. The use of complementary and alternative health care products and therapies are on the rise across Canada and there is little research on the safety and efficacy of many of these treatments and products for children and youth, as well as the effects of the interactions between natural health products and conventional medicine. For this reason, the Foundation has taken a first step to build research capacity on which to base practice and policy in these areas.
To this end SickKids Foundation funded Autism Canada in the amount of $5,000 to support their conference: Changing the Course of Autism in Canada.
I hope this helps to answer some of your questions.
Grants Officer, National Grants
525 University Avenue, 14th Floor
Toronto, Ontario M5G 2L3
(P) 416.813.6166 x 2354
Depressing. Regular readers of this blog will recognize this e-mail as worthy of the Weekly Waluation of the Weasel Words of Woo (W5) What bothered me about Ms. Gilliland’s e-mail even more than what she wrote is what Ms. Gilliland left unwritten. Despite several of the letters of complaint mentioning the anti-vaccine slant of Autism One, Ms. Gilliland wrote not a word about vaccines, as if she were assiduously and intentionally ignoring this very important point, namely that by funding Autism One Canada, the SickKids Foundation is lending its name to one of the greatest threats to the health of children: the anti-vaccine movement. If the anti-vaccine movement gets its way, vaccination rates will fall, and children will suffer and die. I realize that the anti-vaccination movement doesn’t see it that way, that its adherents think that vaccines cause autism, but the end result of their efforts will be the suffering and deaths of children nonetheless. Yet, here is a charity dedicated to helping children through scientific research and which funds a large amount of truly good research supporting a group that is part of a movement that is the most serious threat to public health in general and children’s health in particular. I would like to think that Gilliland probably has no clue that this is the case, but her refusal to address the issue implies to me a level of shame, as though she knows what Autism One really stands for.
This is the sort of thing that happens when pseudoscience infiltrates academia.
WHEN SCIENTISTS FAIL TO SEE THE OBVIOUS
The National Vaccine Information Center (NVIC) has a deceptively benign-sounding name. There’s little doubt that this was an intentional choice of its founder, Barbara Loe Fisher, who is profoundly antivaccine, as her blog’s title Vaccine Awakening suggests, as does her defense of Andrew Wakefield, spreads misinformation about the HPV vaccine and brain injury (and it is misinformation), and her promotion of “vaccine choice” (which is very much like the Orwellian term “health freedom” in that it is designed to disguise the true intent behind it. It’s not a coincidence that a well-known “vaccine injury” litigator is on the board of directors of NVIC or that it includes a list of law firms on its website that specialize in “vaccine injury” cases.
The bottom line is that the NVIC is one of the oldest anti-vaccine groups out there, and Barbara Loe Fisher is the grande dame of the anti-vaccine movement, having been at it since the 1980s. A brief perusal of the NVIC website will show that it supports the discredited idea that mercury in vaccines causes autism and the equally discredited notion that vaccines cause autism and all sorts of dire outcomes. Indeed, there’s even a “vaccine memorial” for the “victims” of vaccines.
The NVIC has a conference, too, the 4th International Public Conference on Vaccination in October. Barbara Loe Fisher announces her conference in this YouTube video:
Note the clever P.R. Note how Fisher never once uses the word “against” or “anti-” anything. She paints her antivaccine group NVIC as “pro-education” and “pro-informed consent” and for “defending your right to choose.” She even ends her video by saying, “Stand up for vaccine freedom of choice.” To look at Generation Rescue, note how Jenny McCarthy is always saying she’s not “anti-vaccine” but rather “pro-safe vaccine.” The anti-vaccine crowd knows that it’s far better PR to be seen as being for something rather than just against something. Of course, her spin belies the speaker list:
- Andrew Wakefield. Readers of this blog need no introduction to Dr. Wakefield. He’s the guy who started the MMR scare in the U.K. through a combination of bad science, lack of ethics, and falsifying data.
- Barbara Loe Fisher. The founder of NVIC. ‘Nuff said.
- Joe Mercola, DO. Woo-meister supreme, anti-vaccinationist, spreader of misinformation, and promoter of quackery on his website Mercola.com.
- Rick Rollens. One of the strongest believers in the pseudoscience claiming that vaccines cause autism.
- Kim Stagliano. Blogs for Age of Autism. Enough said.
- Gary Null. Whoa. This guy has it all. He’s a perfect storm of pseudoscience: Anti-vaccine to the core, an HIV/AIDS denialist, and a promoter of all manner of dubious medicine–to put it kindly.
Look who else is speaking, though. That’s right, it’s David Ayoub. Yes, that David Ayoub, whom I like to call David “New World Order” Ayoub. This is a guy who’s so into conspiracy theories that he thinks that vaccines are part of a population control plot by the Illuminati, along with birth control, women’s rights, and all sorts of other nefarious plots by the government, all complete with black helicopters and everything. Really. Just check out this video:
Check it out especially around the 44 minute mark, where Ayoub starts talking about “stealth population control” and genocide. Truly, there is some serious craziness in his talk. I have to wonder if Ayoub will manage to restrain his New World Order/Illuminati/Black Helicopter ramblings for this conference. (No doubt Barbara Loe Fisher told him to check his crazy at the door.) Speaking of Black Helicopters, Ayoub actually does mention them right around the 57 minute mark of the video above.
But, wait, there’s more! Check out these talks:
“Homeopathy: The Impossible Cure”
Amy Lansky, PhD
Executive Board, National Center for Homeopathy
“Pregnancy, Birth & Child Health: Why Chiropractic Works”
Jeanne Ohm, DC
Executive Board, International Chiropractic Pediatric Association
“Vaccines & Inflammation”
Andrew Wakefield, MD
Executive Director, Thoughtful House Center for Children
“Homeopathy & Vaccines: What Our Pets Teach Us”
Richard Pitcairn, DVM, PhD
Founder, Animal Natural Health Center
“Vaccines, Informed Consent & Public Health: A Chiropractic Perspective”
Matthew McCoy, DC,MPH
Associate Professor, Clinical Sciences, LIFE University
Wow! So, there’s not just Andrew Wakefield, the subject of a rather shoddy NBC news report a couple of weeks ago and the man who is more than anyone else responsible for the MMR scare in the U.K., but two talks on homeopathy! What does homeopathy have to do with vaccines, I wonder? Who knows? Yes, I realize that some homeopaths try to liken homeopathy to vaccination as “like cures like,” but that’s a specious analogy. In any case, if you peruse the list further, you’ll see lots of talks on “health freedom” (which I like to call “freedom for quacks”) and how to evade vaccination by using philosophical exemptions. It’s not a coincidence that a well-known “vaccine injury” litigator is on the board of directors of NVIC.
Yet, paradoxically, despite the presence of so many–shall we say?–scientifically dubious speakers, there are a handful of reputable scientists and academics speaking at the NVIC conference For example, there is (or, as we shall see, was) Tom Jefferson, MD, who is a prominent member of the Cochrane Group, being one of the editors of the Cochrane ARI Group, a member of four other review groups and two methods groups, and the coordinator of the Cochrane Vaccines Field. In his capacity with the Cochrane Group, he is also co-author on many of the Cochrane Reviews on influenza and the flu vaccine. So what is Dr. Jefferson doing listed not only as a speaker at the NVIC Conference, but as an award recipient? Indeed, a general e-mail to NVIC attendees forwarded to me by a “mole” states:
The Saturday night special Awards Banquet recognizes the
accomplishments of Andrew Wakefield, who is receiving NVIC’s Humanitarian Award; and presentations of the NVIC Courage in Science Award to Italian epidemiologist Tom Jefferson; the NVIC Visionary Award to holistic health pioneer Joe Mercola; the NVIC Courage in Journalism Award to Mothering magazine founder Peggy O’Mara; and the NVIC Parent Leadership Award to child health advocate Vicky Debold.
As a proponent of science-based medicine, I’d love to be in the same awards ceremony receiving a “Courage in Science” award from the NVIC along with Andrew Wakefield, Joe Mercola, and the editor of Mothering magazine (yes, that Mothering magazine, the same one that promoted Christine Maggiore’s HIV/AIDS denialism and whose contents and discussion boards are filled with the rankest anti-vaccine pseudoscience). (Obviously, that’s sarcasm; what the NVIC considers “courageous” science considers pseudoscience.) So what on earth motivated Dr. Jefferson to accept this invitation? Was he buttered up by the possibility of receiving an award? Was he ignorant about the nature of the NVIC, the nature of which a simple perusal of its website, with its online shrine and memorial to “victims” of vaccination, its Cry for Vaccine Freedom Wall and its approving links to all manner of pseudoscience would have told him in less than a few minutes?
The reasons why Barbara Loe Fisher invited him are obvious, at least to me. Jefferson is well-known as a bit of a gadfly when it comes to the influenza vaccine, having authored a BMJ commentary in 2006 that criticized the evidence for the efficacy of flu vaccines as being of lower quality. This article is widely cited in anti-vaccine circles. Similarly, he authored a systematic review of the literature that concluded that industry influence has an undue effect on the studies that are published about the efficacy of seasonal flu vaccination, which is also widely cited by anti-vaccinationists, including Barbara Loe Fisher herself. Don’t get me wrong; publishing those studies does not make Jefferson in any way “anti-vaccine,” nor is the possibility of one’s work being abused by cranks for their own ends a reason not to publish. However, Jefferson seems quite naive if he thought that he was invited for any reason other than using him to apply a patina of scientific respectability to the rank pseudoscience much of the rest of the NVIC conference promotes.
Fortunately, I have learned from a private source whom I trust that, in response to e-mails to him pointing out the true nature of the NVIC, Dr. Jefferson has pulled out of the conference and will not be speaking there. I wish I could say more to back up my assertion right now. For the moment you’ll just have to take my word for it because Jefferson’s name is still prominently listed on the NVIC website, but I assure you that he will not be speaking there. The reasons he gave mainly emphasized his displeasure at being on the same stage with Wakefield, whose abuse of his research to support anti-vaccine nonsense greatly annoyed Jefferson; and his desire not to be used and manipulated by the NVIC. Good for him! Beter late than never! But that still leaves three others who are scheduled to speak.
These include Peter Doshi, Visiting Researcher, Faculty of Medicine, University of Tokyo and a doctoral candidate at Massachusetts Institute of Technoloy (MIT) in History, Anthropology, and Science, Technology and Society, who is known for skepticism about whether the bird flu would become pandemic and has written commentaries stating as such, one of which revere has roundly criticized. He is also known for claiming that the CDC intentionally inflates the death figures from influenza and that pandemic flu is no worse than seasonal flu. So it’s not surprising that he was invited. Moreover, I know that the same source from whom I learned of Jefferson’s withdrawal from the NVIC conference has also contacted Doshi and been rebuffed with a lame “my speaking there does not imply endorsement” gambit. Doshi will speak at the NVIC conference.
Next up is Diane M. Harper, MD, MPH. She’s an Associate Professor in the Department of Obstetrics/Gynecology and Community & Family Medicine at Dartmouth Medical School in Hanover, New Hampshire; serves in the Women’s and Gender Studies Department of Dartmouth College; and is the Director of the Gynecologic Cancer Prevention Research Group at the Norris Cotton Cancer Center in Lebanon, New Hampshire. She directs the referral colposcopy/high resolution anoscopy clinics at DHMC. Dr. Harper is know for her views on the HPV vaccine (Gardasil in the U.S.). It’s not that she thinks the vaccine is not effective or that it’s unsafe. She doesn’t, although I do think she overstates the risk of Guillan-Barré syndrome from the vaccine. Rather, Dr. Harper questions whether Gardasil should be incorporated into the adolescent vaccination schedule and promoted the way it’s being promoted, given that the regular Pap smears most women in industrialized countries undergo produce similar benefits against cervical cancer:
However, there is also another very important part to the cervical cancer prevention story, Dr. Harper said, and that is regular Pap tests. Even women who are vaccinated need to have regular Pap testing, as otherwise they are still at risk of developing cervical cancer. And women who decide not to have the vaccine can still protect themselves by undergoing Pap testing.
Dr. Harper feels this message has not been made clear to the general public and that it has been overshadowed by what she considers to be aggressive and inappropriate promotion of Gardasil. As a gynecologist dealing with the general population, her advice on the HPV vaccine is that “if you are at all concerned, then don’t have the vaccine — have regular Pap smears and you will be equally protected from cervical cancer.”
In other words, she thinks it’s a potentially useful vaccine for countries where women don’t get regular Pap smears but its benefits are not nearly as impressive in industrialized countries. I actually happen to agree with her (mostly) in that I’m not yet convinced that Gardasil’s benefits are worth the expense or that the risk-benefit ratio of the vaccine is so overwhelmingly in favor of the vaccine as MMR and other common childhood vaccines. However, unfortunately, at times Dr. Harper’s rhetoric has not been quite so measured, particularly when she has blasted Merck and referred to the vaccine as a “great big public health experiment.”
It’s fairly easy to figure out why Dr. Harper was attractive as a speaker for the NVIC Conference. I don’t think she’s anti-vaccine; she’s just skeptical of the HPV vaccine and its overpromotion, skepticism I share to some extent. However, I also don’t think that Dr. Harper has clue one about what the NVIC is and represents or that she is being brought in to bolster the NVIC’s anti-vaccine viewpoint. At least, I hope she doesn’t. Perhaps I will e-mail her a link to this post after it goes live and ask her, pointing out to her that she is being used. When tells Ben Goldacre that she supports Gardasil, just not the way it’s marketed, quite frankly, I wonder whether she’s being disingenuous or clueless, given that she’s speaking at a major anti-vaccine conference
Finally, there’s George Annas, JD, MPH. I don’t know much about him other than that he’s the Chair and Edward R. Utley Professor of the Department of Health Law, Bioethics & Human Rights at Boston University and that he is a highly respected lawyer and bioethicist. Doing a Pubmed search on his name only revealed five articles relevant to vaccines, the most recent of which was published in 2003 and was about bioterrorism and public health. He’s also written numerous books on bioethics, patients’ rights, and human experimentation, three of which have been listed on an anti-vaccine website as being recommended, although almost certainly not because Professor Annas is in any way anti-vaccine. My guess, given the title of his talk (“False Choices & Worst Case Scenarios: How Taking Informed Consent Seriously Can Improve Public Health”), is that the NVIC roped him in by asking him to talk about informed consent and vaccines (or just the issue of informed consent), without revealing the sheer amount of pseudoscience that will be presented in the very same conference. I suspect he will be quite disturbed at the talks he will see before and after him. Or maybe not. The day’s schedule around his talk appears carefully constructed to keep Dr. Harper, Peter Doshi, and Professor Annas carefully insulated from the likes of Wakefield, Ayoub, et al. If Professor Annas just flies in for one day to give his talk, he might not ever even realize the pseudoscience being promoted during the rest of the NVIC conference.
CRANKS AND THE APPEARANCE OF SCIENTIFIC RESPECTABILITY
If there’s one thing that cranks in general, and the antivaccine movement in paritcular, crave, it’s to be taken seriously by the scientific community. Moreover, although such cranks often show a marked hostility to science in that they ignore or attack scientific evidence that contradicts their beliefs (as well as the scientists who generate that data); rely on anecdotal evidence instead of epidemiology or randomized clinical trials; and engage in extreme conspiracy mongering about scientists and physicians who advocate science-based medicine. Yet, on the other hand, they desperately crave the appearance of science. To achieve this appearance, they adopt the conventions of science, including “scientific” studies that are not; crank journals to report the results of these “studies”; and “scientific” conferences like the NVIC Conference. When they can, they especially like to hold their conferences in a way that implies endorsement or support by a real scientific organization or a university, as Autism One has done with its Autism One Canada conference.
They also realize that it’s not enough just to have the same old cranks, like Wakefield, Ayoub, Rollens, et al. speaking at their conferences. They need to co-opt real scientists and real academics, like Drs. Jefferson and Harper and Professor Annas. My guess is that they were all persuaded to speak through appeals to individual rights versus public health (Prof. Annas) or controversies over the HPV and flu vaccines (Drs. Harper and Jefferson), with the invitations phrased in such a manner as to camouflage the true nature of the conference. That’s one thing that the NVIC is very good at. Alternatively, groups such as Autism One hide their real agenda behind terms like “biomedical interventions” and “complementary and alternative medicine” (CAM), coming across as just another CAM conference and even getting grants from reputable foundations like the SickKids Foundation and being allowed to hold their conference at a University of Toronto building.
Most physicians, academic or otherwise, or scientists doing research on topics like vaccines are not like me. They’re not like the bloggers here at SBM or even many of the readers in that the vast majority of them do not pay much attention to cranks like those in the anti-vaccine movement. It’s very similar to the situation with evolutionary biologists, the vast majority of whom also don’t pay much attention to attempts by creationists to deny and subvert the theory of evolution or to prevent its teaching in the public schools. They may be aware of the existence of such cranks but all too often consider them inconsequential, wondering how on earth anyone could take them seriously. So it is with the anti-vaccine movement. Morever, with the infiltration of pseudoscience into medical academia (what Dr. R. W. Donnell has termed “quackademic medicine,”) fueled by big money interests like the Bravewell Collaborative, “on the ground” it is becoming increasingly difficult for the average academic to distinguish pseudoscience from science, given the promotion of the latter by so many large academic institutions. Even when they do realize the difference, all too often academics adopt a “shruggie” attitude towards pseudoscience.
So what to do? Certainly, education is key. I highly doubt that either Professor Annas, Drs. Harper or Jefferson, or even Peter Yoshi knew when they accepted that the NVIC is an anti-vaccine organization or that they were invited that they would be used to provide the illusion of scientific or academic legitimacy to the conference. There are many venues in which to discuss legitimate scientific and policy controversies regarding vaccines, but the NVIC conference is certainly not one of them. It is a conference devoted to the manufactroversy that vaccines cause autism and all sorts of other neurological conditions, that vaccines don’t work, and that they do more harm than good, all cleverly couched as appeals to ethics, vaccine safety, and individual freedom. That’s why it is incumbent upon academics such as these, who express viewpoints that are easily co-opted by cranks, to be very careful about whom they endorse or where they speak, lest they taint their legitimate and useful criticisms of current science and public health policy with the stench of crankery. If anything, they should avoid being connected with such organizations because such connections make it easier for their opponents to dismiss them as cranks. Also, at the very least, they should avoid them because of the potential harm to their academic reputations. But, above, all they should avoid contact with such organizations because their presence at such events provides the illusion of legitimacy and actual scientific controversy that cranks crave. That is why I hope that Dr. Harper and Professor Annan–and, yes, even Peter Yoshi–will reconsider their previous acceptance of an offer to speak at the NVIC conference. At the very least, if they still end up speaking there, I hope they will be very careful not to give the NVIC any sound bites that they can use as “proof” that respected academics support the NVIC’s pseudoscience.
I’ll even take the risk that, should any of these academics actually back out of speaking at the NVIC conference, it will be trumpeted as evidence that “they” got to them and wouldn’t let them speak The Truth.
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