Sep 29 2010
Over the last decade there has been a needed discussion about the relationship between politics and science. This has mostly been spawned by the perceived “Republican War on Science,” at the center of which is the global warming debate. In reality, both ends of the political spectrum (as evidenced, for example, by the Huffington Post) tend to trump science with ideology. That is the nature of politics. But at least the issue has been raised.
Briefly, defenders of science have pointed out that science should inform politics, not the other way around. Ideologues should not be allowed to put their thumb on the scale of science in order to get the result their ideology demands. Further, the optimal policy emerges from an honest assessment of the relevant science. Values still come into play for many issues, so science alone is not enough, but the science has to be right.
Within medicine this issue often involves the regulation of the standard of care and public health policy. An example of the former is the law passed last year is Connecticut that essentially exempts professionals who treat “chronic Lyme disease” from the standard of care – the department of health cannot act against their license for treating this controversial condition with unproven therapies.Rather than allowing experts to determine the standard of care, which is an ever moving target, this law locks into place a very controversial, and in my opinion dubious, practice.
Another issue that frequently is caught between politics and science is vaccinations – and just such a conflict is heating up in Florida. Penn Bullock and Brandon K. Thorp report in the Miami News Times that a wealthy chiropractor, Gary Kompothecras, is using his political connections, earned by generous campaign contributions, to promote his apparent anti-vaccine agenda. Kompothecras has two children with autism and he blames thimerosal in vaccines for their condition. Readers of SBM know that thimerosal (which contains ethyl mercury) has not been connected to autism. The scientific evidence overwhelmingly shows that vaccines are not to blame. Most notably with regard to thimerosal specifically, this preservative was removed from most childhood vaccines over 8 years ago in the US, and autism rates have not plummeted as proponents of the thimerosal hypothesis predicted. Yet some, like Kompothecras, still cling to this discredited notion.
A year ago Kompothecras (who calls himself the “rainmaker” – a reference to his political connections) was pushing for a law that would have weakened Florida’s vaccine requirement for public school. Such measures are always sold as parent choice or health freedom, but they are really just anti-vaccine. The bill, which is still languishing, would outlaw certain vaccines with thimerosal and would allow parents to space out and delay vaccines.
This is a good example of the disconnect between science and politics – there is no evidence that delaying or spacing out vaccines has any health benefit, but it does leave children vulnerable to preventable diseases for longer. So delaying vaccines has risk but no benefit.
This is therefore an example of one man who is using political connections to push for legislation that is not based upon science and runs contrary to the consensus of expert opinion.
Kompothecras is now at it again, using political pressure to “bully” the Florida department of health into releasing confidential vaccine records. Kompothecras is a friend and contributor to governor Charlie Crist, and was appointed to the governor’s task force on autism (a scary thought in itself). He wants the DOH to give this confidential information to the infamous father and son team of Mark and David Geier.
We have written extensively about them as well – most significantly their recent trial of lupron (a chemical castrating agent) and chelation therapy (a risky procedure) for autism. The Geiers have been publishing research alleging to show a connection between vaccines and autism, but their results are at odds with other researchers and seem highly flawed and dubious on review. Bullock and Thorpe summarize their career thusly:
Since Mark Geier embraced the autism theory, his appearances in federal courts have led judges to label his testimonies “intellectually dishonest” and “not reliable.” The Institute of Medicine has called his work “uninterpretable.” The American Academy of Pediatrics said one of his studies exhibited “numerous conceptual and scientific flaws, omissions of fact, inaccuracies, and misstatements.”
Now, I am always in favor of transparency of information. As we learned with climate gate, keeping data from those who you perceive to have an anti-scientific agenda can backfire. But confidential medical records are not temperature data. There is an issue of confidentiality that needs to be dealt with. Medical information can be released for legitimate research that is in the public interest – but there’s the rub.
The Geiers have a dubious scientific history of misinterpreting data, apparently to serve an anti-vaccine agenda and to support their lucrative practice of treating alleged mercury poisoning. No one has a right to perform medical research, or a right to privileged medical information. You have to earn the privilege of access by being an ethical and legitimate researcher. In my opinion, the Geiers do not meet these criteria.
Apparently the Florida DOH agrees, but the normal process of assessing the legitimacy of requests for information is being subverted by political pressure from a wealthy and connected chiropractor with an apparent anti-vaccine agenda.
This is a bit of a no-win scenario for the DOH – whether or not they release the data it can be used for anti-vaccine propaganda purposes. Perhaps one compromise would be to release the data to an independent panel of researchers with no conflicts of interest to do an independent and transparent analysis.
Unfortunately, this example of using political pressure to subvert science is not isolated. In many states there are laws to subvert the vaccine program, or to protect dubious practitioners from being held to the standard of care.
The bigger issue is that “alternative medicine” is an industry that has learned to use the political process to advance their interests over that of the consumer and the public health.
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