Saturday, June 07, 2008

Legal Lacunae...
...or why it is Best not to use words you don't understand, lest you look Very Silly

Dr. John Briffa has opened a can of worms over the MMR debate. You can find some comments on his novel use of statistics here. But this is not the subject of this post, which was prompted by some rather bizarre comments posted by Dr. Briffa at JDC's place . They relate to an allegation by a previous commenter relating to Dr. Briffa's comments policy. Dr. B writes:
May I also suggest that the comments you’ve made might be viewed as defamatory in a court of law. And that there has been an instance of a judge in the UK forcing a site to reveal the identity of ‘libellous’ posters. So, while you post anonymously, this may not be as much of a protection as you might imagine. - posted at 10:18am
Oooooooooooooooooooh, that "might be viewed" as a threat. In "view" of this, it's time to look at Dr. Briffa's understanding of the law in general.
He posts about MMR here. I invite you to read the whole thing.

Thinking about this yesterday reminded me of how the whole MMR/autism debacle got underway. And anyone who knows anything about this subject at all will be familiar with the name Dr Andrew Wakefield. For he is the doctor often ‘blamed’ for any mistrust in MMR as a result of his study, published a decade ago, which suggested that their might be link between vaccination (the measles component of the MMR vaccine) and bowel disease/autism. Some of you may know that on and off now for about the last year Andrew Wakefield has been answering charges put to him by the General Medical Council in the UK (this is the body that regulates medical practice in the UK, and it has the power to strike individuals off the medical register). Dr Wakefield stands accused of a variety of charges including conflict of interest (it is alleged he received money from legal sources that he did not declare when he published his paper). He also is accused of subjecting children in his research to unnecessary tests, and not having ethical approval for the research in the first place. Now, most of us will be aware of the big brouhaha regarding Wakefield’s research, but the reporting on his case with the GMC has been scant to say the least. There are no restrictions on the reporting of this case, so why the near ‘radio silence’? In a quiet and undisturbed couple of hours yesterday I thought I’d find out what I could about the Wakefield case, and report it here.

Sadly, the "couple of hours" research didn't extend to the GMC website, where he could have found the dates of the Fitness To Practice panel here: The matter of Wakefield,Walker-Smith and Murch was adjourned on 15th May until the 14th July 2008. The fact the panel is not sitting may explain why the media is not reporting.
Dr. Briffa has a more sinister explaination:

Since then, from what I can make out, we’ve had no stories in the mainstream press regarding how the case is going. I did find this radio broadcast/podcast though on a site dedicated to autism issues ( It features the accounts of the Dr Wakefield/GMC trial from Dr Carol Stott (a psychologist and friend of Andrew Wakefield) and Jim Moody (a lawyer with a special interest in the area). This piece is hosted by someone called Polly Tommey. The first quarter or so of the piece focuses on the alleged misdemeanours of the journalist Brian Deer, who had investigated Dr Wakefield for the Sunday Times and Channel 4 in the UK, and who some believe instigated the GMC case against Dr Wakefield. This section of the recording is all a bit melodramatic and cloak and dagger for my liking, and its true relevance to the case is somewhat tenuous, I believe. However, I reckon it’s worth sitting through, though, if only to get to the interviews with Dr Carol Stott and Jim Moody.

Trial? When did a "Fitness to Practice" hearing become a "trial"? It is no doubt terribly exciting to imagine a government/GMC conspiracy to silence the Trooth by putting its advocates on "trial", but the reality is rather more prosaic: it is a "Fitness to Practice" hearing, about which the GMC states in the very first sentence of the case summary "The GMC does not regard its remit as extending to arbitrating between competing scientific theories generated in the course of medical research."

You may recall Dr Carol Stott from such emails as "Try me shithead", "so go fuck yourself" and "twathead": you can find her uncensored correspondence with Brian Deer here, together with the British Psychological Society ruling against her that followed. Brian Deer, for those who haven't come across his work, is probably the finest medical investigative journalist in the UK. He discovered that she received £100,000 to testify in an MMR lawsuit that burnt through nearly £15 million in legal aid expenses, before it collapsed.

It appears from their accounts that Dr Andrew Wakefield has put up a very robust defense with regard to all the allegations he faces. From what I could glean here, there really is no case to answer. If you listen to Jim Moody’s interview, he suggests that the prosecution team have made deliberately false allegations concerning Dr Wakefield, or at the very least did not do their due diligence with regard to the case or were just extremely careless.

Well, this is remarkable: are we going to be told anything about this "evidence"? It seems far too important not to share it with us. Yet this "evidence" never appears.

Other revelations even more significant revelations followed. Dr Wakefield’s research was published in the Lancet medical journal, edited by Dr Richard Horton. Ever since the MMR/autism storm started Dr Horton has been trying doing his level best to distance himself from Wakefield’s research (although, it should be pointed out that the Lancet organised a press conference to trumpet Wakefield’s findings).

Yes, that's how I try my best to distance myself from things - by organizing a press conference to "trumpet" them.

Perhaps as part of this effort, Dr Horton has said that if he knew about Dr Wakefield’s alleged financial conflict of interest prior to publication, he would not have sanctioned its publication. Dr Horton testified to this effect in front of the GMC last year. However, listening to the autismone podcast I discovered that evidence has come to light which appears to prove that Dr Horton was aware of the alleged conflict of interest well before the study was published. In other words, it appears Richard Horton is lying (or has a very bad memory indeed). Jim Moody suggests there’s a case for Richard Horton himself to be up in front of the GMC, on a charge of giving false testimony.

Wow- that must be incredible evidence. Can we know what it is?

To me, this really is news, and of an order of magnitude far, far greater than the fact the Andrew Wakefield has no specific expertise in paediatric ethics. Hands up now, how many of you out there knew about the fact that the editor of the Lancet medical journal (one of the most ‘respected’ medical journals in the World) appears to have committed perjury? I’d be surprised if many of you do, because I can’t find a single reference about this in the mainstream press. Remember, there are no restrictions on the reporting of this trial.

Well, it still is not a "trial", so of course there are no "reporting restrictions" [the matter, after all, is not sub judice]. However, in the absence of the evidence - that Dr. Briffa does not provide or describe - it strikes me as a remarkably brave claim to state that the editor in question "appears to have committed perjury", even concealed behind an axillary verb.
I also happen to think that unethical conduct is big news.

So, while this week I had no intention to write about MMR, I now feel compelled to do so as a result of what I found when I looked: It seems to me that some distinctly shoddy science and no small amount of bullying has been used in an attempt to ‘silence’ those who dare suggest there is a link between MMR vaccination and autism, including countless parents who believe they witnessed the regression into autism of their children after MMR vaccination before their very eyes. And of course someone’s head had to roll, and Dr Wakefield’s was the obvious one to lop off. Yet, it seems that there really was never any case to answer. And now we find it looks as though the editor of the medical journal who published Dr Wakefield’s research is prepared to lie through his teeth to save his skin and ensure that any fingers of accusation point elsewhere. And the press, for some reason, is keen to have Dr Wakefield the pariah, and is not interested in reporting honestly and openly about the case brought against him by the GMC. [emphasis mine]

Crikey! And he's accusing other people of defamation?

[For the avoidance of doubt: this constitutes fair comment on a matter of public interest. Legal threats may be sent to a.political.scientist - at -gmail dot com. I can always do with a laugh.]


pj said...

Briffa comes across as a bit of a twat doesn't he? As an alternative type you expect obfuscation, poor argument, and playing fast and loose with the evidence combined with poverty of logic and scientific understanding. But I think he adds a particular brand of arrogance (not an uncommon trait in doctors) and vindictiveness, playing to the gallery whilst willfully cavalier with the evidence he is deploying for rhetorical effect. I'm guessing that private practice and media attention are not good for realistic self-appraisal.

Glad I'm never likely to be treated by him.

Political Scientist said...

"Briffa comes across as a bit of a twat doesn't he?"
He doesn't come out of it very well at all.

His remarks to JDC and Andrew Taylor are appalling, quite apart from their irrelevance to the fundamental question of autism-MMR. I can't imagine writing things like that, even were I provoked.

I find it completely shocking that he would post on such an important topic based on such cursory research - I mean, I found the GMC website as the second link of a Google search, and I thought the Deer-Stott correspondence and the ruling that followed would be known to anyone (at least, anyone who has any business writing a blog post about MMR).

I find it remarkable that he didn't know or didn't mention the failed MMR action, and the role of one of his sources in it. And then he seeks refuge in epistemology - "I challenge you to prove a negative" - and bizarre legal threats.

The thing that actually makes me angry is the way that anti-vaccine campaigners state that
"you just don't care!" or "you hate parents" or any of the other wicked
insinuations that are thrown about so lightly.
You can see examples of this in Briffa's comment thread.

"Glad I'm never likely to be treated by him."
I have to say, the three bloggers I read who are docs - yourself, Dr. Crippen, Dr. Goldacre - even if I don't agree with this or that they've written, I would feel completely comfortable about being treated by them.

I certainly do not get that feeling from Dr. Briffa.

I think the legal threats and the bullying may come back to bite him.
He appears to think that the statement
"And now we find it looks as though the editor of the medical journal who published Dr Wakefield’s research is prepared to lie through his teeth to save his skin and ensure that any fingers of accusation point elsewhere."

is protected speech, presumably because it contains the words "it looks as though". I fear he has a steep learning curve ahead of him.

Jon said...

Good coverage of the situation.

It is odd. Over at HolfordWatch, we've even been accused of sedition - an accusation that was repeated despite enquiries as to precisely which lawful authority or government is threatened by our analysis of Holford's corpus of nutritionism.

Mind you, a commenter quoted a quotation from an article in the 90s (sorry for the circumlocution but it is an article that I can't check) that argued that a number of nutri-gurus and similar would meet the classification for some disorders from DSM III. "[A] majority of the gurus of questionable nutrition practices are in fact sociopath/psychopaths, as delineated in the American Psychiatric Association’s DSM III (Diagnostic and Statistical Manual III)."

There again, it's probably hard not to meet the criteria, particularly for the more single-issue driven. To me, there is a stronger resemblance to toddler tantrums.

Political Scientist said...

Hello Jon,

Thank you!

Is the "sedition" in the comments to this thread by "koo"? I thought perhaps I should put together a list of accusations from anti-vaccination campaigners (after the fashion of "In the future, everything will be child abuse for 15 minutes"). "Not caring" and "Big Pharma" are the main ones, but "sedition" takes us to a whole new low, and possibly a whole new alternative reality.

BTW: HolfordWatch is a smashing site!

Jon said...

Yes, that is the 'sedition' thread - plus this one. There are possibly more.

There is a rich vein of anti-vax accusations of viciousness, venality, veniality, eternal damnation, worse than Hitler (might be comparable - can't quite recall and don't wish to exaggerate) etc. at Vaccine/Autism Alarmists on the March.

And thanks for the kind words in re: HolfordWatch. tbh, I can cope with the sedition posts easier than the constipation-obsessives.

Jon said...

I'm including this 'sedition' thread only because it lead to a song.

Political Scientist said...


Thank you for those - the blogosphere definitely needs more songs. The "Hitler" comparison appears in a wonderfully disturbing piece of free verse.

There plenty of material there - I will try and write something, and will post it if it is amusing.