Wednesday 26 May 2010

Failing to adhere to ethics ends professional career

The guardian article reveals the story ...

Andrew Wakefield, the doctor at the centre of the MMR row, has been struck off for serious professional misconduct. Photograph: Anthony Devlin/PA He was not at the General Medical Council (GMC) hearing to receive the verdict on his role in a public health debacle which saw vaccination of young children against measles, mumps and rubella plummet.

The GMC said he acted in a way that was dishonest, misleading and irresponsible while carrying out research into a possible link between the measles, mumps and rubella (MMR) vaccine, bowel disease and autism.

He had "abused his position of trust" and "brought the medical profession into disrepute" in studies he carried out on children.

The GMC said there had been "multiple separate instances of serious professional misconduct".

One of Wakefield's colleagues at the time at the Royal Free hospital in London, John Walker-Smith, 73 and now retired, was found guilty of serious professional misconduct and struck off. Another, Simon Murch, was found not guilty. Wakefield had already been discredited after a series of research projects failed to find any link between the triple MMR vaccine and autism, although a number of families continue to support him, even claiming to have been victimised for working with him.

He said today in an interview with BBC Radio 4's Today programme before the verdict that he and colleagues had listened and responded to "concerns of parents about their very sick children" and had acted "appropriately in the children's best interests to determine what the nature of their problem was".

Months after his research was published, the government withdrew single vaccines for measles, mumps and rubella, which parents could have opted for instead of the triple jab.

"When I made the recommendation to single vaccines they were available in the UK," he said from New York. "It is the government that is to blame for the resurgence of measles."

Wakefield said he had never opposed vaccination or claimed to have proof that MMR was linked to autism.

"I never made the claim at the time, nor do I still make the claim that MMR is a cause of autism," he said.

"You are conflating the two things. You are conflating the link with autism with the overall review of the vaccine."

In a statement after the verdict, he claimed that efforts to "discredit and silence me through the GMC process" had provided a screen to shield the government from exposure over the the MMR vaccine "scandal".

Wakefield had been found guilty in January of acting dishonestly and irresponsibly for carrying out unnecessarily invasive tests on children. He was said to have abused his position of trust, although his dishonesty had not led to personal financial gain.

He and the other doctors published a paper in the Lancet medical journal in February 1998 suggesting the measles virus might be linked to inflammatory bowel disease and play a role in autism.

The paper, based on just eight case studies, conceded that no definite link had been found but Wakefield, at a press conference, said he believed that instead of the triple MMR, children should be given doses in single jabs, preferably a year apart.

The GMC panel in January found Wakefield had conducted the trial unethically, including subjecting 11 children to invasive tests, such as lumbar punctures and colonoscopies they did not need, and without proper approval.

In February 1998, the same month the Lancet paper was published, he applied for ethical permission to run a trial of a new potential measles vaccine and set up a company called Immunospecifics Biotechnologies which would produce and sell it. The father of one of the children he had seen with developmental problems and bowel disease would be the managing director.

Wakefield tried the new vaccine on the child without mentioning it in medical notes or telling the child's GP. He was also found to have unethically arranged for his son's friends to have blood samples taken from them during his birthday party – for which he paid them £5 each.

The GMC panel chairman, Surendra Kumar, said: "In causing blood samples to be taken from children at a birthday party, he callously disregarded the pain and distress young children might suffer and behaved in a way which brought the profession into disrepute."

Wakefield hit on his theory after seeing children with bowel disease who had developmental problems. The third step in the hypothesis was the timing of the MMR vaccine: the first shot is given at around 13 months, about the age when autistic spectrum disorders start to be noticed.

In February, the 53-year-old left his role at a Texan clinic, The Thoughtful House Centre for Children, which he founded to study developmental disorders.

Kumar said Murch's involvement was more limited than that of Wakefield and Walker-Smith. He should have ensured there was appropriate ethical approval for research on the children, but ended the lumbar punctures after being unable to draw any clear inference that the children were suffering from a serious neurological disorder.

"The panel concluded Prof Murch acted in good faith, albeit it has found he was in error," said Kumar. "His actions, although comparable to professional misconduct in respect of undertaking procedures which were not clinically indicated, were mitigated by the fact he was under a false impression that they were clinically indicated."

Terence Stephenson, president of the Royal College of Paediatrics and Child Health, said: "Measles, mumps and rubella vaccines have all been shown to be safe and UK families are fortunate to have free access to these which is not true of many parts of the world. The false suggestion of a link between autism and the MMR vaccine has done untold damage to the UK vaccination programme."

The Department of Health said: "The safety of MMR has been endorsed through numerous studies in many countries.

"Thankfully, more parents are having their children vaccinated with MMR and they see it as being as safe as other childhood vaccines."

Isabella Thomas, 53, from Somerset, insisted that her two sons Michael, 18, and Terry, 16, received "fantastic" treatment at the Royal Free hospital under Wakefield.

"They were normal, then they started to deteriorate neurologically and medically. They were in the most horrendous pain you could think of. I went from doctor to doctor trying to find out what was wrong. I was only too pleased to be part of the study because we needed to find out what was wrong with the boys."

Thomas said that, as controversy erupted surrounding the research, the family was blacklisted.

"When I went to my doctor he said: 'I don't want politics being brought into this surgery'. I said: 'My son is ill, it's not about politics.'"

Allison Edwards, chairwoman of the campaign group Cry Shame which supported Wakefield, said: "This is to issue a warning to doctors not to dissent. No children were harmed in the clinical tests, they were trying to look at the problems and treat them, and the children improved. How do you get charged with doing your job?"

2 comments:

  1. Really interesting and completely relevant to what we have been learning about for ethics. I had heard about this story on the news but not in much detail so i found it really interesting to read rather than hear about.
    Your blog has really grown Rosemary its nice to see your profile and about you.
    Abbi

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  2. I agree with Abbi this is a really post, and very relevent.
    Danielle

    ReplyDelete