How campaigners and the media push bad scienceBMJ 2011; 342 doi: http://dx.doi.org/10.1136/bmj.d236 (Published 18 January 2011) Cite this as: BMJ 2011;342:d236
- Andy Alaszewski, editor, Health, Risk and Society, and emeritus professor, University of Kent
Brian Deer’s three articles in the BMJ series provide a compelling account of bad science and bad scientists.1 2 3 He documents how Andrew Wakefield and his scientific colleagues “discovered” a new disease or syndrome (autistic enterocolitis) “caused” by the measles, mumps, and rubella (MMR) vaccine and tried to convince others of the existence of this disease. Wakefield and colleagues’ Lancet article, published in February 1998,4 was based on weak evidence and the selective presentation of data from a limited number of preselected cases. Despite this the article was sympathetically received by reviewers and editors of the Lancet, journalists hostile to public health, many parents of autistic children, and some parents who were considering the MMR vaccine.
Deer’s story of the Lancet article can be seen as a modern tragedy, about the hubris of a group of scientists that results in a medical disaster. The scientists suffered some of the consequences; for example, Wakefield lost his job, reputation, and medical licence in the United Kingdom. There were other victims. The children involved in the study underwent unnecessary and painful investigations, and because of the public health scare many young children did not receive the MMR vaccine and were consequently exposed to an increased risk of infection by potentially life threatening diseases.
Science involves the application of specific methods to generate and test hypotheses and increasingly involves team work to solve specific problems. “Wakefield’s people” were challenging the established scientific orthodoxy that the MMR vaccine was a safe public health intervention. With hindsight it is clear that they were mistaken, but at the time, and in the context of public concerns about the general safety of medical practice and the specific safety of vaccines, the hypothesis that the MMR vaccine was potentially harmful was reasonable and worth exploring. In other areas of public health, established hypotheses about safety had been shown to be based on flawed logic. In the case of bovine spongiform encephalopathy (BSE), until clear evidence emerged that humans had been infected by eating contaminated beef the scientific orthodoxy was based on analogies, especially with scrapie, and arguments based in ignorance that there was no evidence that humans were at risk.5 As in the case of the MMR vaccine this orthodoxy was challenged by only a few scientific “mavericks.”
Many areas of science are characterised by uncertainty and a lack of definitive evidence, and in such contexts social relations and interactions play a key role in sustaining competing hypotheses.6 So in the case of BSE and Creutzfeldt-Jacob disease a network of government scientific advisory groups played a key role in developing and maintaining the view that it was improbable that the infective agent that caused BSE would affect humans.5 However, in developing his critique of the MMR vaccine Wakefield went beyond scientific team building, becoming associated with an antivaccine campaign group, called Jabs, and with the lawsuit on behalf of 1500 claimants who were seeking compensation for vaccine damage to their children.
The work of Deer and others undermining the evidence linking the MMR vaccine to autism had disastrous consequences for Wakefield and for those parents claiming legal compensation for vaccine damage. However, the antivaccine campaign is alive and active, with the Jabs website alleging an “unrelenting barrage of anti-Wakefield propaganda in the British media”7 and advertising the book Silenced Witness, parents’ accounts of vaccine damage.8 The CryShame website continues to endorse “the concern initially expressed by Dr Andrew Wakefield . . . that some children may be at increased risk of adverse response to MMR vaccine.”9 Such resilience should come as no surprise. Festinger and his colleagues have shown that, when the predictions of social movements fail, their proponents defend the hypotheses on which such predictions are based and reinterpret reality to fit with the hypothesis.10
The mass media played a major role in this affair as the forum in which campaigning groups make claims.11 The media have effectively become the arbiter of truth. The ways in which Wakefield publicised his “findings” were unusually high profile and dishonest, because underlying links to the antivaccine campaign were concealed. The initial presentation of the findings was sympathetically received by those journalists who linked public health to the nanny state. Hauke and Spiegelhalter have shown in a study of two scientific press releases how the media used and reframed stories on the link between obesity and cancer, for example, as evidence of the nanny state.12 A distinctive feature of Deer’s journalism was that he did not reframe the story but treated it at face value, scrutinising the underpinning science, and found it wanting.
Deer’s articles provide a fascinating whodunit. However, underpinning this story are some important questions about the nature of scientific research and its relation with society. Campaign groups will make use of scientific research to make claims. The mass media are a key forum for such claims, and journalists will interpret and evaluate claims and the evidence on which they are based. The relations of scientist to campaign groups and the media need to be more fully explored and understood so that clear ethical guidelines can be established.
Cite this as: BMJ 2011;342:d236
bmj.com Observations: Is research safe in their hands? BMJ 2011;342:d284, doi:10.1136/bmj.d284.