Think harm always
BMJ 2004; 329 doi: https://doi.org/10.1136/bmj.329.7456.0-g (Published 01 July 2004) Cite this as: BMJ 2004;329:0-gAll rapid responses
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"The difficulty of establishing gene involvement is compounded by the
interaction of genes and by their interaction with environmental factors.
"More research needs to be funded in order that all these factors can
be explored in relation to one another."" [1]
That sounds like a tapestry to me John - what do you think?
In my book, using this metaphor, I say exactly this - but vaccines
are also included as a possible causal thread in the autistic tapestry.
1. Blakemore-Brown Reweaving the Autistic Tapestry Jessica Kingsley
Publishers 2002. New imprint 2003.
Competing interests:
Expert in Autistic and ADHD Spectrum disorders
Competing interests: No competing interests
Interviewed in relation to a report of a project (US National
Alliance for Autism Research) to locate "autistic" genes, Lorna Wing,
honorary psychiatric consultant of National Autistic Society "said the
project offered "great hope" for progress in the genetic investigation of
autism".
""There is strong evidence to suggest that genetic factors are of
major importance in the causation of autistic spectrum disorders.
""Scientists have been attempting to identify which genes might be
implicated in autism for some years."
"She added: "Autism is likely to have mutiple genes responsible,
rather than a single gene.
""The difficulty of establishing gene involvement is compounded by
the interaction of genes and by their interaction with environmental
factors.
""More research needs to be funded in order that all these factors
can be explored in relation to one another."" [1]
The question is, why, more than a decade after autism incidence in
the infant population began to go wild are we only talking about
investigating environmental factors?
[1] BBC News, internet version, "Project to search for autism gene",
Monday 19 July 2004.
Competing interests:
Parent of an autistic child
Competing interests: No competing interests
So, what is the "credible" basis for vaccine safety?
Competing interests:
Parent of an autistic child
Competing interests: No competing interests
After an act with good intentions (prescribing medication to treat a
chronic disease), believe the human response to an unintended consequence
(Adverse Drug Reaction) is righteous indignation (Well, it happens & I
was trying to "do the right thing"). Put in the words of hamlet, To treat
or not to treat?...That is the question. Is it nobler to suffer the
slings and arrows of outrageous disease, or should we take arms against a
sea of ADR's. Aye to sleep, perchance to dream...
This great work reveals ADR’s occur too commonly and it is everyone's
responsibility to be aware… but not afraid. What is the risk of chronic
disease left untreated? In the misinformation age believe we’ll be
challenged to accurately measure and communicate risk benefits of medical
interventions. That is our job. We will need to more up to date and
effective communication tools to accomplish the task.
Wellinx is the electronic evidence based prescribing and
communication tool I’ve used for the last four years. No question the
evidence based information as molded in me a more rational prescribing
pattern. Educational information included communicates and reinforces best
evidence to treat.
More rational evidence based measure of risk/benefit in prescribing
key to reducing ADR’s. Communication of ADR possibility key to maintaining
positive doctor-patient relationships.
Believe electronic prescribing with Wellinx reduces risk and improves
communication. All must better understand, however, the tremendous risks
associated with any medical intervention. Then weigh in the balance the
humble alternative risk of doing nothing. Electronic help to reduce human
bias a must.
Competing interests:
None declared
Competing interests: No competing interests
Editor: I very much appreciated your comments. It is always good to
be reminded that there are many instances where I could actually do more
harm than good. Thanks for the re-focus! Beneficence and Non-maleficence!
However, when we are taught with flawed science and biased opinion to
think harm always, in regards to child abuse, SBS, MSbP...it becomes clear
how so many falsely accused, imprisoned and/or dismantled families result.
Thinking dirty and harm always in such cases leads to immediate crime
scene investigation rather than complete and competent thorough medical
investigation. To immediately reject any caretakers description of
events, to collate incriminating tests and simultaneously forego truth
determining studies.
Sounds awful doesn't it? As, in these instances with such drastic
repercussions, harm should only be thought of once exhaustive medical
studies are carried out. Gets a lot worse once you realize it (always
thinking foul play) all began with severely flawed "research" and is based
on insinuation and opinion and/or mis-representation of available data.
When you realize that the opposite of truth, in the form of absurd and
clearly unproven statistics, are testified to in a court of law. That all
along, the statistics actually pointed to a higher probability of "SIDS"
deaths, genetically speaking. That some experts "expertise" can diagnose
homicide from the tele"vision". That all along, minor falls can cause
death, SDH and RH; that old intracranial bleeds can rebleed with little or
no trauma; that craniocerebral disproportion (hydrocephalus, benign extra-
axial spaces) can result in hemorrhage with little or no trauma. That
vaccines can cause encephalitis, autism, life long allergies...and were
introduced after the disease mortality rates had already dropped 90%.
That bleeding disorders are misdiagnosed as abuse. That vitamin
deficiences and malnutrition are misdiagnosed as abuse. That birth
injuries are overlooked. The list goes on and on..and on...and on...and
on...and on...
That when such revelations are pronounced, the "experts" scatter to
cover-up and denigrate those that oppose them. That the "experts" ignore
evidence, that the research they relied on is grossly flawed at best, as
if flawed research design doesn't apply to them. That such cover-ups come
with the pretense that we are only acting in the name of children??? And
we are supposed put our trust in the "system"?
Child abuse is awful, but not nearly as awful as the familial
repercussions and devastation of falsely accusing and convicting the
innocent.
Competing interests:
Know the falsely accused and the utter devastation heaped upon them with dogmatic hands.
Competing interests: No competing interests
I am grateful to Herbert Nehrlich - as ever an eloquent commentator
on our ruthless age. But I should not lose sight of my original metaphor
because it was, of course, I that gave Humpty the push, and was hoping to
see all the King's horses and all the King's men try to re-assemble the
shattered reputation of vaccine safety. Having pointed out that (1)
adverse reactions are systematically ignored, (2) parents are brutally
disregarded when they report adverse side effects and (3) anyone trying to
investigate possible connections between autism, gut disorders and vaccine
is likely to pay a heavy professional price, I ask simply to be corrected
in my view that this is not a system which is genuinely safe. I want to be
told what the safeguards are, and why I should believe in them?
Sir Liam Donaldson could clear the air by issuing a statement that he
expects all possible adverse reactions to vaccine to be reported and
investigated in order to ensure public confidence. I write the day after
the announcement of yet another pathetically inadequate health survey to
look at the possible environmental causes of autism (designed you might
think to resolve nothing and waste time), but look at what happened when
Andrew Wakefield tried find out what was clinically the matter with the
children. This as I remarked once before is a pantomime, looking at the
problem through the wrong end of a telescope - and then pretending that
you care.
Competing interests:
Parent of an autistic child
Competing interests: No competing interests
Dear John Stone: I think all the King's horses and all the King's men
are now working for the purveyors of Pro-Active Medicine.
Poor Humpty isn't just condemned to remain prone, with grotesquely twisted
extremeties, it is also extremely likely that he will be trampled by
hooves and cursed by the drivers.
After all, this is the twentyfirst century.
Competing interests:
None declared
Competing interests: No competing interests
You would think that they would send all the King's horses and all
the King's men. As it is, it looks as if Humpty will just have to lie
there in pieces.
Competing interests:
Parent of an autistic child
Competing interests: No competing interests
Dr. Naseem A. Quereshi writes about 'intervention' which has the
stated aim of "alleviating the suffering of the sufferers". A noble
undertaking indeed.
In the process, he manages to use terms that ought to be banned from this
forum when the subject concerns illness.
While realising that the doctor is not the only one to misuse these
terms and that his native tongue is probably not English (judging by the
name, not by his otherwise excellent command of English), may I suggest
that he (and others) look at the following:
Health providers (how do they do it?)
Health managers (what exactly do they manage?)
Health consumers (do they buy or ingest it?)
Health users (is that where the term "user pays" comes from?)
Health administrators (do they control health "care"?)
We have a sickness industry, sickness benefits, sick rooms,
even sickness providers (all those bad, unhealthy habits).
If we look at "CARE" as Dr. Q. does in terms of "INTERVENTION" then
we must also realise that a healthy entity does not need intervention to
stay healthy, just care (of the non-intervention kind)
Following this train of thought it may be possible to enter the territory
of Pro-Active- Medicine and of Evidence-Based-Medicine.Those are occupying
themselves with the active interference in the life and health of human
beings, all under the name of "Health Care".
And, before we realise it, we are reminded of Joerg Blech's book "The
Disease Inventors' (Die Krankheitserfinder) in which he exposes the modern
ways that people (many of them being healthy) are pin-pointed, tracked,
sweneagled and badgered into having various parts of their anatomy, their
excretions and their thoughts tested for free. Courtesy of "WeCare
Pharmaceuticals". If you don't fit the mold you will then face the
Bamboozle Brigade. And they do like you because they care.And they will
manage,administer and provide for you, the rules being simply that they
are the industry and you the consumer.And if you are not totally consumed
by all this care you may even recover your health.
As an astute observer said: If you are healthy it only means that you
haven't been examined thoroughly enough!
Competing interests:
None declared
Competing interests: No competing interests
Re: Autistic Tapestry - the arguments converge but how do we re-establish trust
I think what Lorna Wing might also have said is that research not
only has to be funded, it has to be allowed in the first place. Throughout
the dispiriting saga of the last decade - just as incidence manifestly
began to escalate - the emphasis from our health officials has been
perversely on the genetic front, rather than on the environmental
dimension. And, of course, without any controls or strong evidence they
have preferred a static model for incidence which is predicated on it
being essentially genetically determined, with the corollary that increase
has to be explained in institutional terms. If, as Lorna Wing orthodoxly
states, there is a critical enviromental component then you would not
expect incidence to be static.
The question is how do we introduce some trust into the system. It
obviously cannot be achieved by another comparatively cheap public health
survey like the one commissioned by the Medical Research Council (MRC)
from Jean Goldring and her Bristol team, or by the continued persecution
of Andrew Wakefield. Nor will we have trust if parents' accounts are
sidelined. If we accept that there are environmental factors in play then
we absolutely have to look at whatever organic damage these children may
have sustained, and we have to start now because the more we delay the
more children will be damaged. When you look at the scope of the Goldring
project in relation to the socially and financially catastrophic nature of
the problem you wonder whether the MRC are not simply being flippant, and
why?
Competing interests:
parent of an autistic child
Competing interests: No competing interests