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Autism’s False Prophets Questions – Part II

vaccines-save-livesA second installment in questions referring to Paul Offit’s book, Autism’s False Prophets. These questions mark the last of those we will cover for this book.

Autism’s False Prophets                                                                           Name:

Chapter 11 Questions

A Place for Autism

  1. What evidence is there for a genetic cause of autism?
  1. Other than genetics, what other things may cause autism?
  1. Who is the Autism Diva, and where did she come from?
  1. Who is Peter Hotez, and how did he get involved in the public conversation about autism?
  1. What does Peter Hotez think is the hardest part of being parent to an autistic child?
  1. What does Kathleen Seidel say is a problem about the way that doctors and scientists see the world?
  1. As always, at the end of a book like this, I like to ask for your feedback on whether you found this book important, what it might lack, and whether you think that I should keep using it in future classes.
 
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Posted by on May 3, 2015 in Uncategorized

 

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Autism’s False Prophets Questions

I’ve been having a difficult time logging into ‘Blackboard’ today to post the questions for chapter 10 of Autism’s False Prophets. Although I don’t like posting any required material here, I’d rather get it out there, so if you are in my pathology class, please spread the word to other students to check in here.

Before you start, check out this video mentioned towards the back of the chapter…

Autism’s False Prophets                                                                           Name:

Chapter 10 Questions

Science and Society

“For many parents, the advice given by heathcare professionals about vaccines is just one more opinion in a sea of opinions offered by the internet.”

-Offit, chapter 10

  1. What is the problem with Dan Burton’s assessment of what he saw at the Stop Autism Now Conference?
  1. How would you interpret the actions of policymakers at the CDC who ‘invariably give these vaccines to their own children and grandchildren’? If you have read Offit’s other book, Vaccinated, do you recall who vaccine maker, Maurice Hilleman, insisted were the first to receive the Hepatitis vaccine made from human blood?
  1. What does Offit say is even more important than reporting the source of funding for scientific investigation on? Why is this so?
  1. What is ‘the price’ of empowering parents to make medical decisions about their childrens’ healthcare?
  1. How does the ‘Scientific Method’ differ from what people often do in their day-to-day lives? How is it similar?
  1. Using the scientific method, data serves to _____________________________ the null hypothesis. What can it NOT do? Why not?
  1. Why is it evolutionarily successful to make ‘the best connections’? What flaws in logic can this leave?
  1. What quotation did Stephen Strauss, former director of NCCAM keep framed on his office wall? What is the meaning of this quotation?
  1. How many people, since 1958, have died from poisoned Halloween candy? (http://www.snopes.com/horrors/poison/halloween.asp)
 
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Posted by on May 3, 2015 in Uncategorized

 

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Science on Trial – Science in the Media

Amongst the many interesting topics that Paul Offit’s Autism’s False Prophets brings up are how science is perceived in the media, received by the public, and judged in the courtroom.

For reference, Offit brings up the fiasco of the 1990s lawsuits against the makers of silicone implants.

Kristin E. Schleiter writes an excellent paper about the history of silicone implants and the litigation that followed them in Silicone Breast Implant Litigation in the AMA Journal of Ethics.

Breast implants, she says, were first introduced in the 1960s. In 1976, the FDA was granted the power to regulate them as medical devices, but did not specifically do so until 1988. Prior to that, in 1984, Maria Stern won [the first case against an implant manufacturer totaling] “$211,000 in compensatory damages and $1.5 million in punitive damages from silicone breast implant manufacturer Dow Corning after claiming that her breast implants caused autoimmune disease.” This was the first, but not last case to bring implants to court. In the 1990s public opinion was against the makers of breast implants and thousands of suits were filed against their makers.

A natural progression

A natural progression

-Schleiter’s paper goes through a list of important individual and class action cases that I don’t feel the need to repeat here, however it is a fascinating read.

In the midst of these lawsuits, the attorney, “John O’Connor, relied on PR and sympathy to win [his case representing client, Pamela Johnson]. O’Connor hired a public relations firm that gave interviews to Phil Donahue and 60 Minutes, and the trial was broadcast in its entirety on Court TV. At trial, O’Connor set up a rebuttable presumption, asking the jury to hold MEC liable unless the company could prove that they knew their implants were safe at the time they marketed them. “

That is, it doesn’t matter whether the implants caused damage, but instead, whether the company, MEC, could prove them to be safe.

In the wake of litigation, studies began appearing showing the lack of any connection between breast implants and negative health outcomes.

Schleiter provides a list of papers reviewing the safety or danger linked to implants consolidated here:

  •  Plastic and Reconstructive Surgery published a study that found no increase in the incidence of breast cancer in women who had received breast implants
  • The New England Journal of Medicine soon followed with a study that concluded that breast implants did not substantially increase a woman’s risk for breast cancer
  • In 1994- New England Journal of Medicine published a study by Mayo Clinic epidemiologists that found no increased risk of connective tissue disease in women with silicone gel breast implants
  • In 1995, the Journal followed with yet another study—this one larger and more refined—that found no association between implants and connective tissue disorders.
  • In 1997, the American Academy of Neurology reviewed existing silicone gel breast implant studies and concluded that there was no link between the implants and neurological disorders
  • Also in 1997 Journal of the National Cancer Institute published a review of studies and concluded that breast implants did not cause breast cancer

However, billions of dollars had already been awarded or settled upon and Dow Corning was forced into Bankruptcy.

With respect to Offit’s book, the question arises, “How should science be settled in court?” It’s tempting to say that the cases should prompt investigations that statistically determine the culpability of, in this case, breast implant manufacturers. But that leads directly to one of the core problems that raised the specter of a MMR / Autism connection. Andrew Wakefield’s paper was intended to do just that – provide scientific evidence to help determine a case. In that case, the British government provided $30M to a law firm in order to fund their investigation. But that’s not proper either. To begin with an outcome in mind, i.e. “MMR shots cause autism” and then try to uncover evidence to support that idea is putting the cart in front of the horse. It’s OK to ask, “Does MMR vaccination cause autism?” and then look for the answer, but starting with the answer in mind – No.

For those in my Pathophysiology class, consider, as you read these next chapters, how these questions should be answered. If you were in the position to outline how cases involving questions of science / healthcare should be handled in court, how would you do it? Are these questions any different from the other questions that courts have to address?

 
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Posted by on February 15, 2015 in Uncategorized

 

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Vitamin Supplements: Vital? or Rubbish?

ImageIn class today, I was asked what I knew about vitamin supplements and whether it was a good idea to take them or not. To follow up on that conversation, I thought I would post a link to an article that addresses this question directly. This article, by Paul Offit, was published by the Atlantic magazine July 19 of this year and deals with some of the same material from his newest book, Do You Believe in Magic?

Vitamines are certainly required for healthy living, something reflected by their very name (vitamin = vital amine). The question is, how much of each of these do we need to add above and and beyond what we get from a well-balanced diet? It has been proposed that excessive doses of certain vitamins could be a panacea leading to elimination of many of life’s ailments.  From the Atlantic article…

In 1970, [Nobel Prize winning scientist, Linus] Pauling published Vitamin C and the Common Cold, urging the public to take 3,000 milligrams of vitamin C every day (about 50 times the recommended daily allowance). Pauling believed that the common cold would soon be a historical footnote. “It will take decades to eradicate the common cold completely,” he wrote, “but it can, I believe, be controlled entirely in the United States and some other countries within a few years. I look forward to witnessing this step toward a better world.” Pauling’s book became an instant best seller.

ImageThese pronouncements would have amounted to nothing coming from many other people, but Pauling was not just any other person. There’s a chance his pair of Nobel Prizes may have held some weight in people’s minds. 

 
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Posted by on November 14, 2013 in Uncategorized

 

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Finishing Offit’s Vaccine Course

ImageI just finished up Paul Offit’s Vaccines course offered for free through Coursera.org. I found this course to be an excellent introduction to the science and history of vaccines which anyone could benefit from regardless of their background. This is particularly important because the act of having children has such a low barrier to entry, yet it immediately puts one in the position to be responsible for another’s life.

I highly recommend this course to anyone who is interested in vaccines, interested in immunology, interested in disease, has children, might have children in the future and really anyone who wants to take their citizenship in the world seriously.

The last lecture on vaccine exemptions was especially informative to me as it discussed not only the current trend in vaccine refusal, but also explored the historical and legal history. Listening to this lecture reminded me of a question that has always bubbled on the back burner of my mind: What are the legal ramifications of vaccine refusal for the physicians who care for these patients? My feeling is that allowing parents to elect to refuse vaccines for their children is akin to asking their doctor to practice sub-standard medicine, something that is often prosecuted in malpractice cases.

ImageConsider the case of Typhoid Mary, who spread her eponymous disease through preparing baked goods in New York. When she was finally tracked down, she was forced to become “quarantined on North Brother Island in a tiny cottage separated from Manhattan by the East River.” Her freedom was certainly infringed upon for the good of the public. Was this a reasonable course of action by the authorities?

I haven’t read this book yet having just discovered in today, but I will be looking into it shortly.Image

You can explore this topic more in Christine Vara’s article here or read Art Caplan’s article on a much more recent case here.

 
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Posted by on November 4, 2013 in Uncategorized

 

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Science Denialism … A TEDed lesson

Michael Specter, a science journalist at The New Yorker and author of Denialism: How Irrational Thinking Hinders Scientific Progress, Harms the Planet, and Threatens Our Lives gives a remarkably powerful talk on the treatment of science in modern times. He asks, ‘Why do we mistrust scientific authority?’ and encourages us to listen to the data even as we keep our skepticism.

This is a really good talk. I wish I had given it. Follow this link to the TEDed page with this talk and some questions. He mentions Paul Offit, the author of Vaccinated, the book we are reading in Microbiology this semester. Although the mention is brief, it does expose the ugly mob mentality that takes over public discourse sometimes. 

 
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Posted by on March 12, 2013 in Uncategorized

 

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