Age of Autism Awards 2008 Galileo Award: Dr. Andrew Wakefield

December 31, 2008
Age of Autism Awards 2008 Galileo Award: Dr. Andrew Wakefield
From the Roman to the Wakefield Inquisition

By Mark Blaxill

As the year draws to a close, all of us at the Age of Autism are very pleased to honor Dr. Andrew Wakefield. As we’ve reported here many times during the past year, Dr. Wakefield has been the subject of a remarkable and unprecedented campaign to discredit his work and character, most notably in a show trial that is still underway in London, in hearings of the General Medical Council. In the face of extraordinary attempts to silence him, Wakefield has stood up to these attacks with grace and determination and has continued his research and clinical work on behalf of children and families suffering from autism. That makes him our first Age of Autism Galileo Award recipient.

Like many of our awards this year, this wasn’t a difficult decision. In fact, this may be one of those unusual cases where the recipient of an award in some ways outshines its namesake. To understand why that might be so, you need to understand a bit more about why we chose to name the award after the Italian scientist Galileo, what he represents to the history of science and how his experience compares with Wakefield’s.

Galileo Galilei was born in Pisa, Italy in 1564. And while he was a physicist and mathematician of some note, Galileo was as much a practical mechanic as he was a grand theorist; indeed it was his tinkering with convex and concave lenses that gave him the tools to leave his lasting mark on the world. As a skilled inventor of early working telescopes, he did not design the world’s first telescope, but he was the first to make them powerful enough for scientific use. In fact, the word telescope (derived from the Greek roots skopein, “to see”, and tele for “far”) was coined in 1611 to describe one of Galileo’s first instruments. For the accomplishments that flowed from his pioneering work, he has been described by many as The Father of Modern Physics; Albert Einstein even went so far as to name him The Father of Modern Science.

But Galileo is celebrated today not as much for his engineering talent as for the suffering he endured in support of an unpopular scientific theory. Because it was Galileo’s work with telescopes in the early 17th century that lent critical support to the theory of heliocentrism, the idea that the earth revolved around the sun and not the other way around. As with his telescope technology, Galileo was not the first to propose the heliocentric theory: that distinction belongs to Nicolai Copernicus. Yet Copernicus, a Polish mathematician, was well aware of the personal risk of disseminating his ideas and delayed their publication for many years. Copernicus’ major work, De revolutionibus orbium coelestium, was published only shortly before his death at age 70 in 1543.

Galileo, by contrast, was an aggressive advocate for the truth as he saw it. He used his telescope to provide clear visual evidence that the sun occupied the center of the solar system. He then published his evidence fearlessly in the prime of his life, starting while in his 40s. And although for a while he obtained the approval of the Vatican to publish some of his work, he was eventually forced to spend most his later life defending himself and his findings. For as the significance of his observations for the prevailing Catholic orthodoxy became increasingly clear, Galileo was derided as a heretic, denounced publicly and finally given an ultimatum: renounce your theory or else. In 1633, he was put on trial by the "Supreme Sacred Congregation of the Universal Inquisition", known today as the Roman Inquisition, and convicted of heresy. Barely escaping prison, Galileo spent the rest of his life under house arrest, where he died nearly ten years later.

The many parallels between the Roman Inquisition and the Wakefield Inquisition are uncanny. Like Galileo, Wakefield came to autism both as a practical man and a scientist; his initial involvement in autism was simply in response to a group of parents who approached him as a specialist in pediatric gastroenterology. They told him, “Our children are not defective, they are sick” and Wakefield listened. Also like Galileo, Wakefield didn’t originate the idea that vaccines might play a role in autism, but has become the most prominent developer of the idea. As Galileo’s telescopes allowed him to discover the moons of Jupiter, so did Wakefield’s use of new ways of seeing, in this case an endoscope to see into a child’s intestines, allow him to discover a distinctive gut pathology in autism. He named what he saw autistic enterocolitis, and it was a finding that quite literally turned the brain-centric view of autism upside down. But this was no ordinary finding, for Wakefield’s specific challenge to the orthodox view of autism science made him a target for the medical establishment. He published his first major work in the prestigious journal The Lancet, where the editor Richard Horton had full awareness of its controversial potential. But when the controversy turned too hot to handle, Horton lost his nerve and in a perfidious betrayal that history should remember (see John Stone’s wonderful essay on Horton (HERE)), Horton turned on Wakefield.

Thanks to Horton’s perfidy, and again like Galileo, Wakefield now finds himself on trial for his license to practice medicine in front of the General Medical Council (GMC). And although the GMC might defend the validity of its allegations, it is plain to all who have followed the case closely that the trumped up charges hold little merit. Still, the outcome of the proceedings lies in considerable doubt, for Wakefield has not been subjected to these months of review on the basis of any actual medical misconduct (not surprisingly, no parent with whom he worked supports the GMC’s case). Quite clearly, and again like Galileo in the face of the Roman Inquisition, the offense for which Wakefield is really on trial is heresy. And whenever an Inquisition has begun to confront the conflicts between religious orthodoxy and inconvenient evidence, one can never predict how the High Inquisitors will render their judgment. The only thing we can predict is that a process like the Wakefield Inquisition is always more concerned with appearances than justice.

Wakefield’s heresy comes at a particularly difficult time for the medical profession that has placed him on trial. The twin pillars of its quest for the causes of human disease, germs and genes, have failed for years to explain the scourge of chronic disease: a scourge that has replaced infectious disease as the main public health problem of the developed world. In the face of a simmering disquiet over what has become an increasingly embarrassing scientific failure, it has become ever more important to the profession’s high priests to distract attention from the crumbling bulwarks of their belief system and take action to defend the tools and targets of those pillars: the germ theory of disease that was medicine’s greatest contribution to human civilization and provided its two principle tools, vaccines and antibiotics; and the genetic model of human disease that has been medicine’s great hope to succeed germ theory and the precious disease targets such as autism that it hopes to explain. Seen in this context, Wakefield’s heresies have been unusually threatening because they operate on both fronts: they compete with the genetic explanations of autism with a causal model that threatens to tarnish the heroic triumphs of germ theory.

So like Galileo’s compelling work in support of heliocentrism, Wakefield’s dual challenge to vaccine development and autism science has evoked a strong response from the highest levels of authority. In Wakefield’s case, his prosecutors have determined not only that he must be shown to be wrong, he must also be punished. That means his work on autism (as well as others doing supportive work) must be stopped while he must also be stripped of his credentials as a member of the medical profession. The modern punishment for heresy may not include death, but it can be exile and excommunication.

Casting the treatment of Wakefield as a religious response is the only way to make sense of the behavior of the medical establishment over the last several years. If it were not so serious, its escalating absurdity would begin to resemble farce. One example is the latest defense of the ever-expanding childhood immunization program. Instead of embracing the importance of improving vaccine safety, the program’s defenders have now declared that the temple of the sacred program must never be defiled, and certainly must not be subjected to conventional safety research. So the obvious research project of comparing the total health outcomes in vaccinated vs. unvaccinated individuals has been rejected not merely as too expensive, now it simply must not be done. In the Orwellian logic of the CDC, such studies in humans would be “prospectively unethical” and “retrospectively impossible.”

Let’s be frank here. This is an epistemological obscenity: It’s not just that we don’t know some very basic things about the safety of the sacred program, we also cannot know and should not seek to know. This stance should offend even the most skeptical scientists. Still, the farce continues.

In the meantime, there remains a body of published evidence that must be dealt with. And for this, since the retraction of every published study is well-nigh impossible (some of Wakefield’s less courageous co-authors famously “retracted the interpretation” of the Lancet paper, but they couldn’t retract the evidence) there is only one answer left. Nullify the source of the heresy itself. Practically speaking, when establishment voices can no longer claim the absence of causal evidence, the fallback position must be that there is “no credible evidence” linking vaccines and autism. Removing credibility from the evidence requires that the high priests get personal: they must mount a systematic attack on the personal reputations and integrity of scientists who pursue and publish heretical lines of investigation.

And this is why, decades after Stalin and Mao, we now have the travesty of a 21st century show trial in London, the Wakefield Inquisition. It’s also why the passionate call on a U.K. parents' web-site, Cry Shame, is so deeply correct.