The value of education?

Here is another instance of the relationship -- or not -- between education and an educated public.

Just a slim majority of Americans -- 52 percent -- think vaccines don't cause autism, a new Harris Interactive/HealthDay poll found. 

Conversely, 18 percent are convinced that vaccines, like the measles-mumps-rubella (MMR) vaccine, can cause the disorder, and another 30 percent aren't sure. 

The poll was conducted last week, following news reports that said the lead researcher of a controversial 1998 study linking autism to the MMR vaccine had used fraudulent research to come to his conclusion.

The poll also found that parents who have lingering doubts about the vaccine were less likely to say that their children were fully vaccinated (86 percent), compared to 98 percent of parents who believe in the safety of vaccines.

For many years many people did not have their children vaccinated against childhood diseases like measles, mumps, or pertussis (whooping cough) because there were allegations that the vaccines were toxic in some ways and could cause autism.  Mercury is in thimerosol, a vaccine preservative, and the MMR vaccine was said to have some other brain-damaging properties.

Figure from BBCnews.com

The absolute risk was low but the consequences when the problem arises are lifelong and can be devastating.  So children were going unvaccinated, but this itself had consequences.  Directly, the unprotected child could suffer harm from disease itself, and some children have apparently died as a result.  Indirectly, a large unvaccinated subpopulation could provide a transmission reservoir for the pathogens.

Many expensive studies were carried out to see if the evidence for the connection between vaccination and autism was real -- which meant a lot of research energy thus diverted from other problems.  Lawsuits were instigated by angry and devastated parents against the producers of the vaccine, who naturally denied any liability.

Well, as we've posted earlier and you've seen in the news, the original Lancet paper was apparently very flawed, if not indeed a fraud, with faked or at least incompetently analyzed data.  The Lancet withdrew the paper, the author was disbarred from medical practice in Britain, and so on.  It seems now that there is consensus about the false nature of the first result.  This has been widely publicized, with great sighs of relief by the established infectious disease community: now, finally, we can get with the modern program and have every child vaccinated and remove the burden of these various diseases!

But no!  This new survey shows that a substantial fraction of the population still believes that the vaccines are dangerous.  Some may feel there's an Establishment conspiracy to silence the risk to feed the greed of Big Pharma.  Some may just not accept the recent outcome because they're so fearful for their children in regard to autism.  And there is the contributing problem that the actual causes of autism remain largely unknown.

So what is the role of education in this kind of situation?  Risks are low (even if they exist) and that means it is difficult to estimate, assess, or dismiss them.  And peoples' sociopolitical views, including suspicion of government, are deeply entrenched.  Conspiracy theories, and advocacy group solidarity, conspire to reinforce tribal feelings of us vs. them.  Since everyone, even scientists (believe it or not) have their own vested interests, it is not easy to define what is 'education' and what is 'propaganda'.  The emotional side of this keeps people in their camps.  Unclear causation is partly responsible.  Low risks or slow risks are very problematic and play into the hands of all of us, in the way we view the world: climate change, evolution, environmental pollutants, and so many other similar issues reflect this.

When we give a lecture in class or write papers, we believe that by educating our students or readers, we are helping in societal progress and enlightenment.  But we're flattering ourselves, at least to some extent.  Knowledge, and action based on knowledge, are vague areas in society and the tide of action is the result of many factors, of which our teaching and writing are but a part, and sometimes perhaps even just a small part.

Art forgeries are better than science forgery

A big challenge for modern biomedical science (and for others, like climate change, for example) is that the evidence is often that effects may be real  but they are slow, slight, or statistical.  What is barely observable year by year can turn into an ice age--or an epidemic after much time or many exposures have occurred.

False ideas under such circumstances can be very costly.  That's why what now appears to have been outright fraud in associating autism with somehow-toxic childhood vaccines has been so serious.  Countless parents shunned vaccine protection because they believed the vaccines were dangerous.  Huge amounts have been spent on the diseases that would have been prevented, on morbidity and serious ill effects, and of research dollars and resources.

The problem became public and political, with parents advocacy groups, lawyers, and politicians getting into the act.  Other problems might have been addressed with the same funds.

The physician who has been accused, Andrew Wakefield, naturally denies the allegations.  Accusations fly back and forth, and those who believe (or hope) in the conspiracy theory that the attack on  him is from Big Pharma trying to protect their profits or from lawsuits, include advocacy groups that have been attacking the vaccines for some time.  Every side, as usual, sticks to its story. We're not in a position to judge, of course, but there's a deeper point.

There is no easy answer for these situations in which causation is statistical and causal effects small.  We have to work out various criteria for making inference about what causes the ill outcome, or what its mechanism or cause-effect pattern is.  We have to work out societal risk-benefit assessments.  So it is very serious indeed when we can't trust the good faith of the evidence as well as its epistemological shakiness.

No matter how much we criticize science today, and no matter how much hyperbole, dissembling, shading and stretching of truths goes on, it is assumed to stay within the lines at least of technical accuracy.  So when there is fraud as has been claimed in this case, or data cover-ups as has been repeatedly claimed for drug trials, the crime is a crime against society and is very serious.

Fortunately real fraud of the data-faking kind seems to be very rare.  When it happens, sanctions have to be strong, to make as sure as we can that it stays very rare.  In situations where the truth is easy to find, fakery has little chance of getting the faker anywhere.  But in the common situation of complex causation, cheating can pay off.  So we have to be rigorous in preventing it.  Generally, we seem to be doing well, and part of the evidence is the degree of publicity that the occasions of real dishonest science receive.