Tag Archives: immunisation

Where do you draw the line? On vaccination and freedom of speech

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I was skimming my Facebook feed this afternoon, and I had to take a second glance at one of the articles when my brain eventually caught up with what was on the screen.

“Australian nurses who spread anti-vaccination messages will now face prosecution”, it said.

My first reaction was, “Wow … that was unexpected.”

So unexpected, in fact, I initially thought it was a hoax.  Then I noticed the story was being reported by several sources, some of which looked reputable.  Perhaps this wasn’t a viral meme after all.  I went to the Australian Health Practitioner Regulatory Authority’s website to get direct confirmation, and sure enough, it was no joke—AHPRA and the Nursing and Midwifery Board of Australia (NMBA) recently issued a statement saying exactly what was reported.

“The NMBA has become aware that there are a small number of registered nurses, enrolled nurses and midwives who are promoting anti-vaccination statements to patients and the public via social media which contradict the best available scientific evidence. The NMBA is taking this opportunity to make its expectations about providing advice on vaccinations clear to registered nurses, enrolled nurses and midwives.”

“The NMBA expects all registered nurses, enrolled nurses and midwives to use the best available evidence in making practice decisions. This includes providing information to the public about public health issues.”

“Any published anti-vaccination material and/or advice which is false, misleading or deceptive which is being distributed by a registered nurse, enrolled nurse or midwife (including via social media) may also constitute a summary offence under the National Law and could result in prosecution by AHPRA.”
~ http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Position-Statements/vaccination.aspx

Vaccination is a pet subject for me—I’m a strong advocate for immunisation and I detest those who would misconstrue the science of vaccines to suit their own twisted agenda.  I think there’s a special place in hell set aside for Jenny McCarthy and Andrew Wakefield.

That said, I’m still a teensy bit uneasy about this new approach by AHPRA, because as much as I hate hearing about people mislead by anti-vaxxers, I want to protect freedom of speech.

Muzzling free speech is a two-edged sword.  Yes, you might stop slimy crack-pots like Wakefield from spreading their malicious fiction, but you also run the risk of stifling legitimate debate.

There’s no evidence that vaccines have toxic levels of mercury or aluminium, or that vaccines cause autism or cancer.  To suggest otherwise is unscientific, and I have no problems in categorically stating that vaccination opponents are currently wrong.  But … what if a legitimate concern about a vaccine arises?  I’m not suggesting the evidence for vaccination is unsettled, but rather, what if a new vaccine is developed that does have unforeseen complications?  Will gag laws prevent a whistle-blower from coming forward for fear of being tarred as “anti-vaccination”?  I wouldn’t put it past the developing drug company from using such a tactic if they wanted an easy way to defend their product.

The other aspect to consider is broader—is this the thin end of the wedge?  If we start gagging health professionals from speaking out against the consensus on immunisation, then what’s next? Abortion law reform? Euthanasia? Climate change?  Each of these issues remains controversial and each side of each issue claims to have science on its side.  Should the side with the perceived ‘consensus’ have the authority or the right to suppress debate from their opponents?

Besides, the problem of anti-vaccination propaganda goes way beyond nurses making comments on social media.  AHPRA’s power only extends to registered health practitioners in Australia.  It doesn’t stop naturopaths or “nutritionists” from promoting anti-vaccination views, and it seems it hasn’t stopped certain chiropractors from subverting the rules either.  It doesn’t stop alternative-health hawkers overseas.

Despite my misgivings, I’m still in favour of AHPRA’s move.  It’s a step in the right direction, and it’s being done for the right reasons—to protect patients from rogue operators that would betray their trust—although this edict might need further discussion before extending it to all AHPRA health practitioners.

Perhaps we should focus on promoting the truth instead of trying to suppress the lies.  For every anti-vaccination blog, there should be a hundred promoting the science behind vaccines.  For every anti-vaxxer celebrity that gets thirty seconds of air time, there should be thirty minutes of air time for reputable scientists and vaccination advocates.  Anti-vaxxers should be able to say what they want even if it’s pseudoscience, but they should be prepared to be pilloried by real scientists using proven facts.

Perhaps that’s a better way to protect all the rights of the community.

What do you think?  Feel free to leave your comments below.

Prayer Proof?

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In Wisconsin, USA, Leilani Neumann is found guilty of second degree reckless homocide of her 11-year-old daughter Kara.  During her recent trial, the prosecution alleged that she ignored the worsening symptoms of Kara’s undiagnosed diabetes for two weeks, and chose prayer instead of seeking medical advice.  Even during the last hours before Kara’s death, Leilani stood with her husband and Bible study members praying for her.  Witnesses said that it was only when the comatosed girl stopped breathing that someone called paramedics.  Neumann family supporters state that the trial was misconducted, without a single witness called for the defense, and an appeal is planned.

Across the other side of the US, Billy is a graduating student of the Bethel School of Ministry, in Redding, California.   He reported on a recent trip to Ecuador where he prayed for a seven year old boy with leg deformities from birth. It was hard for the boy to walk and impossible for him to run, which made him the target of taunts when he tried to play soccer.  Despite their best efforts, doctors had failed to correct the deformities.  Billy prayed for him three times, and after the third prayer, the boy said he saw “the hand of God come down” and touch him.  He took a few tentative steps, and his legs became straighter and straighter.  His mother tearfully confirmed that her previously lame son could now walk and run.  The last thing Billy saw as he was driving away from the crusade was the boy running up and down the car park, staring in wonder at his perfectly straight legs.

Same act of prayer, same God, but two contradictory results.  It is a conundrum that has confused the church for centuries.  Why does God answer some prayer with miracles, and why are some prayers for healing seemingly unanswered?  What is the effectiveness of prayer?

There have been some attempts to measure the effects of prayer scientifically.  One of the first published clinical trials of intercessory prayer was a 1988 study by Randolph Byrd.  Almost 400 patients over a period of time were randomized to receive prayer from born-again Christians, while the other half received no prayer.  The results showed a positive outcome for prayer in six of the twenty-nine variables observed.  Unfortunately, the study was plagued by problems in the construction of the trial, and many feel that the positive results were because of study bias, not the prayer itself.

There have been better studies since then.  The “Study of the Therapeutic Effects of Intercessory Prayer” (“STEP”) was a well conducted trial that took 10 years and $US2.4 million.  1800 patients, all admitted to hospital for the same condition, were divided into three groups: one received prayer and knew they were prayed for, another group received prayer without knowing about it, and the last received no prayer.  The prayer was performed by committed Christians experienced in praying for the sick.  The results were not encouraging for intercessory prayer, with the two groups receiving prayer actually having poorer outcomes than those not prayed for.

On the surface this does little to help the dilemma of prayer for healing.  On deeper analysis, there may have been confounding factors.  Those in the control group (without prayer in the study) may have been praying themselves.  Or perhaps the answer to prayer in those studied came outside of the study’s parameters.  Perhaps God wants us to trust in him and his word, the raw power of faith, rather than in the science of a clean-cut clinical study that “proved” the benefits of prayer.  When it comes to the studying of prayer, Christians and clinicians have noted that prayer is not an easily quantifiable substance.  And neither is God for that matter.  When God works supernaturally, he works super-naturally, literally above the laws of nature.  Prayer, then, cannot be studied scientifically since the scientific method relies on observing and controlling variables within the natural order.

In fact, I personally think that God delights in performing miracles that are beyond our reasoning.  The miracles of Jesus provide many good examples – he placed mud, made out of the mixture of dirt and his saliva, onto a blind mans eyes.  He touched lepers.  He told Peter to find tax money in the mouth of a fish.  These sort of miracles perplex yet inspire us.  Scientifically quantifiable or not, they still move us to worship the greatness of God.

How do we find the wisdom to know when to choose medicine or miracle?  Two of Jesus’ miracles come to mind that might shed light on this delicate balance.  The woman with the issue of blood (Luke 8:43-48) had “spent all her living upon physicians, neither could be healed of any.”  She touched Jesus and was healed, and Jesus told her “thy faith hath made thee whole.”  The lame man at the pool of Bethesda (John 5:1-9) waited patiently near the waters edge and tried as best he could to make it into the waters to be healed but was unable to get there by himself.  When Jesus told him to walk, he got up instantly and was healed.

Both stories are of people in need who didn’t wait passively for healing.  Each did whatever was in their power to find healing, and were at the point where their effort was not enough.  The woman pursued Jesus, whereas Jesus came to the man, but in both cases their faith engaged God and they received healing.  I think the same is true in modern day life.  Healing is by the grace of God.  We do nothing to earn it.  But like many things in the kingdom of God, we also need to ask, to seek and to knock.

I understand that my profession as a GP makes me a little biased, but the healing or prevention of many diseases is available simply by following modern medical advice, or by using simple therapies like vaccinations or antibiotics.  For Kara Neumann, the answer to prayer was in the insulin and fluids that doctors would have given her had they been called in time.  Perhaps it’s because we are so used to the benefits of medicine that we do not see immunizations or pharmaceuticals as miracles, or answers to prayer.  But imagine if you could go back in time one hundred years with some of todays basic medicines like penicillin.  You would be able to cure diseases like syphilis or pneumonia, in that time untreatable and fatal, and you would be labelled as a miracle worker.  Modern medicine is miraculous.

But when modern medicine cannot touch a sickness, either because of limited access to medicine or the limits of medical science itself, the “miraculous” can take place.  Like the boy in Ecuador, or the woman with the the issue of blood, physicians could not heal them, but God did, when personal faith touched his power and grace.

It would be absurd to stand outside in a thunderstorm and pray for God to shelter us when we could just walk inside our house.  In the same way, common sense dictates that we thank God for modern medicine and use it appropriately, because it is just as much a gift of God as our houses are.  Medicines sit along side the astounding phenomena of supernatural power that we define as “miraculous.”  And while the power of prayer may not be quantifiable or reproducible like modern pharmaceuticals, it is nevertheless tangible, just like the love of God that has provided them both.

(Originally published in Alive Magazine, June/July 2009)

Autism Series 2013; Part 1 – Why it matters.

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What do you think of when you think about autism?  Is it a TV character like Jake, from Kiefer Sutherland’s recent series ‘Touch’, or perhaps Sheldon from ‘The Big Bang Theory’?  Or is it a movie character like the savant that Dustin Hoffman played in ‘Rain Man’? They are common stereotypes, but they only depict a tiny fraction of the autism that is all around us every day.  Chances are, you would run into people every day who have autism.  Would you be able to pick them?

The current point prevalence rate of autism is given by various international health bodies including the World Health Organization, as one person in a hundred.  With a prevalence of one percent of the population as having autism, you would think it would be better known, better dealt with by teachers, better handled by public officials, better screened and managed by health workers, and better resourced in terms of assistance to families and in terms of research dollars.

But while funding and recognition are important, the greatest impact that the lack of autism awareness has is the human cost.  It is the cost that can’t be measured in terms of dollars, caused by the maligned stigma that having autism brings.

Autism at the less severe end, what used  to be called ‘high functioning’ autism, or what I prefer to classify as (the now unofficial diagnosis of) Aspergers Syndrome, doesn’t make a person look that much different on the outside.  But it makes their behaviour somewhat odd to everyone else.  They have quirks.  They have strange mannerisms.  They have rigid ways of doing things.  They have very narrow interests.  They misread social cues.

“Normal” people don’t like odd.  Especially children.  If you don’t fit in to their particular group-think view of the world, their intolerant tormenting can be merciless and unrelenting.  Some people never grow up though, and many adults with autism can be marginalised by their adult peers. Every barb, joke and isolating experience eroding at the soul of a person with autism until there is nothing left.

This is the most destructive of all. It is death by a thousand insults.

I am writing this series of blogs because I want to help assist in whatever way I can to reduce the ignorance surrounding autism.  There is still so much ignorance out there – simple ignorance because the message is still diffusing through our social networks, and  obstinate ignorance, by people who use pseudoscientific scare mongering to promote their views, or promote bogus treatments for the sole purpose of taking advantage of the desperation of some of those who live with autism.

No matter which form of ignorance is out there, ignorance is ignorance and it does the same damage.  It needs to be stopped.

When I was a little boy, I was odd.  It took me a while before I started talking.  I had an obsession with vacuum cleaners and watches.  I was the misfit, or the loner.  I was incessantly bullied in the latter half of primary school and almost all the way through high school.  I didn’t want to go out and be with large groups of other kids.  My parents made me go to marshall arts training, cub scouts, church groups and school holiday excursions.

I hated those social outings.  I had huge anxiety being in these large groups.  Even when I wasn’t being mocked or belittled, I still felt anxious because I didn’t naturally fit in with the other kids.  The leaders of the group would go out of their way to include me but that had the opposite effect of highlighting how much of a social misfit I was.  The anxiety was disabling when I was in middle high school.

Thankfully I was smart, mainly in maths and science.  Academic achievement was my only positive, so I took refuge in studying.  I graduated in the top percentile in my state, and made it into medical school.  I did a whole medical degree, five years in hospitals including several in subspecialty paediatrics, and a fellowship in General Practice, and another eight years of GP experience, before my son was diagnosed as being on the autistic spectrum.

Despite years of medical training, It’s only been since my son’s diagnosis that I have been realising just how much of my quirky behaviour and social dysfunction was due to the fact that I’m on the spectrum too.  All those years, I thought I was retarded, socially incompetent, a freak.  All those years, I was bullied, harassed and made to think I was stupid, just because I didn’t naturally understand the unspoken social codes , but no one explained them to me.

That’s nearly forty years of living with self-doubt, low self-esteem, low self-confidence, and various mental health issues, because I never knew, because no one else knew, because of ignorance and intolerance.

So it stings when I hear people spread mistruths about ASD, and it pains me when the mistruths are spread by people who should know better.  It makes me mad when the mistruths come from self-titled ‘experts’.

I don’t want my son going through the same stigma and denigration, or anyone else on the spectrum for that matter.  The truth about autism – what it is, what it is caused by, and what strengths autism bestows, need to hold sway so that death by a thousand insults is no longer tolerable in our progressive society.

I will publish further blog posts over the coming days to weeks on what autism is, on why it seems to be increasing, and the latest scientific evidence on what autism may be caused by.  I will devote a whole blog (or two) to the misinformation surrounding vaccines and autism.  So stay tuned.