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Anti-vaccine claims, misrepresentation and free speech

Imagine the following scenarios:

  1. A mother comments on an anti-vaccine Facebook page belonging to a Doctor known for her opposition to vaccines, saying that she is about to travel to a third world country for which the CDC recommends certain vaccines. She asks what vaccines, if any, she should get for her unvaccinated eight-months old. The doctor responds with “none; these countries are perfectly safe, there’s no higher risk there”.
  2. Another mother comments on the same Facebook page saying that a dog bit her daughter. She asks whether she should, in this case, get the rabies vaccine or tetanus vaccines. The doctor recommends against it, deviating from the standard of care.
  3. An anti-vaccine organization publishes an article describing measles as a “mild childhood disease,” potentially beneficial to the immune system and repeating the debunked claim that the MMR vaccine causes autism. It encourages readers not to vaccinate.
  4. An anti-vaccine doctor records a video recommending that citizens in a country that had polio discovered in the sewers avoid getting the Oral Polio Vaccine, as their Ministry of Health recommends. The doctor claims that: 1) Polio is not generally dangerous, and the polio epidemics in the United States were caused by use of DDT, 2) the polio vaccine is more dangerous than polio itself, or 3) vitamin C can prevent or treat polio.
  5. These claims are demonstrably false.
  6. An anti-vaccine site has an article suggesting that tetanus is not usually dangerous and can be prevented by letting wounds bleed and cleaning them with hydrogen peroxide.

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Court says Freedom of Speech applies to Big Pharma Sales Reps

pills and pill bottlesIn a strange decision, the United States 2nd Circuit Court of Appeals, which has jurisdiction over  Connecticut, New York, and Vermont, ruled that a drug sales representative who promotes “off-label” uses of a particular drug is exercising their “freedom of speech.” The Court decided in a 2-1 vote, in United States v. Caronia (pdf), that the criminal conviction of Alfred Caronia, a former sales representative for a pharmaceutical company, be vacated. The case was an appeal of the sales representative’s conviction for promoting an off-label use of the drug Xyrem, which is approved for treatment of narcolepsy. The Court stated that “we construe the FDCA as not criminalizing the simple promotion of a drug’s off-label use because such a construction would raise First Amendment concerns.”

The Court also found that the FDA allows off-label use by physicians, but “prohibits the free flow of information that would inform that outcome,” while “the government’s prohibition of off-label promotion by pharmaceutical manufacturers provides only ineffective or remote support for the government’s purpose.” The Court also ruled that it construes “the misbranding provisions of the FDCA as not prohibiting and criminalizing the truthful off-label promotion of FDA-approved prescription drugs.”  It also stated “that the government cannot prosecute pharmaceutical manufacturers and their representatives under the FDCA for speech promoting the lawful, off-label use of an FDA-approved drug.” Continue reading “Court says Freedom of Speech applies to Big Pharma Sales Reps”

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Supporting a fellow blogger who is being attacked by a homeopath

I follow some Australian skeptics’ blogs, mainly because of Meryl Dorey, the lunatic who runs the Anti-Vaccination movement in Australia.  One of the better ones is Dan’s Journal of Skepticism, run by Dan Buzzard.  He writes on a lot of issues with regards to pseudoscience, mostly in medicine.  Earlier this year, he wrote about how a homeopath, Francine Scrayen, treated her “patient”,  Penelope Dingle, who was suffering from rectal cancer, with homeopathic potions and lotions.  

In the report on Ms. Dingle’s death, the Coroner for Perth (Australia) reported the following:  

In my view the deceased’s rectal cancer was present and causing bleeding and other symptoms from at least 31 October 2001.  During the period 31 October 2001 until at least the end of November 2002, the deceased regularly described the symptoms of her rectal cancer to a homeopath, Francine Scrayen.  It was not until November 2002 that Mrs Scrayen and the deceased discussed the possibility of reporting her rectal bleeding to a medical practitioner and it was not until 5 December 2002 that she first reported those problems to a doctor.

I accept that Mrs Scrayen  believed that the deceased had suffered from haemorrhoids years earlier and the bleeding and pain was “an old symptom coming back”, but a competent health professional would have been alarmed by the developing symptoms and would have strongly advised that appropriate medical investigations be conducted without delay.

Mrs Scrayen was not a competent health professional. I accept that Mrs Scrayen had minimal understanding of relevant health issues, unfortunately that did not prevent her from treating the deceased as a patient.

This case has highlighted the importance of patients suffering from cancer making  informed, sound decisions in relation to their treatment.  In this case the deceased paid a terrible price for poor decision making. 

Unfortunately the deceased was surrounded by misinformation and poor science.  Although her treating surgeon and mainstream general practitioner provided clear and reliable information, she received mixed messages from a number of different sources which caused her to initially delay necessary surgery and ultimately decide not to have surgery until it was too late.

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