Sunday, July 01, 2007

MAD Science: What does autism have in common with silicone breast implants?

There's a column on "True Believers: Why there's no dispelling the myth that vaccines cause autism." that's kind of interesting.

At right, a parody MAD magazine cover by blogger Bev Harp pokes fun at those who believe vaccines cause autism.

If you're not familiar with that controversy, the short version is that there was a contention that a mercury-based preservative (thimerosol) used previously in the Mumps-Measles-Rubella (MMR) vaccine was responsible for making children develop autism.

This past week concluded a 12-day hearing before the US Court of Federal Claims. The hearings largely confirmed the scientific consensus that there's no connection between autism & thimerosol. A story in the Washington Post summarizes thishere.

With the medical literature surrounding mercury poisoning reviewed in the hearing (which has never shown autistic-like effects), the dose are often 100's to 1000's of times higher than what someone would receive in the MMR vaccines. A number of large epidemiological studies have shown no link to either MMR or other thimerosal-containing medicines.

From the article:

People who study irrational beliefs have a variety of ways of explaining why we cling to them. In rational choice theory, what appear to be crazy choices are actually rational, in that they maximize an individual's benefit—or at least make him or her feel good.

Blaming vaccines can promise benefits. Victory in a lawsuit is an obvious one, especially for middle-class parents struggling to care for and educate their unruly and unresponsive kids. Another apparent benefit is the notion, espoused by a network of alternative-medical practitioners and supplement pushers, that if vaccines are the cause, the damage can be repaired, the child made whole. In the homes of autistic children it is not unusual to find cabinets filled with 40 different vitamins and supplements, along with casein-free, gluten-free foods, antibiotics, and other drugs and potions. Each is designed to fix an aspect of the "damage" that vaccines or other "toxins" caused.

In reality, autism has no cure, nor even a clearly defined cause. Science takes its time and often provides no definitive answers. That isn't medicine that's easy to swallow.....Another explanation for the refusal to face facts is what cognitive scientists call confirmation bias.

Systems of belief such as religion and even scientific paradigms can lock their adherents into confirmation biases. And then tidbits of fact or gossip appear over the Internet to shore them up. There's a point of no return beyond which it's very hard to change one's views about an important subject.

Then, too, the material in discussion is highly technical and specialized, and most parents aren't truly able to determine which conclusions are reasonable. So they go with their gut, or the zeitgeist message that it makes more sense to trust the "little guy"—the maverick scientist, the alt-med practitioner—than established medicine and public health. "History tells us that a lot of ground-breaking discoveries are made by mavericks who don't follow the mainstream," says Laidler. "What is often left out is that most of the mavericks are just plain wrong. They laughed at Galileo and Edison, but they also laughed at Bozo the Clown and Don Knotts."
.....Joined together on the Internet, these actors create a climate of opinion that functions as an echo chamber for conspiracy dittoheads.

The activist community in the breast implant debate is an obvious parallel to this. There's tremendously compelling science not confirming their contentions of related illness, but there still exists heart-felt conviction by these women that their breast implants caused their medical conditions.

A whole counter-culture of "implant survivor" support groups and websites have come up and are filled with anecdotes outlining their beliefs. On display are often desperate stories of depression and swapped tales of homeopathic voodoo-like potions to "detoxify" them of silicone, platinum, mold, etc... The reactions on display, like the parents of some autism patients, seek to point the finger at someone who must be responsible for their illness. This may have been a legitimate question in the late 1980's, but we long since know this to not likely be true with silicone or saline breast implants.


Bubbi said...

Hello Dr.,

I followed your post at my blog to yours and want to comment on early breast implants made with silicone.

My mother was convinced until the day she died (april 16/07) that the rupture of her implants and what she saw as silcone running rampant in her body--caused her illness.

First--it was the worst reconstruction surgery I have ever seen. She ended up with 2 hard knots as "boobs" which caused her endless pain. It took her years to find a doc willing to remove them and when they finally did so--there was nothing but the plastic sleeve left.

She went through thousands of dollars trying to get well, only to end up broke and in my care for the last 11 years of her life.
I dont think I have an opinion on this other than ,ruptured implants cant be a good thing!

I have pictures of this mess--and know of many others who where effected.
Do you not see anything to these womans claims?

Dr. Rob Oliver said...

"Early" breast implants are signifigantly distinct from 4th (those used since the early 1990's) or 5th generation (the forthcoming form-stable devices)and suffered from high rates of gel bleed,rupture rates, and capsular contracture.

Silicone doesn't "run rampant" when an implant ruptures and implants with silicone gel fillers have never been shown to correlate with systemic disease when the epidemiology numbers are crunched. The leap from the fact that a person has implants to the conclusion that it was the cause of disease was certainly plausible at one point, but we now believe that is clearly not the case based on the data.

The parallel to the autism-vaccine are obvious. Observational data and emotion combined with traial lawyers looking for the next asbestos gravy train largely drove the controversy in these two related instances.

Bubbi said...

Did you read my post? I did not say the silcone runs rampant but I said it is what my mother believed.

I am sorry but the number of woman effected by this and given the settlements being paid out suggests that silicone clearly caused serious physical problems.

The extent of which may not be know for years. It was not more than 100 yrs ago that RA was dimissed out of hand.