Saturday, June 25, 2005

More on Thimerosal and Autism

Today's New York Times has a major piece on the controversy.

Update 6/26/05: Ted Frank has posted a reaction to the thimerosal coverage, claiming that money from the plaintiffs' bar is behind the thimerosal scare, and quoting a commentator who says that parents' unfounded fears are leading them to refrain from vaccinating their children, contributing to disease "hot spots" across the country. "Remember that," Frank says, "next time you hear the plaintiffs' bar taking credit for safety innovations that have saved lives."

But hold the phone. Even Frank does not contend, in his post, that liability resulting from a spate of unmeritorious thimerosal lawsuits has driven a socially beneficial product from the market. At issue, rather, is a claim that baseless or exaggerated fears have taken root in the general population, presumably as the result of media coverage. Among the principal events thus covered would be a 1999 thimerosal advisory from the American Academy of Pediatrics and the Public Health Service -- organizations not generally regarded, even by "tort reformers," as fronts for the organized plaintiffs' bar.

The Times also reports concern in the public health community over the growing popularity of unproven and potentially dangerous "treatments" being sold to desperate parents as cures for "mercury poisoning." For example, "hundreds of doctors," according to the Times, "have listed their names on a Web site endorsing chelation to treat autism," even though no evidence supports chelation's efficacy in treating autism, and even though chelation is known to carry risks of its own, such as kidney and liver damage.

So let's be clear. Whatever the merits of the thimerosal debate, there have been health scares, and snake oil salesmen, since well before ATLA ever existed. It is understandable that parents of children with this condition, which has been diagnosed in recent years in dramatically increasing numbers, might be looking for answers. It is unfortunate, but still understandable, that some might latch on to causal theories supported (at least for now) less by rigorous scientific evidence than by strong conviction born of desperation and anger. This is a familiar pattern, no doubt exacerbated by the web and the modern 24-hour news cycle -- and also, in this case, by a round of congressional hearings, called by a Republican congressman whose grandson was diagnosed with autism following a round of vaccinations.

But singling out the "plaintiffs' bar" as the primary force responsible for alarmism over thimerosal in the larger polity is (shall we say) something of a stretch. To put that another way, it is a causal ascription that may be supported more by deeply felt conviction than by any rigorous evidence.


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Fed. R. Evid. 702: If scientific, technical, or other specialized knowledge will assist the trier of fact to understand the evidence or to determine a fact in issue, a witness qualified as an expert by knowledge, skill, experience, training, or education, may testify thereto in the form of an opinion or otherwise, if (1) the testimony is based upon sufficient facts or data, (2) the testimony is the product of reliable principles and methods, and (3) the witness has applied the principles and methods reliably to the facts of the case.