health

Anti-Vaccination Advocates on the Front Line of Public Health

I have a confession to make, people. Sometimes I read the comments. And sometimes I even join in.

Earlier today, ABC News posted a news article on their Facebook page regarding Federal Health Minister Peter Dutton’s meeting with his state counterparts to discuss a possible decision to withhold Family Tax Benefit payments from parents who refuse to vaccinate their children, for non-medical reasons. It’s a complicated issue and one that Dr Julie Leask has addressed in the news article itself.

ABC News’ Facebook moderator invited comments from Facebook users on the topic, prompting much discussion, both advocating and opposing vaccination itself, and agreeing with or criticising the proposal to withhold benefits from families who choose not to vaccinate their children. Having a little free time on my hands, I had a look over the comments and made a few myself; predominantly providing rebuttals to anti-vaccination rhetoric and suggesting that people discuss any concerns that they may have about immunisation with a qualified health professional.

Here’s a fairly typical example of the sort of comment that those who oppose vaccination make on such threads:

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Usually I’ll respond to this sort of statement with an explanation of herd immunity, that unimmunised children increase the risk of vaccine preventable diseases entering our community, the importance of protecting children for whom vaccines are medically contraindicated (be it due to medically diagnosed allergy, an immunocompromised state due to cancer therapy or organ transplant, or being too young to yet be immunised), that vaccines aren’t one hundred percent effective (often noting that seatbelts aren’t either, but it’s sensible to take the high level of protection that we can get over none at all).

We’ve got a couple more fallacies here. “Straight up poisons” sounds fairly terrifying, but doesn’t take into account the rigorous testing vaccines go through, nor the doses at which vaccine ingredients are administered. Break down our foodstuffs and you’ll find scary sounding chemicals in many fruits and vegetables in minute amounts; some of which also occur naturally in our own systems.

To suggest that anybody is proposing that parents will be “forced” to immunise children is also disingenuous. The current proposal is to withhold a payment as an incentive, the option to refuse to vaccinate would still be available.

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Earlier, I mentioned that I often suggest to people that if they have concerns about immunisation, they should discuss them with a qualified health professional. Here, Deb has informed us that she is indeed speaking as a health professional.

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In fact, she is a nurse. The sort of person we should reasonably be able to trust for sound advice and information on vaccines. A practitioner of evidence based medicine.

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Here are some odd generalisations regarding lifestyle choices! Thankfully, many parents who ensure that their kids get outside and play and give them… food stuff that is actually food stuff… also choose to vaccinate.

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Which epidemics? Were vaccinations around during these epidemics also?

Sanitation is a marvel for public health, but it is not responsible for the significant lowering of vaccine preventable diseases. More information on this frequently repeated myth from WHO.

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A healthcare practitioner who buys into the “Big Pharma” business?

It troubles me. Out of curiosity, and using publicly available data, I found Deb’s LinkedIn profile. Her name (she uses a pseudonym on Facebook, but her Facebook URL contained her surname), photo and job description matched, so I am quite confident that I’ve identified her correctly. She works as a clinical nurse in what she describes as a “large, busy, Metro ED Department”.

Her refusal to have the influenza vaccine leaves her prone to contracting it… and working in an emergency department, she is likely to have a high risk of exposure to the virus. If she is at work while contagious, there’s potential for her to pass it on to some very ill and vulnerable patients under her care.

What is also deeply disturbing to me though, is that somebody on the front line of public health – in a position of authority on healthcare – would hold views that so strongly reject many tenets of evidence based medicine. We should be able to trust clinical nurses to know better.

 

 

19:20 – 12/04/2014 Edited to add: Two more of Deb’s posts on the ABC News thread, presented without comment.

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Although the discussion on ABC News’ Facebook page is a public one and Deb uses a pseudonym, I have chosen to pixelate her photograph and surname for this post, as I am noting her as an example of a health professional who espouses anti-vaccination views, rather than an individual to be exposed.

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End of Year Detox – Free Gift Included!

With the end of the year upon us, many of us are feeling the effects of celebratory excesses. The traditional over-indulgence in alcohol and rich foods which can accompany the festive season can leave one feeling somewhat under the weather, particularly when combined with rushing about preparing for parties, attending gatherings of family and friends, and shopping. Tired and flat, the appeal of a New Year’s resolution to improve our health and fitness is understandably rather alluring to many. Gather round ye, ’tis the season for detox!

With the myriad advertisements for detox kits, cleansing diets, “superfood” secrets and liver supporting supplements appearing in health food store windows, on social media and on television, the detox industry is big business. Unfortunately, it’s a business that is built on a falsehood… our bodies are quite capable of “detoxing” themselves.

Unless an individual is suffering liver, kidney or lymphatic system malfunction, or has overdosed on a poisonous substance (both of which should be investigated and treated by a medical professional), our bodies are perfectly capable of filtering and removing waste products from our own systems. The best things that we can do to support these systems (and feel well in the process) are to eat a healthy and balanced diet, remain hydrated, be active and get sufficient sleep. No detox product can either take the place of basic self care, nor improve the body’s ability to look after itself.

So while the detox industry tries to sell you products or secrets this season, I would like to give you something for free. Admittedly, it’s just a somewhat daggy graphic to share – but my hope is that perhaps it may cause someone out there to think twice before investing their money and faith in detox products that are completely unnecessary.

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This was adapted from a tweet I sent to Dr Karl a last week, in response to somebody asking him about detoxing. It amassed a fair few retweets, so I figured that it was a message that people wanted to communicate – I know that I certainly do. And yes, his “billions” amendment is correct!

In this graphic, I also wanted to stress that should somebody have concerns about their health or lifestyle, I would urge them to speak with a qualified health professional. Regarding dietary issues, a dietitian is the most appropriate health professional to provide evidence-based assessment and advice – qualifications in dietetics are much more tightly regulated than those of nutritionists. Here’s a clear summary of the difference between dietitians and nutritionists via the Dietitians Association of Australia.

For more in-depth information on detoxification, visit Sense About Science – Debunking Detox, Science-Based Pharmacy – The Detox Delusion and Science-Based Medicine – The Science of Purging or the Purging of Science?

On a personal note, I would like to take this opportunity to wish you all the best, whatever you celebrate (or don’t) at this time of the year.

The last couple of months have been busy but fulfilling ones for me; the rush of finishing my studies and sitting exams was punctuated by my first skeptics convention unfortunately said punctuation was a pair of brackets rather than a full stop – getting home and back to exam revision was a challenge. I’ve also celebrated the festive season with two curious preschoolers, my four year old son and two year old daughter both simultaneously hitting the “Why?” phase, which I admit I’m reveling in. A nerd parent moment was had last week when my son finally asked me why the ocean was blue – I adore asking the kids about their hypotheses and looking up information with them.

As an aspiring science communicator and advocate, several months ago I set myself a challenge to overcome my shyness and discomfort with verbal communication, be it recorded or with a live audience. Quite unexpectedly, at the Australian Skeptics National Convention, interviewer extraordinaire for The Skeptic Zone PodcastMaynard confronted me with a microphone and an array of questions – if you’re curious to hear my babbling, I make brief appearances on The Skeptic Zone #270 and #271. I don’t feel that it went too badly and have resolved to follow through with some podcast related plans for 2014. I also plan to continue working my way through my science degree – I have especially enjoyed my biology units over the past year and am looking forward to introductory epidemiology and infectious disease units when I hit the books again in late February.

During my break from uni, I hope to get a few posts written here – I have a couple of topics simmering away in the back of my mind. Comments and feedback on this blog are always welcome and if you’re so inclined, you can find me on Twitter at @joalabaster.

Thank you for being with me this year, here’s to a fascinating 2014!

Anti-Abortion Protesters and Breast Cancer Lies in Melbourne.

I am currently staying in Melbourne to attend laboratory classes and have been catching the tram in to the city morning and afternoon to get to university. A couple of mornings ago as I was looking out the window, I noticed some anti-abortion picketers with banners and signs standing at either side of the gates to the Fertility Control Clinic in East Melbourne. They were displaying signs decorated with the pink ribbon symbol and slogans claiming that abortion increases women’s risk of developing breast cancer. On my way home, I was prepared to disembark from my tram so that I could take a photograph of the banners that the picketers had set up and ask them a few questions on where they were obtaining data to support their claim, but when I passed the fertility clinic, I saw that they had gone. They were not present when I went past the next day either.

I wish to note that as disagreeable as I find the distressing messages voiced by anti-abortion picketers, I am an advocate for freedom of speech and I do not want to take away their ability to peacefully state their views; though I do appreciate the argument for exclusion zones around abortion clinic gates and would proudly volunteer to be an escort for women who use the clinic’s services, given the appropriate training.

What I do very much object to though, is when they – or anyone, for that matter – tell lies about health risks in order to scare people in to doing as they wish.

There is no credible evidence to support the claim that having an abortion or experiencing miscarriage increases the risk that a woman will develop breast cancer. When I first saw the protesters this morning and tweeted about their appropriation of the pink ribbon symbol, @danientifically (who I recommend you follow if you enjoy tweets from reasoned, compassionate people with a fine sense of humour) asked the Cancer Council Australia how they felt about it. They kindly responded with this link, which contains a brief run down of credible information regarding the myth of a link between abortion and increased risk of breast cancer.

Having had time to look into it since, I’ve found that anti-abortion protesters have been using this myth for quite some time – and as such, there is much literature citing evidence which refutes their claim. From the American Cancer Society:

In February 2003, the US National Cancer Institute (NCI) held a workshop of more than 100 of the world’s leading experts who study pregnancy and breast cancer risk. The experts reviewed human and animal studies that looked at the link between pregnancy and breast cancer risk, including studies of induced and spontaneous abortions. Some of their findings were:

  • Breast cancer risk is increased for a short time after a full-term pregnancy (that is, a pregnancy that results in the birth of a living child).
  • Induced abortion is not linked to an increase in breast cancer risk.
  • Spontaneous abortion is not linked to an increase in breast cancer risk.

The level of scientific evidence for these findings was considered to be “well established” (the highest level).

The American College of Obstetricians and Gynecologists (ACOG) Committee on Gynecologic Practice also reviewed the available evidence in 2003 and again in 2009. ACOG published its most recent findings in June 2009. At that time, the Committee said, “Early studies of the relationship between prior induced abortion and breast cancer risk were methodologically flawed. More rigorous recent studies demonstrate no causal relationship between induced abortion and a subsequent increase in breast cancer risk.”

In 2004, the Collaborative Group on Hormonal Factors in Breast Cancer, based out of Oxford University in England, put together the results from 53 separate studies done in 16 different countries. These studies included about 83,000 women with breast cancer. After combining and reviewing the results from these studies, the researchers concluded that “the totality of worldwide epidemiological evidence indicates that pregnancies ending as either spontaneous or induced abortions do not have adverse effects on women’s subsequent risk of developing breast cancer.” These experts did not find that abortions (either induced or spontaneous) cause a higher breast cancer risk.

The picketers’ stance against abortion is presumably a moral one, at times supported by religious belief, and I’m sure that they have moral arguments that they feel they can back up their position with. Certainly, moral positions can (and in my frank opinion, should) be backed up with fact – but when the fact being used is a blatant falsehood, I am very much compelled to call that out. Especially when those falsehoods are being used to distress people who may be feeling vulnerable.

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As a person who is strongly pro-choice and an advocate for bodily autonomy, it can be very easy to demonise anti-abortion picketers – especially given the outcomes of their protests; both the harm they cause individuals and the political influence that they hold. The use of graphic images disgusts me, harassment and attacks on both women seeking abortion and abortion providers should be dealt with strongly via the legal system. Something I try to keep in mind when I see them however, is that they genuinely do believe that their view is right – that they are fighting to save the lives of vulnerable beings. Alongside anti-vaccination campaigners who truly believe that vaccines are harming children, and religious prosthelytisers who honestly hope to save our souls from eternal damnation, the majority of anti-abortionists do believe that they are trying to stop a terrible and unjust harm that occurs within our society. It is rare that a passionate campaigner for a cause does so to do evil.

As such, I suspect that it is entirely possible that some anti-abortionists may know that the abortion/breast cancer myth is a falsehood. When I discussed my thoughts on the matter with Felix (who lacks a Twitter account for me to link to), he relayed to me an experience he had years ago, when a friend was trying to convert him to Christianity. Felix went and had a discussion with his friend’s minister and questioned the minister’s claims that homosexuality presented dangers to people’s health. When confronted with somebody willing to question the credibility of his claims, the minister actually outright admitted that they were false, but he felt that telling a lie was an acceptable and minor wrong when looking at the bigger picture; the fate of a person’s eternal soul. Likewise, perhaps some anti-abortionists realise that their claim regarding breast cancer is less than credible, but feel that it is justifiable to use it as a scare tactic in the hope of preventing women from having abortions.

It is a complex situation and I do not believe that I have the requisite knowledge or skills to have a productive conversation with anti-abortion protesters and be able to convince them that their claims regarding breast cancer are scientifically unsound and can not be ethically employed as a part of their argument. However, what I am capable of to a degree is publicly stating that their claim regarding abortion and increased breast cancer risk is incorrect – and in publicising that they are perpetrating a falsehood, I hope that anybody who has been misled by anti-abortion propaganda on this topic can be assured that it is an outright lie.

NB: I have chosen to use the term “anti-abortion” to describe what is also referred to as the “pro-life” movement, as I consider it to be a more accurate descriptor. 

Further reading:

Breast Cancer Risk Factors – A Review of the Evidence Cancer Australia

Is Abortion Linked to Breast Cancer?American Cancer Society

Abortion – Breast Cancer Hypothesis – Wikipedia

The Truth About Abortions and Breast Cancer – Cosmopolitan Magazine

The (soon to be) Network Formerly Known as the AVN

Just before midnight last Friday night (the 14th of December, 2012), some rather fantastic news broke.

New South Wales Fair Trading (a state government department) had that day issued Meryl Dorey, president of the Australian Vaccination Network, with a letter stating that after investigating several complaints made to the department regarding the misleading nature of the AVN’s name, it is the Commissioner’s opinion that the use of the name ‘Australian Vaccination Network’ by a group of anti-vaccinationists is against the public interest. The Commissioner then directed the AVN to change its name. The AVN have been given until the 21st of February 2013 to lodge an application for registration of change of name. If this is not done, the department may cancel the AVN’s registration, close the AVN down and seize their assets.

The full letter is available here. Thank you to Meryl Dorey for making it available to the public.

Several newspapers have run with this story, news.com.au gave us “Anti-vaccine group ordered to change name”, which the Herald Sun ran as “Minister orders anti-vaccination group to change name”, with added quotes from the president of the AMA, while The Daily Telegraph ran the truncated “Anti-jabs lobbyists warned”. A few highlights:

NSW Fair Trading Minister Anthony Roberts fired a broadside at the AVN, saying the information it provided was a public safety issue of “life and death”.

“This is not a victimless issue, it’s about the ability to stop pain and suffering,” he said.

Mr Roberts likened the AVN’s message to sanctioning speeding.

“People do not have the freedom of choice when it comes to endangering others … it’s the equivalent of saying a bloke can speed down the road and endanger others,” he said.

Mr Roberts said he was prepared for any appeals the AVN might make.

“This is an order, it is not a request,” he said.

“The Australian Vaccination Network does not present a balanced case for vaccination, does not present medical evidence to back up its claims and therefore poses a serious risk of misleading the community,” Mr Roberts said in a statement.

NSW Fair Trading Assistant Commissioner for Compliance and Enforcement Robert Vellar says the AVN’s name had misled parents seeking information.

“People are being confused about the true nature of the information they are being provided on the AVN website, the name is misleading,” he said.

The Northern Star, which is the local paper of the Northern Rivers region of New South Wales (which covers the town from which Meryl Dorey runs the AVN), published “Anti-vaccine group must change ‘misleading’ name. This article contains an unusual point worth noting – they attempted to contact Meryl Dorey for a statement, but she did not return their calls. Given Meryl Dorey’s usual eagerness to engage with the media, this is a strange event indeed.

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Here is the cover sheet which will be greeting Meryl at her local newsagency this week.
Many thanks to Alison Gaylard and her friend for snapping a photo and sharing it.

Unsurprisingly, Meryl Dorey has reacted quite strongly to the letter from the NSW Fair Trading and subsequent media attention. She published a lengthy post on her blog in response, entitled “Government puts the boot into the AVN, Democracy and the Truth”.

I do not have the time to review the entire post, but some highlights include:

The Department’s open cooperation with the AMA is analogous to them responding to complaints by mining companies about Greenpeace’s name. After all, Greenpeace is not green, nor do they go around looking for peace, therefore, would the Department tell them to change their name too? How about the Cancer Council? Couldn’t someone be misled into thinking that they are FOR cancer? And the Department of Health? Don’t get me started! The Department of Ill-Health would be more accurate in my opinion.

Greenpeace is not green. Say it with me, “Greenpeace is not green”.

A wonderfully skilled wordsmith of my acquaintance, Shellity, has written a poem in response to the above quote of Meryl’s, I heartily suggest you give it (and the rest of her blog) a read: “Nominal”.

As for the statement regarding the Cancer Council, no Meryl, it is highly unlikely that anybody could be led to believe that the Cancer Council were pro-cancer. It is a reasonable assumption though, they they are an authority on the subject and that they provide trustworthy evidence-based information regarding cancer. The same cannot be said for the Australian Vaccination Network with regards to the topic of vaccination.

Later in the blog post, when discussing NSW Fair Trading, Meryl quips that they “might consider changing that name because at least in the present situation, it is extremely misleading!”. I assume that this is a little Merylese bon mot, but it is hard to be certain.

Several paragraphs on is another statement I that would like to address.

Blog overlap

The letter from the Department was handed to my daughter at approximately 11:45 AM and the first article appeared in the Australian media approximately 10 hours ago. But Skeptic blogs started to announce this information approximately one hour before the media did. How do you think they came by this information? I really do wonder. Is there a direct line of communication between the Australian Skeptics, Stop the AVN (SAVN) and government departments? There is a long and open history of collusion between media outlets and various ‘skeptics’ so it is not impossible that they heard about this letter before the AVN had even received it. Is this collusion one of the reasons why these departments have been ‘putting the boot’ into us for the last 4 years at an apparent cost of millions of dollars to the taxpayer? Is the fact that many SAVN members are actually employed by government departments – and use their government email addresses when writing about the AVN and wanting to close us down – cause for concern? I will leave those questions with you to ponder.

Going by the time on the blog post announcement on the AVN’s Facebook page, 11:40am on Saturday the 15th of December (the post itself has no timestamp), the “approximately 10 hours ago” statement refers to 1:40am the same day.

I was online when the news broke, it first hit Twitter at 11:29pm on Friday evening. This linked to a paywalled version of the Herald Sun article, “Minister orders anti-vaccination group to change its name”, which refers to the 14th of December as ‘yesterday’ and is dated 12:00AM, December 15, 2012, but evidently went live at least half an hour before midnight.

The skeptic (I find the dramatic quotes quite unnecessary) bloggers who wrote posts about the news did so over the next hour; there’s a satirical piece by Dave The Happy Singer titled “Meryl Dorey to rename the Australian Vaccination Network Stop Stop The AVN” (posted at 12:26am Saturday) and a rightfully pleased announcement from Peter Bowditch on The Millenium Project on Ratbags.Com (posted 1:15am Saturday).

Kate from Stop the AVN has made a timeline graphic here, which helps clarify.

Both Dave and Peter’s blog posts refer to the article on the Herald Sun, which went online almost an hour before Dave’s post was made, giving both bloggers adequate time to write and publish. More to the point, both blog posts directly refer to the Herald Sun article and contain no information that is not included in the newspaper article.

Where then is Meryl getting the idea that skeptic bloggers had the information before the media published it? And is it then reasonable that she extrapolate from this the notion that the Australian Skeptics, SAVN and ‘government departments’ are illicitly sharing information and that the media is also in on the act? It’s a long and rather conspiracy-laden shot, Ms Dorey.

On the subject of unsubstantiated finger pointing, the AVN’s website went down on Sunday and this was the announcement:

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(The “View all 8 comments link doesn’t reveal further comments when clicked on, three have been deleted – original post here)

Fortunately, the SAVN admins are people of many talents. Here, Dave Singer outlines why it is inaccurate to blame the AVN’s website problem on a DDOS attack:

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(Original post and subsequent discussion here)

So what next for the AVN from here? I see four options, for them to change their name and complete the appropriate paperwork with all relevant authorities that that would entail, for them to continue with their current name and face being forcibly shut down by NSW Fair Trading, for them to disband in an act of grand martyrdom and for Meryl Dorey to lay low for a while or for them to apply for a right of review of the department’s direction with the Administrative Decisions Tribunal.

Either way, we live in interesting times and I am quite curious to see which direction this will progress in.

Further Reading (and some listening and watching):

Anti-Vac group told to change name – Tracey Spicer and Tim Webster on 2UE Radio discuss the NSW Department of Fair Trade’s decision with phone in guest Anthony Roberts, the Minister for Fair Trade (who is rather critical of the anti-vaccination movement and refers to groups such as the AVN as “nut jobs”). Audio available, I will link to a transcript if I see one about.

AVN ordered to change its name – An article on Australian Doctor’s website (professional credentials and login required to view full article).

Australian Vaccination Network ordered to change it’s name – The media release from the Minister for Fair Trading’s office, also published here on the Australian Healthcare and Hospitals Association’s website.

The AVN Asks – What’s in a Name? – The AVN’s official media release on the department’s direction. I’ll be sure to add links to any news services who run with the story.

AVN’s Meryl Dorey orders NSW Fair Trading to change its name – Another blog post from Dave the Happy Singer

NSW Government orders the AVN the change their name or face closure – A blog post on the Skeptics’ Book of Pooh Pooh

Panellists on ABC’s current events panel show The Drum discuss the AVN in a less than impressed manner. Thank you to Anne Blake for uploading the video.

Anti-vaccination network told to change its name or be shut down – An article on The Conversation by Rachael Dunlop

And now for some Jimmy Rustling of a different kind – And a blog post by landlockedseaotter

David Penberthy: Anti-vaccine set forced to fess up – An opinion piece by David Penberthy appearing in Adelaide Now endorsing NSW Fair Trading’s direction.

AVN – NSW Fair Trading Orders Name Change – Christine Bayne of Diluted Thinking has put together a brilliant run down of the correspondence between the AVN and NSW Fair Trading and the potential liabilities faced by AVN committee members.

I would like to note a special thanks to everyone over at Stop the Australian (anti)Vaccination Network, especially those who have been posting links and information as they’ve come across them. I have been a little overwhelmed recently, trying to work out how to balance university, parenting and getting enough sleep, so my participation and this blog (and the housework) have fallen by the wayside somewhat. I am hoping that after the holiday season is done, I will be able to rest and find the resources to put more time into both SAVN and writing.

If you are interested in supporting SAVN, you are very much welcome to like their Facebook page. SAVN also uses the hash tag #StopAVN on Twitter.

[Edit] 1:45pm 19/12/2012: Added links to the piece in The Conversation and landlockedseaotter’s post to the Further Reading section.

[Edit] 12:00pm 21/12/2012: Added links to David Penberthy’s article in Adelaide Now and Christine Bayne’s post at Diluted thinking to the Further Reading section.

Don’t Ask the AVN, Take Your Child to a Hospital

Today, there has been another instance of an adult concerned for a child’s wellbeing asking the AVN for advice – not a parent this time, but an aunt – and the AVN not issuing an appropriate recommendation to have the child assessed by medical professionals.

It began with this post, from Robert Catalano, who proclaims to be the President of the American Natural Healthcare Society and has authored a book titled, “The Great White Hoax, The Suppressed Truth About the Pharmaceutical Industry, American Freedom vs, Medical Power”. It appears that Robert’s description of himself as an “anti-medicine activist” is one of the few and far between moments of accuracy he experiences in his writing. Judging by this extract (and I cannot imagine how the omitted text could possibly redeem what is written here), his book is a conspiracy heavy diatribe of pure bulldust, as is this post:

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The AVN seem to be allowing a little more disagreement to be visible on their Facebook page than usual at the moment. A discussion ensued, with the AVN supporting Robert’s claims and trying to promote a book that is sold on the AVN’s website, “Diabetes Without Drugs” by Suzy Cohen.

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The uncensored conversation didn’t last long though – the next comment, in which the author suggests that Robert may not be as well informed about diabetes as he claims to be (and includes a copy-paste of accurate information), was made by one of the AVN’s own courageous anonymous admins, CP. It has since been deleted.

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Next though, was the sort of comment which makes my blood run cold (in a metaphorical sense, on the off chance that somebody thinks I’m having a dreadful reaction to the aspartame that was in a cola I drunk yesterday). It filled me with dread, in any case.

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Again, an adult responsible for a child who is described as being unwell, asking for advice on the AVN’s page.

By this point, Robert is no longer participating in the conversation. Several conscientious and sensible commenters rightly urge Jess W to get her nephew to a hospital. The AVN admin (who is not identifying him or herself at this point) ignores Jess’ comment and instead opts to debate the legitimacy of natural diabetes management and cures with Hayley A.

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Jess W returns with a direct question to the AVN. The AVN admin’s reply admonishes her for not having the time to learn about ways to help a 4 year old child and suggesting that Jess’ priorities are not in the right place, completely overlooking the fact that Jess has stated that her nephew is very unwell, difficult to rouse and has an extremely high blood sugar level reading.

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This is the time to be telling Jess W to call an ambulance immediately, not tell her off for not handing over $35, waiting for the AVN to ship the book to her (given their poor performance in delivering their magazine, “Living Wisdom”, which their subscribers pay for, there’s no precedence set for the book to arrive promptly) and reading 432 pages on the dietary management of Type 2 diabetes.

What Jess W is describing needs to be diagnosed by a professional in a clinical assessment – if it is indeed diabetes, it is extremely improbable that a four year old would be facing Type 2. Type 1 diabetes cannot be cured, nor can it be managed through diet alone. Fastidious monitoring of blood glucose levels and administration of insulin are required in order to avoid the person with diabetes developing ketoacidosis, a life threatening condition. From Diabetes Australia’s website:

Ketoacidosis is a serious condition associated with illness or very high blood glucose levels in type 1 diabetes. It develops gradually over hours or days. It is a sign of insufficient insulin.  Most cases of ketoacidosis occur in people with type 1, it very rarely occurs in people with type 2.

Without enough insulin, the body’s cells cannot use glucose for energy. To make up for this, the body begins to burn fat for energy instead. This leads to accumulation of dangerous chemical substances in the blood called ketones, which also appear in the urine.

This is a serious medical emergency and can be life threatening if not treated properly. If these symptoms are present, contact your doctor or go to hospital immediately.

It is also worth noting that “Diabetes Without Drugs” (preview viewable here) contains Quack Miranda Warnings both on the inside cover and on page xii of the introduction, urging readers not to act on the advice contained within without consulting their doctor.

Back to the comment thread, the AVN admin remains anonymous, accuses Hayley A of rejecting the suggestion that diabetes is naturally curable merely because that suggestion is coming from the AVN and then links several YouTube videos to bolster their claims.

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I am not certain what the now missing comment from Karam S was that the AVN admin is replying to in the last comment – I’m vigilant with the screencapping, but I did spend some time taking my kids swimming this afternoon.

Update: The helpful and vigilant Dr Rachael Dunlop has supplied the missing puzzle piece, which is indeed quite puzzling in itself:

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I will admit at this point that I was having doubts as to whether Jess W’s claims were authentic. Not enough to feel that her comments didn’t warrant attention and reasonable responses, but I did entertain the possibility that she was somebody out to demonstrate that the AVN, (who I will remind you now are recognised as a health care provider by the HCCC), provide unconscionable and dangerous advice and misinformation to those who believe them to be a credible source of information.

Thankfully, mine (and many others’) suspicions were found to be within reason. Jess W appeared on SAVN’s Facebook page, knowingly breaking her own ruse to reassure us that there was no sick child whose caregivers were relying on the AVN for advice.

I would like to note that before this afternoon’s events, Jess W was not known to me, nor to any other people involved with SAVN that I saw discussing the matter in public. To the best of my knowledge, she acted independently.

Meryl Dorey posted this when she discovered that Jess W’s story was not real:

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(Pardon the confusing timestamps, Craig D’s comment was, unsurprisingly, deleted)

Note that Meryl’s confusing disclaimer has made an appearance again.

The second comment from an AVN admin is unattributed, so I assume that it came from one of the other admins of the AVN’s Facebook page. To the best of my knowledge, there are four or five admins other than Meryl, who go by the monikers RR, B52, SB, CP and the recently appeared B9. While I support the right of internet users to anonymity and pseudonymity, I find it disturbing that people speaking on behalf of a recognised health care provider do so without declaring their credentials and affiliations.

SAVN admin Kate has posted an open letter to the anonymous AVN admin who made the second comment on the screencap above. Please take a moment to read it here.

As always, there is much considered and varied commentary on today’s events on Stop the Australian (Anti-)Vaccination Network’s Facebook page.

The thread on the AVN’s page has disappeared and reappeared. At the time of writing, it is viewable (and still being commented on) here.

The ethics of Jess W’s conduct are certainly questionable. She did perpetrate a hoax which played with my emotions very effectively and caused me some anxiety. I spent this afternoon imagining a boy of four, much like my own beloved son, listless and unresponsive while his family made the dreadful mistake of seeking advice from the AVN instead of taking him immediately to a hospital. It made me feel ill with worry, helpless and incredibly sad – and I’m sure many others felt similarly, just as we’ve felt reading about the unvaccinated baby exposed to whooping cough and the young boy suspected to have measles whose mothers also recently posted on the AVN’s Facebook page seeking help. I, personally, cannot condone Jess W’s actions, nor endorse such tactics. While they were effective in demonstrating the AVN’s response to a caregiver of a sick child, I do not feel that the lie was worth the outcome. Conversely, I am still finding myself thankful that the AVN’s response wasn’t being demonstrated with a real child’s life at risk.

While thankfully this sick young boy did not exist, he could have. Even if the AVN admins had their suspicions that Jess W’s story was not true, was it really worth ignoring then admonishing her if there was even a tiny chance that a child’s life was at risk? Why did the AVN admins cling so tightly to their need to dispense anti-medicine tropes and keep toeing the party line when they were clearly out of their depth? Why did they refuse to urge Jess W to get her nephew to a hospital?

He could have been real and this could have been tragic. I am terrified that the next time someone comes to the AVN for advice on an ill child, it will be.

The AVN do not deserve the responsibility that they are trying to shoulder. Likewise, trusting parents who are seeking health advice for their children do not deserve the dangerous lies of the AVN.

Previously on this topic:

Don’t Ask the AVN, See your GP

The AVN Issues a Quack Miranda Warning

Further reading:

The day the AVN thoroughly rustled my Jimmies by landlockedseaotter, a great blog post on today’s events which further addresses the claims made by Robert Catalano and the AVN about diabetes cure and management (as well as the AVN’s behaviour).

The AVN Issues a Quack Miranda Warning

At the beginning of this month, I wrote about two instances I’d observed where the Australian (Anti)Vaccination Network provided advice to parents who came to them asking what to do in cases of suspected vaccine preventable disease or exposure to vaccine preventable disease. You can read the blog post here.

When these posts appeared on the AVN’s Facebook wall, there was discussion on Stop the Australian (Anti)Vaccination Network’s Facebook wall regarding the legality of the AVN providing medical advice. Some participants in this discussion stated that they were considering submitting complaints to the New South Wales Health Care Complaints Commission.

Complaints to the HCCC (and to the New South Wales Office of Liquor, Gambling and Racing, who deal with granting fund raising licences) have been submitted in the past by both persons associated with SAVN and others. The most notable complaint thus far led to a hearing in the Supreme Court of New South Wales, in which the HCCC was found to be unable to issue a public health warning against the AVN or require them to place a disclaimer on their website due to a loophole in the legislation. A clear summary of what occurred can be found in this article by Rick Morton on Mamamia. While the outcome of the court case was a great disappointment for those who feel that the AVN should be accountable for the misinformation they spread, we are a persistent lot and I look forward to eventually reporting some very good news as a result of the efforts of my esteemed colleagues.

Understandably, the AVN’s president does not like these complaints. She incorrectly labels them as ‘vexatious’ (these complaints are not intended to cause annoyance, they are intended to assist government bodies reduce the danger the AVN presents), feels that we waste the time and resources of governmental bodies (who exist to deal with precisely what is being submitted) and considers complaints regarding the AVN to be a form of personal abuse and harassment.

After learning that she was facing another round of complaint submissions following SAVN noticing that she was providing dangerous medical advice to parents, Meryl Dorey issued the following announcement on the AVN’s Facebook page.

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The disclaimer here is equivalent to a Quack Miranda Warning, being a statement issued by charlatans to avoid legal action should anyone believe what they have to say or purchase what they are selling. A typical Quack Miranda Warning from the US reads:

“These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.”

Similarly, Meryl’s disclaimer above attempts to absolve her of any responsibility for what she (or others speaking for the AVN) are saying.

Phil Kent on SAVN’s page paraphrased it wonderfully, stating that:

“The pseudoscience I promote personally and as the president and spokesperson of my organisation do not represent my personal views and opinions or those of the organisation I represent.”

It would be interesting to hear the opinion of an expert in law as to whether Meryl’s disclaimer is actually sufficient to provide her or the AVN with any legal protection, given the high standard of conduct expected of an HCCC recognised Health Care Provider.

When I first read Meryl’s announcement about her disclaimer, I wondered whether she was being at all wise in calling people who believed that she was giving advice (rather than ‘sharing information’) “stupid”, given that she may well have been insulting those who will eventually be making decisions regarding the AVN’s future (not to mention the number of esteemed folk who contacted me after I wrote about the AVN’s advice giving, aghast and appalled that they were doing such a thing).

Calling complainants “bastards” did not strike me as wise either, though the potential repercussions may be more substantial than I initially thought, given Section 98 of the 1993 Health Care Complaints Act, which states,

98 Offence: intimidation or bribery of complainants

(1) A person who, by threat, intimidation or inducement, persuades or attempts to persuade another person:

(a) not to make a complaint to the Commission or a professional council or not to continue with a complaint made to the Commission or a professional council, or

             (b) not to have discussions with, or take part in proceedings before, the Commission or a professional council concerning a complaint or a matter that could become the subject of a complaint,

is guilty of an offence.

(2) A person who refuses to employ or dismisses another person, subjects another person to any detriment, or harasses another person, because the other person:

(a) intends to make a complaint, has made a complaint, or has had a complaint made on his or her behalf or otherwise concerning him or her, to the Commission or a professional council, or

(b) intends to take part, is taking part, or has taken part in any discussions with, or proceedings before, the Commission or a professional council concerning a complaint or a matter which could become the subject of a complaint,

is guilty of an offence.

A (since banned and deleted) SAVN commenter on the AVN’s Facebook page questioned whether Meryl was calling complainants “bastards”. Her reply:

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“I wasn’t referring to complainants – I was referring to people on your page who”… “file vexatious complaints”.

Indeed.

The full thread is viewable here, including obligatory cries of ‘sheeple’ and many deleted comments.

Back to the HCCC case that went to the NSW Supreme Court that I mentioned earlier, where the HCCC was found to be unable to demand that the AVN place a disclaimer on their website. That disclaimer is as follows:

1. The Australian Vaccination Network’s purpose is to provide information against vaccination in order to balance what it believes is the substantial amount of pro-vaccination information available elsewhere.

2. The information provided should not be read as medical advice; and

3. The decision about whether or not to vaccinate should be made in consultation with a health care provider.

The AVN put a lot of effort and money in to challenging the HCCC in the Supreme Court. Aside from the acknowledgement that the AVN is anti-vaccination (they prefer to frame themselves as being ‘pro-choice’ and in turn highly inaccurately claim that their critics are ‘anti-choice’), the AVN’s self-imposed disclaimer covers all ground that the HCCC’s disclaimer did… and it is now being attached to each of the AVN’s blog posts and relevant Facebook comments.

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It’s a small victory, but I’m counting it as a win. I’m sure that there are many more to come.

Further Reading:

Quack Miranda Warning – Rationalwiki

The AVN’s Hypocritical Culture of Censorship

Last weekend I was reading through some comments on the Australian Vaccination Network’s blog (here), when I noticed the following comment from Meryl Dorey in response to somebody expressing frustration with the difficulty they’ve experienced when trying to engage in a discussion on the AVN’s blog.

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“Comments are only withheld if they are abusive, harassing or for reasons such as those.”

This has not been my experience when I have tried to enter into discourse with others commenting on the AVN’s blog.

Initially, I thought that perhaps Meryl had a policy of not allowing me to comment because she finds what I say here, on Stop the Australian (Anti)Vaccination Network’s Facebook page and on Twitter objectionable.

A few weeks ago, Meryl posted a blog entry titled “Hate, Threats and Cowardice”, in which she attempted to link anonymous abusive emails she had received to SAVN. Despite my expectation that it would be removed, I decided to have a go at posting a short comment questioning whether Meryl’s assertion that you can judge somebody by the company they keep could also be applied to the AVN (who keep some rather dubious company – AIDS deniers, hateful homophobes who attempt to incite violence, those who harass grieving families [1, 2] and the reprehensible Erwin Alber to name but a few).

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To my surprise, not only did Meryl let my comment past moderation, she replied! Frankly, I was pleased – I spend a lot of time reading what the AVN have to say without any means by which to engage, question or ask for clarification. I’m also quite keen on understanding what makes Meryl and her supporters tick and engaging in discussion with them gives me a greater opportunity to do so than just watching from the sidelines.

Encouraged, I replied to another commenter:

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And also to Meryl:

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Alas, neither of these comments were approved for publication.

I have been trying to work out why these two comments were deemed unacceptable. This is why I was most interested when Meryl posted her statement last weekend on her moderation policy. I asked her if she could further clarify her terms, to give me the best possible chance of respectfully engaging with her and her supporters:

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I understand that Meryl was away on a seminar in Canberra last weekend, so I have waited patiently for her return to see whether she would reply to me. It has been almost a week now and I know that she has been online attending to AVN business, as she has posted on the AVN’s Facebook wall. I sent her a polite message on Twitter earlier today letting her know that I was hoping to hear from her and asking whether I should expect a response:

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So far, nothing. I will update this post if my comment is removed from limbo and either published and responded to or deleted.

Update: My comment was approved and replied to just before 9am the morning after I published this blog post (17/11/2012). Meryl’s reply can be found here, my reply to her will either be found in the same comment section or over here when Meryl decides whether to approve it or not.

I think that it is quite reasonable to wonder why I’ve bothered to demonstrate that the AVN censor comments on their blog to the degree that they do. Taking a look at their Facebook page, it is apparent that the admins are frequent users of the ban hammer – most long comment threads have at least a few comments missing, the awkward and confusing one-sided conversations and the comment totals that don’t match the number of comments visible are a giveaway. Unofficial figures suggest that people banned from the AVN’s Facebook page are upward of 300 (I suspect that this is a conservative estimate, given the number of people likely banned who either do not know of the Facebook group or are not interested in joining). Even some of the AVN’s supporters are cautiously speaking up:

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And you know, I don’t think that it does matter in and of itself. The AVN have every right to ban and censor whoever they like, be it because they feel threatened or abused, because they simply don’t like what somebody is saying or because they object to someone’s fashion sense (I jest). Likewise, there is no onus on them to be consistent with either the content or individuals that they’re happy to let through moderation on any given day. The AVN’s blog and Facebook page are to do with as they wish.

What does matter to me though, is that the AVN continually represent themselves as champions of free speech, as the underdogs who others (being SAVN and The Australian Skeptics) are trying to censor and suppress. It strikes me as incredibly hypocritical to espouse free speech, transparency and open debate while not allowing it (or admitting to the fact that they don’t) on their own turf, nor giving others the opportunity to participate by stating some house rules and sticking to them.

The AVN do not deserve the anti-censorship mantle they attempt to assume.

If their influence wasn’t so dangerous, I would care a lot less. However, the AVN spread harmful misinformation which can endanger the lives of children. As such, I wish for anybody who is considering what the AVN has to say to take a close look at their conduct.

As is it concealed by it’s very nature, the degree to which the AVN moderates blog comments is an unknown. It is not apparent how often comments are suppressed or whether unpublished comments are genuinely abusive or merely not to the moderator’s taste at any given moment.

In the spirit of shining some light on suppressed comments, I have started up a Facebook group, Denied! Rejected Comments from the AVN’s Blog.

As is probably apparent upon reading the title, Denied! Rejected Comments from the AVN’s Blog is a place for commenters on the AVN’s blog to post screenshots of comments that did not make it past moderation. The AVN’s supporters (and even Meryl herself) are most welcome to participate. I hope for some hearty discussion and also for the public to have the opportunity to see the range of information and points of view that the AVN does not wish to have aired on their blog.