One of the most inglorious episodes in recent medical history ended yesterday when the doctor who triggered a global scare about MMR vaccine was struck off the medical register.
Twelve years after publishing the now infamous 1998 Lancet paper which suggested a link between the vaccine, bowel disease and autism, the General Medical Council found Andrew Wakefield, its chief author, guilty of serious professional misconduct over the way the research was conducted.
The GMC and the medical establishment will now hope that, after years of delay, the verdict draws a line under the affair which has seen vaccination rates plummet and cast neither of them in a flattering light. They will also hope it douses speculation in the media, sections of which bear a heavy responsibility for the firestorm of warnings over MMR safety.
The verdict, which came after 217 days of deliberation by the five-member disciplinary panel – the longest in the GMC's 152-year-history – was devastating. Dr Wakefield, 53, was found to have acted "dishonestly and irresponsibly", to have shown a "callous disregard" for the suffering of children, and to have betrayed the trust of patients. He conducted invasive tests on children without ethical approval, including lumbar punctures (a painful procedure in which samples of fluid are taken from around the spinal cord) which were not for their clinical benefit and "repeatedly breached fundamental principles of research medicine".
His misdemeanours constituted "multiple separate instances of serious professional misconduct" yet despite this he showed a "persistent lack of insight" into the gravity of his behaviour, the panel found. The verdict affects his right to practice in the UK, but he is now based in the US.
His colleague, Professor John Walker-Smith, former head of the department of paediatric gastroenterology at the Royal Free Hospital in London, where the research was carried out, was also stuck off the register. Aged 73, he has been retired for a decade and hence unlikely to pose a future risk to patients but the panel said it had decided, "with regret", that removal from the register was the "only proportionate sanction" for his "extensive failures", "non-compliance with ethical research requirements" and "irresponsible and misleading" reporting of the findings.
Professor Simon Murch, who was a junior consultant in the department at the time, was cleared of serious professional misconduct after the panel found that despite demonstrating "errors of judgement" he had acted in good faith. Professor Murch, the only one of the trio to attend yesterday's hearing, swallowed hard as the verdict was delivered and a female member of his legal team gave him a congratulatory pat on the shoulder.
The verdicts cast no new light on the scientific controversy over MMR. Dr Surendra Kumar, chair of the GMC panel and a GP, made it clear that the case revolved around the way the research was conducted, not whether "there is or might be any link between MMR vaccination and autism".
Following publication of the Lancet study, vaccination rates against MMR plunged and have never fully recovered. They stood at 91 per cent in 1997-98 and slipped to 79 per cent in 2003-04 and lower, to less than 50 per cent, in parts of London. National rates have since recovered to 85 per cent, but hundreds of thousands of children remain unprotected from the diseases and cases of measles have soared. Dr Wakefield said yesterday he would appeal. He and Professor Walker Smith have 28 days to do so.
Wakefield case in numbers
217 The number of days of sittings by GMC disciplinary panel, the longest on record
98 The number of cases of measles in 1998, when the Lancet paper was published
1,144 The number of cases laboratory-confirmed cases of measles in 2009 in England and Wales
28 February 1998
Andrew Wakefield and 12 colleagues from the Royal Free Hospital, London, publish research in The Lancet linking the MMR vaccine with bowel disease and autism.
Panel of Medical Research Council experts says "no evidence to indicate any link".
The British Medical Journal says the MMR vaccine cannot account for the soaring rate of autism.
Dr Wakefield moves to US with his family.
National MMR vaccination rates fall to 79 per cent (from 91 per cent before 1997).
The Lancet announces a partial retraction of Wakefield's paper. Ten of the 13 authors of the original paper disown it.
The GMC case against Wakefield and two of his colleagues begins.
24 May 2010
Andrew Wakefield and Professor John Walker-Smith are struck off.Reuse content