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I’ll start this post by admitting right up front: I blatantly stole the idea for the title of this post from Mark Crislip’s most excellently infamous post Nine questions, nine answers. Why? Because I really liked that post and felt like it. Also, there seems to be something about the number nine among anti-vaccine zealots: Nine “questions.” Nine circles of hell.

Nine straw men.

I’m referring to an amazing post that appeared on the anti-vaccine crank blog Age of Autism over the weekend by contributing editor Julie Obradovic entitled The Difference Between You and Me. In this post, Julie describes not one difference, but nine differences, that she perceives between herself (and, apparently, by generalization other parents who have become believers in the myth that vaccines cause autism) and people like SBM contributors and (I hope) the vast majority of our readers, who support science-based medicine, understanding that correlation does not necessarily equal causation and that, most importantly, science not only does not support the belief that vaccines cause autism but provides us with copious evidence that there almost certainly no link between the two. Actually, there are more than nine differences, as Ms. Obradovic packs multiple apparently related differences around each of her nine “differences” and then complains that Alison Singer and, apparently by generalization the rest of us who support SBM and oppose the anti-vaccine movement, misrepresent the reasons why she and her merry band of anti-vaccine activists reject the science that has failed spectacularly to validate their deeply held belief that vaccines cause autism and all sorts of other health consequences. Her post ends up being a collection of straw men constructed to Burning Man size, each of which she then applies a flamethrower of burning nonsense to with self-righteous gusto.

Although no doubt Ms. Obradovic won’t see it that way, the reason I chose her article as an introduction for this post is not to pick on her (although if you look at her other posts on AoA, particularly her equally large city of straw men entitled How to Actually Save the Vaccine Program) she certainly deserves some picking on for her combination of pseudoscience, logical fallacies, and straw men). Rather, it’s because her collection of straw men are highly illustrative of what supporters of SBM have to deal with when dealing with pseudoscience and quackery. Ms. Obradovic’s “nine differences” may be all about vaccine-autism mythology and victimization that those mean and nasty scientists don’t take her beliefs seriously, but they could be about almost any form of non-science-based medicine. If you don’t believe me, do this simple thing. Wherever Ms. Obradovic writes “vaccines,” insert your favorite woo du jour and then channel the all-purpose quackery crank site Whale.to or NaturalNews.com. It doesn’t work for all of them (the part about the government “mandating” vaccines, for instance), but it works for enough of them to show my point.

Another reason why I’m going to discuss Ms. Obradovic’s collection of massive straw men peppered with other logical fallacies is that her attitude is not unique. What she writes demonstrates some key attitudes and belief systems towards science and points out many of the obstacles that those of us who try to promote science over pseudoscience, whatever the field, be it vaccines or any other area of quackery or pseudoscience, must address and overcome.

Straw men on flame with logical fallacies (apologies to Blue Öyster Cult)

Ms. Obradovic appears to be very incensed about a talk that Alison Singer, President of the Autism Science Foundation, arguably the only truly science-based autism charity in existence at the moment, and she uses a talk by Singer that was lambasted by Generation Rescue big macher J.B. Handley in three parts, as her jumping off point:

I am growing increasingly tired of the real reasons there is such controversy regarding vaccines and Autism being misconstrued to make me look pathetic. Alison Singer’s attempted explanation at Yale earlier this month (HERE) is a perfect example.

Contrary to what she suggests, our differences are not due to the internet. They are not due to desperation or the traumatization of having a child with Autism coupled with the need to blame someone. They are not due the media or the anti-establishment-toxic-earth movement. They are not due to the dismissive attitude of society and physicians who for years believed bad parenting was to blame. They are not due to an inability to simply accept clear science. They are not due to lack of an education or ability to think rationally. They are not due to being taken advantage of. They are not due to the cult of celebrity.

Wrong. Sorry. Not even close.

Actually, all of the above are excellent partial explanations for why parents like Ms. Obradovic refuse to accept science and continue to believe that vaccines cause autism. The reason Ms. Obradovic “looks pathetic” is not because some cabal of scientists are trying to make her look pathetic; it’s because she does an excellent job by herself of making pathetic arguments.

As I pointed out above, the rest of Ms. Obradovic’s post is structured as nine descriptions of what scientists and those of us who accept the science that doesn’t support her belief that vaccines cause autism believe, and her responding, “I don’t,” followed by a heapin’ helpin’ of what she does believe. Unlike Mark’s post, I’m not going to cover each and every one of these fallacies one by one in detail the way Mark did. I will note that upon rereading the post I just realized that Ms. Obradovic forgot a #3, disobeying the rule regarding the Holy Hand Grenade of Antioch: “Three shall be the number thou shalt count, and the number of the counting shall be three. Four shalt thou not count, neither count thou two, excepting that thou then proceed to three.” Of course, Ms. Obradovic has two straw men #5; so it all evens out to nine straw men again.

So let’s start with straw man #1:

1. You believe the government (the Department of Health and Human Services) has the legally protected right to research, develop, patent, license, supervise, judge, approve, recommend, mandate, and profit from a product (vaccines) that they produce in partnership with a private entity (the pharmaceutical industry). You further believe they have the right to simultaneously oversee the quality, safety and efficacy of this product, and that they objectively do so. You even further believe that they have the right to fund and conduct studies used to defend their product and policy in a court that they serve as judge and jury over in the event you are harmed by it; and moreover, that if they do find in your favor, they have the right to award you compensation at their discretion using money that was secured by a tax you paid on the product when you purchased it and/or were mandated to use it. And finally, you believe this should be protected by law; that neither the government nor the private entity should be held criminally or financially responsible for negligence in the event it maims or kills you.

I don’t.

See what I mean? Straw man #1 is in reality several straw men prefaced by misrepresentation of Ms. Obradovic’s opinion as fact. The fct is that the government does by law have the power to fund the development of vaccines, purchase them for government-run vaccination programs, and recommend them. Note also how Ms. Obradovic is specifically castigating the federal government (DHHS is a federal, cabinet-level department) when in reality the federal government has relatively little power to mandate vaccines in the civilian sector. (If you don’t believe that, check out how few Americans were vaccinated against H1N1 last year despite a massive government effort to persuade Americans to be vaccinated). It is the state and local governments that set specific vaccine mandates required of children. True, they usually use the recommendations made by the CDC and AAP, but it is not primarily the federal government that “mandates” vaccines.

As for compensation, Ms. Obradovic is referring to the Vaccine Court. While it is true that the government requires that claims against vaccine manufacturers first be adjudicated through the Vaccine Court, as has been described on this blog and elsewhere, the Vaccine Court is actually a complainant-friendly venue, where the Daubert rule for scientific evidence is usually not enforced and it is not necessary to prove negligence. Moreover, for purposes of the Vaccine Court, there are a set of “table injuries,” which are in essence recognized potential complications from vaccines that are automatically compensable. These injuries are simply assumed to have been from vaccines, based on science documenting these as potential complications from vaccines. Also, unlike regular courts, the Vaccine Court will pay attorney’s fees and reasonable expenses even to losing petitioners. A petitioner need only demonstrate that the petition was filed in good faith and that there was a reasonable basis for the claim, the idea being to make it as easy as possible for ordinary citizens to seek compensation for vaccine injuries without incurring huge legal bills or being unable to find a lawyer to represent them on a contingency basis. Indeed, attorneys like Clifford Shoemaker have made quite the cottage industry of bringing claims before Vaccine Court, knowing that their expenses will be paid, win or lose. Finally, if an action fails in Vaccine Court, the parent is perfectly free to pursue it in the regular courts.

What straw man #1 reveals is that, like many supporters of pseudoscience and crankery, Ms. Obradovic views science and the government as being arrayed against her, all in cahoots with big pharma. Whatever the short comings and misbehavior of big pharma, some of which I’ve personally documented right here on this very blog, cranks like Ms. Obradovic go far beyond reasonable concerns about big pharma, as we will see.

On to straw man #2:

2. You believe the only protection the consumer needs to be afforded in the aforementioned situation is trust. People should simply trust that those given such enormous power and protection are honorable, ethical, and responsible human beings with families of their own who would never abuse it or put profit over safety primarily because they are smart, went to prestigious medical institutions, and are at the top of their field. You do trust them. And you trust that there are just too many of them involved to all be bad, somehow making the system safe from corruption based on numbers. This is the one point people rely on to debunk the “conspiracy theorists”.

I don’t.

First of all, trust is earned. So is respect. I don’t care what letters you have after your name. You’re smart? Great. So am I. I’m not impressed, nor am I intimidated. Smart doesn’t mean ethical. And some of the smartest people I know are also those with the least common sense.

Does this sound familiar? It’s very much the same anti-intellectual attitude that J.B. Handley once bragged about. Here’s a hint for Ms. Obradovic. Being “smart” isn’t what matters. “Common sense” isn’t what matters. Understanding and accepting the scientific method and how science works does. Ms. Obradovic honestly seems to believe that the reason the scientific community doesn’t accept her wild beliefs that vaccines cause autism is because of a lack of ethics, plus the government, big pharma, and scientists being all in some grand conspiracy, not because the scientific evidence doesn’t support her belief. Unlike the case for scientists, it never occurs to Ms. Obradovic that she might be wrong or that the reason her belief that vaccines cause autism are not taken seriously by scientists is because, well, she is wrong. But not just wrong, spectacularly and arrogantly wrong about the science. It is the the pure arrogance of ignorance, born of anti-intellectualism.

In brief, I’m not in the least bit impressed by Ms. Obradovic’s trumpeting of her being so “smart.” She has not earned respect in any scientific discussion–quite the contrary. She has proven time and time again that she does not know what she is talking about when it comes to science and that her emotion and distrust of science trump all. Contrary to Ms. Obradovic’s apparent belief that the science behind vaccines is rotten to the core, in actuality it is scientists, not misguided conspiracy mongers like Ms. Obradovic, who point out the shortcomings in the vaccine program.

Next, I’ll skip ahead a bit, because it’s a lot more of the same ranting about the government and the scientific community, and it can all be boiled down to straw man #5-1 (given that there are two straw men #5) anyway:

5. You believe the science funded and conducted by the DHHS, pharmaceutical companies, vaccine patent holders and government witnesses (there exists no widely accepted study without this level of participation and conflict) thus far on the potential role between vaccines and the onset of Autism Spectrum Disorder and other health outcomes (for which they will be held accountable) is objective and adequate as it stands right now in both quantity and quality to dismiss a link between the two.

I don’t.

There is not enough space in this article to explain why, but a detailed explanation can be found through the series of articles I wrote here at Age of Autism on the 14 Studies. I’ve read, analyzed and presented every single study multiple times. What you call clear science, I call crap. And no, I’m not willing to accept crap when it comes to my child.

The problem is, of course, that Ms. Obradovic doesn’t have the background to determine whether a scientific study is “crap” or well-designed, well-executed, and reliable. It is the arrogance of ignorance once again asserting itself. In addition, it is a straw man to claim that we supporters of SBM believe that the science “funded and conducted by the DHHS, pharmaceutical companies, vaccine patent holders and government witnesses” is adequate because there’s so much more than evidence funded by the U.S. government. There’s more to the world than just the United States, you know. There have been many studies not just in the U.S., but in several other countries, including Denmark, Canada, the U.K., Japan, Italy, and elsewhere that have failed to find a link between thimerosal in vaccines and autism or between vaccines and autism. Surely all these countries can’t be in on the conspiracy, can they? A much more accurate way of saying this, without the intentional use of the logical fallacy of poisoning the well, is that the totality of the scientific and clinical evidence, when taken as a whole, does not support a link between either thimerosal in vaccines and autism or between vaccines and autism. In contrast, by mentioning the execrable Fourteen Studies website, Ms. Obradovic demonstrates that what she views as “good science” is any science that reinforces her belief, no matter how biased it is or poorly designed and executed, as Steve Novella, Mark Crislip, and I have all demonstrated in our deconstructions of that particularly misinformation-packed Generation Rescue-sponsored propaganda effort. Let’s just put it this way. Anyone who doesn’t easily see through the distortions and misinformation in the Fourteen Studies website has forfeited any claim to an understanding of scientific studies adequate to make grandiose statements about the validity of existing science, such as what Ms. Obradovic makes in straw man #5-2:

5. You believe everything about Autism is a coincidence: the dramatic rise in incidence; the parallel increase in vaccinations given at the same time; the similarities to mercury poisoning; the ratio of boys to girls; the identification of this new disorder in 1943; the timing of the onset of symptoms; the anecdotal evidence of parents; the original CDC findings; the recovery of children who are treated medically; and more.

I don’t.

Science is rooted in observation, and yet, every observation here listed is casually tossed aside as a cosmic lining up of the stars. There is nothing scientific about calling all of this coincidence and explaining it away with unproven excuses (see your list in the second paragraph)…and crap.

This particular straw man demonstrates a misunderstanding of epidemiology so profound as to be beyond belief. In actuality, Ms. Obradovic’s “observations” are nothing more than the blatantly obvious confusing of correlation with causation. As has been pointed out time and time again, mercury poisoning and autism do not resemble each other that strongly. The “dramatic rise” in autism incidence can be largely (although it is unclear if it can be completely) explained by widening of the diagnostic criteria and diagnostic substitution. Also, an example I’ve used before is the Internet. The rise in Internet use beginning in the early 1990s very closely parallels the rise in autism diagnoses and autism prevalence. Surely, by Ms. Obradovic’s logic, the Internet should be just as plausible as a cause of autism as vaccines.

She’s also dead wrong that the hypothesis that vaccines cause autism has been “casually tossed aside” as coincidence. In fact, scientists have studied extensively vaccine safety, looking for a linkage between vaccines and autism, largely driven by the concerns of mothers like Ms. Obradovic. They haven’t found any. In fact, I can retort that one difference between someone like Ms. Obradovic and someone like me is that she doesn’t understand that correlation does not equal causation and that, when science has failed to find a linkage between two things, when that the most likely explanation for any linkage between the two is coincidence. It’s a really hard concept for most people to accept, particularly when they have an emotional investment in a claim of causation, but it’s true. Confusing correlation with causation, confirmation bias, and a number of other cognitive factors conspire to prevent people from easily accepting that sometimes bad things are a coincidence.

One excellent example came from an article about the H1N1 vaccine using the example of H1N1 vaccination and heart attacks.Given that there are this number of people having heart attacks each and every day, during the months when so many people were being vaccinated against H1N1, it was inevitable that there would be dozens, if not hundreds of coincidences a day in which something bad happens to a person after having the H1N1 vaccine. If you’re one of those people, it will seem all the world as though the vaccine caused the badness to happen. It’s not because these people are stupid or ignorant; it’s because, not knowing the expected rate of these coincidences, most people assume that the rate of coincidence is far lower than it truly is. They assume that the rate is close to zero, that such a coincidence would be rare, but that assumption is wrong when dealing with large numbers.

Yes, that’s one difference between Julie Obradovic and me. I understand that. She doesn’t. She thinks herself to be too “smart” ever to make the mistake of mistaking correlation for causation. One of my favorite movie quotes of all times comes from, of all places, a Dirty Harry movie, specifically, Magnum Force. In it, Dirty Harry Callahan says at one point, “A man’s got to know his limitations,” and at another point, “A good man always knows his limitations.” This applies to women as well as men, and Julie Obradovic doesn’t know her limitations with respect to science. From my perspctive, if Obradovic’s world view were more accurate than mine, if big pharma really did have the power to fake research findings all over the world, I’d have to wonder: Why bother to put all those alleged “toxins” in vaccines? Why not use homeopathic vaccines, something harmless but ineffective, and then make up evidence to make it look as though they work?

I think that, in the end, the difference between Ms. Obradovic and someone like me, a supporter of science-based medicine, is that there is evidence that, if produced, would change my mind about whether or not there is a link between vaccines and autism, and I know what that evidence would have to be right now. All it would take would be a couple of well-designed, well-executed, well-analyzed epidemiological studies showing a strong link between vaccines and autism. Produce those, and I would start to reconsider my position. Or, as Tim Minchin put it so brilliantly about homeopathy in his nine minute beat poem Storm (please be warned that Minchin is fond of the f-word):

Science adjusts its beliefs based on what’s observed
Faith is the denial of observation so that Belief can be preserved.
If you show me
That, say, homeopathy works,
Then I will change my mind
I’ll spin on a fucking dime
I’ll be embarrassed as hell,
But I will run through the streets yelling
It’s a miracle! Take physics and bin it!
Water has memory!
And while it’s memory of a long lost drop of onion juice is Infinite
It somehow forgets all the poo it’s had in it!

You show me that it works and how it works
And when I’ve recovered from the shock
I will take a compass and carve Fancy That! on the side of my cock.

The same goes for me and not just homeopathy, but the belief that vaccines cause autism. I’d be embarrassed as hell for having been wrong, and I might resist changing my mind for a while, but eventually science would win out, and I’d realign my beliefs to conform with science. I would, however, abstain from bringing any sharp instruments anywhere near my genitals, and I’m not sure if I’d go running through the streets yelling, “Vaccines cause autism!” I would, however, write about it right here on SBM, minus the use of the f-word. In contrast, there is clearly no evidence that will ever change Ms. Obradovic’s fanatical belief that vaccines cause autism. Just try asking her if you don’t believe me.

The question that remains is: Why do people like Julie Obradovic refuse to accept the science that shows that vaccines are safe and effective and that they are not associated with autism? I’ve already pointed out one reason: Failure to understand that correlation does not equal causation, coupled with failure to let go of a belief that isn’t supported by science. Obviously, though, that alone is not sufficient to explain the intensity of her reaction.

Next week (or the week after if something comes up that catches my fancy), I’ll consider mechanisms by which we protect irrational beliefs from science.

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Posted by David Gorski

Dr. Gorski's full information can be found here, along with information for patients. David H. Gorski, MD, PhD, FACS is a surgical oncologist at the Barbara Ann Karmanos Cancer Institute specializing in breast cancer surgery, where he also serves as the American College of Surgeons Committee on Cancer Liaison Physician as well as an Associate Professor of Surgery and member of the faculty of the Graduate Program in Cancer Biology at Wayne State University. If you are a potential patient and found this page through a Google search, please check out Dr. Gorski's biographical information, disclaimers regarding his writings, and notice to patients here.