27452983Although he doesn’t detest me nearly as much as antivaccine honcho and founder of Generation Rescue J. B. Handley does, Santa Monica celebrity pediatrician Dr. Jay Gordon doesn’t like me very much at all.

Actually, I’m not sure whether that’s entirely true or not, but Dr. Gordon sure doesn’t like it when I criticize him for his antivaccine rhetoric. He affects an oh-so-wounded posture and self-righteously assures me that he is not “anti-vaccine” and that it is “beneath me” to use such rhetoric against him. Whether such rhetoric is “beneath me” or not, however, I’ve never quite understood why Dr. Gordon gets so upset at when I describe him as “anti-vaccine.” After all, his words are frequently apologetics for the anti-vaccine movement, and his actions frequently give it aid and comfort. After all, he is Jenny McCarthy‘s son Evan’s pediatrician, and as a result of that connection he has been giving speeches to antivaccine rallies, such as the “Green Our Vaccines” rally in Washington, D.C. in June. (He is the man in the sunglasses behind Jim Carrey in the picture at the top of this post by me.) After all, he has been palling around with luminaries of the antivaccine movement, such as Jenny McCarthy and her boyfriend Jim Carrey, the aforementioned J. B. Handley, Robert F. Kennedy, Jr., Boyd Haley, and numerous others at events like the “Green Our Vaccines” rally.

But, above all, over the last three or four years, Dr. Gordon has become the go-to pediatrician that the media seemingly always wants to interview when a vaccine “skeptic” with an MD after his name is required to provide the “balance” that journalists worship above all else, even when that “balance” gives undue credence to pseudoscientific nonsense. He clearly relishes that role, too, most infamously on his appearance with Jenny McCarthy on Larry King Live!, in which McCarthy shouted down pro-vaccine physicians and yelled “Bullshit!” (as if she who yells the loudest and is the most foul-mouthed wins the debate) and as evidenced by his appearances on certain antivaccination mailing lists, from which messages are occasionally forwarded to me.

What else am I supposed to think, except that Dr. Jay is at the very least an apologist for the antivaccine fringe, if not a card-carrying member himself?

Unfortunately, Dr. Gordon strikes me as being mostly a nice guy. I say “unfortunately” because it would be much easier to be as harsh on him as his promotion of antivaccine pseudoscience deserves if he were not. He also clearly believes that he is right based on the evidence. Based on science and clinical evidence, he most definitely is not. Recently, I had decided more or less to lay off him for a while, so as to avoid the wounded cries that invariably accompany valid charges that he is an apologist for the antivaccine fringe. Also, I felt kind of bad beating up on him so regularly and thought that perhaps a respite was in order. Then I found out that Dr. Gordon wrote the foreword to Jenny McCarthy’s new antivaccine and pro-autism quackery book, Mother Warriors: A Nation of Parents Healing Autism Against All Odds. Then, one of my readers actually took the time to transcribe Dr. Gordon’s foreword and e-mail it to me.

I read it, and I was appalled.

That foreword demonstrates that Dr. Gordon has firmly allied himself with the antivaccine camp (more later). What I still can’t figure out is: Why? So, at the risk of provoking another self-righteous wail from Dr. Gordon that he really, truly isn’t “antivaccine,” I thought I’d explore a bit about his views, why they are so wrong, and why I reluctantly had to come to the conclusion that, even if Dr. Gordon does not see himself as “antivaccine,” he has clearly allied himself with the radical antivaccine movement and become one of its chief apologists, in the United States at least. My primary purpose in writing this is not to take another swipe at Dr. Gordon (although that is unavoidable), but rather to try to coax him back to science and, failing that, to inform SBM readers why his arguments are fallacious.

Dr. Gordon and me: Three years and going strong

I first “met” Dr. Gordon online in 2005, which is, as I’ve pointed out before, when I first encountered the die-hard antivaccine movement. Indeed, my first encounter with Dr. Gordon was shortly after my discovery of thsi movement and my rather wide-eyed and innocent dive into the online fray. I also noticed him when I noticed, a mere three weeks after its going live, that The Huffington Post had become a bastion of antivaccine pseudoscience, a position that it has maintained to the present day. Mixed right in among posts written by such mercury militia antivaccine apologists such as David Kirby, Robert F. Kennedy, Jr., there was Dr. Jay Gordon. Ever since then, the two of us have intermittently sparred about vaccines in various online locales. Months will go by with no contact, and then suddenly Dr. Gordon will write or say something that provokes a debunking, and there’s a kerfluffle, after which there is silence for months. Usually, Dr. Gordon is unhappy that most of the time I have criticized him under a pseudonym. Having seen his foreword in Jenny McCarthy’s book, I decided that now was an opportune time to take that excuse away from him and see if he will answer evidence- and science-based criticisms if he can’t complain about my anonymity.

One thing that has become clear to me over the last three years is that Dr. Gordon, like virtually all advocates of pseudoscience, does not realize or accept that he is a advocating pseudoscience. Indeed, he thinks he’s a scientist, but, alas, he makes arguments that are most unscientific. For instance, in e-mail exchanges, he has argued that anecdotal evidence from his own practice and his own observations, coupled with his own reading, have convinced him that vaccines cause autism. Never mind the science that finds no plausible mechanism by which mercury in vaccines or vaccines themselves might result in autism and the multiple large epidemiological studies powered to find even small correlations between mercury and autism or vaccines and autism that have failed to support the claim that vaccines cause or contribute to the development of autism in infants. Dr. Gordon trusts his clinical experience above that. He also thinks that David Kirby’s book Evidence of Harm is “meticulously researched and a great read” and that Robert F. Kennedy, Jr.’s infamous Deadly Immunity essay is “important.” (It wasn’t.) Such is the level of Dr. Gordon’s understanding of science. Dr. Gordon also wrote in 2005:

Mercury in vaccines causes autism and other brain injury. The IOM twisted the facts to suit the CDC and the vaccine industry.

No, it doesn’t, and no it didn’t.

To demonstrate why Dr. Gordon is not a reliable or credible source of vaccine information, I would like to discuss a recent interview and then conclude with a discussion of his foreword to Mother Warriors.

Dr. Gordon and formaldehyde

Early this summer, around the time of that Amanda Peet made her controversial statements defending vaccines, once again Dr. Gordon demonstrated his skill with anti-vaccine talking points in this interview with Cookie Magazine. It was painful for me to read such misinformation coming straight from the mouth of a fellow physician. Indeed, it was even worse than listening to Dr. Michael Egnor spew creationist nonsense hither and yon, because at least for Dr. Egnor evolution is not part of his area of expertise. I don’t know about you, but I always thought that vaccines were a key area of expertise for pediatricians. In the case of Dr. Gordon, however, you’d never know it from the data-free, anecdote-filled nonsense he spouted in this interview. For example, listen to his response to a question about why he buys into the “too many, too soon” mantra and advocates “staggering” vaccines:

I think the immune system, like every other system of the body, matures slowly, and that it can better tolerate viral infection at older ages and better tolerate one virus at a time. The other thing is that vaccines all contain other ingredients. They contain aluminum, they contain tiny bits of formalin [an aqueous solution of formaldahyde]. So I recommend waiting as long as parents are comfortable, and vaccinating very, very slowly. I also ask parents to wait at least six months before the first vaccine. I prefer to wait a year.

Formaldehyde? Aluminum? Oh, my goodness! Toxins! I could not believe a physician was parroting the “toxin” gambit about vaccines. That’s arguably the single most scientifically ignorant rhetorical gambit antivaccinationists use, and Dr. Gordon appears to have bought into it. Did Dr. Gordon skip pharmacology class in medical school?

Of course, Dr. Gordon, showing that even physicians can be prone to putting too much stock in testimonials and anecdotes over science and epidemiology, points out cases of regression he’s seen after vaccination, and argues:

Now, many people would argue that vaccines are only for the better. I would say that there’s no free lunch; it is lovely to be immune to whooping cough, but if I have to diminish your health a little bit to do that, I have to hesitate. Integrity demands that I tell you other parts of the story: I saw one child who developed seizures two days after her two-month appointment, and she didn’t get any shots. It’s true that the onset of autism often coincides with the time that kids are getting their shots. But the vast majority of times that I see a temporal relationship, I’m assuming it’s not a coincidence.

Assuming? Note that Dr. Gordon cannot produce a single scientific study to support his beliefs. Not one. In fact, I once replied to one of his e-mails chastising me for referring to him as “anti-vaccine.” In my response, I pointed out that I had seen snippets of his videos posted to YouTube and his own website as well as a video of his speech to the “Green Our Vaccines” rally:

Note how Dr. Gordon states that he bases his conclusions that vaccines probably cause more harm than good on “over 30 years” of his own experience and above all (emphasis mine) “listening to you,” meaning the audience of antivaccinationists whom he is addressing. It never occurs to him that, as he became more famous in antivaccination circles, more and more parents would seek him out, creating a self-reinforcing echo chamber effect impervious to outside information and the overwhelming mass of data not consistent with his belief that vaccines cause autism and various neurological conditions, not to mention diabetes and others. I also can’t help but ask what planet he comes from that he can claim with a straight face that doctors do not discuss potential risks of vaccination with parents and then blame doctors for not warning parents that vaccines can cause autism when there is no good evidence upon which to base such a warning.In response, I asked Dr. Gordon pointedly but politely if he could provide me with citations for scientific studies in the peer-reviewed literature that support what he said in those videos, what he said in this interview, and, most importantly, at the “Green Our Vaccines” rally, most of which was nothing more than testimonials. Dr. Gordon never got back to me with the references or a coherent discussion of the science that leads him to make such conclusions. I’ve periodically tweaked him about that ever since, and I plan to continue to do so, but wonder if he’ll get back to me now. While I wait, I’ll point out that Dr. Gordon continues to spread misinformation about the MMR virus, like:

It’s a live-virus vaccine. A live-virus vaccine, in order to work, creates a little bit of an infection. And when you get measles, you get it through your nose and your throat, [which triggers a very specific immune response.] When we inject measles, we are bypassing that system and going right into the bloodstream. And we’re finding that yes, there can be some impact on the intestinal tract and to the brain from the measles vaccine. And it’s a vaccine of almost no benefit to American children, one by one. Now, in terms of public health, I don’t want to be the guy who said, “Boy, this vaccine stinks.” It doesn’t stink. It works very, very well. The reason we don’t have measles in America is because the vaccine works great. But sit down, please. Let’s talk about the fact that your cousin and your other cousin both have autism. Or that your son has some questionable neurological issues, he seems to be speaking or walking a little later. I don’t want to mess with him.

Number one: The measles vaccine is not of “almost no benefit to American children.” It keeps measles at bay, and the resurgence of measles that we have seen in the U.K. and are now seeing in the U.S., thanks to decreased levels of vaccination due to fearmongering about the MMR vaccine shows how little it would take for herd immunity to fail. Number two: There is zero scientifically sound evidence that the MMR causes autism or other neurodevelopmental disorders–or even “autistic enterocolitis.” None. All we have is Andrew Wakefield’s litigation-driven and incompetent “research,” research so badly done that his co-authors almost all disavowed it when its deficiencies came to light. That Dr. Gordon apparently continues to believe that shoddy pseudoscience concerns me greatly.

It gets worse. Gordon repeated the usual misinformation about mercury in flu vaccines and even mentioned a 7-year-old getting a tetanus booster with mercury in it. It makes me wonder if he served as an uncredited background consultant for Steve Wilson, so similar is his patter to the misinformation served up by that “investigative journalist.” Most children do not get the flu vaccine, especially not under two years of age, and, even as the use of the flu vaccine is encouraged, flu vaccines containing more than trace amounts of thimerosal are increasingly uncommon because of low demand. It is likely that the marketplace will soon render them all but extinct, except for adults (Indeed, the flu shot I got a couple of weeks ago contained not only thimerosal but formaldehyde!) Also, children don’t suddenly get autism at age 7 after getting a vaccine. The bottom line is that children’s exposure to thimerosal from vaccines is lower than it has been since the 1980s and is continuing to decline, but there’s no sign of a significant decline in autism diagnoses. None. That’s about as bulletproof epidemiological evidence as there is showing no correlation between the two. Not that this stops Dr. Gordon:

Right now we’re creating vaccines using ingredients that are cheap preservatives, but it could be done better. It means, let’s see if we can get the aluminum out of them. Let’s see if we can get the formaldehyde out of them. Let’s see if we can produce them in a way that makes a little more sense for safety.

Aluminum is not a preservative. It is an adjuvant. It’s there to make the vaccine produce a stronger immune response and thus make the vaccine work better. It’s an integral component of what makes the vaccine work. There’s also no evidence it has anything to do with autism or any other neurodevelopmental or immunological disorder. Of course, now that the mercury is gone from nearly all vaccines routinely given to children under two and multiple epidemiological studies have exonerated mercury in vaccines as a cause of autism, we all know that aluminum is becoming the new mercury for antivaccinationists. Never mind that aluminum has been used for 80 years and has an exemplary safety record.

Also, I know formaldehyde a convenient scary-sounding chemical used in the vaccine manufacturing process that antivaccinationists like to point to, but by the time the finished vaccine is made, there’s nothing more than a trace amount in any vaccine. Dr. Gordon breathes more formaldehyde sitting in an L.A. traffic jam in his Lexus than is in any vaccine. The plastic products and varnishes in your house produce more. In fact, the human body makes far more formaldehyde than is in any vaccine, as described here:

The average quantity of formaldehyde to which a young infant could be exposed at one time may be as high as 0.2 mg (see table below). This quantity of formaldehyde is considered to be safe for two reasons. First, formaldehyde is essential in human metabolism and is required for the synthesis of DNA and amino acids (the building blocks of protein). Therefore, all humans have detectable quantities of natural formaldehyde in their circulation (about 2.5 ug of formaldehyde per ml of blood). Assuming an average weight of a 2-month-old of 5 kg and an average blood volume of 85 ml per kg, the total quantity of formaldehyde found in an infant’s circulation would be about 1.1 mg — a value at least five-fold greater than that to which an infant would be exposed in vaccines. Second, quantities of formaldehyde at least 600 — fold greater than that contained in vaccines have been given safely to animals.

I’ve tried to point out to Dr. Gordon these facts, and, at least as far as I can tell, he’s no longer playing the formaldehyde gambit, which gives me hope that he is educable. However, if you want to know what Dr. Gordon thinks of vacccines, he finished up with this tidbit:

I think that the public health benefits to vaccinating are grossly overstated. I think that if we spent as much time telling people to breastfeed or to quit eating cheese and ice cream, we’d save more lives than we save with the polio vaccine.

That’s right. Dr. Gordon seems to be arguing that breast feeding and keeping cheese out of the diet will prevent the spread of infectious diseases better than vaccines. Funny, but Europeans eat lots more cheese than Americans, and they don’t seem to be any less healthy than we are. On the other hand, per capita U.S. cheese consumption has been rising since the 1980s. Hey, I have an idea! Maybe it’s maternal cheese consumption, not vaccines, that causes autism! In the meantime, we can have a whole bunch of svelte, otherwise healthy kids suffering from vaccine-preventable diseases. In actuality, Dr. Gordon has a point that decreasing obesity and encouraging breast feeding would increase infant health in the U.S. However, his comparing vaccination unfavorably to these other public health measures reveals his true agenda. It’s possible to encourage breast feeding and a more healthy diet without denigrating the known benefits of vaccines. Dr. Gordon chooses to denigrate them. Indeed, his attitude towards vaccines can apparently be summed up by what he said in a comment:

I gave a half dozen vaccines today. I gave some reluctantly but respected parents’ wishes to vaccinate.

I found it most telling that Dr. Gordon said that he “reluctantly” gave some vaccines because he “respected parents’ wishes to vaccinate.” Why, if Dr. Gordon is not “anti-vaccine,” was he “reluctant” to give these children appropriate vaccines? What is there to be reluctant about? It certainly sounds to me as though Dr. Gordon tried to persuade some parents not to provide their children with standard vaccines.

And then there’s Dr. Gordon writing in the foreword to Jenny McCarthy’s new book, which is what pushed me to write this post.

A panoply of antivaccine fallacies on display

In Jenny McCarthy’s latest book, Mother Warriors: A Nation of Parents Healing Autism Against All Odds, McCarthy blames her son Evan’s autism on vaccines and claims to have “cured” his autism with so-called “biomedical interventions. If past internet exchanges with Dr. Gordon are any indication, one could expect that this foreword would be replete with pseudoscience and “brave maverick doctor” posturing. Aside from completely unsupported claims of fact like, “Vaccines can cause autism,” and “hyperbaric oxygen works,” to assertions of “tremendous increase in autism,” Dr. Gordon has indeed laid out quite a spread of logical fallacies and pseudoscience in his foreword. Indeed, Dr. Gordon doesn’t waste any time when it comes to deploying logical fallacies. In fact he begins right from paragraph one:

The AAP and the Centers for Disease Control and Prevention (CDC) are filled with doctors who not only don’t believe the ideas in this book but actively ridicule them and spend a lot of money trying to disprove the causes and treatments so well presented when Jenny Mccarthy and others in the cure-autism community speak and write.

Unfortunately, ridicule neither validates nor invalidates a claim. The AAP and the CDC may well have doctors who ridicule the ideas in Jenny’s book, but that they ridicule such claims does not make those doctors incorrect, nor does their ridicule validate such claims. In fact, what Dr. Gordon appears to be doing is combining a whine about being ridiculed with the Galileo gambit, in which those “brave maverick doctors” are implicitly likened to Galileo, who was persecuted for his science because it conflicted with the reigning paradigms of the time. It’s an invalid comparison, as Michael Shermer writes in his book Why People Believe Weird Things:

For every Galileo shown the instruments of torture for advocating scientific truth, there are a thousand (or ten thousand) unknowns whose ‘truths’ never pass scientific muster with other scientists. The scientific community cannot be expected to test every fanstastic claim that comes along, especially when so many are logically inconsistent.

Or, more succinctly:

They laughed at Copernicus. They laughed at the Wright brothers. Yes, well, they also laughed at the Marx Brothers. Being laughed at does not mean you are right.

Thus, being laughed at does not mean that Dr. Gordon is correct. Sometimes, as in this case, ridicule is a completely appropriate response to what a person says or promotes. What makes Dr. Gordon’s critics and the critics of the antivaccination movement correct from a scientific standpoint is that current science supports them and does not support Jenny McCarthy and the movement whose celebrity face she has become. In addition, Dr. Gordon is one to talk about ridicule. After all, what is he doing in his foreword but ridiculing the AAP, CDC, and any who have the temerity to point out that science does not support Jenny McCarthy’s ridiculous (and I chose that word intentionally) claims? He has also frequently ridiculed Dr. Paul Offit in various online exchanges, leading me to think of the old Usenet retort: “Pot. Kettle. Black.”

Not that that stops Dr. Gordon from making a couple of assertions of what he considers to be fact. Indeed, Dr. Gordon states baldly:

Vaccines can cause autism.

Of course, Dr. Gordon offers not one whit of scientific evidence to support this claim. He has never been able to provide a coherent scientific argument for why he believes this claim to be true. Instead, he simply makes it as though it were self-evident. It’s not, and there is no good scientific evidence that vaccines can cause autism. When challenged to provide support for this sort of assertion, Dr. Gordon is invariably flummoxed, usually retreating back to his “clinical experience” garnished with logical fallacies, more of which are discussed below. His stating that “vaccines can cause autism” in this way suggests that no specific scientific support or mechanism for autism causation will be offered in the book that follows. Readers will need to chalk this up to the following format of fallacious logic, “X is true. The evidence for this claim is that X is true.”

Dr. Gordon also sees the issue of “biomedical interventions” for autism as a false dichotomy:

Diet and supplements and other alternatives to doing nothing can lead to recovery from autism. Period.

“Period”? Wow, that’s pretty definitive! (Putting the word “period” after an assertion is always great for convincing people.) It’s also fallacious.

The implication would seem to be that “biomedical” interventions, such as gluten-free diets, chelation therapy, and other woo and “doing nothing” are the only choices. They are not, but pseudoscientists pushing the vaccine-autism link and “biomedical” treatments for autism desperately want parents to believe that these are the only two choices. Although “recovery” certainly isn’t clearly defined by Dr. Gordon, parents can focus on education and social skills without getting into the expense of unnecessary supplements, restrictive diets, or other alternative medicine at all. Although some may not, many parents who focus on education and social skills for will see “improvement” as a result.

There is a false premise under this fallacy as well, and that is that autism is a condition of developmental stasis and that any development observed must be due to whatever intervention the parent is making. It is not; autism is a condition of developmental delay. Autistic children can and do develop, sometimes dramatically–occasionally even dramatically enough to lose their diagnosis of autistic spectrum disorder. Indeed, there’s huge variability in the development of autistic children as well, not to mention variability in the developmental course of a single child, with periods of apparently little progress intermingled with periods of rapid development. Morever, there is a great deal of expectation effect in parents’ reporting of the results of their interventions, along with a lot of confirmation bias.

For these reasons, and many more, it is impossible to conclude with any scientific validity that any “biomedical” intervention “works” in “improving” autistic symptoms without controlled randomized trials as evidence showing it does. Anecdotal experience and “personal clinical experience” (favored by Dr. Gordon) do not constitute sound scientific evidence, no matter how much Dr. Gordon would like to persuade you that they do. After all, physicians believed for hundreds of years that bloodletting was an effective treatment for a wide variety of conditions based on “personal clinical experience” and anecdotes.

Of course, no foreword to a book about pseudoscience would be complete without blaming physicians for something they haven’t done:

We doctors need to stop deceiving our patients into thinking that immunizations are “free.” Every medical intervention costs the body something, and we have a legal and moral obligation to tell parents.

Above all else, physicians also have a legal and moral obligation to be accurate in boiling down the best scientific evidence for a medical intervention, and claiming that vaccines might cause autism based on no good scientific evidence that they can or do is simply not accurate. Most doctors would not agree to a statement claiming that “we doctors are deceiving our patients into thinking that immunizations are free.” Doctors do consider the contraindications before administering any injection – that alone conveys knowledge that all medical procedures are not “free.” Immunization requires a risk/benefit analysis, as do all medical interventions. But, of course, Dr. Gordon doesn’t see it quite that way. Instead, he sees dark conspiracies everywhere:

The official position of the American Academy of Pediatrics may be the same as my personal position, but they are far too involved with the pharmaceutical industry to actually do anything but pay lip service to an open discussion. The CDC and the AAP are filled with doctors whose research, speaking engagements, and travel are often funded by the manufacturers of vaccines. Many of these same doctors are paid consultants, and some later go to work full-time for the pharmaceutical industry.

Again, this is a gambit beloved of advocats of pseudocience: The Pharma Shill Gambit. Indeed, Dr. Gordon has on at least one occasion tried out this particular gambit on me in e-mails demanding to know if I receive renumeration from pharmaceutical companies. Dr. Jay seemed most disappointed to learn that I do not. Also, as his history demonstrates, Dr. Gordon’s also rather quick to pull out the pharma shill gambit as well to preemptively slime those who might refute antivaccination and pro-quackery nonsense, after which he retreats to the “oh, sorry, I spoke too soon and really didn’t mean it” ploy.

Of course, ties to and support from the pharmaceutical industry exist, and they should be watched and carefully considered as potential conflicts of interest. However, research funding simply being connected to vaccine manufacturers, does not automatically invalidate science. Poor data, statistics, experimental methodology, and lack of reproducibility invalidate science. Sure there’s room for added transparency in any such arrangement where industry is involved with, or even produces some of the science, but Dr. Gordon’s apparent belief in a vast conspiracy hell-bent on making truckloads of money, no matter how many children are supposedly harmed, goes beyond the pale.

Still, Dr. Gordon is apparently smart enough to realize that beating the dead “autism = mercury poisoning” horse will not help his flailing arguments against vaccines, and so he quickly changes the subject:

Yes, most vaccines have much less mercury, but wait until the evidence against aluminum in vaccines becomes common knowledge. The body of research regarding aluminum’s harm to human cells already contains hundreds of articles.

Of course, Gordon isn’t about to make any scientific connection to autism with the aluminum. He can’t, because there isn’t. Nor can he make any connection between aluminum and any measurable harm to infant health. Again, he can’t, because there isn’t, at least not from the doses of aluminum used as adjuvants in vaccines. In reality, this is nothing more than a variation of the deceptive and downright “toxin” gambit, one that Dr. Gordon has credulously repeated in the past. Again, now that mercury has been cleared as a potential cause of autism by several very large epidemiological studies, for the antivaccine movement aluminum has become the new mercury. So, being utterly unable to make a coherent case that aluminum adjuvants in vaccines cause harm, Dr. Gordon next resorts to even more fallacious logic and science:

Like many of you and like some of my colleagues, I’m extremely concerned about what has caused the tremendous increase in autism and related disorders over the past decade. The presumption that doctors are much better at diagnosis is absurd and unscientific. (I know that I’m not 400 or 800 percent smarter than I was years ago.)

If ever there were a straw man argument, this is it. This one, better known as the “better diagnosis” straw man, seeks to imply that any increases in autism prevalence cannot just be explained by “better diagnosis”–and therefore there must really be an autism epidemic. The problem for Dr. Gordon is that absolutely no one–I repeat, no one–is making such an argument, except as a straw man argument to slap down, as Dr. Gordon does with gusto. In reality, this particular straw man is an intellectual crutch, and an ineffective one at that, for those who don’t have the slightest idea how to address the real arguments of those who state (correctly so far), that there is no evidence of any autism epidemic. The real arguments are much more substantial than a simple, “doctors are better at diagnosis.” Read up on the changing definition of autism, broadening of diagnostic criteria, diagnostic substitution, increased awareness and recognition, and the influence of access to services, for more information.

Dr. Gordon also likes to indulge in special pleading:

Last but far from least, we have to support and reinforce the intelligent and fiercely held hope these parents of children with autism have. Doctors have to acknowledge and help research the therapies that lead to recovery from autism, recovery brought on by therapies long ignored by the AAP and others. Dairy-free, gluten-free, sugar-free diets have succeeded far too many times for any doctor to claim that they’re not “evidence-based.”

That’s a pretty bold implication, asserting with such confidence that there are dietary therapies that lead to recovery from autism. It’s also not true that such claimed therapies have been ignored. They may not have had all the attention some true believers would like, but there is in fact research on the subject. Unfortunately, for Dr. Gordon’s assertion, the evidence that gluten-free diets improve autistic symptoms is much like the evidence for most “alternative” medical interventions. Smaller, unrandomized, uncontrolled (or poorly controlled) trials suggest a therapeutic effect, but the better designed the trial the more likely it is to show no effect distinguishable from that of a placebo.

Let’s set that aside for the moment though. Is there more to Dr. Gordon’s unscientific assertion that diets have succeeded far too many times for any doctor to claim that they’re not “evidence-based”? Perhaps he’ll present some scientific evidence in support of his claim.

Or not:

Evidence doesn’t spring just from medical studies funded by drug companies and supervised by MDs and researchers on their payrolls.

Brilliant! Not only is this a classic straw man argument, but the pharma shill gambit is woven seamlessly into it! Alas for poor Dr. Gordon, no one, and I mean no one, is claiming that evidence can only spring “just” from medical studies “funded by drug companies and supervised by MDs and researchers on their payrolls.” That doesn’t mean satisfactory evidence can come from just anywhere though. So, where does Dr. Gordon suggest we look for this evidence? Surprise, surprise! It’s not from scientists!

It’s from The People, man:

Evidence can come from the hundreds of families and doctors who have watched children with autism get better and even fully recover from the symptoms that have kept them from mainstream education and social opportunities. This is hard evidence and to deny it is specious reasoning and bad science.

Unfortunately, anecdotes from hundreds of families and doctors, do not represent “hard” evidence. Dr. Gordon’s apparent acceptance of anecdote is not “good science.” Rather, it is not science at all. In the critically thinking world, to which Dr. Gordon is apparently an outsider, acceptance of anecdote as scientific “evidence” is called “believing.” The very reason that science-based medicine is so important is because humans are prone to find patterns where none exist, especially when looking at small numbers and limited information. Such pattern finding ability probably had a survival advantage in the past, but it leaves humans with cognitive quirks that lead us frequently to attribute causation when none exists. Dr. Novella wrote an excellent discussion of the proper role of anecdotal evidence in science-based medicine. I suggest that Dr. Gordon read it.

Dr. Gordon’s argument is nothing more than argumentum ad populum, also known as an appeal to popularity. The observation that supposedly hundreds of families and doctors have watched children with autism get better and even fully recover from the symptoms is very close to meaningless. It wouldn’t matter if there were thousands of families and doctors with the claim. A large number of believers doesn’t equate to truth of the conclusion. There are hundreds, if not thousands, of people who have claimed to have seen Bigfoot. Does this mean that Bigfoot is real? There are hundreds, if not thousands, of people who claim to have been abducted by aliens and subjected to various experiments. According to Dr. Gordon’s apparent logic, he should answer, “evidence can come from the hundreds of outdoorsmen and others who have seen Bigfoot” that Bigfoot exists or “evidence can come from hundreds of people who have been abducted by aliens” that aliens are visiting Earth and abducting people. Many other examples come to mind: Belief in ghosts, psychics, astrology. Many, many people believe in these things and have believed in these things for millennia. Does that mean they are real or that they work?

In Conclusion

Boiled down to its essence, Dr. Gordon’s entire foreword says very little about autism, or Jenny McCarthy’s understanding of the subject. It appears to be little more than an indictment of vaccines in general, and a fallacy-filled presentation of “science doesn’t have all the answers” and “vaccines did it.” Sadly, it’s also of a piece with his previous writing, public appearances, and online activity since at least 2005. Indeed, Dr. Gordon’s entire public career says very little about autism, although it does say that he is clearly deeply “skeptical” of vaccines based on his own “clinical experience” rather than scientific evidence and well-conducted epidemiological studies. Based on excessive use of fallacious logic, our lesson from this foreword from Dr. Gordon can be summed up thusly, “complete pseudoscience probably follows.” I can’t say for sure that it does because I haven’t read the book, but, given Jenny McCarthy’s track record I’d be shocked if such were not the case. (I’d actually read McCarthy’s book, except that I really, really don’t want to buy the book, because morally I cannot abide the thought of contributing to Jenny McCarthy’s income.)

Finally, I really wish that Dr. Gordon had not debased himself so far in writing this foreword. To throw his own words back at him, writing such a chapter is beneath him. After all, Dr. Gordon seems like a nice enough guy. Unfortunately, he appears to have become too enamored of the hero status he’s been given by the anti-vaccine contingent and his time in the limelight with the celebrity mother of his patient Evan. Of more concern to me is this: Given that McCarthy’s book seems to argue that biomedical interventions can cure autism, Dr. Gordon’s stamp of approval in the form of his foreword makes me wonder whether he prescribes the woo described therein. After all, if Dr. Gordon believes that these biomedical bits of woo that Jenny McCarthy has advocated in her most recent book and in her previous book help “recover” autistic children, than why wouldn’t he recommend them to his patients? If he really believes they work, then ethics would demand that he do so. In actuality, I really, really hope that Dr. Gordon doesn’t use such treatments in his practice. In the end, because Dr. Gordon strikes me as a nice enough guy whose general credulity and lack of scientific acumen has led him down a disturbingly wrong path, I keep hoping against hope he’ll eventually see the light. However, his having penned such a brain dead, fallacy-filled introduction to a brain dead, fallacy-filled book advocating dangerous quackery does not make me optimistic that this will ever happen. It’s just the latest example of his apologia for antivaccinationist pseudoscience. Dr. Gordon can proclaim to high heaven that he really, truly is not “antivaccine,” but that doesn’t make it so. His words and actions belie his denials, and it is quite accurate to conclude that, at the very least, he is an apologist for the antivaccine movement.

More’s the pity.

Note: Special thanks to Dad of Cameron over at Autism Street, for contributing to parts of this post.



Posted by David Gorski