MMR panic in Swansea and policing
By P.A.J. Waddington
I often think that we learn more from the experiences of those whose lives are different from our own than we do from those who share our experiences. Distance often confers clarity and gives a greater appreciation of context, enabling similarities and differences to become visible. This occurred to me recently as the news of the increasing measles epidemic in Swansea began to grow more alarming. What on earth, you might ask, has this to do with policing? Well, quite a lot.
The origin of this measles epidemic is widely attributed to a controversy that erupted in medicine in the late 1990s. Dr Andrew Wakefield published an article in the Lancet claiming to have found an association between the MMR (measles, mumps and rubella) vaccine and autism. This initiated a media–hyped panic which prompted parents to become wary of having their children vaccinated. In due course, the panic abated, Dr Wakefield’s claims were investigated and refuted, and the Lancet article was retracted. However, what remained was a pool of unvaccinated children who were growing into adolescence and it is feared that it is the existence of this pool of vulnerable young people that has created the conditions in which the current epidemic has flourished.
On the face of it, this is a catastrophic failure. Dr Wakefield’s research was described as “fraudulent” by the British Medical Journal and the General Medical Council found him guilty of breaches of the code of medical ethics for which he was struck off the Medical Register in 2010. However, was the Lancet to blame for publishing research that turned out to be erroneous? Most definitely not!
The logic of scientific discovery, as the eminent philosopher of science — Sir Karl Popper — reminds us in his book with that title is one of conjecture and refutation. The whole point of science is that it advances by people making what appear to be wildly counter–intuitive, even outlandish, suggestions that resist all attempts to refute them. The history of science is littered with names now elevated to the status of secular sainthood, whose theories contradicted the verities of their age and disturbed and outraged informed opinion. Ignaz Semmelweishad the effrontery to suggest that patients were dying in hospital because doctors failed to wash their hands before touching them. For this he was hounded out of Vienna and eventually died an ignominious death. Semmelweis was right and his legacy is that device on the hospital wall that invites all visitors to clean their hands with antiseptic before entry. Because a hypothesis is unpopular does not mean that it is wrong.
The genuine problem for medicine is how it can remain open to controversial hypotheses — most of which will be wrong, but occasionally one of them will be correct and spark improvements in health care — whilst avoiding creating needless panic and the disastrous consequences that may continue to be felt decades afterwards.
This too is a problem for evidence-based policing, which is self–consciously, and correctly, modelled on scientific methods. Let us take an example: in good faith forensic scientists a hundred years ago asserted the infallibility of fingerprints as evidence of identification. On that basis, numerous criminals have been convicted and imprisoned; doubtless, some of them were executed. Now, and for some years past, the infallibility of fingerprint evidence has been questioned by, amongst others, Dr Itiel Dror at the University of Southampton Management School.
The grounds for his scepticism lie not in the biology of unique fingerprints, but in the psychological process of deciding whether two prints match, especially when one of them is a partial “latent” print found at the scene of a crime. He has conducted experiments in which forensic scientists are asked to match prints under varying conditions and his results are, to say the least, disturbing. If he is right, should we throw open the prison gates and allow out all those whose convictions rested on fingerprint evidence, especially if some of those are terrorists or serial murderers? Or should the scientific establishment seek to smother Dr Dror’s outrageous conjecture, taking their lead from the physicians of 19th century Vienna? It is a dilemma, just like the dilemma over Dr Wakefield’s hypothesis. Real lives may be at stake.
The criminal justice system is intolerant of error. It erects huge obstacles (the burden and standard of proof) to securing a verdict of “guilty”. When error is detected, scandal ensues, public confidence is damaged, scapegoats are paraded, reviews are initiated and revisions to procedures are made to ensure that no such calamity can be repeated. On the other hand, science thrives on error. It was the inability of Newtonian physics to fully explain the orbit of Mercury that prompted Einstein’s theory of relativity. Geneticists used to think that most DNA was “junk,” but latest developments have shown that, on the contrary, it is essential.
Could the shibboleths of our justice system withstand the scepticism of science? Could it survive in an environment in which truth was only ever asserted provisionally and remained open to refutation? Perhaps, like the physicians of Vienna, we must learn to do things differently. If so, that goes well beyond washing our hands!
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