And those magic wristbands don’t work, either

6 01 2011

Andrew Wakefield is a fraud—and the British Medical Journal has the evidence to prove it.

I tend to stay away from anti-vaxers, not because they don’t deserve the derision, but because there are many who are much better situated than me (see, for example, this post by Orac at Respectful Insolence) to take ’em on.

It’s not that there are no risks associated with vaccines or that no one has ever been adversely affected by vaccines—every year, for a quick example, there are people who are adversely affected by the flu vaccine who likely would have been fine without it—but one has to be clear what those risks are.

Stating that the measels, mumps, and rubella (MMR) vaccine causes autism is not clarifying those risks.

In fact, Wakefield was not only wrong when he made that connection in a 1998 Lancet article (an article which was retracted in 2010), he was deliberately wrong, that is, he fucked with the data. As the editors of BMJ note:

The Office of Research Integrity in the United States defines fraud as fabrication, falsification, or plagiarism. Deer unearthed clear evidence of falsification. He found that not one of the 12 cases reported in the 1998 Lancet paper was free of misrepresentation or undisclosed alteration, and that in no single case could the medical records be fully reconciled with the descriptions, diagnoses, or histories published in the journal.

Who perpetrated this fraud? There is no doubt that it was Wakefield. Is it possible that he was wrong, but not dishonest: that he was so incompetent that he was unable to fairly describe the project, or to report even one of the 12 children’s cases accurately? No. A great deal of thought and effort must have gone into drafting the paper to achieve the results he wanted: the discrepancies all led in one direction; misreporting was gross. Moreover, although the scale of the GMC’s 217 day hearing precluded additional charges focused directly on the fraud, the panel found him guilty of dishonesty concerning the study’s admissions criteria, its funding by the Legal Aid Board, and his statements about it afterwards.

Furthermore, Wakefield has been given ample opportunity either to replicate the paper’s findings, or to say he was mistaken. He has declined to do either. He refused to join 10 of his coauthors in retracting the paper’s interpretation in 2004, and has repeatedly denied doing anything wrong at all. Instead, although now disgraced and stripped of his clinical and academic credentials, he continues to push his views. [emphasis added]

Again, I leave it to the medical and scientific folk to tear into Wakefield’s manipulations; I want to address the public health implications of his fraud.

BMJ’s editors note that it is difficult to trace declining vaccination rates in the UK and elsewhere directly to Wakefield’s work, but it is clear that rates had fallen after 1998, and are still below the World Health Organization’s recommended coverage of 95 percent of a population. In 2008, measles were “declared endemic in England and Wales”, and an outbreak of mumps in Essen, Germany revealed that of the 71 children affected, 68 hadn’t been vaccinated. Finally, according to a June 2009 Pediatrics article (as discussed in the Wired article linked to, above), pertussis rates jumped from 1000 in 1976 to 26,000 in 2004.

So what? So some kids get sick for awhile. Sucks for them, but that’s what they get for having anti-vax parents.

Except that it’s not fair for those kids, and it puts others at risk of morbidity and mortality. Measles can kill. Meningitis can kill. Pertussis can kill, and on and on. Furthermore, many of the diseases which can be prevented by vaccines depend on herd immunity—they work mainly by preventing a disease from settling into a reservoir in a population—which means that if enough people in any given group are unvaccinated, the disease can spread.

Again, what’s the problem? If folks don’t get themselves immunized, that’s on them.

But it’s not. There are some people—infants, transplant patients, people with compromised immune systems, those  who may be  allergic to (as I am to the egg in flu vaccines) or otherwise intolerant to ingredients in the vaccine, among others—who are vulnerable to outbreaks. And even those who have been vaccinated may be at risk if, say, an especially virulent form of a disease is allowed to spread.

So back to the beginning(ish): There are risks to vaccination, but so there are greater risks to not vaccinating, not only to yourself or your kid, but to everyone around you.

Some parents feel quite comfortable withholding vaccines from their kids, but the only reason they can safely do so is because every other parent is vaccinating her kids. And hey, guess what, if everyone else has to take the risk to keep the disease at bay, then so should the anti-vaxers. Unless they are willing to keep themselves and their kids away from everyone else for as long as they all remain unvaccinated, they are free-riding on the rest of us. They are, in a sense, ripping us off.

If you want the benefits, you have to bear the burdens.

Finally, it is worth noting, along with the editors of BMJ,that

[P]erhaps as important as the scare’s effect on infectious disease is the energy, emotion, and money that have been diverted away from efforts to understand the real causes of autism and how to help children and families who live with it.

Wakefield and Age of Autism and Generation Rescue are doing no favors for those who do have autism or their families. Jennifer McCarthy and JB Handley, parents of kids with autism, may sincerely believe their bullshit, but the sincerity of those beliefs does not make that bs any less malodorous.

Who knows, maybe there is a specific cause for autism, one which, if rooted out, could lead to the end of this syndrome.

But that cause ain’t the MMR vaccine.





Free free, set them free (pt II)

19 08 2009

When we last left off, we were discussing the difference between free and, well, not-free. . . .

More to the point, while we humans may generate bits, we ourselves are made of atoms. However useful may be the comparisons between one’s genome and the bits and bytes of computing, our genomes require us to take in a certain amount of energy (in the form of calories, a.k.a., food) in order to function. And in order for these genetic information processors to receive their requisite amounts of energy, some other genetic information processing unit (gipu) must grow and deliver said energy to a location wherein multiple gipus may—wait for it—purchase said energy for their use.

Information may be free, but food isn’t. And for one to acquire such food, one must be, yes, paid, for one’s work. This payment, of course, also allows for the purchase of such old-economy items as a home, clothing, car, bike, beer, and computer, electricity, and broadband connection.

Thus, while I may blog for no payment, I don’t rely upon this blogging to pay for the rest of my life. And while WordPress may recoup costs by placing ads in my blog (as, for example, my e-mail providers do with my messages), that I neither pay nor get paid doesn’t mean that money isn’t changing hands somewhere up or down the line.

So how do I get paid? By absorbing, rearranging, and delivering information, i.e., I teach. And as much as I enjoy teaching, if CUNY wouldn’t pay me, I wouldn’t be doing it. In other words, I distinguish between a hobby (blogging) and wage-labor (teaching). Were such wage-labor to disappear, so too would would the hobby.

In other words, if I don’t get paid, I am unable to support my life—as in lifestyle, or, at the extremes, the biology itself.

Thus the basic question: if the economy is to be based on free, how is anyone to live?

Marx noted that capitalism required its laborers to be sustained, however minimally, in order to be able to work. (Corpses tend toward absenteeism.) Among the elements of the allegedly-inevitable crisis of capitalism would be the immiseration of the proletariat below the level of sustainability.

Some capitalists have made a similar observation. Even that old anti-semitic bastard Henry Ford  got one thing right about the labor force in a capitalist economy, namely, that if you wanted people to buy your product, you had to pay them enough to afford it. With this insight, he married two essential elements of any economy—the dynamic of consumer supply and demand for products, and the role of labor in creating those products. (In so marrying these elements, he highlighted the dual role of the laborer as both producer and consumer, creating a sustainable form of consumer capitalism that Marx did not foresee.) Capitalism in particular relies upon the differential between the cost of production and the price for the products for the creation of profit; thus, price must more-than-cover costs for profit to be generated.

Anderson breezes past all this. It is fashionable to discount the role of labor in production and to focus exclusively on supply and demand, such that the price for a product is allegedly solely based on s&d and bears little relation to labor costs, but:  no labor, no product. If labor costs didn’t matter, corporations wouldn’t bother to move production overseas in order to drive down those costs.

It’s one thing to engage in a hobby, which presumably one finds pleasurable, for free; it’s quite another to slog through a pile of exams or operate a punch-press or make caramel macchiatos for caffeine-crabby customers for free.

Oh, but manufacturing and retail are so atom-based, so they don’t count (I don’t know if Anderson has anything to say about teaching or medicine or law—rather significant information-based professions). But if this is a truly new economy, then how does one account for such atom-based activity? And given that the bit-based economy requires the presence of such atom-activities, wouldn’t this new information economy be better understood as the icing on the, ah, old capitalist cupcake?

Or is what’s new the notion that we are to labor for free? The costs of producing, say, an investigative report or song or book are completely discounted because the production itself doesn’t matter; what matters is the selling of that product. Thus, a band doesn’t tour to promote their music, a band promotes its music (for free) in order to sell the product (the band itself, on tour).

Again, the selling or trade of a product is a part of any economy, but in order for such trade to become or remain sustainable, it must have some positive relation to the costs of production. Metallica and Madonna have become sufficiently well-known commodities that they can, in fact, sustain themselves  through the sale of themselves, i.e., touring, but how can the unknown band or musician  support themselves outside of such a profitably virtuous circle?

What, posting on YouTube and blogging and Twittering one’s way into fame? Nothing against YouTube or Twitter—and hell, I’ll drop my anti-Facebook stance and throw that in the mix as well—but if everyone is using these fancy bits to generate publicity for themselves, how the hell is one supposed to distinguish oneself well enough to launch that profit-generating (and atoms-based) tour?

Do you know what musicians (and actors and writers and dancers and artists) are called in New York City? Waiters, baristas, teachers, and temps. Our vocation may be in the arts, and we may put a great deal of work into our vocations, but until we get paid for it, it ain’t wage-labor. Which means we have to find another way to pay the rent.

It’s not as if Anderson doesn’t make some intriguing points about third-party payment for certain technologies, and, in this Wired article from 2008, he notes that time has its own costs (although he doesn’t go so far as to make the brilliantly original observation that time is money, perhaps because he’s trying so hard to get away from money). And he notes in this article that ‘free’ is distinct from ‘cheap’ in psychologically important ways. (I won’t comment on this latter observation because 1) I fail to understand what’s new or particularly significant about this observation and 2) he does apparently expend a fair amount of energy in the book explaining what is new and significant about it. Plus, this post is already too long.)

But allow me one last jab. In the Wired article Anderson quotes Milton Friedman’s adage that ‘there’s no such thing as a free lunch,’ but then goes on to wonder if so-called traditional economics doesn’t have it wrong. Thus:

a free lunch doesn’t necessarily mean the food is being given away or that you’ll pay for it later — it could just mean someone else is picking up the tab.

Exactly. But there’s little new or innovative, much less revolutionary, about this kind of economics, not least because  usually you do, somehow, pay for it later, as, say, in the expenditure of your time viewing or listening to advertising—or, as broke young hotties looking for a sugar daddy or mama learn, in some other atom-based way.

And if you don’t? Say it with me: It’s not free; it’s freeloading.

Ain’t nothing new about that.





Free free, set them free (pt I)

16 08 2009

This is not a book review of Chris Anderson’s Free.

Mainly because I do not want to pay for Free, but, given what I’ve heard him say repeatedly on various radio talk shows, I’m not at all sure I want to read it.

That said, I’m an academic, and what’s a Ph.D. for if not opining on something about which I know little?

Anderson’s basic argument is that technological innovation has reached the point of near-vanishing costs, such that information (in a variety of forms) is, essentially, free.

In the book excerpt available at Scribd, Anderson notes the early adventures of those who would sell Jell-O and Gillette razor blades. They couldn’t, in fact, sell the products, so they gave them or something associated with them away for free or at a steep discount:

Thus was born one of the most powerful marketing tools of the twentieth century: giving away one thing to create demand for another.

The key, for Anderson, is not that the freebies were used to entice people to pay, but that they were, in fact, free. Thus, in the brave new millennium, free takes its rightful place at center stage:

This new form of Free is based not on the economics of bits, not atoms. It is a unique quality of the digital age that once something becomes software, it inevitably becomes free—in cost, certainly, and often in price. . . . The twentieth century was primarily an atoms economy. The twenty-first century will be equally a bits economy. Anything free in the atoms economy must be paid for by something else, which is why so much traditional free feels like bait and switch—it’s you paying, one way or the other. But free in the bits economy can be really free, with money often taken out of the equation altogether.

Sounds good; too bad he’s wrong.

You see, Anderson isn’t really arguing that all information will be free—just that you, the consumer, won’t have to pay for it. While that might seem to be free, it’s actually freeloading. Because you’re freeloading off advertising (i.e., information paid for by, say, a corporation), this is unlikely to offend anyone’s (be they from the left or the right) sensibilities. And since the advertiser knows that she’s paying for you to look [for free], she’s not offended, either; in fact, she’s counting on you to look.

Win-win, right? Hell, I watch shows on Hulu (finally caught the last few episodes of Battlestar Galactica last night), and have no problem with the few ads which pop up at the beginning or in the midst of the shows. I can watch or look away or get up to grab a beer or popsicle. Whatever. They pay, I play.

But is this sustainable? Maybe. But if Hulu or the producers which supply it with content can’t make money from it, it’ll go away. I may not pay, but damned well somebody has to.

Malcolm Gladwell has already written a much-cited & -linked takedown of Anderson’s argument, noting

Free is just another price, and prices are set by individual actors, in accordance with the aggregated particulars of marketplace power. “Information wants to be free,” Anderson tells us, “in the same way that life wants to spread and water wants to run downhill.” But information can’t actually want anything, can it? Amazon wants the information in the Dallas paper to be free, because that way Amazon makes more money. Why are the self-interested motives of powerful companies being elevated to a philosophical principle?

(I’m not much of a fan of Gladwell’s—his m.o. is to take note of a particular behavior or set of behaviors in a specific context, then generalize this behavior beyond all context and, often, reason—but perhaps his glibness is a perfect match for Anderson’s own shallowness.)

But let’s say that Anderson deals with all this in his book, and is able to delineate how this model is qualitatively different from, as opposed to a simple iteration of, the old (twentieth century! atoms-based!) model.

And this is where I want to stick the knife in: into that alleged gap between the atoms (material) and the bits (information). For one, as Gladwell so ably points out, bits rely on atoms:

“The more products are made of ideas, rather than stuff, the faster they can get cheap,” [Anderson] writes, and we know what’s coming next: “However, this is not limited to digital products.” Just look at the pharmaceutical industry, he says. Genetic engineering means that drug development is poised to follow the same learning curve of the digital world, to “accelerate in performance while it drops in price.” But, like Strauss [who thought electricity would someday be ‘too cheap to meter], he’s forgotten about the plants and the power lines. The expensive part of making drugs has never been what happens in the laboratory. It’s what happens after the laboratory, like the clinical testing, which can take years and cost hundreds of millions of dollars.

Hulu may provide free-for-me viewings of Buffy, but it relies on my having purchased a computer, reliable electricity (which in turn relies upon coal, nuclear, or hydro energy, delivered through cables, etc.), and decent broadband services. None of which are free.

Next: capitalism! labor theory! cupcakes!