“I think you’ll find it’s a bit more complicated than that” – Ben Goldacre
adj. Describes the state of maintaining a healthy level of scepticism about what is read or portrayed in both popular media and academic publications.
In the last few weeks, women everywhere have been confronted by an astonishing and unexpected revelation that may change their lives forever. It turns out there is absolutely no need to take a seven day break in your oral contraceptive pill. Well, I hear you muse, that is pretty astonishing. But on the other hand, it’s not unheard of, or even unusual, for new research to take advantage of more advanced techniques to disprove something that we have taken for granted for many years. Fair enough. Tough crowd. How about this then: there has never been any real need to and we’ve known all along. Say whaaaaaaaaat??
This isn’t the first time that there has been a mass hoodwinking about an important health related issue. Some of you reading this may not have very vivid memories of the events of 1998, but many of you will remember it as the year Andrew Wakefield and his team published in The Lancet that they had found a quantifiable link between the MMR vaccine and autism. The events that followed are undeniably one of the most catastrophic public health failures that high income countries have seen in modern times. And we are still trying to fight our way out of the quagmire twenty years on despite the evidence being disproved many times over since its original publication.
So how does this happen? In one word: agenda. Everyone has one. Some of them are laudable and some of them are ethically dubious, but they exist nevertheless. In Andrew Wakefield’s case, a 2004 investigation by a Sunday Times journalist revealed that the families involved in his initial study were suing the manufacturers of the MMR triple vaccine and Wakefield was offered a substantial financial incentive by their legal teams to produce and publish evidence that would back their case.
What about our friend the oral contraceptive pill? It has been revealed that one of the scientists working on the development of this pioneering medication was staunchly Catholic and felt that the seven day break would not only mimic a woman’s natural cycle, but would also be more palatable to the Catholic church, especially the Pope, who are known to be firm opponents of contraception of any kind.
Both of these cases have the propensity to evoke outrage in anyone who reads them, but before you paint your placard and march to Speakers Corner to yell at innocent bypassers, remember, everyone has an agenda.
A closer look at Andrew Wakefield’s case reveals that whilst his practices were abominable and have cost the health and wellbeing of thousands of children, he wasn’t single handedly responsible for the sensationalism that followed the publication of his research. UK media, led by Melanie Phillips in the Daily Mail, created a scare that caused a drop in uptake of the vaccine from over 90% to just under 79% in 2003. The death of a 13 year old boy from measles in Manchester and a recorded 450 cases of measles meant that 2006 saw the highest recorded incidence of measles in the UK for over 20 years. This was swiftly followed by 1000 cases of measles in South Wales in 2013 following a media storm led by the South Wales Evening Post declaring the vaccine unsafe.
How does this relate to our Pope pleasing pill story? The story about the Catholic scientist was published in the Daily Telegraph a few weeks ago, but by no means tells the whole story. Jane Dickson, Vice President of the Faculty of Sexual and Reproductive Healthcare, sets the story straight by explaining that advice to take a seven day break in the pill when it was first introduced in the UK for free on the NHS in 1961 was multifactorial. Firstly, the doses of hormones in the contraceptive pill back then were 100 times higher than the ones we have today. Women often felt unwell whilst taking the pill and the seven day break was often welcome relief from the side effects of having so many hormones in their body. Secondly, the “bleed” that was experienced has been seen as confirmation of the absence of pregnancy, although we now know that this is false. Over the last 60 years, our research has improved and we are now able to take much more tolerable amounts of hormone to interrupt the normal cycle and prevent pregnancy and the anxiety over such a new and radical drug has subsided.
You can probably see that there is a common denominator in these two stories; the media. I am by no means suggesting that you can’t believe or trust anything you read, but in the end, the media also have an agenda, and, spoiler alert, it’s not to keep us up to date with the news in an unbiased way. They want to make money and sensationalism sells. And whilst this is not intended as a political piece in any way, with Brexit currently being splashed across our papers and news feeds daily, you may choose to apply this information in any way you wish.
But don’t burn your newspapers, delete your news apps and live in a remote cave just yet. The point of sharing all of this is to remind you that it pays to maintain a healthy level of scepticeamia and to be mildly cynical about what you hear and read when it is presented as absolute fact. The same goes for research. Critical analysis is no more than being a little bit wary of accepting information at face value. If something doesn’t seem to add up or only provides one side of the story, investigate. Stay curious. Without curiosity, the truth is never found.