AmyTuteurMD

AmyTuteurMD
Bio
Dr. Amy Tuteur is an obstetrician-gynecologist. She received her undergraduate degree from Harvard College and her medical degree from Boston University School of Medicine. Dr. Tuteur is a former clinical instructor at Harvard Medical School.

Editor’s Pick
DECEMBER 25, 2008 4:36PM

The unnecessary death of a little girl

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Three year old Eliza Jane Scovill died on May 16, 2005  of AIDS related pneumonia. The death of any child is a terrible tragedy, but is even more poignant if it is avoidable. When Eliza became ill, her mother, Christina Maggiore, neglected to tell the doctors that both she and Eliza were HIV positive. It is not clear that Eliza could have been saved by the time she was brought to the hospital, but without an accurate medical history, doctors lost valuable time in determining the causative agent, and therefore, the appropriate treatment for Eliza's pneumocystis carinii pneumonia. Pneumocystis is an otherwise harmless bacteria that causes pneumonia only in people who are severely compromised by AIDS or other immunologic failures.

Why did Christine Maggiore withhold this critical information? She did it because she is an activist who believes that HIV does not cause AIDS.

Maggiore had a homebirth with Eliza because no doctor would care for her unless she agreed to take medication to prevent the transmission of AIDS to her unborn child. She was counseled not to breastfeed Eliza, but she did so, and published pictures of herself breastfeeding Eliza to show her confidence in her belief that HIV does not cause AIDS. She never allowed Eliza to be tested for HIV, because she felt that there was "no need". After her daughter's death, she gave interviews claiming that she did not mention her HIV status, and the fact that her daughter was almost certainly HIV positive, because she did not want the doctors to "discriminate" against her daughter. Although the autopsy report and the slides of the pathology examination have been released publicly, Maggiore insists that Eliza died of an anaphylactic reaction to antibiotics, not of pneumocystis pneumonia. 

Christine Maggiore is guilty of the medical neglect of her daughter Eliza. According to the American Academy of Pediatrics position paper Recognizing and Responding to Medical Neglect, written by Carol Jenny of the AAP Committee on Child Abuse and Neglect:

Several factors are considered necessary for the diagnosis of medical neglect:

1. a child is harmed or is at risk of harm because of lack of health care;

2. the recommended health care offers significant net benefit to the child;

3. the anticipated benefit of the treatment is significantly greater than its morbidity, so that reasonable caregivers would choose treatment over nontreatment;

4. it can be demonstrated that access to health care is available and not used; and

5. the caregiver understands the medical advice given.

Reasons for medical neglect include: poverty, lack of access to care, family chaos, lack of awareness, lack of trust in health care professionals, and caregiver’s belief systems described as:

Some caregivers have belief systems that are inconsistent with Western medicine. A parent of a child who has a serious illness may decide to rely on untested remedies or alternative medicines. Some caregivers will seek healing through religion rather than medical care...

The paper outlines the provider's ethical and legal obligations when confronted by medical neglect due to parental beliefs:

Medical neglect evaluations should focus on the child’s needs rather than the caregiver’s motivations or justifications. Religious objections, therefore, should not be granted fundamentally different status from other types of objections.

Although competent adults have the right to refuse life-saving medical care for themselves, the US Supreme Court has stated that parents do not have the right to deny their children necessary medical care. The court made this clear in 1944 in Prince v Massachusetts. "The right to practice religion freely does not include the liberty to expose the community or child to communicable disease, or the latter to ill health or death. . . . Parents may be free to become martyrs themselves. But it does not follow they are free, in identical circumstances, to make martyrs of their children. . . ." The American Academy of Pediatrics has taken a firm stance on the rights of seriously ill children to receive lifesaving medical care even if their parents subscribe to religious beliefs that are antithetical to medical care.

There is no special status granted to religiously motivated medical neglect, and therefore, there is no special status granted to medical neglect motivated by belief systems such as AIDS denialism.

Did society fail Eliza? Or do parents have the "right" to sacrifice the lives of their children because of their own delusions? There is a very good chance that Eliza would be alive today and AIDS free if her mother had followed medical advice. Did Eliza have a right to the best medical care that society can offer or does her mother's right to follow her own beliefs supercede a child's right to live a healthy life, or even to live at all.

What is the difference between the delusions of Christine Maggiore, and the delusions of vaccine rejectionists? Both have precisely the same scientific foundation, which is to say no foundation at all.

What are the responsibilities of health care providers who counsel AIDS denialism? Eliza's pediatrician was Paul Fleiss (Heidi's father), a pediatrician known for his unconventional views, who has said he could be "convinced either way" about the role of HIV in AIDS. Does he bear any responsibility for Eliza's death?

Christine Maggiore, for her own personal reasons, truly and deeply believes that HIV does not cause AIDS. Many vaccine rejectionists truly and deeply believe that vaccination is not safe. The risk of death from AIDS is much higher than the risk of death from vaccine preventable diseases, but the principle is the same. Do parents have a "right" to sacrifice the lives of their children on the altar of their personal beliefs?

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Once the child is out of the mother's body, the mother has absolutely no right to sacrifice the child's life "on the altar of their own personal beliefs". This woman should have had her parental rights terminated by the court and the baby should have received anti-retroviral therapy and formula, not breastmilk.
A question about the doctors that refused to care for her because she refused HIV medications, such that she had to have a home birth. What is/was their responsibility?
hollycomesalive:

"the baby should have received anti-retroviral therapy and formula, not breastmilk."

I agree. This case seems pretty clear cut. However, we need to be able to articulate some general principles to guide us overall. For example, there's no scientific basis for vaccine rejectionism, so should we deny all requests for vaccination waivers? How about cases of cancer where no one can say for sure that chemotherapy has a good chance of success? Should parents be allowed to forgo chemo for their children if they think the risks and side effects outweigh the benefits?

This is a very difficult area of medical ethics because we don't want to interfere with the ability of parents to raise their children any way that they want unless there are absolutely compelling ethical reasons.
Chris Wolak:

"What is/was their responsibility?"

No doctor is required to provide care that they believe is substandard or dangerous.
This case is particularly disturbing to me because many of my friends revere Paul Fleiss/Jay Gordon and take their children to these two pediatricians. They are extremely popular and do not take new patients because they are so busy - neither of them accepts health insurance either and the fee per visit is out of this world expensive. Both were involved in the Maggiore case and both are extremley popular physicians. They are nice guys and I agree with some of the tenets of their practices but others seem outrageous to me.
This is tragic but I think your comparison between this and parents making informed decisions not to vaccinate is ridiculous.
The parent has no right to put the life of the child at risk; except of course when the country has to be defended from the risk of Iraqi WMD and it wouldn't look good if Jr. didn't sign up.
I had a half sister 2 years younger than me who I never got to meet because her mother did not believe in medical care. She denied doctors permission to put in a shunt to drain the excess fluid from around her daughter's brain. My sister died because of this and I have been a vehement supporter of child's basic medical care despite religion since then.
Natalie B:

"This is tragic but I think your comparison between this and parents making informed decisions not to vaccinate is ridiculous."

They are not making "informed" decisions anymore than Christine Maggiore was making an informed decision to deny that HIV causes AIDS.

That's why these situations are so difficult ethically. The parents almost always believe that they are "informed" and that they are doing what is best for the child, but they are objectively wrong.
Nerdyjen:

"I had a half sister 2 years younger than me who I never got to meet because her mother did not believe in medical care. She denied doctors permission to put in a shunt to drain the excess fluid from around her daughter's brain. My sister died because of this ..."

How terrible your family, for you and most of all for your sister.
I hate to jump on the bandwagon and agree with almost everyone else on this site, but you're wrong. Again. I made a choice not to immunise any future children I may have after my daughter was hospitalised after a vaccine. I weighed the benefits and the risks and came to a decision based on what I had researched.

Your assumption that you know best about everything is not only irritating its also hurtful. Blanket statements and sweeping generalisations don't do anyone any favours.
Many vaccine rejectionists truly and deeply believe that vaccination is not safe. The risk of death from AIDS is much higher than the risk of death from vaccine preventable diseases, but the principle is the same.

To be clear on the general principle, do you believe that the soldiers who refused to take the anthrax vaccine a few years ago were right or wrong?
This is so sad. In 2008, when we live in world of health, hope, and medical effectiveness our poor ancestors could only dream of, created by the real-world miracles of vaccination, antibiotics, careful scientific enquiry, systematic procedures and testing...acch.

The willful ignorance and simple-mindedness of (usually) the left, and "new age" adherents, when it comes to the confluence of corrupt Big Pharma and a bloated/malfunctioning health system on one side, and personal health on the other, is complex, to say the least.

But the moment someone points out the excesses of paranoia, anti-science, gullibility, and hypocrisy that plague progressives when they address the proven fruits of science, they are under attack for being a tool of corporations, or of the Right, or unenlightened, heaven forfend!

I have been a liberal, progressive Democrat my whole life, pro-union, voted for Obama, anti-war and anti-nuke activist, going back to my first demo in 1967. I have an open mind, but no so much that my brains fall out, as they say.

Please: Natalie, Blue Eyes, et al: read this: 20 Logical Fallacies (http://www.theskepticsguide.org/logicalfallacies.asp). This is the REAL enemy. All else is temporary players, succumbing to or USING these to fool us. If placed in a room and confronted with a list of 100 improvements we wish Obama would make, I'll bet 90% of OS's would agree on most of them, in principal if not methods. We are all concerned about compassionate, smart, and just healthcare.

But recognize her careful reasoning for what it is, and address the points directly, using consistent logic and science, not anecdotes and invective.

Dr. Amy is making the case. Make yours, and if you want it to be taken seriously as rational, scientific thinkings, learn how it is done. None of us should trust "claims" that can't be falsified, tested, reproduced in well-designed studies. Like it or not, vaccines pass those tests spectacularly well. Almost all of the claims made by alt med do not. You can't "win" by changing the playing field to one of scorn, ridicule, and selective deregulation...er, well, actually that last item HAS been accomplished. And it has led to tragedies like the one described here, where citizens, unable to trust a broken health care system, fall prey to pseudo-science, false labeling, magic elixirs, and simplistic theories. They won't make up for indifferent caregivers and inadequate health resources, we need to fix that, but the failings of the one do not rationalize the inanities of the other.
what exactly is amy's point though? that a lot of kids die from parental neglect? we already know that. or is it that doctors are always right and laymen are always wrong? i've seen plenty of cases where that is NOT true. so, what's amys point? didn't really see one.
Parents have the ultimate say in what medical treatments their children get and do not get.

You are correct Amy, in the sense that this case is so hard to "weigh", as ethics isn't always clear cut.

I can understand some parents wanting to hold off on certain vax, but a mother who willingly witholds vital info regarding her childs health history and thus refusing treatment to save her life . . .excuse me but that is just f'd up, period. That IS abuse and neglect.

Also, what do you do when a parent wants to try something other than the recommended treatment? Do you go over their head and get the courts invloded to force the treatment "the Dr's" feel is best or you you allow the parents to make that call?

There are no easy answers, unfortunatly.
Natalie,
What you are doing is banking on the fact that every other child has been vaccinated / will be vaccinated. You think that, therefore, you can get away with not vaccinating your own child. That is ethically wrong.
Natalie B:

" I made a choice not to immunise any future children I may have after my daughter was hospitalised after a vaccine. I weighed the benefits and the risks and came to a decision based on what I had researched. "

If your child had a documented vaccine reaction, her situation is entirely different than the overwhelming majority of children. Severe vaccine reactions are well known, do occur and may be a contraindication to future vaccination.

Claiming that there is something wrong with vaccination for that reason is equivalent to claiming that penicillin is dangerous because some people are allergic to it. Both are predictable, known events, which are expected in a some subset of the population.
Greg Carroll:

"But the moment someone points out the excesses of paranoia, anti-science, gullibility, and hypocrisy that plague progressives when they address the proven fruits of science, they are under attack for being a tool of corporations, or of the Right, or unenlightened, heaven forfend!"

That's because vaccine rejectionism is not about vaccination, anymore than AIDS denialism is about AIDS. It's all about the parents and their need to pretend that they are "educated" and "empowered."

Vaccines have been around for more than 200 years, and vaccine rejectionists have been around for almost as long. Over the years, they have made countless accusations about the "risks" of vaccines, and they have been wrong every single time. Despite the fact that vaccine rejectionists have been 100% wrong in their understanding of vaccines, statistics, risks and claims of specific dangers, they still have a large following. In large measure that is because the cultural claims of vaccine rejectionists resonate with prevailing cultural assumptions. Vaccine rejection is a social construct that has little if anything to do with objective reality or science.

The problem that vaccine rejectionism is based on false premises is elided by ignoring the actual scientific data and focusing instead on whether parents agree with health professionals or refuse to trust them. Agreement with doctors is constructed as a negative and refusal to trust is constructed as a positive cultural attribute.

Vaccine rejectionism is about the parents and how they would like to see themselves, not about vaccines and not about children. In the socially constructed world of vaccine rejectionists, risks can never be quantified and are always "unknown". Parents are divided into those (inferior) people who are passive and blindly trust authority figures and (superior) rejectionists who are "educated" and "empowered" by taking "personal responsibility".
Lady Miko:

"this case is so hard to "weigh", as ethics isn't always clear cut."

And this isn't even the most difficult kind of case. The most difficult cases usually involve parents who believe in faith healing. They reject medical treatment for their children because they honestly believe that it imperils the child's soul. They are not amenable to scientific evidence, because science is literally beside the point.

We rightfully take religious freedom very seriously, so ethical conflicts of this kind are among the most difficult to resolve.
Amy:

Your description of the issue is well-written. I agree: there is a pervasive need to feel, to BE, empowered. Over the last eight years individuals on the left in particular have struggled with personal issues of powerlessness, and perhaps now Reagan Democrats and millions of others at last feel the same frustrations.

And as we would agree, it does not justify glomming together the two: the real need for honest, more responsive politico-corporate institutions and to have more direct effect when systems fail or rights are trampled on, vs. the false sense of power that comes from the denial of, and refusal to make use of, reliable science. I appreciate the finegrained understanding you demonstrate of motivations, and I agree that this is a social construct, a dangerous one, and not-reality-based.

This is in fact the point: they reject empiricism as some kind of immoral plague, demented thinking, a demonized mindset, and foolishly believe it is no less a social construct than their own.

Which is why I go at it head-on. Here on OS there is a glimmer of hope, that the most ardent True Believers out there, the ones convinced that Science = Rigid/Wrong/Conspiracy, are at least in this forum exposing themselves to refutation. Not hiding in Weil's pages, but daring to confront rationalism. So I say Yes! stay and continue to grapple!

But to those who would just wave their hands dismissively at the real dangers of allowing polio to return (my father went from iron lung to brace during my childhood; I KNOW from this), or play obtuse, or attempt to change the subject and make it about personalities: this is about, and ONLY about, objective, verifiable science. If you want to engage, cite your sources, make your case, and use SCIENCE. Join us on the level playing field of honest discourse.

Sure, it is conceivable that ANY vaccine might have a flaw, that any homeopathic treatment, herbal remedy, ear candle, or meditation might someday prove to be effective. Go, do good science, let us know what you find. Meanwhile, immerse yourself in the existing research, examine the methodologies, and CATCH UP. Don't just parrot the unscientific hysteria of gadflies and swindlers and deluded anti-intellectuals.

There is a scientific method. It works. It is why we no longer believe in crystal spheres that hang the stars like lanterns. It is why we don't ascribe disease to vile humours and invisible phlogiston anymore. None of us would let a shaman pilot our 747. We all GET this. Systematic examination is the only way.

We must ALL expect to be fooled by data, and to keep questioning; True Believers get that part right. But the answer is never to buy into the first neat, simple-minded, blame-them theory that shows up. The answer, the hard work of modern life, is to be a skeptic, to assemble information, to trust contingently, and to support normative science until and unless it fails to apply, or stops using, real scientific methods.

What the New Age wants is for us to throw out the very thing that prevents self-delusion. Imperfect it is, yep, in fits and starts as it presses outward into new territory, but over the arc of the last 700 years, science has organized out knowledge of the world, made reliable predictions, and eased our burdens.

I'll take this age, plain and simple, whatever it is, carefully examined, again and again, because so far New Age = Dark Ages, and reverential Self-Empowerment = Ignorance.
This is certainly one of the saddest things I've heard in a long time. Not just sad, horrifying, deeply disturbing. My heart breaks, but not just for the child, for the mother too.

The point here, for me anyway, is not to get "revenge" on one individual, the mother, for neglect or abuse (which this certainly was). How does that help? Perhaps people hear about it, perhaps she is "made an example of," and perhaps people who share her belief system (out of sadness, fear, and desperation -- but also a completely justifiable distrust of the western medical industrial complex, a hegemony that propogates its own impenetrable and sometimes harmful (or just wrong) belief system) will then react by only feeling more attacked, more misunderstood, more justified in shoring up their outsider status).

For me this story is a powerful example of the danger and consequences of denial and wishful thinking. These two things are present in each of us, all the time -- they are fundamental in maintaining the motivation(s) that pull every one of us through daily life, form our sense of self, and color our thoughts.

The stakes of wishful thinking are incredibly high -- life and death, as this story shows. Wishful thinking -- which sounds like such a harmless thing really -- is actually a form of violence. This mother killed her child. I assume she truly did not want to do that. Her wishful thinking had a much stronger grip on her than her love for her daughter. We can hate her for that -- which does nothing to change the problem that pervades our culture and is not just one isolated sad story -- or we can recognize that this like of brain-washing is present, at some level, in some form, in all of us.

The question is this: Are any us capable of truly, genuinely, changing our minds? Really changing, taking in new information, thinking about it without fear of our sense of self being shifted in some way that we can't handle?

All of this danger, all of this sadness, is imbedded in the so-popular concept of "hope." Sometimes hope is poison. Hope can kill people. Hope, very often, is wishful thinking. But making a choice, almost like a vow (because it's that difficult), to do more than just "face" reality, to engage with it, to question it, in the form of truly keeping what we call an "open mind," is the most powerful medicine on earth. This mother had what felt like "hope" to her. That's what killed her innocent child. What she needed was an open mind. We are all living between those two ideas, and the consequences are indeed life and death. The consequences of the inability to have a truly open mind, to not be controlled and defined by opinions that seem to make you who you are, that comfort your fears and don't make you confused or anxious -- that consequence is the condition in which we see our world today.

It's just that vast, just that important. This is not one isolated story.
I don't hate this mother or want her "punished." She's already had her punishment. I just fear for all of us who have such a hard time thinking, reasoning, and changing our minds.
Shunyata:

I had a strong response to your plea, to understand how we can change our minds. It is the essence of the thing.

Thanks
Amy:

I strongly believe in the power of faith in regards to health and heaing, but I also have the sense to know when prayer and meditation need a boot from traditional medicine.

I understand what you are refering to, honesty that kind of thing scares me a little. It is one thing to have faith and use it in in conjunction WITH medicine . . .its is a much differant beast to reject medicine altogether.

I wonder if it has less to do with "faith" and more to do with fear?
Amy, yes. She had a documented, recorded reaction. I won't be taking the risk. I'm not anti-vaccine. I don't agree with the current schedule. I think it's too intense.

April, please don't tell me what I'm doing. You don't know me or my family. I'm not banking on anything. My little girl was hospitalised after a vaccine and we thought she was going to die. I hope against hope that this doesn't happen to your children, but if it ever does then maybe I'll consider your opinion on my viewpoint.
Greg Correll:

"There is a scientific method. It works. It is why we no longer believe in crystal spheres that hang the stars like lanterns. It is why we don't ascribe disease to vile humours and invisible phlogiston anymore. None of us would let a shaman pilot our 747. We all GET this. Systematic examination is the only way."

Exactly! If something works, it can be demonstrated scientifically.

Interestingly, everyone understands that there is no such thing as "alternative" engineering or "alternative" computer science, yet the are willing to suspend disbelief in order to accept "alternative" medicine.
Being in the medical field myself, and also being the mother of a son who is considered to be on the Autistic spectrum, I have strong feelings on a parents role in the child healthcare.
I am appalled at the mother for not disclosing her childs previous medical condition.
It is one thing to have a belief based on religion, it is another to have a belief based on ignorance and denial. That child is unable to make her own decisions, and even if she could, the woman who is called her mother has instilled her beliefs, so she would not be able to make an informed decision.
It is an ethical decision. If the doctors who are caring for the child has the same beliefs, then they will not report. The doctors who cared for the child while in the hospital is not going to know that they needed to report the mother for neglect, because they don't know about the childs medical history. If it wasn't disclosed by the mom, and they don't have any records on her, then they cannot make the right decision to help the girl. In this case the medical staff are in the dark and are unable to make an informed decision. You will not know if they knew the information when they started to treat her if her life could have been saved, but we do know that she would have had a better chance of survival if her "Mom" had given that vital piece of information. A doctor cannot knowlingly provide substandard care. It does not follow the standard of care to allow a pregnant woman to jepordize her unborn child with ignorance and denial. It would have been good in hidsight to report the mother at that point to the court system to have her comply, or have social services to follow once the child was born.

On the vaccine issue...I believe that the immunization schedule puts a lot on a small childs body to build up their immune system. I understand that they want children to build up an immunity to as many diseases as possible as quickly as possible. I do believe that if they spaced the immunizations out, and stopped combining them so that when there is a reaction, you would know which one is causing the problem, then you would have a lot more children immunized. I also know that there is the fear that if you spread them out, less people will get immunized because of the lack of prevenative health care after the age of 2. Either by choice, or circumstances.
I also understand that many people are scared to immunize their children because of the Autism issue. My son is on the Autism spectrum. I knew it before he turned one that something was amiss. He wasn't diagnosed until he was 3 1/2 years old. I DO NOT believe that immunizations played a role in his condition. ( I have another theory for that and I should write it one of these days) I do know that for a lot of children the diagnosis for Autism comes after a child enters Kindergarten. This is because the child is now around other children and the teachers are able to guide the parents into realizing that their child needs to be evaluated. It happens to be that at that time the child just recieved all of their 5 year old immunizations, the rite of passage to starting school. I have several more things to say on this subject alone, so I will save it for my blog that I will start at some point. (in my spare time)
LuluandPhoebe:

"A parent does not have the right to sacrifice the life of their child because of their own beliefs. It happens when intervention occurs to late to change anything, but children are supposed to be protected by stringent child abuse/neglect laws and the people they would ordinarily come in contact with are mandated reporters. Someone failed this kid big time."

I agree.
Shunyata:

"For me this story is a powerful example of the danger and consequences of denial and wishful thinking."

This is a critical insight. The roots of AIDS denialism, vaccine rejection and other similar beliefs are denial and wishful thinking.
LadyMiko:

"I wonder if it has less to do with "faith" and more to do with fear?"

There's probably an element of both, but, as a general matter, religious faith is the more important motivator. For a person who genuinely believes that faith can heal, rejecting medical care might make sense.
Natalie B:

"I don't agree with the current schedule. I think it's too intense."

The truth does not depend on what you believe. If there was evidence that the schedule is "too intense," we would see it, but there is no evidence for that.
ZZ Boys Mom:

"I also understand that many people are scared to immunize their children because of the Autism issue."

I have a child on the autistic spectrum also, so I have a personal as well as professional interest. There is no evidence that vaccination leads to autism. The incidence of autism is the same in populations who are vaccinated and those who are not.
"The incidence of autism is the same in populations who are vaccinated and those who are not."

That's absolutely untrue.
Natalie B:

"That's absolutely untrue."

Really? Do you have any scientific evidence to support that claim?
""There is no evidence that vaccination leads to autism. The incidence of autism is the same in populations who are vaccinated and those who are not. "

You made this claim, Amy.

Show us your scientific proof. "

The original claim made many years ago merited attention. Studies were done. The results do not support your claim. But it is still being made by anti-vaccinatioinists, in this form: the many well-designed studies investigating a possible link between autism & vaccines are just...wrong.

Apparently, Natalie & J L et al, you want the scientific community to investigate again and again and again, until we finally prove you right. As if this were a little-guy-beats-the-odds movie. OK. If you are convinced, then immerse yourself in the literature and data, design a study, improve on the methods if you can, raise a little $ to carry it out, see what you come up with. If you fudge the results science will uncover it, but if you really find something, you have done a great service!

We are at a unique time in history, when laypeople can actually do this. We have access to the data via the internet, the tech for studies, meta-analysis at least, is available to all, and the liberal laws of western civ allow it. Go for it!
CDC
http://www.cdc.gov/ncbddd/autism/vaccines.htm

Has these links among others:
Lack of Association between Measles Virus Vaccine and Autism with Enteropathy: A Case-Control Study
September 4, 2008
and note the remarkable interntl author list, and the array of institutions:
Mady Hornig1*, Thomas Briese1, Timothy Buie2, Margaret L. Bauman3, Gregory Lauwers4, Ulrike Siemetzki1, Kimberly Hummel5, Paul A. Rota5, William J. Bellini5, John J. O'Leary6, Orla Sheils6, Errol Alden7, Larry Pickering8, W. Ian Lipkin1*

1 Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, New York, United States of America, 2 Division of Pediatric Gastroenterology and Nutrition, Massachusetts General Hospital, Boston, Massachusetts, United States of America, 3 Department of Neurology, Harvard Medical School and Departments of Neurology and Pediatrics and Learning and Developmental Disabilities Evaluation and Rehabilitation Services (LADDERS), Massachusetts General Hospital, Boston, Massachusetts, United States of America, 4 Department of Pathology of Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts, United States of America, 5 Measles, Mumps, Rubella, and Herpesvirus Laboratory Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America, 6 Department of Histopathology, Trinity College Dublin, Dublin, Ireland, 7 American Academy of Pediatrics, Elk Grove Village, Illinois, United States of America, 8 National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America

OK, busted: Logical fallacy # 3 "Argument from Authority" (http://www.theskepticsguide.org/logicalfallacies.asp). But the essential point is how well-represented normative science is here, how unlikely it is a "conspiracy" exists.
__
Frequently Asked Questions - Vaccines and ASDs
(http://www.cdc.gov/ncbddd/autism/faq_vaccines.htm#whatresearch)
_________________________________
Popular press articles
"Study: No link between measles vaccine and autism - CNN.com"
"California Study Finds No Link Between Vaccines, Autism | Wired ..."
"Study Shows ‘No Connection’ Between Measles Vaccine, Autism" WSJ
"Vaccine Compound Is Harmless, Study Says, as Autism Debate Rages"

Bad article, great user comments
"Fighting the Autism-Vaccine War"

Google these; OS does not allow URL parameter strings embedded in URLs pasted in here
_________________________________
EXCELLENT survey of MANY studies and nimble dissection of the ruses and misdirection used by anti-vaccinationists:
"Another very bad day for antivaccinationists: Yet another study fails to find a link between thimerosal and autism"
(http://scienceblogs.com/insolence/2008/01/another_very_bad_day_for_antivaccination.php)
_________________________________
Studies on Possible REAL corollaries to Autism, all avail via Google or via CDC site:
"Advanced parental age and the risk of autism spectrum disorder."
"Autism Prevalence Trends Over Time in Denmark"
"Birth Weight and Gestational Age Characteristics of Children With Autism, Including a Comparison With Other Developmental Disabilities
Mitochondrial Disease and Autism"
Well, interesting in the sense that I am often a pompous, know-it-all, buttinsky, pseudo-intellectual, would-be scholar. Amy will probably provide more specific links and pertinent studies. Maybe.

And I used the word "apparently", thus inoculating myself -- he he -- against charges of presumption. I would much prefer to discuss the merits of the science, not your possible motivations. Did you read the studies to which I posted links? Do you have anything material to offer, about the merits of the studies, the science in question, in this public forum, to which all are invited to contribute? It is the Main Thing.

Here's a suggestion: IMO, the SCIENCE suggests your strongest suit is the permeable barrier that thermisol and other substances can move thru. While good studies show Thermisol doesn't pan out as the culprit for Autism, perhaps there are other substances in the environment that do. Get busy with that, contribute to your local research facility, let us know what you come with.

Good science FAILS often to find answers contantly, and that's a positive thing. If we approach the work with a agenda we see only what we want to see. So if your investigations simply result in a long list of substances that DON'T co-relate to Autism, when transmitted thru the mother, that is useful in and of itself.

I speak up here, btw, because of the nonsensical conspiracy-mongering and ad hominem attacks. If you love reason, you must defend it these days. I loath the state of Big Med/Big Pharma, but abandoning science for ancient Chinese "secrets" and superstitious fearfulness is ridiculous.
You know, even when I agree, I find Amy Tutuer to be annoyingly condescending and arrogant. I like science. I think vaccines are effective. HIV=AIDS deniers baffle me entirely. I also think religion is a crock and that praying for healing is living in some sort of fantasy land. But I also don't assume that I am always correct, let alone know the best decisions for others. In fact, I don't even agree that the end-all be-all we should strive for for everyone, in spite of themselves, is preventing death.
People are much to complex in their mind/body interaction with some valuing the spiritual much more than the corporeal, to equate medicine to computer science or engineering. An approach like that would be a turn off to me, and I'm rational at heart. I respect Dr.s like Ms. Maggiore's physicians that provide care for someone with whom they disagree, and their willingness to respect their patient's decisions even when they differ from their own when it's clear the choice isn't a result of lack of information. I don't want a Dr to make decisions for me but to respect mine and my beliefs. Certainly a Dr. can choose to treat or not treat whomever they like, but if a Dr. backed out in the middle of a course of care because, say, I refused to believe in the power of Jesus as part of surgical recovery, I'd be as appalled as I am by a Dr. who would back away from care because of a patient's irrational belief in Jesus. So a patient has a deeply held unmovable irrational belief or 3. So do some Dr.s.
I don't hold the doctors Christine Maggiore consulted responsible, I hold her responsible. And as horrified as I am by her actions, beliefs, and their tragic result, I still think parents have a right to choose their children's medical care. Obviously, there's a fine line of abuse and neglect in there, but I'd like to conservatively err on the parental side. To do otherwise assumes the government and Dr.s (and perhaps science,) are better suited to raise someone's children, which I just don't see in most cases. (Despite my desire to see fewer religious nuts out there.)
- Oh, and the comparison drawn to non-vaccinators is intentionally inflammatory on Amy Tuteur's part. While I think science agrees that untreated HIV leads to AIDS and an early death... Vaccinating is a preventative measure primarily against diseases very unlikely to threaten the life of a healthy person. Creating herd immunity to protect the weak has no fair mirror in not treating a demonstrably deadly disease, regardless of whether you personally think that the 2 camps are thinking in similar ways.