When a doctor stops behaving like one

You’ve probably heard of the Hippocratic Oath, an oath taken in one form or another by the majority of graduating medical students in the United States. One of the major tenets of the oath is the principle of beneficence: do no harm, prevent any harm, relieve any harm. A physician, and basically anyone who has decided to devote their life to medicine, is morally, ethically, and even legally bound by this principle. They must not cause any harm through their medicine, or take reasonable steps to not cause it. They must prevent their patients from being harmed, or take the reasonable steps to prevent said harm. And they must relieve any harm being caused to their patients, or do the reasonable thing to bring about this relief. I threw in the reasonable clauses there because physicians and other healthcare providers can only do so much. Patients are in many ways responsible for their actions, but it is up to the provider to give proper guidance and counseling based on all the available evidence.

All the available evidence on the MMR vaccine (the vaccine against measles, mumps, and rubella) is that it works very, very well and is very, very safe. Any person getting both doses of the vaccine is over 99% likely to be immune against measles. As an epidemiologist, when I’ve investigated outbreaks of measles in the literature, I’ve found that very rarely are there vaccinated people in the group of those who are sick. In my personal experience, I am yet to find a vaccinated person with measles. (Mumps is another thing. The vaccine seems to wane when it comes to mumps.) So the vaccine is 99% effective. But is it safe?

Yes, yes it is. Despite any claims to the contrary, there are no links between the MMR vaccine and any of the ailments exaggerated by the anti-vaccine crowd. It doesn’t cause autism. Very, very few people get more than a local reaction to it. Rarely does it cause encephalitis, but that clears up on its own. In short, the vaccine has prevented measles cases in orders of magnitude greater than any injury it has caused. I will bet my life’s savings on the vaccine any day of the week over a bout of measles. With modern medical technology, measles is less of a killer than it was before the vaccine, but you still don’t want to get it. It can be crippling, incapacitating.

To recap so far: Vaccine good. No vaccine bad. Thus, based on the principle of beneficence, healthcare providers must recommend and give the MMR vaccine to their patients to prevent a harm called measles, especially when there is an outbreak of the bug going on in their vicinity.

One physician in the United States who graduated from Georgetown University is Robert “Bob” W. Sears, MD, FAAP. He went through medical school and must have learned about immunology, virology, and maybe even some epidemiology. He is board certified in pediatrics. If I were a betting man, I’d bet that he knows all about the Hippocratic Oath and about beneficence. It’s just that (to me) he acts like he doesn’t, or like he doesn’t understand the things he should have learned in college and medical school, and beyond. Why? Because of his stance on vaccination.

“Dr. Bob” wrote a book called “The Vaccine Book: Making the Right Decision For Your Child“. The title is innocent enough to make you think that maybe he is for vaccines but just wants them spaced out. Maybe he knows something we don’t? After all, he is a board certified pediatrician. The trouble with his book is that he gets a lot of things wrong. Don’t take my word for it. Take the word of Dr. Paul Offit, a pediatrician himself, vaccine researcher and developer:

“Sears wants parents to use the information he has provided to make their own decisions about whether to vaccinate their children. “I have offered you all the information you need to make this decision,” he writes, “but I have held back from actually telling you what to do. I want you to formulate your own decision without letting my opinion sway you one way or the other.” Unfortunately, Sears, who wants parents to make informed decisions, has written a book that will largely misinform them.”

And take the word of the world’s authorities on vaccination science.

Still, you might be inclined to think that Dr. Bob is not anti-vaccine. After all, he’s not saying that you should stop vaccines altogether. He just wants you think that you can delay the administration of them because… Because something. I don’t know why. There’s no real reason to do so; No scientific reason, anyway.

Let’s stop here quick for an update on the return of measles to the United States. According to the California Department of Health, there have been 32 confirmed cases of measles this year, compared to only three last year. Ten of this year’s cases are in Los Angeles alone. If this isn’t an outbreak, I don’t know what is. And I know my outbreaks, I’m an epidemiologist and I’ve taught epidemiology. But Dr. Bob has a different take on this outbreak. To him, it’s not an outbreak at all:

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Here’s the text:

“Measles Epidemic . . . NOT!

Why is it that every time there are a few cases of measles, everyone panics? I just don’t get it. So, here’s the situation in the O.C., where I live and practice. Seven cases. Seven. That’s 7. Not 700, not a million Seven. So, why do people panic? Here’s one reason: the ^$#@*&%&*$# media. News reports go out stating that there are outbreaks of measles, and everyone needs to be concerned. Everyone is quick to blame those who don’t vaccinate, AND those who don’t vaccinate start to panic. We’ve gotten dozens of calls to our office with people wanting to know if they should come in for the vaccine.”

I do wonder if Dr. Robert “Bob” W. Sears is acting like a physician and recommending the vaccine to his patients in a time of a measles outbreak in his state, under the principle of beneficence? What kind of specialized knowledge does Dr. Bob have that the California Department of Health doesn’t to assure his patients that there is no outbreak of measles in the state, though there are ten times more cases right now than this same time frame last year? If anyone has answers to these questions, let me know. I’m not asking them rhetorically. This is a pediatrician, a board certified physician, blowing off information from public health authorities. It is in the public’s best interest to know if one of the physicians charged with taking care of the public’s children is not acting like a physician and more like an anti-vaccine activist.

But, then again, we don’t need to look far to see if Dr. Bob is anti-vaccine:

PAOAV

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Well, if he is not anti-vaccine, then I’m the Prime Minister of Burundi. I mean, he is the administrator of a goddamned anti-vaccine, private Facebook group. So has he been lying when he says he’s not anti-vaccine? Probably. I’d have more respect for the man if just came out of the anti-vaccine closet and proudly proclaimed to be anti-science, like other medically-trained healthcare providers have. Then we wouldn’t have to play this game of exposing Dr. Robert “Bob” W. Sears to the world for the anti-vaccine activist that we see in him.

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