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But while the disciplinary panel was examining the children’s medical records in public, Deer compared them with what was published in the .
His coauthors seem to have been unaware of what he was doing under the cover of their names and reputations.
As the GMC panel heard, they did not even know which child was which in the paper’s patient anonymised text and tables. Although only two (John Walker-Smith and Simon Murch) were charged by the GMC, and only one, the paper’s senior author Walker-Smith, was found guilty of misconduct, they all failed in their duties as authors.
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Drawing on interviews, documents, and data made public at the GMC hearings, Deer shows how Wakefield altered numerous facts about the patients’ medical histories in order to support his claim to have identified a new syndrome; how his institution, the Royal Free Hospital and Medical School in London, supported him as he sought to exploit the ensuing MMR scare for financial gain; and how key players failed to investigate thoroughly in the public interest when Deer first raised his concerns.11Deer published his first investigation into Wakefield’s paper in 2004.12 This uncovered the possibility of research fraud, unethical treatment of children, and Wakefield’s conflict of interest through his involvement with a lawsuit against manufacturers of the MMR vaccine.
Building on these findings, the GMC launched its own proceedings that focused on whether the research was ethical.
The Office of Research Integrity in the United States defines fraud as fabrication, falsification, or plagiarism.13 Deer unearthed clear evidence of falsification. 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? 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.
He found that not one of the 12 cases reported in the 1998 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. 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.14Furthermore, Wakefield has been given ample opportunity either to replicate the paper’s findings, or to say he was mistaken. He refused to join 10 of his coauthors in retracting the paper’s interpretation in 2004,15 and has repeatedly denied doing anything wrong at all.