Whenever a person, especially a child, goes missing, the psychics/mediums won’t be too far behind. Most of them no doubt believe sincerely in their special powers and that they are only there to help, but they can cause a great deal of harm — emotional, psychological, even economic — and interfere with the real investigation.
Every time a media outlet reports on a medium’s involvement approvingly, they provide more marketing material for this industry and more tacit approval for the psychological manipulation of desperate vulnerable people. Law Professor Christine Corcos, author of a book on the 1944 trial of psychic Helen Duncan, notes:
“Law enforcement officials who allow non-law enforcement trained personnel to participate…are putting both the cases and their jobs at risk. The fact is that few, if any, police departments actually admit to using psychics. Most officials [say] that psychics simply waste time predicting that bodies or missing persons will be found near water, or trees, or buildings with red roofs. Experienced detectives combing particular areas can do as well, and will not raise false hopes among the families and friends of the victims.”
I Sleuth Dead People
Few families are prepared to reject any possible chance of finding missing loved ones, or to publicly criticise. But those who don’t want to be manipulated have reported being badgered and tormented by people claiming to have useful information which turns out to be hurtful hype. The NZ Skeptics received this comment following celeb psychic Deb Webber commenting on a missing child case as part of a publicity tour:
“With regard to psychics, mediums and the like, I can tell you that in the months and years following my sister’s disappearance, my family was contacted by no less than 100 of these people. No two of them were able to agree on the location of my sister, alive or dead.”
And the police were obliged to follow up each and every one of them, on the chance that the information was real, i.e. someone pretending to be a psychic to convey something they knew about the case. So not only do these freaks inflict profound emotional harm, they are also an enormous waste of police resources.
Psychics Strike Out
A survey of the New Zealand police force concluded that, unlike practical shows like Crimewatch or public appeals for witnesses, there had never been any accurate, useful psychically derived information that was instrumental in leading to a successful conclusion.
In 1975, 18-year-old hitchhiker Mona Blades went missing. British psychic-medium Doris Stokes claimed to have assisted the New Zealand police to recover her body, but this is untrue as the body has never been found and the case remains open. In 1983, the Kirsa Jensen case saw over a hundred contacts from psychics and others. Ian Holyoake, the officer in charge, said:
“[It] did not advance the investigation one bit. Most of the information was not specific as to any area where a body might be located, but some was quite graphic in detail and disturbing by its very nature”.
In 1992, the disappearance of 2-year-old Amber-Lee Cruickshank brought “letters from clairvoyants, card readers, star watchers, prayer groups, crystal readers, palm readers, spiritualists, people who have visions, premonitions and total lunatics”. None of them assisted the search. Initial claims saw her being found “near water or trees”; a 2007 episode of Sensing Murder claimed she had been abducted.
In 1992, clairvoyants and a Spiritualist medium told the family of missing Wellington man Michael Kelly that he was still alive. They appealed to racist stereotypes by saying he had been assaulted and abducted by “rough-looking” tattooed Maoris, and dumped at various locations. Police received calls from people worried about Maoris, and private searches were made. Kelly’s body was eventually found at the bottom of a light shaft in central Wellington where he had fallen.
In 1998, Nelson clairvoyant Margaret Birkin and four other psychics went out on a boat to look for missing Blenheim friends Ben Smart and Olivia Hope. Birken stated that she knew where the pair was to be found. Despite additional searches with professional divers and support by the Holmes show, she failed to locate the pair, whose bodies remain undiscovered.
In December 2001, psychic Kathy Bartlett joined searchers looking for missing teenager Elon Oved. Her examination of the “aura” at the scene was of no help, and it was another anguishing couple of months for his family before his body was found by a search-and-rescue team member.
In March 2003, a $20,000 reward was offered for information on missing woman Sara Niethe. Several psychics called police saying that they had had visions of where she and her car could be found, but neither has ever been located.
Sensing Murder? Sensing Nonsense
The exploitainment TV show Sensing Murder titillates viewers with the idea that psychics can provide new information about unsolved cases, but not one murder has been solved and many grieving people have been exploited. What has been revealed are the usual tricks and techniques common in the psychic industry:
- extravagant claims with no supporting evidence In the episode “A Bump in the Dark”, about the rape and murder of Alicia O’Reilly, the psychics were said to have established “key facts” about the girl’s personality. One had said Alicia was a little shy, her mother described her as out-going.
- truisms touted as amazing revelations: Psychic Kelvin Cruickshank said “It sounds a little weird, but she must have been buried in a white coffin.” However, this is common for children.
- obvious cueing or spurious affirmations: Cruickshank, in looking at Alicia’s drawings, spots “her dog”. Off-camera someone says “a cat” (the film crew knew there was a pet cat). “O cat is it?” says Cruickshank, “oh it is too.”
- bare-faced errors going unchallenged: Cruickshank made much of Alicia talking about children’s TV show “What Now?”, a Saturday morning treat in the 80s. A dramatic voice-over noted that Alicia had been murdered in 1980, apparently supporting his claim. However, “What Now?” didn’t start on air until nine months after Alicia’s murder. Perhaps the implication there is that TVNZ shows are good enough to appeal to spirits in the after-life! What do you think?
Fake bomb detector leads to deaths
One of the main reasons for the success Al Qaeda has had in getting bombs past checkpoints in Iraq is that the main device used to detect explosives is a uselss fake (NZ Herald, 24 July).
The Iraqi government paid large sums for the detector, originally produced in Britain by a company whose managing director, Jim McCormick, has been arrested on suspicion of fraud. Export of the device, formally known as the ADE-651 but called a ‘sonar’ in Iraq, has now been banned.
The detector, a black plastic grip with a silver-coloured wand out the front, supposedly receives its power from the operator, who shuffles his feet to generate static electricity. If explosives or firearms are present, the wand is meant to incline towards them, like a water diviner’s rod.
The only electronic component is a small disc, similar to that attached to clothes in shops to stop people taking them without paying. Although each device costs US$50 ($68) to make, Iraq spent US$85 million on them in 2008 and 2009.
An Iraqi police chief said privately the police knew the detectors did not work but went on using them because they were ordered to. The presumption is that somebody was paid a bribe to buy them and does not want to admit they are junk. They remain in use today.
According to the Times Online (January 22), McCormick believes a lot of the opposition to the device is driven by its rather primitive appearance. “We are working on a new model that has flashing lights,” he said.
‘Lady Luck’ has no favourites
Sports writer and poker devotee Ian Anderson had some very refreshing things to say about luck in his Waikato Times column (28 August).
“Many people will tell you,” he writes, “that great teams create their own luck. Many people, of course, are idiots. Luck doesn’t get created – it’s a random act of variance – and it doesn’t favour one team or the other, be they great, woeful or middling.”
The All Blacks, in the middle of an unprecedented run of test match victories, had just squeaked home against the Springboks in Johannesburg, thanks to a try which the referee, on another day, might not have given. If it hadn’t been awarded, the All Blacks would have been left licking their wounds – much as they were in the 2007 World Cup when the critical refereeing decisions went the other way.
Sports fans have very selective memories, Anderson says. While people tend to focus on incidents that happen late in a game, a wrongly awarded try in the sixth minute carries as much weight as one in the 76th.
“We can also instantly recall any gross misfortune that has befallen our favourite sides but struggle to dredge up any memories of decisions that go in our favour.”
The same applies to poker players, who without exception think they’re better at the game than they are, and who sincerely believe most losses are the result of incredibly bad luck while victories come simply through outplaying their opponents in the hand.
“Yet a trawl through hand histories will glaringly reveal that each player… receives his fair share of bad beats and fortunate suck-outs.” Presumably these are technical poker terms.
UFO ‘Trick of the light’
A famous UFO filmed in the Australian desert in 1964 has been explained in recently released British Ministry of Defence (MOD) files as a trick of the light (Stuff, 5 August).
When footage of the Blue Streak rocket tests at Woomera were broadcast by the BBC, television viewers were “shocked” to see what appeared to be a flying saucer near the launch pad. Many wrote to the MOD asking for an explanation.
Then, when documentary maker Jenny Randles went to investigate the footage she found it was missing from the National Archives. An MP who saw the documentary then launched an inquiry. The newly released files, however, show that the people who made the film at the time were clear that the ‘UFO’ was an internal camera fault. The ‘missing’ canister of film had been stored at the Imperial War Museum, rather than the National Archives.
The incident is just one of thousands of UFO sightings investigated by the MOD. The latest bunch of files covers more than 5000 pages of correspondence on them.
David Clarke, author of The UFO Files and a senior lecturer in journalism at Sheffield Hallam University, said people who believe in UFOs were unlikely to be convinced.
“The truth is that people see things in the sky that they can’t explain, but the vast majority have got simple explanations. That is the truth, but they won’t accept that.”
Massey to study NDEs
If you’ve ever had a Near Death Experience, Massey University researchers would like to talk to you (Dominion Post, 27 August).
Psychologist Natasha Tassell and sociologist Mary Murray are carrying out New Zealand’s first large-scale study of the phenomenon. They estimate up to a quarter of those who have come close to dying may recall a form of near-death experience. “It’s a known phenomenon, but we don’t know how it occurs and exactly how prevalent it is,” Dr Tassell said.
They also wanted to know what variations existed and whether there were cultural dimensions. About 15 people had already shared their experiences, but they were hoping to attract about 100 participants 21 years and older for the two-year study.
Dr Tassell’s interest was sparked after an experience of her own, when she lay down after feeling unwell, and recalled travelling down a tunnel with a bright light at the end.
Alt med scrutinised
It was good to see Victoria University’s Professor Shaun Holt giving a public lecture on the potential dangers of alternative cancer therapies recently (Dominion Post, 1 September).
Chiropractors were good at helping people with bad backs but would not help cancer, reiki was “chanting mumbo jumbo”, reflexology was “absolute nonsense”, and colonic irrigation was dangerous, he said.
Professor Holt was however reported as stating that yoga could be effective for breast cancer patients, though the article didn’t say how. Taking ginger was as effective as pharmaceutical drugs for patients experiencing nausea and vomiting.
He also said acupuncture, massage therapy, aromatherapy and art therapy could help alleviate symptoms such as stress, anxiety, pain and depression. He might perhaps have mentioned that it doesn’t matter where you stick the needles to get a response from acupuncture – it’s more about stimulating endorphin release than directing energy flows.
Toxic slugs create panic
Reports of toxic sea slugs on beaches around Auckland are taking on an almost hysterical flavour with news items about them and their ‘spread’ appearing almost daily (eg TV3 News, 3 September, NZ Herald, 9 September, Radio New Zealand News, 25 September).
The animal in question, Pleurobranchaea maculata, is perhaps the most common and widespread sea slug in the country. It is found all around the coast, in many habitats from low tide to a depth of 250 metres. It gained notoriety in 2009 after some dogs on an Auckland beach were poisoned after eating some that had washed up.
It has always been known that the slugs are toxic – that’s how they can survive without a shell – but it’s since been learned that the toxicity is due to tetrodotoxin, which is originally produced by bacteria, and known from several marine animals including fugu (Japanese puffer fish) and blue-ringed octopus.
It appears that the toxicity levels vary in different areas, and there’s now quite a bit of work going on to learn more about these fascinating animals (Rodney Times, 28 September). It’s a pity it appears to take a certain level of hype to get some basic research done on even the most common of the animals that live in and around this country.
Alison Campbell finds some claims about raw foods hard to swallow.
I was reading a couple of articles about ‘raw foods’ today. This is ‘raw foods’ as in ‘foods that you don’t heat above 40°C in processing them.’ It’s also as in, a vegetarian diet. (I do rather enjoy vegetarian food, but I don’t think I could eat nothing but, all the time; I like meat too much.) Anyway, what caught my eye wasn’t so much the diet programme itself but the mis-use of science to promote it. That did rather get my goat broccoli.
Apparently you should get your kids to eat their greens (along with the rest of the diet) by telling them that plants do this wonderful thing: they turn sunlight into chlorophyll and – when you eat it – it will give you extra oxygen. Sigh… This concept was repeated in the second article, which told me that raw (but not cooked) foods are ‘oxygenated’ and thus better for your brain, which needs to be fully oxygenated to work properly.
Well, yes, and so do all your other bits and pieces, and they don’t get the oxygen from food. As Ben Goldacre once said, even if chlorophyll were to survive the digestive process and make it through to the intestine, it needs light in order to photosynthesise, quite apart from the fact that you don’t normally absorb oxygen across the gut wall. And it’s kind of dark inside you.
The second shaky claim related to digestive enzymes. Because raw foods are ‘alive’ then they are full of enzymes. And so we’re told that eating them will help you to digest your meals better.
Er, no. First, because when said enzymes – being proteins – hit the low pH environment of your stomach they are highly likely to be denatured. This change in shape means that they lose the ability to function as they should, and in fact they’ll be chopped up into amino acids like any other protein in your food, before being absorbed and then used by your cells to make their own enzymes.
And second – the raw foods diet is plant-based. Yes, plants and animals are going to have some enzymes in common. I’d expect that those involved in cellular respiration and DNA replication/protein synthesis would be very similar, for example, because these are crucial processes in any cell’s life and any deviations in form and function are likely to be severely punished by natural selection. But we already have those enzymes; they’re manufactured in situ as required. In other words, even if the plant enzymes somehow made it into cells intact and capable of functioning, they’d be redundant.
However, with a very few exceptions, plants aren’t in the habit of consuming other organisms so, in regard to plant cells being a good source of the digestive enzymes required for the proper functioning of an omnivore’s gut – no, I don’t think so. No.
Some might ask, why on earth do I bother about this stuff? After all, it’s not doing any harm. But the thing is – science is so cool, so exciting; it tells us so much about the world – why do people have to prostitute it in this way? Kids (and others) are fascinated by the way their bodies’ organ systems work, and I can’t see why there seems to be a need to provide ‘simple’ – and wrong! – alternative ‘explanations’ when the real thing is so wonderful.
This article is a response to ‘Truth is the daughter of time, and not of authority’: Aspects of the Cartwright Affair by Martin Wallace, NZ Skeptic 96.
The Cartwright Inquiry1 was held after the publication of “An Unfortunate Experiment at National Women’s” in Metro magazine in June 1987. The events leading up to the publication of the article and the findings of the subsequent inquiry have been contested ever since.
The inquiry heard from 67 witnesses, many doctors, 84 patients and relatives, and four nurses. In addition, 1200 patient records were reviewed, with 226 used as exhibits. The final report released in August 1988 has had a long-lasting impact. It recommended many changes in the practice of medicine and research, including measures designed to protect patients’ rights and a national cervical screening programme. These have since been implemented. The Medical Council announced in 1990 that four doctors were to face disciplinary charges resulting from the inquiry’s findings of disgraceful conduct and conduct unbecoming a medical practitioner. Charges against Dr Herbert Green were dropped due to ill health.
The report of the Committee of Inquiry has withstood many challenges, including judicial reviews and many articles alleging its findings to be flawed. Yet there have been allegations of a miscarriage of justice, charges of a witch-hunt, even a feminist conspiracy.
Where does this leave Dr McIndoe and others who had mounting concerns for so many years? Why did so many women develop cancer? In this article I will explore the findings of the Cartwright Inquiry, its context, the research and the criticisms, and attempt to find a more nuanced understanding of the “unfortunate experiment” and its ongoing effects. Page numbers in parentheses refer to pages in the Cartwright Report. CIN3 and CIS are interchangeable terms for a lesion of the cervical epithelium which can be a precursor to invasive cancer.
The Findings of the Inquiry
The report found that Green, rather than developing a hypothesis, aimed to prove a point (p 21) that even at the time was known not to be the case. A 1961 compilation of studies from Paris, Copenhagen, Stockholm, Warsaw, and New York showed CIS progressed to invasive cancer in 28.3 percent of cases (p 23). As at 1958 the official policy was “… treatment of carcinoma of the cervix Stage 0, [CIS] should be adequate cone biopsy … provided the immediate follow-up is negative and … the pathologist is satisfied that the cone biopsy has included all the carcinomatous tissue” (p 26). Standard treatment of the time involved excising all affected tissue and the ‘conservative’ treatment of conisation was in use well prior to 1966.
Green’s initial proposal stated “… It is considered that the time has come to diagnose and treat by lesser procedures than hitherto, a selected group of patients with positive (A3-A5) smears. Including the four 1965 cases, there are at present under clinical, colposcopic, and cytological observation, 8 patients who have not had a cone or ring biopsy. All of these continue to have positive smears in which there is no clinical or colposcopic evidence of invasive cancer”… The minutes then record that “… Professor Green said his aim was to attempt to prove that carcinoma-in-situ (CIS) is not a premalignant disease”… (p 22). This appeared to come about because of concern about unnecessarily extensive surgery for CIS between 1949 and 1962. During this period, some centres were beginning to use cone biopsy as effective treatment; however there were limitations to its use (p 27).
There were some questions over whether the work was a research project. The inquiry concluded this was the case and that a research protocol, however flawed, was put in place (p 69). Green published in peer-reviewed journals on his hypothesis and findings. By 1969, three cases of invasive disease had occurred in patients with positive cytology monitored for more than a year, and this should have made it clear that following patients with persistent CIS was unsafe (p 52).
Green then explained those patients by concluding that they’d had invasive cancer that was missed at the outset. The report contends this was dangerous to the patients as it demonstrated that the proposal was incapable of testing the hypothesis. These patients were reclassified by Green and the patients removed from the study (p 55). In addition, patients over the age of 35 were included in the research in breach of the protocol vp 49).
There were many subsequent issues, including lack of patient consent (p 136). Patients also had to return for repeated tests and other invasive procedures, often receiving general anaesthetics in the process (p 42-49). A collection of cervices from foetuses and stillborn infants and another of baby uteri in wax were collected by Green for research which was later abandoned. This did not appear to comply with the Human Tissue Act (1964) as no consent was obtained from the parents of the stillborn infants (p 141).
As part of an earlier 1963 trial to test whether abnormal cytology in women later developing CIS or invasive cancer was present at birth (pp 34 & 140), 2,244 new-born babies had their vaginas swabbed without formal consent from the parents (there was a decision to abandon this trial soon after it started but this wasn’t communicated to nursing staff until 1966).
Procedures such as vaginal examinations and IUD insertions/removals on hysterectomy cases were performed by students without patient knowledge or consent while they were under anaesthetic (p 172). There was a further study on carcinoma of the cervix treatment, where patients either had radiotherapy alone or hysterectomy and radiation (p 170). The method of randomisation was by coin toss.
The idea that patients were divided into two experimental groups arose from McIndoe et al (1984)2. The patients were divided retrospectively into two groups which overlapped strongly but not completely with groups defined by Green, that he called “special series”. In his 1969 paper, cited in the report (p 40-41) he stated: “The only way to settle the question as to what happens to carcinoma in situ is to follow adequately diagnosed but untreated lesions indefinitely … it is being attempted at NWH by means of 2 series of cases. (I) A group of 27 women … are being followed, without ‘treatment’, by clinical, colposcopic, and cytologic examination after initial histological diagnosis of carcinoma in situ … has been established by punch biopsy … (II) A group of 25 women who have had a hysterectomy (4 for cervical carcinoma in situ) and who now have histologically-proven vaginal carcinoma in situ, has been accumulated …” This was done semi-randomly, with cases presenting themselves fortuitously.
The outcome for the group of 25 who were included in the punch biopsy “special series” was summarised in the McIndoe et al (1984) paper. Nine out of 10 women who were monitored with continuing positive smears developed invasive cancer. Only one out of 15 women who had normal follow-up cytology later developed invasive cancer. While Coney and Bunkle may have made a mistake, it’s clear the judge didn’t. The report states: “Green’s 1966 proposal was not a randomised control trial, but it was experimental research combined with patient care” (p 63).
Green’s interpretation of the data in his 1974 paper is suspect, having concluded that the progression rate was 7-10/750 (0.9 to 1.3 percent) or 6/96 (6.3 percent) of ‘incompletely treated’ lesions (p 54). These were explained by suggesting that either invasive cancer was missed at the start, or over-diagnosed at the end. Dr Jordan (expert witness) deemed this interpretation incorrect as of the 750 cases, 96 had continuing positive cytology, meaning that the other 654 patients could be considered free of disease. Of that 96, 52 patients had not been assessed further, making it impossible to know whether or not this group already had unsuspected invasion. Of the 44 patients remaining with ongoing carcinoma in situ who had more investigations, seven were found with invasive carcinoma. The incidence of known progression was therefore 7/44 (16 percent), which approximates McIndoe et al (1984) findings. This means that the proportion of invasive cancer cases in those inadequately treated was much higher compared with those who had returned to negative cytology, even before any cases where slides were re-read and excluded are considered.
McIndoe et al (1984) covered the follow-up data for 948 patients with a histological diagnosis of CIS patients who had been followed for a minimum of five years; there was a further paper in 1986 regarding CIS of the vulva. The same method used by Dr Green to group women by cytology after diagnosis and treatment was used, but using the correct denominators and the original diagnosis. Patients who were diagnosed with invasive cancer within one year were excluded to avoid the possibility the cancer had been missed initially. The management was cone biopsy or amputation of the cervix in 673 patients, with 250 managed by hysterectomy. The only biopsies in 25 women were punch biopsy (11), wedge preceded by punch biopsy (7) and wedge biopsy alone (7). Twelve out of 817 (1.5 percent) of group 1 patients developed invasive cancer. Given the lengthy follow-up with negative cytology for group 1 patients, the authors concluded these represented the development of new carcinoma. There were marked differences in the completeness of excision between the two groups and the second group shows markedly different results, with 29/131 (22 percent or 24.8-fold higher chance) with positive cytology developing invasive cancer. At 10 years this was 18 percent rising to 36 percent after 20 years, irrespective of the initial management or histologic completeness of excision. This needs to be explained, as those figures strongly suggest the progression of CIS to invasion when it is and was a totally curable lesion. The answer is that a prospective investigation, as done by Green, has to establish that invasive disease is not present, while conserving affected tissue that is required for later study. The argument has been posed that women in the second group did get cone biopsies and hysterectomies. This ignores the fact that while many women were treated with various procedures, there was evidence of continuing disease, demonstrating that the intervention was inadequate. This was not followed up, posing a high risk of development of invasive disease.
This differs from group 1 patients, who were successfully treated at the outset. It’s pertinent to point out that the Cartwright Report did not rely on this study (or the Metro article) to reach its conclusions, but on review of patient records.
There have been two follow-up studies. McCredie et al (2008)3 examined medical records, cytology and histopathology for all women diagnosed with CIN3 between 1955 and 1976, whose treatment was reviewed by judicial inquiry. This paper gave a direct estimate of the rate of progression from CIN3 to invasive cancer. For 143 women that were managed by only punch or wedge biopsy the cumulative incidence was 31.3 percent at 30 years and 50.3 percent in a subgroup who had persistent disease at 24 months.
The cancer risk for 593 women who received adequate treatment and who were treated conventionally for recurrent disease was 0.7 percent at 30 years. These findings support McIndoe et al (1984) and extend the period of follow-up.
McCredie et al (2010)4, described the management and outcomes for women during the period 1965-74 and makes comparisons with women diagnosed 1955-64 and 1975-76. This showed that women diagnosed with CIN3 in 1965-74 were less likely to have treatment with curative intent (51 percent vs 95 percent and 85 percent), had more follow-up biopsies, were more likely to have positive cytology during follow-up and positive smears that were not followed by curative treatment within six months, as well as a higher risk of cancer of the cervix or vaginal vault.
Those women initially managed by punch or wedge biopsy alone in the period 1965-74 had a cancer risk 10 times higher that women treated with intention to cure. This was despite the 1955-64 group being largely unscreened, which would have delayed diagnosis. This study is important as it shows the medical experience of the women, where they were subjected to many interventions that were not meant to treat but rather to monitor.
Scientific misconduct happens, and for those trying to address it the risks are high. Brian Martin5 looked at several cases, and stated: “In each case it was hard to mobilize institutions to take action against prestigious figures. Formal procedures, even when invoked, were slow and often indecisive.”
McIndoe and others encountered similar difficulties and ultimately failed to get Green’s proposal reviewed. The concept of “clinical freedom” (p 127), where the doctor was the arbiter of the best course of action for the patient, was one major issue to emerge from the report. Colleagues tended to be very reluctant to intrude upon this, and this meant that the proposal could continue with little oversight or intervention. McIndoe had mounting concerns, particularly after 1969, which were disregarded or treated lightly.
These concerns were shared by pathologist-in-charge Dr McLean, and were raised internally with Medical Superintendent Dr Warren, who consulted with the Superintendent-in-Chief, Dr Moody and an internal working party set up to look at the issue in 1975. Twenty-nine cases that had developed invasive disease were referred to it; however only 13 were examined, and having set up its own terms of reference it only considered whether the protocol had been adhered to and disregarded concerns about patient safety (p 83).
The 1966 proposal effectively ceased when McIndoe withdrew colposcopic services and Green reverted to cone biopsy in most new cases (p 88), but it was never formally terminated. While Green himself did not take any steps to prevent the review of records by McIndoe and colleagues, Bonham did, and wrote a letter to the Medical Superintendent (p 92).
There are some important lessons to be learned from this, including that those with the authority to deal with the situation should make the best effort to achieve a balanced view of the situation and assess it fairly to allow the claimant a fair hearing.
The potential risks of Green’s proposal outweighed any benefits such as avoiding hysterectomy or cone biopsy. Invasive cancer could not be ruled out because there were poor safeguards against the risk of progression. This was unethical from the outset, regardless of the issue of informed consent. In addition, patients that developed invasive disease had their slides reclassified and were removed by Dr Green from the study. This would be considered research misconduct then and now as it manipulated the data.
It does not matter if the initial motivations were sincere; they ultimately fail on these points. This proposal had a very human cost. Moreover Green’s views had long-term effects, including influence on undergraduate and postgraduate medical students, and support for the attitude that cervical screening was not worthwhile. This ‘atypical’ viewpoint was also promoted in the scientific literature and in the press, creating confusion within the medical scene and with the public.
It can be incredibly hard to admit our failings and let go of old loyalties. In the aftermath of the report many doctors objected to cervical screening, ‘unworkable’ consent forms and the intrusion of lay committees on practice6. It’s true this had negative effects on the perception of doctors overall, particularly in regard to practices that were widespread in hospitals at the time, and there were times that unfair criticisms were aired. This impacted on the nursing profession as well, for nurses are meant to be patient advocates.
This was also about power. The really unfortunate thing is that medical responsibilities to patients are almost totally ignored in the midst of the argument, when they should be brought to the forefront. Likewise respect, justice and beneficence were lacking for the patients involved. No doctor raised concerns about the lack of consent, even though from the 1950s there was the growing expectation that this be sought, particularly with participants in research.
The Medical Association working party that examined this stated that it was “regrettable that the trial deteriorated scientifically and ethically and did not change as scientific knowledge advanced or as adverse results were observed”7. They found it deplorable that patients involved did not know they were part of a trial, and that it took a magazine article for it to be investigated.
Unfortunately, instead of addressing this and examining whether Dr Green made any errors or misinterpretations himself, the findings in McIndoe et al (1984) and other papers were not accepted. There is the unfortunate implication that, rather than there being mounting and valid concerns over decades, that Green was unfairly toppled and the resulting inquiry was a whitewash.
The report couldn’t have been written without the assistance of the medical community as expert witnesses and advisors. It’s not surprising that there would be loyalty for a colleague, but perhaps instead of attempting to rehabilitate Green it’s time McIndoe and his colleagues were vindicated. Morality did not totally fail and attempts were made to prevent patients being harmed8.
Acknowledgements: many thanks to Dr. Margaret McCredie of Otago University who assisted me with my research.
- The Cartwright Report: www.nsu.govt.nz/current-nsu-programmes/3233.asp
- W.A. Mcindoe; M.R. McLean; R.W. Jones; P.R. Mullins 1984: J. Am. Coll. Obst. 64(4).
- M.R.E. McCredie; K.J. Sharples; C. Paul; J. Baranyai; G. Medley; R.W. Jones; D.C. Skegg 2008: The Lancet Oncology DOI:10.1016/S1470-2045(08)70103-7
- M.R.E. McCredie; C. Paul; K.J. Sharples; J. Baranyai; G. Medley; D.C. Skegg; R.W. Jones 2010: A&NZ J. Obst. Gyn. DOI:10.1111/j.1479-828X.2010.01170.x
- B. Martin 1989: Thought and Action 5(2), 95-102.
- J. Manning (Ed.) 2009: The Cartwright Papers: Essays on the Cervical Cancer Inquiry 1987-88. Bridget Williams Books Ltd.
- L. Bryder 2009: A History of the “Unfortunate Experiment” at National Women’s Hospital. Auckland University Press.
- C. Paul 2000: BMJ 320, 499-503.
Rayna Ramsey produced a photographic record of this years NZ Skeptics conference.
This year’ s NZ Skeptics conference in Auckland was the usual mix of stimulating presentations and good companionship, but it will go down in the society’ s history as the end of Vicki Hyde’ s term as chair-entity. In this issue of the NZ Skeptic we farewell Vicki and meet Gold, who is taking on the chair-entity role.
At the conference dinner, Paul Ashton invited founding member Warwick Don to present Vicki with a framed ‘ Skeptic trump’ by British cartoonist Crispian Jago (crispian-jago.blogspot.com). These are highly sought after – the other 70 recipients include Richard Dawkins, Stephen Fry, James Randi and Susan Blackmore; Ricki Gervais wanted one but was declined. Vicki is the first Kiwi. To illustrate the length of time she has been in the chair Paul drew on a technique often used in describing geological time scales: if all of NZ Skeptics history occupied one day, then Vicki became chair- entity at 6:17 in the morning.
The event began with a relaxed Friday 13th evening spent tempting fate (breaking mirrors, walking under ladders etc), watching skeptical videos and partaking from Butterfly Creek’s fine cafe and well-stocked bar. Then the conference proper got under way on Saturday morning with Robert Bartholomew, who lost a shouting match with the rain before resorting to electronic assistance. But his talk on mass delusions gave a solid historical perspective to much of what followed.
Though there was a strong medical focus this year, with talks on immunisation, the ‘ unfortunate experiment’ (for another perspective see Michelle Coffey’s article in this issue) , and the demonisation of fat, there was also room for topics as varied as data compression software (see opposite) , how to deal with ‘ wingnuts’ , basic techniques of mediumship, and some good old-fashioned debunking of the alleged apocalypse in 2012. YouTube has TV3’s coverage – search for ‘Skeptics conference 2010’. We’ll be running more presentations in the NZ Skeptic over the coming year; if you missed the conference and can’t wait, the Science Media Centre website has several of the talks as podcasts in its Reflections on Science section – posted 16 and 17 August.
Vicki leaves the chair-entity role with the society in good heart, as evidenced by the high level of attendance at the conference and the good proportion of younger faces there. The rapid changes in the so-called new media are providing new pathways for spreading the skeptical message, and these are fields that Gold has considerable expertise in. Interesting times to be a skeptic.