Sir, The hysterical reaction to the disclosure that Dr Andrew Wakefield was funded by the legal aid authorities to undertake research in relation to litigation by parents at the same time that he submitted his seminal paper on MMR to The Lancet (report, February 23) reveals a remarkable divergence between current legal and medical views of what constitutes bias.

The Lancet’s current general guidance to authors states:

A conflict of interest exists when an author or the author’s institution has financial or personal relationships with other people or organisations that inappropriately influence (bias) his or her actions.

The guidance contains a list of conflict of interest which includes “paid expert testimony”.

But the courts do not consider that the engagement of someone to act as an expert witness in relation to litigation has the effect that that person is then biased. Indeed, if this were the legal position, no paid professional could ever at any time give evidence to a court.

Instead, as established at common law by at latest 1993, and as since set out in the Civil Procedure Rules with effect from 1999, the overriding duty of an expert witness is to provide independent assistance to the court by way of objective, unbiased opinion in relation to matters within his expertise.

Accordingly, the fact of funding to conduct research in relation to litigation, or even the receipt of payment to give evidence, does not in law give rise to bias.

It is disturbing to find that the medical establishment appears to believe that the opinions of paid experts are so irremediably biased that their views are not fit to print, when courts are ready to decide cases or convict on the basis of such opinion.

Yours faithfully,
ROBERT HANTUSCH,
(Barrister),
3 Stone Buildings,
Lincoln’s Inn, WC2A 3XL.
February 23.

From Dr T. Ashcroft

Sir, In all the publicity over MMR and autism I have seen no mention of a recent study on the subject published in the journal Paediatrics and reported in the most recent edition of the British Medical Journal.

The study looked at the MMR vaccine history of 624 autistic children and a control group of 1,824 school-matched non-autistic children, and concluded there was no connection between the vaccine and autism. This seems an important contribution to the debate.

Yours faithfully,
T. ASHCROFT,
10 Mitchell Avenue, Jesmond,
Newcastle upon Tyne NE2 3LA.
February 23.

From Dr Andrew Marchetti

Sir, I was surprised to read that the Health Secretary, John Reid, has called for an inquiry into the MMR controversy to be carried out by the General Medical Council. Surely an issue as far-reaching as this would be better determined by a full independent public inquiry funded by the Department of Health, rather than from fees from registered medical practitioners in this country, most of whom disagreed with Dr Wakefield’s findings from the outset.

This issue has already been clouded by accusations that Dr Wakefield is the victim of an establishment witch-hunt; having the medical establishment lead the inquiry will further compound the problem.

Yours faithfully,
ANDREW MARCHETTI,
16 Edwards Way,
Alsager, Stoke-on-Trent ST7 2YB.
andrew.marchetti@tiscali.co.uk
February 23.

From Mr Gareth Child

Sir, Richard Horton, the Editor of The Lancet, says that Dr Andrew Wakefield’s controversial 1998 study might never have been published if The Lancet had known that Dr Wakefield had received cash as part of a legal action against vaccine manufacturers.

I trust he also refuses to publish studies that are paid for by the vaccine manufacturers themselves.

Yours,
GARETH CHILD,
55 Greencliffe Drive,
York YO30 6NA.
February 23.

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