Bioethics Discussion Blog: Equipoise and Autism: Fairness of Research Within a Controversy

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Wednesday, November 21, 2007

Equipoise and Autism: Fairness of Research Within a Controversy

Equipoise is said to be an essential element in clinical trials--not knowing beforehand which arm of a trial will give the best results. I understand that equipoise is necessary to provide an ethical basis for the use of experimental drugs in a patient subject. I would like to extrapolate equipoise to medical research in general. Should the public be subject to the apparent results of research into clinical conditions where the investigators are or appear to be associated with activist organizations or organizations holding a particular point of view? That is, researchers with an apparent conflict of interest? For example, in this morning's news is a study which suggests that autism is related to wi-fi radiation.

The article is

“Wireless Radiation in the Etiology and
Treatment of Autism: Clinical Observations and Mechanisms"


J. Aust. Coll. Nutr. & Env. Med. Vol. 26 No.2 (August 2007) pages 3-7

By Tamara J Mariea, Internal
Balance Inc, Nashville TN and Safe
Wireless Initiative, Washington, DC
and
George L Carlo, Science and
Public Policy Institute, Safe Wireless
Initiative and The George Washington
University School of Medicine and
Health Sciences, Washington, DC


Except for the George Washington University School of Medicine, all the other associations appear to be directed toward one goal.. one "arm". Although there should be freedom of investigation and freedom of speech, in view of such a public controversial and heated issue such as the cause of autism, shouldn't investigations and their publicity be carried out by researchers who themselves hold an "equal position" as they initiate the research? ..Maurice.

3 Comments:

At Friday, November 23, 2007 12:45:00 PM, Anonymous Anonymous said...

Why does the major cause of autism that has been noted for almost 40 years or more get ignored by the media and doctors? In whose interest is this factor denied?

It is very possible that Paternal Age is the Major Predictor for autism---Harry Fisch, MD







Harry Fisch is the author of The Male Biological Clock, The Patient's Guide to Vasectomy Reversal, The Patient's Guide to Varicocele Repair and Managing The Vasectomy Patient. He is one of the nation's leaders in the diagnosis and treatment of male infertility and microsurgical vasectomy reversal. Dr. Fisch is director of the Male Reproductive Center and directs urologic microsurgery in the Department of Urology at Columbia University Medical Center of New York Presbyterian Hospital in New York City. He is also professor of clinical urology at Columbia University, where he was recently named Teacher of the Year in his department.
For over fifteen years, Dr. Fisch has focused his research, practice, and surgery on male infertility and reproduction.




From the Psychology Today article:


"Everybody was familiar with the concept of women's biological clock, but when we introduced 'male' to the equation, the reaction was 'What are you talking about? Men can have children at any age,'" recalls urologist Harry Fisch, director of the Male Reproductive Center at Columbia Presbyterian Hospital in New York City and author of The Male Biological Clock. "It became a social issue. Men do not like to be told they have a problem."
Nonetheless, a virtual tidal wave of recent research has made it irrefutable: Not only does male fertility decrease decade by decade, especially after age 35, but aging sperm can be a significant and sometimes the only cause of severe health and developmental problems in offspring, including autism, schizophrenia, and cancer. The older the father, the higher the risk. But what's truly noteworthy is not that infertility increases with age—to some degree, we've known that all along—but rather that older men who can still conceive may have such damaged sperm that they put their offspring at risk for many types of disorders and disabilities.
"Men thought they were getting off scot free, and they weren't. The birth defects caused by male aging are significant conditions that can cause a burden to families and society," says Ethylin Wang Jabs, professor of pediatric genetics at Johns Hopkins University and leader of a recent study showing the link between aging paternity and certain facial deformities in offspring. "We now know that men and women alike could be increasing the risk of infertility or birth defects by waiting too long to have children." In other words, by looking for perfection in your life before you conceive, there's a very real chance you'll have less perfect kids."
In the past several years, studies worldwide have found that with each passing decade of their lives and with each insult they inflict on their bodies, men's fertility decreases, while genetic risk to offspring slowly mounts. The range of findings is staggering: Several studies have shown that the older the man, the more fragmented the DNA in his ejaculated sperm, resulting in greater risk for infertility, miscarriage or birth defects. Investigations out of Israel, Europe, and the United States have shown that non-verbal (performance) intelligence may decline exclusively due to greater paternal age; that up to a third of all cases of schizophrenia are linked to increasing paternal age; and that men 40 and older are nearly six times more likely to have offspring with autism than men under age 30. Other research shows that the risk of breast and prostate cancer in offspring increases with paternal age. "


Not only does male fertility decrease decade by decade, especially after age 35, but aging sperm can be a significant and sometimes the only cause of severe health and developmental problems in offspring, including autism, schizophrenia, and cancer.

http://psychologytoday.com/articles/pto-20070830-000004.xml

 
At Sunday, December 02, 2007 2:52:00 PM, Blogger Maurice Bernstein, M.D. said...

Though the above posting is not pertinent to the issue of this thread regarding whether unbiased studies can be performed to explain a condition when those performing the studies are already strongly oriented to one direction, it provides an example of another "accepted" explanation for autism. For example, could a scientist who already assumes that there is plenty of evidence that autism is caused by sperm from "old dads" fairly evaluate the role of electromagnetic energy in the causation of autism?

Let's stick to the issue of bias in scientific investigation and experiments when the investigator has already made up his or her mind and may already belongs to a group of like-minded individuals. OK? ..Maurice.

 
At Friday, November 14, 2008 3:47:00 PM, Anonymous Anonymous said...

I have heard of many cases of people with autism. I actually have a dear friend who has schizophrenia it is very tough for him to maintain or handle. I know autism is quite the disease to be hated upon, Nobody likes diseases, but I guess thats just the way the cookie crumbles.

 

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