In the 1919 Supreme Court case of Schenck vs. United States, Oliver Wendell Holmes, Jr. famously wrote "The most stringent protection of free speech would not protect a man falsely shouting fire in a theater and causing a panic." By "falsely," Justice Holmes clearly meant shouting fire while not believing there to be a fire. It goes without saying, shouting fire in the event of an actual fire would never be a cause for punishment. It appears that shouting fire while holding a mistaken belief that there was a fire, a terrible and possibly lethal error, would likely be no cause for punishment, either. But what if that belief was based on no good evidence?

A shipowner was about to send to sea an emigrant-ship. He knew that she was old, and not overwell built at the first; that she had seen many seas and climes, and often had needed repairs. Doubts had been suggested to him that possibly she was not seaworthy. These doubts preyed upon his mind, and made him unhappy; he thought that perhaps he ought to have her thoroughly overhauled and refitted, even though this should put him at great expense. Before the ship sailed, however, he succeeded in overcoming these melancholy reflections. He said to himself that she had gone safely through so many voyages and weathered so many storms that it was idle to suppose she would not come safely home from this trip also. He would put his trust in Providence, which could hardly fail to protect all these unhappy families that were leaving their fatherland to seek for better times elsewhere. He would dismiss from his mind all ungenerous suspicions about the honesty of builders and contractors. In such ways he acquired a sincere and comfortable conviction that his vessel was thoroughly safe and seaworthy; he watched her departure with a light heart, and benevolent wishes for the success of the exiles in their strange new home that was to be; and he got his insurance-money when she went down in mid-ocean and told no tales.

What shall we say of him? Surely this, that he was verily guilty of the death of those men. It is admitted that he did sincerely believe in the soundness of his ship; but the sincerity of his conviction can in no wise help him, because he had no right to believe on such evidence as was before him. He had acquired his belief not by honestly earning it in patient investigation, but by stifling his doubts. And although in the end he may have felt so sure about it that he could not think otherwise, yet inasmuch as he had knowingly and willingly worked himself into that frame of mind, he must be held responsible for it.

William K Clifford - "The Ethics of Belief" (1877)

Now, let's have a look at the crowd that have been making so much fuss about vaccines, particularly MMR, being the cause of autism. What might make them think that this is true? Other than Jenny McCarthy's ludicrous claim to knowledge by her mommy instinct, their evidence consists of little more than these two pieces: the signs of autism appear around the same time as childhood vaccinations and the original paper linking MMR with autism, the 1998 Lancet article by Andrew Wakefield.

Does autism show up right after vaccinations? Yes, occasionally it does. Here are the facts: The average age for diagnosis with autism is between 3 and 5 years (though the first symptoms are often present before one year of age) and the majority of the vaccines a child receives come in the first six years of life. (Recommended Immunization Schedule for Persons Aged 0 through 6 Years-United States - 2009) But that is no smoking gun, not on its own at least. Why not? Autism generally becomes apparent when children fail to achieve or have delays in acquiring normal verbal and social skills that are expected during those early years. This could be noticed soon after any of the many vaccinations that occur during this same time period. How can we tell if these two things are really connected or not? This is actually easier than it may sound. You just compare the prevalence of autism in populations that have and have not had the vaccine or vaccine component you are concerned about. This has been done. It has been done repeatedly, on a large scale, and with many variations. The findings have always been the same. Autism rates do not vary by: vaccinated or not vaccinated; schedule of vaccination; or vaccination formulation. No correlation can be found between vaccination and autism at all, except in the case of the Wakefield paper.

So, what about that paper by Andrew Wakefield? Here are some facts uncovered about Andrew Wakefield and his paper since its publication in 1998. You can decide for yourself the trustworthiness of that paper, afterwards. The paper was funded by British trial lawyers seeking evidence to use against vaccine manufacturers (undisclosed conflict of interest.) Nine months before the article's publication, Wakefield was a party to patent applications for a "safer MMR vaccine." This MMR competitor would undoubtedly benefit by damage to the reputation of the existing vaccine (giant undisclosed conflict of interest.) Ten of the twelve coauthors have since retracted the conclusion that there exists an association between MMR and autism. The Sunday Times has discovered that Wakefield "cooked" his data to support his conclusion. Most importantly, every follow-on study attempting to replicate the Wakefield findings have failed to do so.

Recently, a special federal court finished hearing the first three test cases for possible injury by the MMR vaccine. The three cases were chosen by the anti-vax litigators as the strongest and most compelling of the thousands of cases they are prepared to bring. The Special Masters (judges) were unimpressed. Here are a few highlights of the rulings. "Unfortunately, the Cedillos have been misled by physicians who are guilty, in my view, of gross medical misjudgment," and "the petitioners in this litigation have been the victims of bad science conducted to support litigation rather than to advance medical and scientific understanding (of autism)." From the Austin American Statesmen, "In every case, the judges believe that Wakefield and Krigsman are wrong and gave the families false hope. Worse, the reaction to Wakefield's theory has been a surge in measles cases fed by unvaccinated children."

What we are left with is a bogus paper and people such as McCarthy endlessly screaming about the (refuted) link between autism and vaccines from the roof tops. These combine to put the idea that there is a link between MMR and autism into more parents' heads. These misinformed parents then have children of their own diagnosed with autism coincidently soon after a vaccination. Presto, they are convinced that the vaccine led to the autism. The causes of this autism anti-vax crusade are no more complicated to understand than that. People are pattern seekers. We are ‘wired' to learn this way. If autism follows a vaccination, it must be the vaccination to blame. Except frequently, it just isn't true. Understanding this extremely common failing of human reasoning is one of the first steps of practicing good medicine. It is must be tamed to go anywhere in any branch of science. This is known as the ‘post hoc ergo propter hoc' fallacy. This is a very elementary fallacy to be aware of. It is near unbelievable that the very people who are claiming to be experts, writing even more (bogus) papers, and fanning the fires of public panic continue to fall for it at every turn.

This leads me back to "Shouting Fire" and the ethics of belief. Jenny McCarthy, her boyfriend Jim Carrey, the crew of the Age of Autism, and the cadre of quacks given mouthpiece by the Huffington Post are all surely "shouting fire" in the sense that they are creating an extremely dangerous public panic by providing a warning about a non-existent danger. No doubt that many, if not all, of them sincerely believe the message that they promote. But, as in the story of the ship owner before, they have no right to believe on the evidence as it stands before them. Even worse, they disregard every warning and cannot be bothered the tiny bit of learning necessary to avoid that ‘post hoc' error in reasoning. They are a group of people, completely untrained in any relevant field of expertise, contradicting the virtually unanimous verdict of the world's experts. It has been conclusively demonstrated time and again that the only correlation between vaccination and autism is the coincidence of their timing. As has often been said, everyone is entitled to their own opinion but not to their own facts. Their failure to be convinced only reveals an unwillingness to consider evidence that contradicts their already-held convictions. These are not opinions honestly held.

As has been established, these people are not medical doctors. They have no expertise in any relevant field. They are ignorant of even the basics of critical thinking and methods of science. They've been fooled by a pitifully unconvincing Wakefield and are now presenting themselves as medical authorities on the subject of autism and vaccines and giving bogus MEDICAL ADVICE of a truly life-or-death nature. Worse still, uncritical media pundits (Larry King and Oprah, as examples) give them essentially unopposed air time to voice their unsupported hypothesis. In fact, they are often portrayed as brave crusaders courageously fighting against the profit-driven, corrupt, medical establishment rather than the deluded gadflies that they really are. When the inevitable happens and children die because their parents listened to Jenny's non-sense, at least some of those parents will wake up and discover the truth. They will find they have inadvertently killed their own children by following the medical advice of someone who had no business dispensing it. Perhaps it is a good thing that so many of the anti-vax brigade are so well-heeled. The victims might be well compensated, at the very least. No doubt, they would all prefer to have their children back.

This should be a warning to Jim, Jenny and the Huffington Post. If they aren't already, they certainly will be responsible for unnecessary and avoidable deaths and disabilities. By giving medical advice they are utterly unqualified to give, their liability will be clear. I hope they're ready, because someday they will be held accountable for "shouting fire".

With many thanks to Joseph A. Albietz III, MD

Scott Hurst is a longtime friend and frequent photographer of the JREF.