I had a long day in the operating room yesterday; so I was tired last night. As a consequence, I thought that today might end up being one of those rare weekdays free of new Insolence. Then, in the morning as I was doing my usual brief perusal of e-mail and blogs before heading to work, I noticed a post on that wretched hive of antivaccine scum and quackery, Age of Autism, that was such a perfect distillation of the reason why antivaccinationists refuse to accept all the evidence that autism has its roots largely in genetics that I couldn’t help but whip off a quickie post. The post revealed such an astounding hypocrisy, coupled with an even more astounding lack of self-awareness, that I couldn’t help but address it briefly (for me, at least).
Not surprisingly, it was Anne Dachel, who’s all in a lather because apparently an antivaccine comment was removed from an article in The Guardian by Christina Chew entitled Would you abort a disabled child? Unlike a typical AoA post, Chew was nuanced and caring in her analysis of the thorny ethical issues that prenatal genetic testing can result in. Dachel, on the other hand, works herself up into a fine lather because apparently the moderator deleted one of her comments, in which she denied a primarily genetic basis to autism. The comment itself was typical antivaccine blather, laden with straw men, such as how there can’t be a “genetic epidemic.” Personally, I don’t think the moderator should have deleted it, but then I’m much more tolerant of opinions that don’t jibe with my own. It doesn’t even matter much if those opinions are pure pseudoscience, as antivaccine opinions nearly universally are. I thought about writing primarily about the utter hypocrisy of someone like Dachel, whose own blog ruthless deletes comments with dissenting opinions, the better to create an echo chamber in which its antivaccine denizens feel “safe,” but instead this part of her post caught my eye:
This was very disconcerting for a number of reasons. First of all, the not-too-subtle message here is that kids are born autistic. When we have perfected genetic testing, it may be possible to detect which children will develop autism while they are still in the womb. This is a complete surrender to autism. Autistic children happen; there’s nothing we can do to prevent it.
No longer are we blaming cold, unaffectionate refrigerator moms for autism. Now we have our sites on the parents with defective genes that produce autistic babies. There’s no mention of kids who are fine and who meet every developmental milestone but who suddenly regress into autism. Even asking the question makes no sense. How can a disorder that no one ever heard about just 25 years ago now be something babies are born with?
And there you have it. Dachel is correct to point out that the “refrigerator mother” hypothesis of autism was pure crap that blamed parents for autism. That’s one of the rare things we agree about. Now note what she moves on to. Unfortunately, she thinks that accepting a genetic basis of autism is somehow “blaming” parents as well for having “defective” genes. In other words, Dachel admits something that I (and quite a few other skeptical bloggers) have been saying all along: That the reason some antivaccinationists can’t accept evidence implicating genetics in autism pathogenesis is because they view it as an attack on them every bit as much blaming “refrigerator mothers” for autism was. If it’s genes, then it must be their fault! One wonders if Dachel thinks that it’s the fault of the parents if a child with Down’s syndrome, Tay-Sachs disease, or any of a number of genetic syndromes is born. Does she view, for example, parents who have a child with sickle cell disease as somehow genetically inferior? It sure sounds as though the answer is yes. In any case, the genetics of autism is not single-gene alterations. It’s hideously complex, and we don’t understand it yet. We do, however, understand that there is a genetic basis, most likely highly complex and multigene, and it is not beyond the pale to imagine a day when we understand the genetics well enough to be able to test for autism prenatally, which makes Chew’s discussion highly relevant given that she has an autistic child.
It also points to a trait among antivaccinationists that seems to be ramped up to 11 all the time, and that’s a view that it’s impossible that they could have contributed to their children’s autism in any way, including biological. If autism is mostly genetic in nature, then it must be a slap at the parents of an autistic child, because obviously they must have had “defective,” less than perfect genes. Never mind that each and every human being has mutations and changes in their genes that could be considered “imperfect.” It’s part of our evolutionary heritage. I also suspect that denying genetics provides two other things they desperately crave. First, it provides them with the ability to blame someone else for their children’s autism, which they do in spades, blaming vaccines (which doctors forced them to accept for their children), the pharmaceutical companies who made the vaccines (which, of course, enticed the doctors to force the parents to accept the vaccines), and the governments that encourage them and require them for school entry (which, of course, in antivaccinationists’ eyes, protect the pharmaceutical companies that enticed the doctors to force the parents to accept the vaccines). Second, it allows them to have what appears to be a comforting illusion to them, that their “real” child was “stolen” by autism, thanks to vaccines, “toxins,” and whatever else. No, that autistic child in front of them can’t be their real child! Their real child is buried somewhere within, if only they could find the right combination of quackery to bring him back. I found an example just the other day in the (Un)Thinking Moms’ Revolution, in which The Rev writes:
GIVE ME MY SON BACK DAMNIT! I want HIM. I WANT HIM. I WANT NOAH PATRICK GOES! I want to squeeze him without his body going rigid. I want to hear him laugh at something that is really funny, not his brother crying. I want him to be able to tell me what he wants instead of pulling my hair in frustration. I want this baby in the picture. I want his sweet life so full of hope RESTORED and I want the institutions that harmed him brought to justice. NOW. That’s what I want and that is how I feel.
As much as I detest the antivaccine movement, even I can’t help but feel sorry for The Rev and even understand to some extent why she might feel this way, even as I decry the massive harm she and her fellow antivaccine activists cause with their fear mongering. To The Rev, the Noah in front of her is not her son; the Noah from before he started showing obvious symptoms of autism is. After all, she did everything right, except (in retrospect to her) vaccinating. In her mind she continues to do everything right and can’t imagine why her son is still autistic and has multiple health problems. To Dachel, it can’t be her genes that contributed to an autistic child. As misguided as her belief is, she believes that if autism is mainly genetic, then she is imperfect and her child is a daily accusation against her of that imperfection.
If it’s the vaccines, on the other hand, then it’s not Dachel’s “imperfection” that caused her son’s autism. It was an outside force that robbed her of her son. And if it was an outside force that robbed her of her “real” son, then maybe something can get him back. So instead of accepting the child that she has, she keeps looking for a child that will never be again, just like The Rev.