Kirby tries to cover his posterior
I tried not to write anything during this last weekend of my vacation, but then I became aware of David Kirby's CYA response to the tragic death of a boy during chelation therapy for his autism last week:
But even as the grieving immigrant mother makes funeral arrangements for her beloved boy, opponents of the theory that drew the family to America (the theory that mercury triggers autism, and removing it through chelation may improve symptoms) are holding his death up as proof that the idea is bogus. They claim that the use of chelation to treat autism is foolishly dangerous, and should be shut down at once.
Some people have come perilously close to exploiting this tragedy to further their own political or personal agendas. Some blame the boy’s death on his mother, who has been labeled as reckless and “desperate.” Others blame the Pennsylvania doctor -- and any autism doctor willing to try chelation (the use of certain chemicals to remove heavy metals from the body) – for the tragedy. Some fault me, for writing a book that dared to include the topic of chelation and autism within its pages.
Give me a freakin' break! It's way more than "possible" that the chelation treatment killed the boy. It's highly likely. Otherwise healthy five year olds don't just drop dead of cardiac arrest for no apparent reason, particularly while sitting in a doctor's office. It happens, but it's extremely rare. For this boy to have just happened to have droppped dead of a cardiac arrest while he was receiving a therapy that can lower serum calcium and magnesium levels to levels low enough to cause cardiac arrest is one a hell of a coincidence. Unfortunately, the autopsy results may never conclusively show that chelation killed the boy. Electrolyte abnormalities leading to sudden cardiac arrest (the most likely cause of death in this case) can be hard to pin down in an autopsy. If the autopsy fails to find conclusive evidence for this cause of death, it will allow the chelation advocates wiggle room to claim "reasonable doubt" over whether their pet treatment killed the boy.First of all, only an autopsy will reveal the actual cause of death, and I think it is prudent to wait before jumping to any conclusions about the general safety of chelation and autism. That said, the boy did die while undergoing the procedure, and it’s possible the controversial treatment is what killed him.
Worse, Kirby is now trying to blame the scientific community for Abubakar's death, rather than where the blame should be placed if chelation killed him, at the hands of the doctor who administered the chelation for a condition for which it is not indicated and those who support this quackery. (At least he properly asks the question why this doctor was using intravenous EDTA, rather than other, safer methods.)
He goes on:
Just think, if the government had listened to the very IOM report it commissioned back in 2001, we might know a lot more about chelation and autism than we know today. If clinical trials had gotten underway then, we would know with certainty whether chelation could heal, or kill.
Finally, Kirby says:
If hard scientific proof had been uncovered that chelation was 100-percent worthless in the treatment of autism, no parent or doctor would still be pursuing the therapy today. If evidence had surfaced in clinical trials that children could be harmed or even killed by chelation, no one would be using it today. The doctor in Pennsylvania would have halted chelation therapy long ago, and this poor grieving family would never have crossed the ocean from the UK in pursuit of its false promise.How reasonable-sounding. How charmingly naïve. (I also have to wonder if Kirby is aware that it's pretty rare for a clinical study to provide 100% evidence of any conclusion. Medicine deals with probabilities, and those probabilities only very rarely turn out to be 100%.) Kirby clearly doesn't have much experience with "alternative medicine." Studies don't matter to alties, and that goes triple for conditions for which conventional medicine does not yet have highly effective treatments. Study after study showed that Laetrile didn't help advanced (or even early stage) cancer back in the 1970's and early 1980's. Altie practitioners still use it, and patients still seek it. Recent studies have shown that homeopathy does no better than placebo for a variety of conditions, but do you think that homeopaths will stop using it or people stop seeking it? Studies have come out showing that echinicea doesn't help common colds, but I wouldn't sell my stock in companies selling the herb if I were you. Study after study have shown that chelation therapy does no better than placebo for coronary and peripheral vascular disease. It's still being used, and NCCAM has even funded a large study to see if it works, not because of the science so much but because of its popularity. If the NCCAM study fails to show a benefit for chelation over placebo, you can bet that alties will dismiss the study and that chelation will continue to be used for heart disease. If a study ever conclusively shows that chelation does no good for autism, you can further bet that it won't be believed by the mercury/autism advocates and that chelation will continue. None of this means that we physicians and scientists shouldn't do the studies, of course. That's how science progresses and ineffective treatments are slowly weeded out of our medical armamentarium. However, Kirby's faith that such studies can cause such a rapid halt to the use of dubious treatments is almost touching in its naïveté.
This comment by Kirby, however, is not so touching or naïve:
But what if the opposite were true? What if the “rigorous science” recommended by the IOM had yielded proof that chelation can indeed help some kids -- provided that it’s done with the safest agents, at the safest doses, and through the safest routes of administration (not to mention in combination with other therapies)?
Either way, if America had done its scientific homework, as recommended by its top science professors, Abubakar might still be alive today.
Sadly, it appears that Kirby is more interested in spinning this tragedy to decrease criticism of him and the mercury/autism hypothesis that he's become so enamored of than in critically looking at the claims that underlie the use of this dubious "therapy" for autism.
ADDENDUM: Peter Bowditch weighs in on the death of Abubakar Tariq Nadama. Stand back. He's really pissed off.
ADDENDUM #2: More information here and here.
ADDENDUM #3: On January 5, 2006, the coroner announced the results of the autopsy, concluding that it was indeed EDTA chelation that killed Tariq.