Saturday, April 27, 2013

Medical ethics violations by anti-wind lobbyists such as Sarah Laurie receiving attention



There are at least three former medical professionals who are leveraging their no-longer-active medical credentials to lend weight to their campaigns against wind energy and performing research without oversight. Medical ethics watchdogs are starting to take note.
 
Perhaps the most prominent is Nina Pierpont, a former paediatrician who advertised via anti-wind groups looking for people who blamed wind farms for their health conditions, interviewed 23 of them in ten families by phone only, accepted hearsay evidence on a further 15, did no direct examinations or medical histories and on the basis of this self-published a 294-page book with 60 pages of charts and graphs. From this remarkably flimsy tissue, she proclaimed a new medical condition, Wind Turbine Syndrome, and established a cottage industry for herself and her husband. They preside over a website of the same name where dissenting opinions are not welcome and comparisons of wind energy supporters to Hitler and Nazis are regular features.
 
 
In Canada, Carmen Krogh, retired pharmacist and member of the Advisory Group of the anti-wind energy campaigning organization, the Society for Wind Vigilance regularly speaks to media and groups, and regularly submits to wind farm siting
reviews against wind energy.
 
In Australia, the dubious distinction of being the theoretically credentialed anti-wind medical activist goes to Sarah Laurie, a former general practitioner who is now de-registered and in fact has been non-practicing longer than she was actively helping people. She is the CEO of the Waubra Foundation, an anti-wind lobbyist group with strong fossil fuel ties, a Board made up of rich NIMBYs and a track record of questionable behaviour. Ms. Laurie’s ethics infractions are the subject of this article.
 
 
The first principle of medical ethics is “First, do no harm”. An outcome of that principle is that medical professionals, past and present, must take care when doing any research or asserting any health implications that they do not cause worse problems than they are researching. As such, any medical research, especially that involving direct contact with a study group, involves a medical ethics assessment by a group set up for that purpose.
 
Since 2009 at least, a strong hypothesis for increasing health complaints near a subset of wind farms in English-speaking countries has been that they are being caused by the nocebo effect, and are in fact a psychogenic or communicated disease. The nocebo effect, first named by WP Kennedy in 1961, is the negative side of the placebo effect (The Nocebo Reaction, Kennedy, W P., Medical World, Vol.95, (September 1961), pp.203-205). Instead of suggestions leading to positive health outcomes, suggestions lead to negative health outcomes. The nocebo effect causes health issues in psychogenic health hysterias such as “fan death” in Korea, where people believe that a fan in a closed room chops oxygen molecules in two, causing them to be unable to breathe. It causes some side-effects of medicine, challenging ethical disclosure of potential side-effects. It’s a confounding factor in clinical trials of medication and treatment. It’s such a powerful and evident effect, that direct studies into the nocebo effect have been banned due to medical ethics concerns since roughly the 1970s.
Researchers are now assessing the nocebo and psychogenic hypotheses and finding strong evidence that they are the cause of the majority of complaints and are responsible for significant increases in numbers and severity of complaints. Professor Simon Chapman and team of the Public Health Faculty of the University of Sydney of Australia found strong supporting evidence for the psychogenic hypothesis being the dominant factor in wind farm health complaints in a recently epublished study undergoing formal peer review and publication now. Ms. Fiona Crichton and team of the University of Auckland in New Zealand found strong supporting evidence for the nocebo effect being the cause of significantly increased numbers and severity of symptoms attributed to infrasound, one of the key bogeyman in the pseudo-scientific attack on wind energy.
 
Studies such as Crichton’s which assess the nocebo effect must ensure that the larger goals of the study are expected to have positive health outcomes, that the negative impacts of the nocebo effect are monitored during the study and the study terminated if they become too severe, and that study participants are clearly told after the study that the goal was assessing the nocebo effect and that symptoms they felt were caused by that, not by the purported cause, in Crichton’s case infrasound.
 
Most of the research done by anti-wind campaigners has been conducted outside of the ethical framework that registered practitioners are expected to submit to. Amanda Harry’s surveys of health complaints in the UK were riddled with challenges that were likely to increase negative impacts. Michael Nissenbaum, also of the Society for Wind Vigilance, performed similarly challenged surveys in Maine, and then collected data from the same wind farms which he wrote up in a study, one of many challenges with his report (see two critical reports in the same journal).
 
However, these biased researchers who are operating without ethical oversight have received a free pass from medical oversight organizations.
 
Until now.
 
Yesterday it was reported in an Australian media outlet, the Crikey, that Sarah Laurie was being investigated for medical ethics violations by the National Health and Medical Research Council of Australia. She might be subject to a $30,000 fine for her transgressions of ethics. Further, this would reasonably lead to questions of whether she could be the subject of lawsuits for the harm she has caused. As she has ignored open letters requesting that she stop promoting health scares and causing negative health impacts — just as Carmen Krogh has rejected direct questions on the subject –, it’s good that formal interventions are occurring.
 
Here’s what the Crikey article has to say:
Well-known anti-wind farm campaigner Sarah Laurie is being examined by the national peak body for medical research over claims she breached ethical codes of research conduct.

The National Health and Medical Research Council confirms it has received a complaint regarding the research being conducted by Laurie, the CEO of the Waubra Foundation (a small but powerful anti-wind farm activist group). A spokesperson told Crikey: “NHMRC takes all complaints received seriously and are following up on this matter.”

The concerns about Laurie’s research ethics are outlined in a document written by an anonymous academic and first sent to the Public Health Association Australia. The document alleges Laurie is not currently registered as a medical practitioner but has been conducting activity that meets the definition of medical research involving human subjects. On her website, Laurie uses the title of “Dr” and describes herself as a former GP.
The dossier outlines the incidents where Laurie claims to have conducted interviews with residents affected by wind turbine health issues, collected blood pressure data, given medical advice and/or clinical judgment, referred to people as “research subjects” and discussed accessing medical records and personal health journals. It also asks if Laurie’s research has been reviewed by a Human Research Ethics Committee:

“The Medical Board of Australia in conjunction with the Australian Health Practitioner Regulation Agency advises that medical practitioners should be registered if they have any direct clinical contact with patients or provide treatment or opinion about individuals.”

After examining the document, the CEO of the Public Health Association Australia, Michael Moore, forwarded it on to the heads of the NHRMC, the Australian Health Practioner Regulation Agency, the Health and Community Service Complaints Commissioner of South Australia and the Waubra Foundation.

“It was something which should not be ignored because I thought there were serious ethical issues which had been raised, ethical issues that would distort the debate over the appropriateness of wind farm technology,” Moore told Crikey.

For years Laurie and her Waubra Foundation (named for the Waubra wind farm in NSW) have campaigned against the use of wind farm technology, claiming wind turbines have serious health impacts — known as “wind turbine syndrome” — for local residents. As Australia’s most prominent anti-wind farm campaigner, Laurie is regularly used as a media commentator about wind farm health issues; she recently appeared on ABC Radio National and 2GB.

“From our perspective, it’s a matter of ensuring that policy debates take place on sound evidence and that the research is appropriately conducted,” said Moore.

A new study by public health professor Simon Chapman indicates health complaints about wind turbines were rare until anti wind-farm groups began a campaign against supposed medical issues in 2009. Another recent study led by University of Auckland researcher Fiona Crichton demonstrates that residents who expect health issues from wind turbine health issues are more likely to develop the symptoms.

When called to ask about the document and its claims, Laurie told Crikey it was “inappropriate for me to comment at this time”.

The Health and Community Service Complaints Commissioner of SA and the Australian Health Practioner Regulation Agency told Crikey they don’t comment on individual cases. An AHPRA spokesperson notes it is an offence under the Health Practitioner Regulation National Law to present as a registered medical practitioner if you are not, and a court may impose a maximum penalty of $30,000 for an individual “holding out”.

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