One need only read the Jan. 28, 2010 report of the General Medical Council (GMC)’s Fitness To Practise Panel Hearing to understand why Dr. Andrew J. Wakefield has been judged to be immoral, unethical and a disgrace to the medical profession. After finding him guilty on multiple counts of misconduct, including subjecting children to unnecessary tests and procedures, the GMC will soon decide whether he should be stripped of his licence to practice in the U.K.

For those who may not recognize his name, Andrew Wakefield is a British surgeon who now directs Thoughtful House, an unconventional autism clinic he founded in 2005 after moving to Austin, Texas. In 1998, while affiliated with London’s Royal Free Hospital, Wakefield published a highly-publicized and now-retracted paper, in The Lancet.

Given the prestigious reputation of that medical journal, Wakefield’s “study”, co-authored with 12 colleagues, caused pandemonium when it suggested a link between the combined vaccine for mumps, measles and rubella (MMR) and a new syndrome of small bowel inflammation associated with a severe form of autism, called “disintegrative disorder.” Wakefield believed that measles virus, present in a live, attenuated (weakened) form in the MMR vaccine, infected the small bowel, causing inflammation that ultimately released brain-damaging toxins into the bloodstream.

While the Lancet paper did not claim a proven link between MMR and autism, it clearly implicated recent vaccination in eight of 12 children who were “consecutively referred” to the Royal Free hospital’s gastroenterology department following the rapid onset of the brain disorder, accompanied by bowel inflammation resembling Crohn’s disease.

In a news conference to highlight the paper’s findings, Wakefield stoked the fire of fear: to be safe until more research was done, he recommended children receive single mumps, measles and rubella shots a year apart, rather than the combined MMR vaccine. As a result, many anxious parents refused to have their children immunized at all. Predictably, the vaccination rate in the U.K. fell from 92% in 1996 to 80% in 2003. With that many unprotected children, overall population (herd) immunity dwindled and the number of cases of measles, a highly infectious and potentially serious disease, rose from 56 in 1998 to 1,348 by 2009.

Early on, concerned experts around the world scrambled to find answers. Yet, as hard as they looked, none of them could find any evidence to support a link between MMR, bowel inflammation or autism. One telling statistic: a rise in autism in Japan continued after the MMR vaccine, first available in 1989, was discontinued in 1993. Moreover, in a study using blinded samples to test for the presence of measles virus in bowel tissue from autistic and non-autistic children with bowel symptoms, three separate laboratories agreed that no difference in the level of the virus was detectable between the two groups.

While Wakefield continued to staunchly defend his claims, 10 of his co-authors wrote to The Lancet in 2004 to “retract the interpretation” that MMR was linked to autism.

Starting in 2004, here is what Deer uncovered: far from being an unbiased researcher, prior to, and during the time he was carrying out his study, Wakefield received a consultant fee of over  £435,000  from Richard Barr, a London lawyer who represented various families who believed that the MMR vaccine caused autism in their children. Wakefield never reported this obvious conflict of interest to The Lancet’s editor.

To make matters worse, prior to the start of the study, Wakefield and Barr applied for funding to the U.K.’s Legal Aid Board. Their objective? “To seek evidence that will be acceptable in a court of law of the causative connection between [MMR]…and certain conditions which have been reported with considerable frequency by families who are seeking compensation.” In other words, even before studying his first patient, Wakefield implied that MMR was linked to the “syndrome” he would soon “discover”!

Moreover, although he had applied for permission to the hospital ethics committee to do the study, he tested most of the 12 children before receiving ethics approval.

But it didn’t end there. While Wakefield reported that the eight children developed autism within an average of six days after receiving the MMR vaccine, Deer and, subsequently, the GMC panel, discovered that several of them had documented medical records showing that autistic or other brain symptoms preceded immunization, often by many months. As for bowel inflammation, the pathologists reported that many of the biopsies showed “no significant abnormality.”  Despite that, after a “review of the data”, Wakefield stated that all the children had abnormal biopsies.

How could such a bogus, destructive paper be published by The Lancet? Although all journals urge authors to strictly adhere to rules of ethical conduct and report all potential conflicts of interest, the truth is that bad actors can still sometimes slip through the cracks. That said, I, and many others, believe that The Lancet’s editors should have seen the bright red flag raised by the co-authors in 2004 and fully retracted the paper then, rather than waiting another six years until compelled to do so by the GMC’s ruling.