Goliath and the Gnats

  • Posted by Dr. Jay Gordon

Well, that wasn’t April’s only storm. An April Fool’s joke I posted to a private group of a few thousand doctors, lactation experts and other medical experts triggered alarm in the halls of my club, The American Academy of Pediatrics.

Interestingly, the AAP may actually have dramatically increased integrity under Dr. David Tayloe, our new president, but someone else violated the first rule of publicity: Don’t complain when some one makes you look a lot better than you really are. Even if he does it on April First!!

Dr. Susan E.Burger is one of the world’s foremost experts on international nutrition and epidemiology who shared with me her submission to the New York Times. The Times did not publish this excellent article and I asked her permission to post it here. Thank you very much, Dr. Burger


Goliath and the Gnats:


The resuscitation of an April fools’ joke that should have been allowed to die.
by Susan E. Burger, MHS, PhD, IBCLC, RLC

Increasingly, professional medical associations are evaluating their ethical standards and setting the bar higher. The American Psychological Association responded to a grassroots effort of their membership base by placing moratorium on psychologists participating in the interrogation of detainees. The International Lactation Consultant Association, of which I am a member, recently decided to stop accepting sponsorship from a company that is no longer complying with the International Code of Marketing of Breast-milk Substitutes. On April 1st, the Journal of the American Medical Association published a proposal for controlling conflicts of interest (and it was NOT a hoax).

As a parent, I would expect a professional medical association that declares itself to be “dedicated to the health of all children” to uphold standards at least as high if not higher than others. Unfortunately, it seems as if the American Academy of Pediatrics (AAP) has become distracted by the urge to protect its reputation through silencing one of its critics, rather than clarifying and improving its ethical standards.

The AAP’s protectionist response was triggered when one of its own members posted on Lactnet, a listserve frequented by members of my profession. The pediatrician in question posted a fake press release from the President of the AAP. It does not take a neonatal surgeon to realize that the prominent display ofApril 1st and the poster’s own name suggests this was an April fools’ joke. Just in case anyone missed these obvious clues, the pediatrician clarified that the press release was a fake within several hours of his original post.

What was the essence of the spoof?

The fake press release stated that the AAP would end the ethical problem of receiving money and sponsorships from the pharmaceutical industry.

It apologized for the AAP’s role in watering down a national breastfeeding campaign and allowing a formula company logo to be printed on the Academy’s book on breastfeeding.

It finished with the assurance that the AAP would seek to comply with the International Code on the Marketing of Breast-milk Substitutes, a code published by the World Health Organization (WHO) and endorsed by the United States.

What is true in the fake press release is that the AAP does receive money and sponsorships from the pharmaceutical and formula industry; it did play a role in watering down the breastfeeding campaign; the front cover of its breastfeeding book is imprinted with a formula company logo; and it does not meet its obligations under the International Code of Marketing of Breast-milk Substitutes. What is not true in the fake press release is that the President of the AAP wrote it, apologized about the conflicts of interest, and made assurances about code compliance.

For a day, the false press release provided mild amusement and sighs of “wouldn’t it be great if this were true”. By the next day, the spoof had leaked into online forums and gone global!

A frequent blogger on issues of breastfeeding advocacy who goes by the username of Lauredhel, investigated the resulting chatter in the blogosphere and concluded, “no one who’s paying attention believes it is real”. Like many an April fools’ joke, this spoof should then have quickly disappeared into obscurity.

Unfortunately, the AAP itself resuscitated the discussion. On April 15th, the moderators of Lactnet posted a letter from Nicole Finitzo, attorney for the AAP, to ensure that members of the listserve understood the AAP’s position on the fake press release. The letter from Ms. Finitzo claimed that the fake press release “contains patent misstatements of fact and misrepresents the AAP’s position, and it is defamatory.” The breastfeeding advocacy blogger, Lauredhel, commented,“I do believe this is the very first time I’ve seen someone accused by a lawyer of defamation for claiming that an organization was more ethical than it actually is.”

Ms Finitzo also demanded of the listserve moderators that, “it will be essential for the original items and all copies on your server, wherever located, to be immediately taken out of circulation immediately.” Since the AAP has over 60,000 members and the Lactnet listserve merely comprises a few thousand members, this heavy-handed letter seems like Goliath swatting at gnats. Unfazed by the demand to remove the original items, the moderators of the listserve offered to post a statement on behalf of the AAP if they wish to further illuminate their stance on financial relationships with industry. The AAP has not yet replied.
I’m hoping that the AAP will come to its senses and realize swatting at gnats is a futile endeavor unlikely to earn anyone’s respect. I think the AAP would earn more respect if they chose to set higher standards to control the conflicts of interests that influence policies for children’s health.

Susan E. Burger, MHS, PhD, IBCLC, RLC

Proud member of the International Lactation Consultant Association, the United States Lactation Consultant Association, and the New York Lactation Consultant Association.

Excellent Follow up at HOYDEN ABOUT TOWN


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