As a paediatrician, I urge Australians to be guided by scientific evidence when making decisions on medications | Mike Freelander

I treated more than 200,000 patients in almost 40 years of medicine in practice. Autism is a complex disorder that can present itself in different ways and in a spectrum of gravity. Causality is a very important consideration and, as a pediatrician, I know that parents often ask why their child is autism.

In particular in the severe end of the autism spectrum, genetic disorders may have autistic characteristics; For example, Angelman syndrome, Smith-Magnis syndrome, Williams syndrome and many others. However, for the majority of children diagnosed with autism, no cause is found. We also know that the number of children diagnosed with autism in the developed world increases. There are many reasons for this, especially that we are better to diagnose it. However, in my work, I have often heard the question “Why is my child autistic?”

There have been many studies during several decades trying to answer this question. There have also been a certain number of discredited complaints – such as those around MMR vaccines propagated by false prophets (including the Secretary in the United States and social services Robert F Kennedy Jr one) which has led to bad results for health and caused considerable distress and damage. These statements have been refuted several times but continue to be promulgated by some.

The recent comments by American President Donald Trump concerning a possible link between the use of paracetamol (acetaminophen, Panadol, Tylenol) during pregnancy and the causality of autism are very disturbing on several levels.

First, there is no evidence of causality in a study that I have seen, and although there can be small associations, a causal effect has been refuted by the largest and most recent Swedish study and the Japanese study. Second, there has already been a significant distress caused and nothing has been made to explain what evidence was used and what is scientific proof of its comments.

Paracetamol is a very important and commonly used medication during pregnancy and is classified as safe. Alternative drugs are not as safe and can affect the fetus.

Medicine regulators around the world, including in the United Kingdom and our own TGA (therapeutic administration of goods), have concluded that paracetamol is sure for use during pregnancy according to “rigorous evaluation of the best scientific evidence available”.

We must trust our regulatory framework in order to provide us with the best scientific evidence to make decisions about health care and a non -scientific and poorly informed health policy.

Our regulation agency, the TGA, is the best in the world and I am confident in their advice.

Any comment on the diagnosis, management and causal mechanisms of complex neurodevelopmental disorders has the potential to cause significant anxiety and distress. They can also lead to inappropriate health results.

It is very important that the concerns are dealt with by a timely evaluation of scientific evidence and that we listen to experts. The American president and secretary of health has failed to do so in the past and continue a model of ad hoc action that will not end well.

In Australia, we are very lucky to have regulatory systems of the highest standards and we must trust it.