How the History of Autism Spectrum Disorders Can Improve an Understand of Public Health Ethics

Research into the causes of autism spectrum disorders (ASD) are as old as the diagnosis, first named by Dr. Leo Kanner in 1943. More than a half-century of research has offered explanations, from psychiatric to biological to environmental, for the disorder. Some claims related to etiology and treatment have been inaccurate and harmful. In the 1960s the psychologist Bruno Bettelheim blamed autistic behaviors on what he termed “refrigerator mothers,” or mothers who were emotionally distant. Bettelheim's treatments were later shown to be fraudulent and sometimes abusive of children and their families. More recently, inaccurate assertions that childhood vaccination caused an epidemic rise in ASDs have triggered potentially dangerous drops in vaccine rates in locations in the United States and United Kingdom. The growing scientific consensus is that the disorder has complex etiologies likely involving gene-environment interactions yet to be identified. Given the history of speculation regarding the etiology of ASD, and of the deleterious impact of some of this speculation on public health safety, stakeholders have ethical obligations to insure that research in this area continues and that research findings are communicated to the public in an accurate and coherent manner. Drawing on the history of the ASD diagnosis, this presentation will identify the ethical failures of both past research and the communication of that research to the public, and suggest ways to ethically conduct and communicate ASD research to the general population. The presentation will also identify how historical methods are particularly useful to furthering this area of inquiry.