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Scientific evidence and best patient care practices should guide the ethics of Lyme disease activism
  1. Paul G Auwaerter1,
  2. Johan S Bakken2,
  3. Raymond J Dattwyler3,
  4. J Stephen Dumler4,
  5. John J Halperin5,6,
  6. Edward McSweegan7,
  7. Robert B Nadelman8,
  8. Susan O'Connell9,
  9. Sunil K Sood10,
  10. Arthur Weinstein11,
  11. Gary P Wormser8
  1. 1Division of Infectious Diseases, Department of Medicine, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
  2. 2Section of Infectious Diseases, St Luke's Hospital, Duluth, Minnesota, USA
  3. 3Division of Allergy, Immunology and Rheumatology, Department of Medicine, New York Medical College, Valhalla, New York, USA
  4. 4Division of Medical Microbiology, Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
  5. 5Atlantic Neuroscience Institute, Summit, New Jersey, USA
  6. 6The Mount Sinai School of Medicine, New York, New York, USA
  7. 7Crofton, Maryland, USA
  8. 8Division of Infectious Diseases, Department of Medicine, New York Medical College, Valhalla, New York, USA
  9. 9Lyme Borreliosis Unit, Health Protection Agency Microbiology Laboratory, Southampton General Hospital, Southampton, UK
  10. 10Division of Pediatric Infectious Diseases, Schneider Children's Hospital at North Shore, Manhasset, New York, USA
  11. 11Section of Rheumatology, Department of Medicine, Washington Hospital Center and Georgetown University Medical Center, Washington, DC, USA
  1. Correspondence to Dr Gary P Wormser, New York Medical College, Division of Infectious Diseases, Munger Pavilion Room 245, Valhalla, NY 10595, USA; gary_wormser{at}


Johnson and Stricker published an opinion piece in the Journal of Medical Ethics presenting their perspective on the 2008 agreement between the Infectious Diseases Society of America (IDSA) and the Connecticut Attorney General with regard to the 2006 IDSA treatment guideline for Lyme disease. Their writings indicate that these authors hold unconventional views of a relatively common tick-transmitted bacterial infection caused by the spirochete Borrelia burgdorferi. Therefore, it should come as no surprise that their opinions would clash with the IDSA's evidence-based guidelines for the diagnosis and treatment of Lyme disease. Their allegations of conflict of interest against the IDSA resemble those made against the National Institutes of Health, the Food and Drug Administration and the Centers for Disease Control and Prevention in 2000, which were found to be baseless. It is the responsibility of all physicians and medical scientists to stand up to antiscientific, baseless and unethical attacks on those who support an evidence-based approach to caring for patients.

  • Activist
  • allocation of healthcare resources
  • applied and professional ethics
  • Borrelia burgdorferi
  • chronic Lyme disease
  • education for healthcare professionals
  • Lyme disease
  • position statements (of organisations/groups)

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  • Competing interests PGA, JSB, RJD, JJH, JSD, RBN, SKS and GPW are members of the Infectious Diseases Society of America (IDSA) and JSB, RJD, JSD, JJH, RBN and GPW served on the 2006 IDSA Lyme disease guidelines panel. SOC and AW served as consultants to the 2006 IDSA panel. EM is a former Lyme disease programme officer at the National Institutes of Health.

  • Provenance and peer review Not commissioned; externally peer reviewed.