Friday, July 28, 2006

But aren't you on the payroll, doctor?

Health researchers haven't been faring too well in the news lately. The most recent revelations about scientific misbehavior concern the failure of several prominent health researchers to disclose their financial interests in the treatments they praised in print. Info in the NYT here, here, and here.

Why should the general public care about conflict of interest in professional medical and scientific publishing? Because this one of the main sources (other than online databases) postgraduate physicians use to get information about what's the best way to treat patients. So if an author recommends a certain medication or treatment on the basis of his own financial gain--rather than on what's best for patients--your doctor may (unknowingly, trustingly) recommend that treatment for you or for a family member. (Btw, both of these studies are about treatment for depression--and one includes data on treating depression in children. High-stakes stuff.)

In related news, have you seen the new ads for Lipitor (a cholesterol-lowering medication) featuring Dr. Robert Jarvik? Yes, that's Dr. Jarvik, as in the artificial heart. You can hear ethicist Katie Watson's NPR piece about it here, and read about it here.

And don't get me started on Hwang Woo-Suk. I predict his next blame-deflecting move will be to claim alien abduction.


Emilie Clemmens said...

Transparency in conflicts of interest in science and medicine has been a hot topic this year for the media. As a scientist myself, I am glad to see it, as I think it’s critical that we not only make others aware but also are mindful of how our associations might consciously or unconsciously influence our decision-making.

That said, I think it’s important to keep in mind that scientists are human beings. Certainly there are those who engage in unethical behavior, but this is true for all professions. Do we distrust all businessmen because of Enron? Should we distrust all scientists because of Hwang Woo-Suk? The vast majority of scientists and physicians spend their days trying to help, not fleece, the public. Not the stuff of sensational headlines, I know, but important to keep in mind.

Sue Trinidad said...

Thanks for engaging, Emilie. Of course, the fact that there are some bad apples does not mean that all scientists are doing bad things. At the same time, it offers an opportunity to consider whether these really are simply bad apples, or whether there are system-level issues or structures that enable or reward misbehavior.

And, to your comparison re Enron--the truth is that, yup, many people *do* now look more closely at business ethics than they used to. I don't think a little healthy cynicism is a bad thing, though. Imo, if it makes people think more critically about what's going on in the world, it's all to the good.

Jeffrey Dach MD said...

Perhaps you have seen the Direct-to-Consumer TV and print advertisements with Robert Jarvik, the inventor of the Jarvik Heart, speaking on behalf of the Pfizer’s anti-cholesterol drug, Lipitor.

Perhaps Jarvik is not the best choice for the Lipitor campaign which has had mixed reviews. Instead of Jarvik, a more convincing yet unlikely spokesman would be the popular Duane Graveline MD MPH, a former NASA astronaut, and author who was started on Lipitor during an annual astronaut physical at the Johnson Space Center, and 6 weeks later had an episode of transient global amnesia, a sudden form of total memory loss described in his book, Lipitor Thief of Memory.

Two more unlikely spokesmen for the Lipitor ad campaign include Mary Enig and Uffe Ravnskov.

Should either one be selected as Lipitor spokesman, I myself would run down to the corner drug store to buy up the drug. It seems unlikey that even Pfizer’s deep pockets could ever induce them to recant their opposing position on the cholesterol theory of heart disease.

Mary G. Enig writes, ”hypercholesterolemia is the health issue of the 21st century. It is actually an invented disease, a problem that emerged when health professionals learned how to measure cholesterol levels in the blood.

Uffe Ravnskov MD PhD is spokesman for Thincs, The International Network of Cholesterol Skeptics, and author of “The Cholesterol Myths, Exposing the Fallacy That Saturated Fat and Cholesterol Cause Heart Disease”. His controversial ideas have angered loyal cholesterol theory supporters in Finland who demonstrated by burning his book on live television.

For more discussion on this, see my newsletter:

Lipitor and The Dracula of Modern Technology

Jeffrey Dach MD