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Medicine and mendacity  
   
Follow the Science (?)  
   

Follow the Science is a term we heard trotted out with monotonous regularity by mainstream media during the pandemic. Ironically, this only served to highlight numerous questions about scientific integrity in general, and medicine and the pharmaceutical industry in particular.

Those familiar with the content of this web site will no doubt be aware of some of the controversies surrounding cosmology and the varying reasons they have come about. While these may seem a little intangible to many, however, concerns relating to medicine bite much closer to home. A recent piece in the highly respected British Medical Journal, The BMJ, is entitled The illusion of Evidence Based Medicine. The authors argue that modern medicine has been corrupted by corporate interests, failed regulation, and the commercialisation of academia.

From the article (my bold):
https://www.bmj.com/content/376/bmj.o702

The advent of evidence based medicine was a paradigm shift intended to provide a solid scientific foundation for medicine. The validity of this new paradigm, however, depends on reliable data from clinical trials, most of which are conducted by the pharmaceutical industry and reported in the names of senior academics. The release into the public domain of previously confidential pharmaceutical industry documents has given the medical community valuable insight into the degree to which industry sponsored clinical trials are misrepresented. Until this problem is corrected, evidence based medicine will remain an illusion.

The philosophy of critical rationalism, advanced by the philosopher Karl Popper, famously advocated for the integrity of science and its role in an open, democratic society. A science of real integrity would be one in which practitioners are careful not to cling to cherished hypotheses and take seriously the outcome of the most stringent experiments. This ideal is, however, threatened by corporations, in which financial interests trump the common good. Medicine is largely dominated by a small number of very large pharmaceutical companies that compete for market share, but are effectively united in their efforts to expanding that market. The short term stimulus to biomedical research because of privatisation has been celebrated by free market champions, but the unintended, long term consequences for medicine have been severe. Scientific progress is thwarted by the ownership of data and knowledge because industry suppresses negative trial results, fails to report adverse events, and does not share raw data with the academic research community. Patients die because of the adverse impact of commercial interests on the research agenda, universities, and regulators.

The pharmaceutical industry’s responsibility to its shareholders means that priority must be given to their hierarchical power structures, product loyalty, and public relations propaganda over scientific integrity. Although universities have always been elite institutions prone to influence through endowments, they have long laid claim to being guardians of truth and the moral conscience of society. But in the face of inadequate government funding, they have adopted a neo-liberal market approach, actively seeking pharmaceutical funding on commercial terms. As a result, university departments become instruments of industry: through company control of the research agenda and ghostwriting of medical journal articles and continuing medical education, academics become agents for the promotion of commercial products. When scandals involving industry-academe partnership are exposed in the mainstream media, trust in academic institutions is weakened and the vision of an open society is betrayed...

Another editorial in the BMJ has this to say:
https://www.bmj.com/content/371/bmj.m4425

When good science is suppressed by the medical-political complex, people die!
Covid-19: politicisation, 'corruption,' and suppression of science

Politicians and governments are suppressing science. They do so in the public interest, they say, to accelerate availability of diagnostics and treatments. They do so to support innovation, to bring products to market at unprecedented speed. Both of these reasons are partly plausible; the greatest deceptions are founded in a grain of truth. But the underlying behaviour is troubling.

Science is being suppressed for political and financial gain. Covid-19 has unleashed state corruption on a grand scale, and it is harmful to public health...

 

"When scandals involving industry-academe partnership are exposed in the mainstream media, trust in academic institutions is weakened and the vision of an open society is betrayed."
The BMJ 16/03/22

 

 

drug_addled_braın

 

 

“Scientists tend to resist interdisciplinary inquiries into their own territory. In many instances, such parochialism is founded on the fear that intrusion from other disciplines would compete unfairly for limited financial resources and thus diminish their own opportunity for research.”
Hannes Alfvén

 

 

Bad Pharma

Who fact checks the fact cheeckers?    
     

It seems anyone can call themselves a fact-checker these days, and many do. In one famous example of 'fact checking', Facebook removed a number of articles published by the New York Times about severe vaccine reactions, despite the fact that they were, as a matter of fact, factual. In other words, some facts are more equal than others when political interests, big pharma, and much of the media march in lockstep.

Dr John has a PhD in a medical field and became a popular source for reliable information during the pandemic.

  “Doublethink means the power of holding two contradictory beliefs in one’s mind simultaneously, and accepting both of them.” George Orwell
     
2024 Update: The Death of Science    
     

As already mentioned, "Follow the Science" was the battle cry during the pandemic of 2020, although there wasn't too much science available at this early stage. Ironically, as more science has emerged the tendency has been to ignore it.

Dr John has continued to follow the science, and as a result he has reviewed his opinion on a number of medical issues. In this interview with respected oncologist Professor Angus Dalgleish, they discuss Dalgleish's new book, The Death of Science.

   
     
2023 Update: Viral origins and dystopia    
     
At 21:30 Dr John and Prof Angus Dalgeish discuss a controversial paper commissioned by Dr Anthony Fauci during the pandemic. It immediately raised red flags and was considered suspicious because it was too black and white, and it was submitted and published within 5 days...something that has never happened with Peer Review before! Furthermore, as soon as it was published in Nature, Fauci was waving it around. "Here is the proof," he shouted. Anyone who questioned it was labeled a conspiracy theorist, because Nature is a respected publication, after all. "It's the worst scientific paper (most flawed) I have ever come across in my life! The references don't support the statements." Professor Angus Dalgleish MD, FRCP, FRCPA, FRCPath, FMedSci    
     
The Emperor's New Drugs    
     

In his 2009 book The Emperor's New Drugs – Exploding the Antidepressant Myth Irving Kirsch posits that the chemical imbalance theory of depression is wrong, and that most antidepressants have little or no direct effect on depression. Furthermore, he argues they are powerful active placebos with common and often serious side-effects.

Kirsch is Associate Director of the Program in Placebo Studies and a lecturer in medicine at the Harvard Medical School, Beth Israel Deaconess Medical Center, and a professor emeritus of psychology at the Universities of Hull and Plymouth in the UK, and the University of Connecticut in the United States. His research interests include placebo effects, antidepressants, expectancy, and hypnosis. He is the originator of Response Expectancy Theory.

While analyzing antidepressant trials as part of his research into the placebo effect, Kirsch discovered that drug companies do not publish all of their unfavourable clinical trial data, and that most decisions about the efficacy of an antidepressant are based solely on published results. Using the Freedom of Information Act (FOIA), he and his colleagues acquired unpublished trial results from the US Food and Drug Administration for six antidepressants. When the results from both published and unpublished studies were compared and averaged, the researchers concluded that the drugs produced a small but clinically meaningless improvement in mood compared with that of an inert placebo (sugar pill)!

Book link: https://www.amazon.com/Emperors-New-Drugs-Exploding-Antidepressant/dp/0465022006

  "The one thing we do know is that the chemical imbalance theory — the theory that people get depressed when they don't have enough serotonin in their brain — we know that that's wrong."
Irving Kirsch
     
The suppression of clinical trial data    
     

Ben Goldacre wrote Bad Pharma and had this to say about SSRI antidepressants in a Guardian article (https://www.theguardian.com/commentisfree/2008/jan/26/badscience):

Meanwhile, in popular culture the depression/serotonin theory is proven and absolute, because it was never about research, or theory, it was about marketing, and journalists who pride themselves on never pushing pills or the hegemony will still blindly push the model until the cows come home...

He says this about the suppression of clinical trial data in the same piece:

If there's one thing I love, it's academics who take on the work of investigative journalism, because they are dogged. This has been a bad week for the SSRI antidepressants. First there's the stuff you already know: bad data got buried. In a cracking new analysis of the "publication bias" in the literature, a group of academics this week published a paper in the New England Journal of Medicine which listed all the trials on SSRIs that had ever been formally registered with the Food and Drug Administration, and then went to look for the same trials in the academic literature.

Thirty-seven studies were assessed by the FDA as positive and, with one exception, every single one of those positive trials got properly written up and published. Meanwhile, 22 studies that had negative or iffy results were simply not published at all, and 11 were written up and published in a way that described them as having a positive outcome...

  “It is clear from the evidence presented in this book that the pharmaceutical industry does a biased job of disseminating evidence - to be surprised by this would be absurd - whether it is through advertising, drug reps, ghostwriting, hiding data, bribing people, or running educational programmes for doctors.”
Ben Goldacre Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients
Pharmageddon    
     

Another prominent pharmacologist, David Healy, has stated that SSRIs represent the triumph of marketing over science. He also argues that treatment induced problems need to be more widely recognised. He wrote the 2012 book Pharmageddon.

From his web site https://davidhealy.org/

About Data Based Medicine | Dr. David Healy

Adverse drug events are now the fourth leading cause of death in hospitals

It’s a reasonable bet they are an even greater cause of death in non-hospital settings where there is no one to monitor things going wrong and no one to intervene to save a life. In mental health for instance drug-induced problems are the leading cause of death — and these deaths happen in community rather than hospital settings...

 

Pharmageddon

Ghost writing    
     

Medical journals are haunted by ghostwriters. Given that readers are more likely to trust a paper written by a physician than a pharmaceutical company, drug companies regularly engage in ghostwriting. While students might get kicked out of university for putting their names on papers they didn’t write, doctors are often financially rewarded for it. In addition to violating readers’ trust, switching author names can have dangerous consequences. Physicians rely on medical journals in order to make informed decisions. Papers written by pharmaceutical companies tend to emphasize the benefits and downplay the negatives, which can mislead doctors into thinking a drug is safer than it actually is. Add this to well documented issues with clinical trial data and we have a big problem.

In 2004 the Lancet's chief editor Richard Horton lamented that "journals have devolved into information laundering operations for the pharmaceutical industry." This was way back in 2004. The problem is probably worse now.

This Guardian article is from 2011: Elliot Ross reveals the secret 'army of hidden scribes' paid by the drug companies to influence doctors!

   
     
Lobbying and regulation    
     

The many critics of the pharmaceutical industry are quick to point out that most Big Pharma spend more on lobbying and marketing than they do on research. This appears to be the central plank of their business model.

The below is quoted from from CorporateEurope.org Sept 2015.

Policy Prescriptions: the firepower of the EU pharmaceutical lobby and implications for public health

The pharmaceutical industry – including companies, associations and the top ten lobby firms they employ – have a declared lobby spend of nearly €40 million. That is around 15 times more than the lobby expenditure of civil society and consumer groups which work on public health or access to medicines. Although many pharma industry actors declare more realistic expenditure in the lobby register than three years ago, the real spending may be much more.

   
Who pays the piper? In summary    
     

To reiterate. In case anyone is wondering about the relevance of medicine to cosmology, the point is simple enough. Given it appears that profit can take precedence over public health, is it really any surprise that ideology can dominate in other fields of science? After all, it is difficult to take the people out of science and the sad reality is that egotism and greed can play their part.

The highly qualified indviduals above all believe drugs have their place, but they've nonetheless voiced their concerns about the many compromises being made for the benefit of big business.

How can we trust the science if the science follows the money?

  "Unthinking respect for authority is the greatest enemy of truth." Albert Einstein
     
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