“Follow the Science” became a refrain repeated with monotonous regularity by much of the mainstream media during the pandemic. Ironically, the slogan served less to clarify matters than to raise deeper questions about scientific integrity itself — particularly within medicine and the pharmaceutical industry.

Readers familiar with the themes explored on this website will already be aware of the kinds of controversies that arise when consensus hardens in fields such as cosmology, and of the institutional pressures that help sustain it. While such debates may feel abstract or remote to many, concerns surrounding medicine are far more immediate, with direct consequences for public health and personal decision-making.

Significantly, these concerns are not confined to critics outside the system. A recent article in the highly respected British Medical Journal, titled The Illusion of Evidence-Based Medicine, argues that modern medical practice has been increasingly compromised by corporate influence, regulatory failure, and the commercialisation of academic research itself.

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

“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

As already mentioned, “Follow the Science” became a ubiquitous slogan during the pandemic of 2020. At the time, however, the scientific picture was necessarily incomplete, evolving in real time as data slowly accumulated. That uncertainty was understandable. What is more curious is what followed. As more studies were published, more data gathered, and more long-term evidence emerged, public discussion did not always broaden accordingly. Instead, certain lines of inquiry were quietly sidelined, while others were amplified, often in service of preserving the original pandemic narrative. The tendency within much of the mainstream media has been less to reassess earlier assumptions than to play down or ignore evidence that complicated them.

Dr John has continued to follow the science in precisely this broader sense, and as a result has revised his views 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, and the wider implications of a medical culture increasingly shaped by consensus, authority, and narrative management rather than open scientific debate.

At around 21:30, Dr John and Professor Angus Dalgleish discuss a controversial paper commissioned by Dr Anthony Fauci during the pandemic. The publication immediately raised concerns, not least because of its unusually black-and-white conclusions, but also because of the extraordinary speed with which it moved from submission to publication — reportedly in just five days.

Such a turnaround is virtually unheard of in conventional peer review, which typically takes weeks or months. Compounding the unease, the paper was cited prominently by Dr Fauci almost immediately after appearing in Nature, giving it an authority and visibility that far outpaced the normal process of scrutiny and debate.

"'Here is the proof,' he shouted. Anyone who questioned it was labelled a conspiracy theorist, because Nature is a respected publication, after all. It is the worst scientific paper — the most flawed — I have ever come across in my life. The references do not support the statements."
Professor Angus Dalgleish MD, FRCP, FRCPA, FRCPath, FMedSci

In his 2009 book The Emperor's New Drugs: Exploding the Antidepressant Myth, Irving Kirsch argues that the widely accepted chemical imbalance theory of depression is fundamentally flawed, and that most antidepressants have little or no direct therapeutic effect beyond placebo. He further contends that these drugs function largely as powerful active placebos, often accompanied by significant and well-documented side effects.

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

While analysing antidepressant trials as part of his research into the placebo effect, Kirsch discovered that pharmaceutical companies routinely failed to publish unfavourable clinical trial data, and that assessments of antidepressant efficacy were often based solely on selectively published results. Using the Freedom of Information Act (FOIA), Kirsch and his colleagues obtained previously unpublished trial data from the US Food and Drug Administration covering six antidepressants. When both published and unpublished results were analysed together, the researchers concluded that the drugs produced only a small and clinically insignificant improvement in mood compared with an inert placebo.

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

What this episode in medicine reveals is not a failure of science itself, but a familiar pattern: when institutional authority, funding, and reputational inertia align, inconvenient data can be sidelined — a dynamic that will be immediately recognisable to anyone following the debates in modern cosmology.

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...

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...

Medical journals are quietly haunted by ghostwriters. Because readers are far more likely to trust a paper authored by a practising physician than one produced by a pharmaceutical company, drug manufacturers have routinely employed professional writers to draft papers that are later published under doctors’ names. While students would be expelled for attaching their names to work they did not write, physicians are often financially rewarded for doing precisely that.

This practice does more than violate readers’ trust — it carries real clinical risk. Physicians rely on medical journals to guide diagnosis and treatment decisions. Papers originating within pharmaceutical companies tend to emphasise benefits while minimising harms, creating a distorted picture of safety and efficacy. When combined with well-documented problems surrounding selective reporting and suppressed clinical trial data, the result is not merely poor science, but a systemic threat to evidence-based medicine.

In 2004, The Lancet’s then editor-in-chief, Richard Horton, issued a stark warning, observing that “journals have devolved into information laundering operations for the pharmaceutical industry.” That was two decades ago. If anything, the structural incentives and financial entanglements that prompted his concern have only deepened since — suggesting the problem is not resolved, but entrenched.

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

Critics of the pharmaceutical industry often note that many major drug companies spend significantly more on lobbying and marketing than on research and development. This imbalance is not incidental; it appears to be a central feature of the modern pharmaceutical 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.