Pharmageddon by David Healy Read Free Book Online Page B

needs because Zyprexa has caused diabetes, Donna and her doctor will find themselves up against a radical skepticism. When it comes to the hazards of a pharmaceutical company's drug, the rules of science do not apply and causality, it seems, can never be proven. A more succinct definition of the arch-skepticism of postmodernism cannot be found than the phrase “doubt is our product.”
    Almost the only critique left in town is limited to attributing all our problems to conflict of interest—the reason things are going wrong is that companies can hire academics to proselytize on their behalf. Somewhat ironically the champion of this charge has been a Republican senator, Chuck Grassley, rather than anyone from academia or the “left.” 22 While Grassley has been nothing if not magnificently persistent in pursuing academics with links to pharmaceutical companies, forcing a number of eminent figures 23 to resign from their university posts, and in proposing a Sunshine Act, 24 his activism risks creating the impression that our problems stem primarily from a few rotten apples in the academic barrel rather than from anything more deep-seated. This is postmodernism for the twenty-first century—the text gets written according to the interests of the piper who pays the tune.
    This superficial conflict-of-interest critique helps industry by focusing attention away from their unwillingness to allow access to the data. It is ignorant of the history of science, forgetting that John Snow's case for removing the handle on the Broad Street Pump was only aired because it was in the interest of the owners of local abattoirs and other businesses who were being blamed for the cholera epidemic to provide a platform for these views that supported them. 25 It appears to imply that the State rather than private companies will need to run clinical trials or fund the academics who will present the results of these trials but this forgets that the specter of conflict of interest in science was first raised by another Republican—Dwight Eisenhower—concerned that public funding of research might lead to a military-industrial complex: “In holding scientific research and discovery in respect, as we should, we must also be alert to the equal and opposite danger that public policy itself could become the captive of a scientific and technological elite.” 26 If there is no access to the data, it is immaterial if the funding for science comes from private or public sources.
    Eisenhower caught a glimpse of a world in which both the market and science might become forces for alienation rather than liberation. We have arrived there. This is a failure of historic proportions—seen rarely before except in the former Soviet Union. In the face of this failure, some belated critiques of practices such as ghostwriting or concerns about conflict of interest are profoundly inadequate.
    In the face of the industrial postmodernism we see today, we need to recapture the ability to say that an increase in mortality is an increase in mortality and blockbuster drugs cause adverse events. We need to be able to recognize that little that glistens with statistical significance is therapeutic gold, and refuse to allow companies, their experts, and regulators to stand common sense on its head. Speaking out would be a way for doctors and scientists to demonstrate the “right stuff.” In addition to helping remedy our current difficulties, doing so might engage a wider public in the task of making real progress possible, rather than have us lulled into quiescence by fantasies of progress.
    We need our media studies and other university departments to deconstruct industry rhetoric. But we also need to recover a belief in real progress and a faith in the biological sciences that would explain what lies behind the correlations thrown up by controlled trials. At present, in part because it suits industry, doctors are being taught that