Jay D. Amsterdam: The paroxetine 352 bipolar study. Ethical conduct
Kenneth Gillman’s comment
Many of us share feelings of anger and dejection when reviewing yet another example, like Jay Amsterdam’s Study 352 exposé of the myriad instances of corruption of science by naïveté, stupidity and venality. It is but one facet of how, society-wide, such behaviors are destroying the planet, as unbridled greed, fomented by capitalism, overwhelms and devours our world.
Greed is to aspiration, as rape is to love
Ken Gillman 2021
I remember my sense of foreboding when, as a young man, I saw the potential downside of the Reagan-Thatcher laissez-faire, neo-neoliberal, self-regulating capitalism asserting dominance. There is insufficient recognition that we live in a plutocracy, not a democracy — the greed and inequality thus catalyzed are reflected in all branches of society, including medical science. The adverse effects of this plutocracy on medical science, facilitated by the massive wealth of pharmaceutical companies, is now threatening to complete its ruination. It encourages a short-term outlook and a descent to the lowest common denominator, of which the epithet “publish or perish” is a prominent exposition.
Much of the educational system is now dependent on, and ghost-manipulated by, the wealth of industry — and while aspiration and ambition may be fine qualities, when they transmute into greed and short-term gain, disaster is close at hand. It is the belief among many that short-term goal-directed research is the efficient way forwards. However, most discoveries and advances are serendipity and come from “left field,” an observation that has become lost to the common consciousness.
Deceit, outrageous deceit, has been perpetrated on three levels: first, deceit about the mechanisms by which drugs work (pharmacology); second, deceit about whether they do indeed work well, or at all (efficacy); and third, deceit about on how many manufactured diagnoses they can be claimed to work (disease mongering). I have written extensively concerning the deceit and misrepresentation of the pharmacology of how drugs work. This is so extensive and affects such a large proportion of the drugs about which I write that it is impossible to discuss the pharmacology without explaining that much of the data in the literature is either misrepresented, or frankly deceitful.
Jay writes more about the misrepresentation of the efficacy, via manipulations of trials and the unethical behavior of individuals. These three facets combine to produce an unsettling exemplar of George Orwell’s “universal deceit.”
“In an age of universal deceit, telling the truth becomes a revolutionary act” and,
“The further a society drifts from truth, the more it will hate those who speak it.”
Jay Amsterdam’s analysis of the deplorable, unethical and unprofessional behavior surrounding the 352 charade is necessary and laudable in its probity, thoroughness and historical value.
The society of medicine has drifted sufficiently far from probity and truth that Jay will be disliked and even reviled. His analysis will be read in its entirety by too few. Nevertheless, it must be “on the record” for those who in the future wish to learn from history — forlorn hope as such learning might be — I will leave research on the exact wording of Hegel’s quotation about “people not learning from history” to others.
When I say “Greed is to aspiration, as rape is to love” I acknowledge that incentive, aspiration and ambition may help to drive discovery, but, when without a moral compass and unbridled, as all too evidently, they have become, they soon take a destructive downhill path.
What more can be said? We live in times where nurturing optimism is difficult and where acting as an ethical academic is to be a stranger in your own land. Those who are affecting these undesirable outcomes are, in part, and moral judgements aside, simply reflections of the wider changes in culture and society — just soiled flotsam bobbing along on the floodtide of history.
Will the tide change in our time?
February 10, 2022