As confidence in authorities plummets, one cherished bastion remains: the hallowed halls of medical scientific research. There we picture white-coated scientists making objective research determinations. Upon that bedrock, we make health decisions.
But does our image correspond to reality?
"The pharmaceutical companies say they're about the science, but they're really about marketing," Melody Petersen, author of Our Daily Meds, told Bill Moyers on television last night.
A former New York Times reporter with privileged entrée into the pharmaceutical world, Petersen, over eight years of research, sought to find just one scientist, who was not on a drug company payroll and could validate research science. None could be found. The so-called independent and objective experts were all in pharmaceutical company employ.
The "trustworthy expert" is a PR fabrication, first developed back in the 1930's by Edward Bernays, a nephew of Sigmund Freud, who applied Freudian psychology to mass media marketing. According to Trust Us, We're Experts, Bernays' time-tested formula (still used today) was hiring seemingly independent experts (and front groups) to manufacture the illusion of credibility in order to sell product.
"Whether a medicine helps or hurts is secondary to profit," says Petersen. "A lot of money is spent selling drugs that don't work. The FDA found that 100,000 people die annually from drugs correctly prescribed and taken. That's a life and death matter."
But doesn't research, conducted by qualified independent scientists, weed out harmful or ineffective drugs"
Not necessarily, says Petersen. "The ad agency writes the study, and then hires doctors to put their name on it as authors," she told Moyers. "They put their words in the mouths of someone who looks independent."
Studies can also be manipulated, says Petersen, so that the outcomes will demonstrate greater efficacy or safety. Whenever research results favor the drug tested, the companies will "get that research published over and over in many journals," Peterson found. "But if another study produces unfavorable results, that study will disappear. That's why some scientists view the medical literature as "propaganda.""
Where are the gatekeepers? Doctors are on the payroll with research monies, junkets, and cash fees. Peer-reviewed journals rely on pharmaceutical advertising. Companies pay the FDA huge sums for drug review, so that the regulators are beholden. Drug company lobbyists outnumber Congressmen by two to one. And then there's the media.
TV advertising of pharmaceuticals:
First, allows PR firms to medicalize often minor health problems and "rebrand" them as worrisome new conditions, requiring drugs.
Second, undermines the media's independence to question science (or report objectively on lower cost options.) Drug companies are big advertisers.
The net effect? Yes, it's rising health costs and people taking pills in record numbers. But it's also lack of critical reporting and information. How can people make the right health care decisions in a muddle of misinformation? How can we can consider all available health options in the divisive and opinionated environment created by a profit dominated health sector?
Last winter, I reported on a study finding that, for the majority of people, taking antidepressants was no better than taking a placebo.
"Placebo" is biological science's term for the effects of psychology, belief, emotion, and conditioning on biological parameters. In pharmaceutic dominant research, placebos are deemed unworthy of study. But on the other side of the hallway, in the Marketing Department, accessing the placebo effect to influence people's feelings and beliefs about health is the name of the game.
We have yet to study how drug advertising conditions its audience. Manipulating you to make you believe you're sick? That reminds me of Charles Boyer in the film, Gaslight. No, thanks! This is an instance of the "nocebo effect," the negative impact of words and images on one's health. Ingrid Bergman may have cowered in the corner, but I prefer to change the channel the moment a drug ad appears.
What happens when we all submit to powerful images telling us to trust so-called experts? What's the health impact of repeated messages that we suffer from mysterious and newly minted "health conditions?" How does the sum total of all this market-driven entree into the hearts and minds of our nation, influence our health status individually and collectively? The U.S. currently ranks below all other developed nations. Can we still afford to believe that this is objective science?
There's no doubt that some drugs are beneficial and even life-saving, but there's no way to know which ones are truly effective or necessary until all the real outcomes -- biological, psychological, economic, and sociological -- are considered. And until the independence of science, free of vested interests, is restored.
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