Do You Believe in Objective (Ha! Ha! Wink, Wink!) Science?

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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Comments

[capitalismisntamoral]

"Peer-reviewed journals rely on pharmaceutical advertising."

Yet another argument for free/low-cost/not-for-profit online scientific publishing.

"Drug company lobbyists outnumber Congressmen by two to one."
Only 2 to 1?
That makes it 1070.
Ok, sounds about 1000 too many (or 1,070).

[Ajita]

The pharmaceutical companies have little to do with real science and a lot to do with using the work of science for their benefit. Most real science is done by researchers in universities across the world.
What is also annoying is when people criticize science itself. Science is the most objective way of studying the natural world. Its a pity that in order to sell a post, some have resorted to such maligned headlines. Why can't the the title be more specific (drug companies) or even be against capitalism? That would seem like the real problem here. The fact is that in America we are taught to not challenge capitalistic principles but find scapegoats like the truly honorable discipline of science.

[dougbremner]

That's a good point. It is the job of the pharmaceutical industry to sell prescription medications, and they do a good job at it. The problem is that we have become mesmerized with the propaganda that their job is to save lives, or make life saving medications. It is not their job to save lives, it is their job to sell medications, just like it is Goodyear's job to sell tires. And to maximize profit for their shareholders. With all of the hype doctors have become confused about whether it is their job to sell medications. That isn't their job, their job is to save lives. As for not being able to find a single non-conflicted expert, I might remind the journalists that they too have participated in the shilling of pharma and healthcare with their hyping of 'new drugs' and 'medical breakthroughs', and their insistance on going to *the* thought leader for any particular topic. http://www.beforeyoutakethatpill.com/2008/1/medical_breakthroughs.html
Did they ever stop to consider that pharma may have contributed to (been responsible for?) the buzz that made that person the go to guy in the first place?

[Lesscancer]

Good Post-

There is little incentive to prevent illness-the "big prize" of course is in the profit that comes in treating illness.

Prevention unfortunately is not the rule- take cancer treatment as an example the biggest machine of them all, a thriving industry- a cash cow.

To me for the most part medicine no longer seems to be the work of humanitarians but seemingly now has the flavor of another type of industry.

And while thankfully more and more there is a cure- we must expand our view to include all avenues of prevention to include environmental exposures that may be linked with cancer.

We must turn the tide in the way we view cancer- cancer must not be an expected stage of life that you reach for a pill for the one bad day its your turn you hear the dreaded news. Thank god there is a pill,the cure can never be underestimated- however we must open the doors to all possibilities in preventing cancer that has affected the lives of countless Americans.

When it comes to environmental exposures that are known and or either suspected to be linked to cancer, if there is an opportunity to avoid those exposures we should.

Like so many of the "cures" that may have unintended negative outcomes- scientist will tell you that there are negative outcomes for the environmental toxins that may cause harm to human health include cancer.

The environment=human health

Bill Couzens, Founder Lesscancer.org

[Desiderata]

Classic marketing case #1:

(1) invent Attention Deficit Disorder

(2) market the false concept in all the medical journals, with attribution of those that have Doctorates in the psuedo science of psychology, psychiatry, and the neuropharmacologists.

(3) market to schools and families as the reason Johnny doesn't find classwork and teachers more interesting than fishing__a potential customer base of squirming boys in the millions.

(4) immediately lay the groundwork for future sales after the boy market peaks: invent Adult Attention Deficit Disorder.

One pill makes you larger.

One pill makes you small.

And another doesn't really do anything at all.

Go ask Alice, when she's ten-foot tall.

[cheverlycats]

You obviously have never had or have an unfounded bias against what is a very real disorder!

If you haven't suffered from it, don't tell other children and adults that they're duped pawns from the pharmaceutical companies!

[Sciguy]

Nonsense. Of course drug companies have drug company employees. The reporter looked at pharmaceutical companies. Surprise! He found pharmaceutical company employees. That's like going to a horse farm and finding horse farmers.

There are lots of independent scientific experts out there. Try looking at a university's pharmacology department. You'll find experts in assorted fields who are not on the drug companies' payrolls. They usually buy the drugs they study, but if it's an experimental drug, the only way to get it is to ask the drug company for it. Whether one gets a sample or not has a lot do to with the scientist's name - the well-known ones have a better chance of getting some - but the experimental results are just plain science. Those results are presented at scientific meetings and are published in peer-reviewed journals.

It sounds like Ms. Levy may have fallen prey to the "Trust No Expert" syndrome pushed by the far right in order to discredit science as a whole (and replace it with Noah's ark and faith healers' therapies). Please don't fall for it, Ms. Levy. The drug companies may be scum, but they do have genuine experts working for them. The machinations of their marketing departments overrule even the best science - but scientific experts are still scientific experts. Sure, experts disagree. They''ve read every paper on a given drug, and know in great depth the body system the drug affects. They disagree **because** they're experts on the science involved.

[tompoe]

"The drug companies may be scum, but they do have genuine experts working for them." You got that right. They either tow the company line, or the company makes sure they lose their hospital rights, among other things. Don't play the game, and your medical practice becomes a nightmare. As for the universities. Any "expert" that doesn't cooperate costs the university literally millions in research grants, sponsored by the companies. How long will the independent expert last? Try hours. Not sure what you mean by some group trying to discredit science as a whole. I suspect you're talking about apples and oranges, here.

[Sciguy]

I hope I can answer your concerns.

I know many scientific researchers at universities who are funded by agencies including the NIH or NSF, not drug companies. The chairman of my pharmacology department was an internationally renowned expert. He was among the first to describe the addictive properties of Valium - even though Roche had been marketing it as non-addictive - and we got the Valium from Roche. We were grant generators. We raised millions of dollars for the university.

As for the same group trying to discredit science as a whole: the easiest target for people who want to undermine logic and reason is the scientists who worked for tobacco companies. After that, scientists who work on drug research are targets. It goes something like this:

1. Tobacco is bad, so tobacco scientists are whores.
2. Drug companies charge too much, so scientists who study drugs must be whores, too, toeing the line. Since they're whores, they should not be believed.
3. All scientists work in the same general way, and they're proud to tell you about their scientific method.
4. Since they all work in the same way, they, too, should not be believed.
5. You can't believe in the science those scientists did because the scientists are bad.
6. The Truth only comes from our god anyway, and now you know why you should believe in our god's way instead of the scientists' way.

[Sciguy]

Addendum - most scientists have Ph.D.s, and they don't have hospital rights anyway. Only MDs have that.

[luziannagirl]

Sciguy

Nonsense to your nonsense.

And, as for Ms.Levy's phrase "hallowed halls of medical scientific research" --- a nicely alliterated oxymoron. Doctors have about as much to do with mainstream basic science as, oh, let's see, plumbers have to do with theoretical physics. In fact, real scientists often quietly gnash their teeth when medicine is referred to as "science". Brand dilution, and all.

I come from a multi-generational medical family and have worked in hospitals myself. Our rule of thumb is to avoid doctors and hospitals whenever possible, except of course as places to work.
And, if you can avoid any kind of invasive procedure, operation , shot, or pill by changing your lifestyle, even drastically, it's usually well worth it.

The current astounding hospital-borne infection rate, an open dirty little secret most medical insiders know all about (just get one good & drunk and ask about it sometime) alone is enough to convert most to believers in the practice of doctor-avoidance.

Let me put it this way: Just counting up on my fingers,of the last five friends and family members who've been admitted as hospital inpatients, four acquired post-procedural infections, two confirmed MRSA, (methicillin-resistant staphilococcus aureus) . And these are people who know to insist on hand-washing and speak "hospital".

Oh, yeah, it is that bad, and it's been that bad for some years now. It's the money.

[cc]

Got a problem? Any problem! Take a drug! Yeah, that'll fix you right up and you know why? Because dis-ease is caused by drug deficiencies! So . . . if drugs are the best remedy for dis-ease then why aren't ALL feel-better/good drugs legal and freely available to the sick and potentially-sick amongst us? Considering the proliferation of pharmaceutical drug ads everywhere these days and the often dire warnings that accompany them, it's even beginning to look like street drugs are the healthier choice! Yeehaw!

Actually, I think it's long past time for a major belief-change about the lack of health in our civilization and that belief would have to be changed from:

"I don't feel good because I have a drug deficiency or because germs, my mother, my father, my government, my ancestors, you, the universe, etc., etc. visited/transmitted evil/contagion/malaise upon me."

to the unvarnished truth:

"I don't feel good because of the crap I believe, the fears I entertain, and the events I expect."

Oh wait--no one would make any money on that. Never mind!

[Tags]

Melody Petersen is doing for pharmaceuticals what Michele Simon is doing for food.

Godspeed to both.

[checkyourpremises]

She isgreat, a journalist of Moyers' caliber. And thank you Alison for bringing this book to my attention. Your "Ha Ha" is veyr appropriate. I'll be laughing even harder when these crooks and liars are brought to justice, or at least to regulation.

[hankm]

It'll take a lot to regulate or imprison these crooks. Who do you think provides the big campaign contributions?