Can the medical journals be trusted to provide accurate, unbiased
information about medicine even as they are almost entirely
funded by drug companies?
Medical journals have a specific kind
of advertising content within their pages. All their ads are
for hospitals or drugs; there's not a non-medical ad in sight.
Since medicine is the subject of the entire journal, medical
ads seem par for the course. But what should an editor do if
a product advertised on a particular page isn't 100 percent
safe? It might not be cost-effective for a budget-strapped medical
journal to remove the ad and publish an article discussing the
product's drawbacks. They run the risk of angering the pharmaceutical
company and losing revenue. Donald M. Epstein, author of Healing
Myths, adds that even if the dangers of a drug or medical procedure
were to be included in a respected medical journal, often the
"religious" belief that doctors, and even patients,
have in conventional medicine overrides their decision-making
process.
People believe that if a drug is FDA-approved and on the market,
it must be okay. If a drug proves fatal to 10 or even 10,000
patients, doctors will still staunchly defend it, claiming the
benefits outweigh the risks. Epstein's feelings are that anyone
with a little common sense should be enraged by the fact that
the entire industry is operating with self-imposed blinders
-- from the pharmaceutical companies that hawk unsafe drugs
to the medical journals that publish doctored clinical studies
and misleading ads.
Richard Smith, the ex-editor of the British Medical Journal
(BMJ), publicly criticized his former publication, saying the
BMJ was too dependent on advertising revenue to be considered
impartial. Smith estimates that between two-thirds to three-quarters
of the trials published in major journals -- Annals of Internal
Medicine, Journal of the American Medical Association, Lancet
and New England Journal of Medicine -- are funded by the industry,
while about one-third of the trials published in the BMJ are
thus funded. He further adds that trials are so valuable to
drug companies that they will often spend upwards of $1 million
in reprint costs (which are additional sources of major revenues
for medical journals). Consumers trust medical journals to be
the impartial and "true" source of information concerning
a prescription drug, but few are privy to what is truly going
on behind the scenes at both drug trials and medical journals.
Scientists who conduct drug trials may be hard-pressed to stay
impartial when the manufacturers so often pay them for lectures
and consultations, or when they are conducting research that
has been funded by the company. In addition, as stated by doctors
Mark Hyman and Mark Liponis in Ultraprevention, since drug companies
are so reliant on the word of doctors, they often visit doctors'
offices to hand out free samples, take the staff out to lunch,
offer free gifts -- including toys for kids, seminars at expensive
restaurants and junkets to the Caribbean islands -- and frequently
sponsor continuing education for doctors.
The scandal in medical research is far more shocking than the
corporate scandals that recently created headlines, according
to John Abramson in Overdosed America. Abramson says that the
withholding of negative results and the misrepresentation of
research are accepted norms in the field of drug trials, or
"commercially sponsored medical research."
He even goes as far as to say that there is a web of corporate
influence in the form of "regulatory agencies, commercially
sponsored medical education, brilliant advertising, expensive
public relations campaigns, manipulation of free media coverage,"
as well as the aforementioned relationship between trusted medical
voices and the medical industry. In Abramson's view, this all
contributes to the silencing of the industry's corruption. He
likens the situation to the recent corporate scandal in which
securities analysts received payments in order to write reports
that drove up stock prices.
According to Ann Blake Tracy, PhD, author of PROZAC: Panacea
or Pandora, a "CBS HealthWatch" article even accused
pharmaceutical companies of authoring drug studies themselves,
then paying doctors to sign their names onto them. Furthermore,
of the approximately 3,000 medical journals published monthly,
only 10 percent are cross-indexed into a computer system, according
to Charles T. McGee, in his book, Heart Frauds. This cross-indexed
material is closely reviewed by "conservative editorial
boards" in order to screen out controversial content. The
10 percent of material that's been approved is the only material
available to a doctor when he asks a medical librarian to conduct
a computer search or a search of a CD-ROM service such as Medline.
On top of that is Kenny Ausubel's report, contained in his book,
When Healing Becomes a Crime, that many drug companies just
cut out the middle-man and publish their own medical journals.
Opponents of the perceived corruption in medical journals offer
many solutions. Smith, as mentioned previously, would either
like more privately-funded studies published or have none published
at all. Abramson feels that researchers have to have access
to all the results of their studies, perform their own analysis
of data, write their own conclusions and submit the report to
peer-reviewed medical journals. A change may be in the cards,
and as Richard Gerber, MD, notes, the number of patients seeking
alternative medical answers to their problems is becoming too
large for mainstream medical media to ignore. Gerber says that
some medical journals are even publishing articles that explore
the nature of these "unorthodox" treatments and discuss
why patients are seeking alternative health care.
Related articles:
Reference
Source 136
October
5, 2005
