Abstract
This chapter examines various structural and institutional loop-holes and market incentives that allow pharmaceutical companies to maximize profits at the expense of public health, create institutional corruption in academic and healthcare settings, and undermine the scientific integrity of medical research. Practices that are discussed include illegal off-label promotion and prescription of drugs, financial incentives and kick-backs to physicians to alter their prescribing behaviours, financial incentives to academic centres and journals, the deliberate creation and dissemination of biased research findings through ghostwriting, suppression of negative results, and widespread conflicts of interest. The wide-spread systemic nature of these problems means that solutions will have to be equally wide-spread and systemic, with unprecedented changes across multiple sectors.
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References
Baker, C.B., M.T. Johnsrud, M.L. Crismon, R.A. Rosenheck, and S.W. Woods. 2003. Quantitative analysis of sponsorship bias in economic studies of antidepressants. The British Journal of Psychiatry 183 (DEC): 498–506.
Balon, R., and S. Singh. 2001. Status of research training in psychiatry. Academic Psychiatry 25 (1): 34–41.
Bentall, R.P. 1992. A proposal to classify happiness as a psychiatric disorder. Journal of Medical Ethics 18: 94–98.
Brown, N., C. A. Vassilas, and C. Oakley. 2009. Recruiting psychiatrists—A Sisyphean task?, Psychiatric Bulletin.
Brownlee, J. 2020. The corporate corruption of academic research. Alternate Routes: A Journal of Critical Social Research 26, no. Retrieved from http://alternateroutes.ca/index.php/ar/article/view/22311.
Caplan, P.J. 2014. Diagnostisgate: Conflict of interest at the top of the psychiatric aparatus. Aporia Journal 7 (1): 30–41.
Chappell, N., A. Cassels, L. Outcalt, and C. Dujela. 2016. Conflict of interest in pharmaceutical policy research: An example from Canada. International Journal of Health Governance 21 (2): 66–75.
Christensen, H., P.J. Batterham, I.B. Hickie, P.D. McGorry, P.B. Mitchell, and J. Kulkarni. 2011. Funding for mental health research: The gap remains. Medical Journal of Australia 195 (11): 681–684.
Cosgrove, L., and A. Vaswani. 2019. Critical psychiatry. Controversies and Clinical Implications. Springer Nature Switzerland.
Cosgrove, L., and E.E. Wheeler. 2013. Drug firms, the codification of diagnostic categories, and bias in clinical guidelines. Journal of Law, Medicine and Ethics 41 (3): 644–653.
Cosgrove, L. 2010. Psychiatric taxonomy, psychopharmacology and big pharma. Couns. Sch. Psychol. Fac. Publ. Ser. Pap. 7.
Duval, G. 2004. Interest: Protecting accountability. Int Comp Heal Law Ethics A 25-Year Retrosp Winter: 613–626
Egilman, D.S., and N.M. Druar. 2011. Corporate versus public interests: Community responsibility to defend scientific integrity. International Journal of Occupational and Environmental Health 17 (2): 181–185.
Fanelli, D. 2012. Negative results are disappearing from most disciplines and countries. Scientometrics 90 (3): 891–904.
Frances, A.J., and T. Widiger. 2012. Psychiatric diagnosis: Lessons from the DSM-IV past and cautions for the DSM-5 future. Annual Review of Clinical Psychology 8 (1): 109–130.
Gagnon, M.A. 2013. Corruption of pharmaceutical markets: Addressing the misalignment of financial incentives and public health. Journal Law, Medicine and Ethics 41 (3): 571–580.
Gopal, A.A., L. Cosgrove, and H.J. Bursztajn. 2010. Commentary: The public health consequences of an industry-influenced psychiatric taxonomy: ‘Attenuated Psychotic Symptoms Syndrome’ as a case example. Accountability in Research 17 (5): 264–269.
Gøtzsche, P.C., et al. 2009. What should be done to tackle ghostwriting in the medical literature? PLoS Medicine 6 (2): 0122–0125.
Hamoda, H.M., M.S. Bauer, D.R. Demaso, K.M. Sanders, and E. Mezzacappa. 2011. A competency-based model for research training during psychiatry residency. Harvard Review of Psychiatry 19 (2): 78–85.
Hart, B., A. Lundh, and L. Bero. 2012. Effect of reporting bias on meta-analyses of drug trials: Reanalysis of meta-analyses. BMJ 344 (7838): 1–11.
Hughes, S., D. Cohen, and R. Jaggi. 2014. Differences in reporting serious adverse events in industry sponsored clinical trial registries and journal articles on antidepressant and antipsychotic drugs: A cross-sectional study. BMJ Open, 4(7).
Jablensky, A., R. E. Kendell. 2002. Criteria for assessing a classification in psychiatry. In Psychiatric diagnosis and classification, eds. M. Maj, W. Gaebel, J. J. Lopez-Ibor, and N. Sartorius, 1–24. Wiley.
Jernigan, D.B., L. Kargacin, A. Poole, and J. Kobayashi. 2001. Sentinel surveillance as an alternative approach for monitoring antibiotic-resistant invasive pneumococcal disease in Washington State. American Journal of Public Health 91 (1): 142–145.
Jureidini, J.N., and L.B. McHenry. 2011. Conflicted medical journals and the failure of trust. Accountability in Research 18 (1): 45–54.
Kupfer, D.J., S.E. Hyman, A.F. Schatzberg, H.A. Pincus, and C.F. Reynolds. 2002. Recruiting and retaining future generations of physician scientists in mental health. Archives of General Psychiatry 59 (7): 657–660.
Lexchin, J. 2012. Sponsorship bias in clinical research. The International Journal of Risk and Safety in Medicine 24 (4): 233–242.
Le Noury, J., et al. 2015. Restoring study 329: Eficacy and harms of paroxetine and imipramine in treatment of major depression in adolescence. BMJ 351.
McHenry, L.B., and J.N. Jureidini. 2008. Industry-sponsored ghostwriting in clinical trial reporting: A case study. Accountability in Research 15 (3): 152–167.
Moffatt, B., and C. Elliott. 2007. Ghost marketing: Pharmaceutical companies and ghostwritten journal articles. Perspectives in Biology and Medicine 50 (1): 18–31.
Polster, C. 2007. The nature and implications of the growing importance of research grants to Canadian universities and academics. Higher Education 53 (5): 599–622.
Rafols, I., et al. 2014. Big Pharma, little science?. A bibliometric perspective on Big Pharma’s R&D decline. Technological Forecasting and Social Change 81 (1): 22–38.
Rodwin, M.A. 2013. Drug Use. Journal of Law, Medicine and Ethics Fall: 654–664.
Rodwin, M.A. 2013. Introduction: Institutional corruption and the pharmaceutical policy. Journal Law, Medicine and Ethics 41 (3): 544–552.
Rothman, D.J., et al. 2009. A proposal for controlling conflict of interest. JAMA, the Journal of the American Medical Association 301 (13): 1367–1372.
Schafer, A. 2004. Biomedical conflicts of interest: A defence of the sequestration thesis—Learning from the cases of Nancy Olivieri and David Healy. Journal of Medical Ethics 30 (1): 8–24.
Schott, G., H. Pachl, U. Limbach, U. Gundert-Remy, W.D. Ludwig, and K. Lieb. 2010. The financing of drug trials by pharmaceutical companies and its consequences. Deutsches Ärzteblatt International 107 (16): 279–285.
Sismondo, S. 2009. Ghosts in the machine: Publication planning in the medical sciences. Social Studies of Science 39 (2): 171–198.
Sismondo, S. 2013. Key opinion leaders and the corruption of medical knowledge: What the sunshine act will and won’t cast light on. Journal Law, Medicine and Ethics 41 (3): 635–643.
Smith, R. 2005. Medical journals are an extension of the marketing arm of pharmaceutical companies. PLoS Medicine 2 (5): 0364–0366.
Somerville, M.A. 2002. A postmodern moral tale: The ethics of research relationships. Nature Reviews. Drug Discovery 1 (4): 316–320.
Stuart, H., et al. 2015. Images of psychiatry and psychiatrists. Acta Psychiatrica Scandinavica 131(1).
Turner, E.H. 2013. Publication bias, with a focus on psychiatry: Causes and solutions. CNS Drugs 27 (6): 457–468.
van Lent, M., J. Overbeke, and H.J. Out. 2013. Recommendations for a uniform assessment of publication bias related to funding source. BMC Medical Research Methodology 13: 120.
Watson, G.L., A.P. Arcona, D.O. Antonuccio, and D. Healy. 2014. Shooting the messenger: The case of ADHD. Journal of Contemporary Psychotherapy 44 (1): 43–52.
Yager, J., J. Greden, M. Abrams, and M. Riba. 2004. The institute of medicine’s report on research training in psychiatry residency: Strategies for reform—background, results, and follow up. Academic Psychiatry 28 (4): 267–274.
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Stuart, H. (2023). Structural Problems in the Practice of Psychiatric Research. In: Zima, T., Weisstub, D.N. (eds) Medical Research Ethics: Challenges in the 21st Century. Philosophy and Medicine, vol 132. Springer, Cham. https://doi.org/10.1007/978-3-031-12692-5_24
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