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On the Suppression of Medical Evidence

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Abstract

Financial conflicts of interest in medical research foster deviations from research standards and evidentially lead to the suppression of research findings that are at odds with commercial interests of pharmaceutical companies. Questionable research practices prevent data from being created, made available, or given suitable recognition. They run counter to codified principles of responsible conduct of research, such as honesty, openness or respect for the law. Resulting in ignorance, misrepresentation and suspension of scientific self-correction, suppression of medical evidence in its various forms is both a threat to the epistemic and the moral integrity of medical science. This paper discusses an example of the suppression of medical evidence in recent influenza research and develops a conceptual framework for the description and assessment of questionable research practices applied in research and publication processes to suppress evidence.

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Notes

  1. A comprehensive timeline about this case can be found on BMJ`s website about the case (www.bmj.com/tamiflu, retrieved November 20, 2016), cf. Jefferson and Doshi (2014) and Godlee (2009a, b, 2012a, b).

  2. http://www.cdc.gov/mmwr/preview/mmwrhtml/00050459.htm, retrieved October 6th, 2016.

  3. http://www.who.int/csr/resources/publications/influenza/whocdscsredc991.pdf, retrieved October 6th, 2016.

  4. http://www.who.int/csr/resources/publications/influenza/11_29_01_A.pdf, reference can be found in Annex 5, p. 7 and was put forward as evidence for efficiency in treatment.

  5. http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/EnforcementActivitiesbyFDA/WarningLettersandNoticeofViolationLetterstoPharmaceuticalCompanies/UCM166329.pdf, retrieved October 6th, 2016.

  6. Cf. Romero (2016) who demonstrated in computer simulations, that science is only automatically self-correcting, when ideal conditions like the presence of incentives for replicative research and access to research findings were satisfied.

  7. Martin does in fact acknowledge this and points to the conflict between data suppression and the principle of openness, famously introduced into the discussion by Merton (1973). But I still think Martin´s focus on openness is short-sighted. I will discuss the ethical/moral assessment of the suppression of medical evidence later.

  8. I suggest that concepts in research ethics ought to be defined in a way that easily allows for codification and implementation into institutional policies. Philosophers like Thomas Reydon plead for a narrower scope of research ethics and assign research ethicists first and foremost an advisory role in decision processes. Contrary to such a view, I suggest that research ethicists should take an active role in policy making, an argument for this can be found in my review of Reydon’s otherwise convincing and instructive introduction to research ethics (Reydon 2013).

  9. Since the freedom of science allows within certain limitations for the definition of a research agenda. Under certain conditions, secrecy about research findings can be justified on ethical grounds and even public scrutiny can be illegitimate if it is used to obscure the fact that there is a well-founded consensus on the answer to a scientific question. Proponents of scientific creationism and intelligent design, for example, make use of principles of public scrutiny in science in order to keep an already concluded debate about the existence of biological evolution running.

  10. http://www.oecd.org/chemicalsafety/testing/oecdguidelinesforthetestingofchemicals.htm, retrieved April 9, 2017.

  11. Identifying openness as the principle violated by suppression of evidence is way too uninformative in this context. Saying that suppression of evidence is a problem for openness in science is like saying that violence is a problem for peoples’ safety.

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Acknowledgements

I would like to thank Frauke Albersmeier for helpful comments on earlier drafts of this article. I also would like to thank Gerhard Schurz, Hartmut Klimt, and Torsten Wilholt for discussing the topic of suppression in medical research with me on several occasions. Furthermore, two anonymous reviewers read the paper carefully and provided me with a kind and constructive feedback, I am very grateful to both of them.

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  1. Düsseldorf Center for Logic and Philosophy of Science (DCLPS), Heinrich Heine University, Universitätsstraße 1, 40225, Düsseldorf, Germany

    Alexander Christian

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Christian, A. On the Suppression of Medical Evidence. J Gen Philos Sci 48, 395–418 (2017). https://doi.org/10.1007/s10838-017-9377-9

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