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In favour of a Millian proposal to reform biomedical research

Synthese volume 177, pages 427–447 (2010)Cite this article

Abstract

One way to make philosophy of science more socially relevant is to attend to specific scientific practises that affect society to a great extent. One such practise is biomedical research. This paper looks at contemporary U.S. biomedical research in particular and argues that it suffers from important epistemic, moral and socio-economic failings. It then discusses and criticises existing approaches to improve on the status quo, most prominently by Thomas Pogge (a political philosopher), Joseph Stiglitz (a Nobel-prize winning economist) and James Robert Brown (a philosopher of science). Finally, it sketches an alternative proposal and argues for its superiority. The proposal has four components: changing the intellectual property regime; instituting independent clinical research; aligning innovators’ and patients’ interests; and enacting additional regulation.

References

  • Aaron H. (2003) The costs of health care administration in the United States and Canada—questionable answers to a questionable question. New England Journal of Medicine 349(8): 801–803

    Article  Google Scholar 

  • Adam M. (2008) Promoting disinterestedness or making use of bias? Interests and moral obligation in commercialized research. In: Carrier M., Howard D., Kourany J. (eds) The challenge of the social and the pressure of practice: Science and values revisited. Pittsburgh University Press, Pittsburgh, PA, pp 235–255

    Google Scholar 

  • Als-Nielsen B., Chen W., Gluud C., Kjaergard L. (2003) Association of funding and conclusion in randomized drug trials: A reflection of treatment effect of adverse events?. Journal of the American Medical Association 290(7): 921–928

    Article  Google Scholar 

  • Angell M. (2004) The truth about the drug companies. Random House, New York, NY

    Google Scholar 

  • Anuradha, R. V. (2001, May 20). Biopiracy and traditional knowledge. The Hindu.

  • Bekelman J., Li Y., Gross C. (2003) Scope and impact of financial conflicts of interest in biomedical research. Journal of the American Medical Association 289(4): 454–465

    Article  Google Scholar 

  • Biddle J. (2007) Lessons from the Vioxx debacle: What the privatization of science can teach us about social epistemology. Social Epistemology 21: 21–39

    Article  Google Scholar 

  • Blumenthal D., Campbell E., Anderson M., Causino N., Louis K. (1997) Withholding research results in academic life science. Journal of the American Medical Association 277(15): 1224–1228

    Article  Google Scholar 

  • Bodenheimer T. (2000) Uneasy alliance. New England Journal of Medicine 342(20): 1539–1544

    Article  Google Scholar 

  • Boldrin, M., & Levine, D. (2002). Perfectly competitive innovation. Research Department Staff Report 303. Minneapolis, MN.

  • Boldrin M., Levine D. (2008) Against intellectual monopoly. Cambridge University Press, Cambridge

    Book  Google Scholar 

  • Brown J. R. (2002) Funding, objectivity and the socialization of medical research. Science and Engineering Ethics 8: 295–308

    Article  Google Scholar 

  • Brown J. R. (2004) Money, method, and medical research. Episteme 1: 49–59

    Article  Google Scholar 

  • Brown, J. R. (2006). Regulation and research: Approaches to market failures in medicine. In Commerce, politics and science conference, Notre Dame.

  • Brown J. R. (2008) The community of science®. In: Carrier M., Howard D., Kourany J. (eds) The challenge of the social and the pressure of practice: Science and values revisited. Pittsburgh University Press, Pittsburgh, PA, pp 189–216

    Google Scholar 

  • Campbell E., Gruen R., Mountford J., Miller L., Cleary P., Blumenthal D. (2007) A national survey of physician-industry relationships. New England Journal of Medicine 356(17): 1742–1750

    Article  Google Scholar 

  • Carrier M. (2008) Science in the grip of the economy: On the epistemic impact of the commercialization of research. In: Carrier M., Kourany J., Howard D. (eds) The challenge of the social and the pressure of practice: Science and values revisited. University of Pittsburgh Press, Pittsburgh, PA, pp 217–234

    Google Scholar 

  • Cartwright N. (2006) Well-ordered science: Evidence for use. Philosophy of Science 73: 981–990

    Article  Google Scholar 

  • Cartwright N. (2007) Are RCTs the gold standard?. BioSocieties 2(2): 11–20

    Article  Google Scholar 

  • Chalmers I. (1990) Underreporting research is scientific misconduct. Journal of the American Medical Association 263(10): 1405–1408

    Article  Google Scholar 

  • Chin, T. (2002, May 6). Drug firms score by paying doctors for time. American Medical News.

  • Chow S.-C., Liu J.-P. (2002) Design and analysis of clinical trials: Concepts and methodologies (2nd ed.). Wiley, Hoboken, NJ

    Google Scholar 

  • Christensen J., Orlowski J. (2005) Bounty-hunting and finder’s fees. IRB: Ethics & Human Research 27(3): 16–19

    Article  Google Scholar 

  • Cohen J., Gürtler R. (2001) Modeling household transmission of American trypanosomiasis. Science 293: 694–698

    Article  Google Scholar 

  • De Francisco, A., & Matlin, S. (2006). Monitoring financial flows for health research 2006: The changing landscape of health research for development. Geneva: Global Forum for Health Research.

  • Donohue J., Cevasco M., Rosenthal N. (2007) A decade of direct-to-consumer advertising of prescription drugs. New England Journal of Medicine 357: 673–681

    Article  Google Scholar 

  • Getz K. (1999) AMCs rekindling clinical research partnerships with industry. Centerwatch, Boston

    Google Scholar 

  • Global Forum for Health Research. (2004a). The 10/90 report on health research 2003–2004. Geneva: Global Forum for Health Research.

  • Global Forum for Health Research. (2004b). Monitoring financial flows for health research (Vol. 2). Geneva: Global Forum for Health Research.

  • Harris, G. (2004, December 6). At F.D.A., strong drug ties and less monitoring. New York Times.

  • Hartman, M., Martin, A., McDonnell, P., Catlin, A., & the National Health Expenditure Accounts Team. (2009). National health spending in 2007: Slower drug spending contributes to lowest rate of overall growth since 1998. Health Affairs, 28(1), 246–261.

    Google Scholar 

  • Heffner, S. (2004, March). Beyond the CRO. Contract Pharma.

  • Hilts P. (2003) Protecting America’s health: The FDA, business, and one hundred years of regulation. University of North Carolina Press, Chapel Hill, NC.

    Google Scholar 

  • Hollis A., Pogge T. (2008) The health impact fund: Making new medicines accessible for all. New Haven, CT, Incentives for Global Health

    Google Scholar 

  • Howson C., Urbach P. (2005) Scientific reasoning: The Bayesian approach. Open Court, Chicago and LaSalle, IL

    Google Scholar 

  • Kaiser Family Foundation. (2008). Prescription drug trends. Menlo Park, CA: Kaiser Family Foundation.

  • Kincaid H. (2004) Contextualism, explanation and the social sciences. Philosophical Explorations 7(3): 201–218

    Article  Google Scholar 

  • Kincaid, H., Dupré, J., Wylie, A. (eds) (2007) Value-free science? Ideals and illusions. Cambridge University Press, Cambridge

    Google Scholar 

  • Kincaid, H., McKitrick, J. (eds) (2007) Establishing medical reality: Essays on the metaphysics and epistemology of science. Springer, Heidelberg

    Google Scholar 

  • Kitcher P. (1993) The advancement of science. Oxford University Press, Oxford

    Google Scholar 

  • Kitcher P. (2001) Science, truth and democracy. OUP, Oxford

    Book  Google Scholar 

  • Kreling, D., Mott, D., Wiederholt, J., Lundy, J., & Levitt, L. (2001). Prescription drug trends: A chartbook update. Menlo Park, CA: Kaiser Family Foundation.

  • Krimsky S. (2003) Science in the private interest: Has the lure of profits corrupted biomedical research?. Rowman & Littlefield, Lanham, MD

    Google Scholar 

  • Longino H. (1990) Science as social knowledge. Princeton Universty Press, Princeton, PA

    Google Scholar 

  • Longino H. (2002) The fate of knowledge. Princeton Universty Press, Princeton, PA

    Google Scholar 

  • Mayo D. (1996) Error and the growth of experimental knowledge. University Press, Chicago IL

    Google Scholar 

  • McGoey, L., Reiss, J., & Wahlberg, A. (forthcoming). The health complex: Progress and pathologies in global health funding and governance. BioSocieties.

  • Mirowski P., Sent E.-M. (2002) Introduction, Science bought and sold: Essays in the economics of science. University of Chicago Press, Chicago IL

  • Mirowski P., Van Horn R. (2005) The contract research organization and the commercialization of scientific research. Social Studies of Science 34(4): 503–548

    Article  Google Scholar 

  • Mitchell S. (2009) Unsimple truths. University of Chicago Press, Chicago, IL

    Google Scholar 

  • Morgan S., Raymond C., Mooney D., Martin D. (2008) The Canadian RX atlas (2nd ed.). Centre for Health Services and Policy Research, Vancouver, BC

    Google Scholar 

  • Moynihan R. (2003) Who pays for the pizza? Redefining the relationships between doctors and drug companies. British Medical Journal 326: 1189–1196

    Article  Google Scholar 

  • Pogge T. (2005) Human rights and global health: A research program. Metaphilosophy 36(1/2): 182–209

    Article  Google Scholar 

  • Pollack, A. (2001, January 8). Bristol-Myers and Athersys make deal on gene patents. New York Times.

  • Public Citizen. (2001). Rx R&D myths: The case against the drug industry’s R&D “scare card”. Washington, DC: Public Citizen.

  • Public Citizen. (2003). 2002 Drug industry profits: Hefty pharmaceutical company margins dwarf other industries. Washington, DC: Public Citizen.

  • Public Library of Science. (2006). Special issue on disease mongering. PLoS Medicine, 3(4).

  • Putnam H. (2002) The fact/value dichotomy and other essays. Harvard University Press, Cambridge, MA

    Google Scholar 

  • Reiss J., Kitcher P. (2009) Biomedical research, neglected diseases and well-ordered science. Theoria 24(3): 263–282

    Google Scholar 

  • Risse, M. (forthcoming). The grounds of justice. Princeton, NJ: Princeton University Press.

  • Rosenthal M., Bernt E., Donohue J., Frank R., Epstein A. (2002) Promotion of prescription drugs to consumers. New England Journal of Medicine 346(7): 498–505

    Article  Google Scholar 

  • Selgelid M. (2005) Ethics and infectious disease. Bioethics 19(3): 272–289

    Article  Google Scholar 

  • Shuchman M. (2007) Commercializing clinical trials—risks and benefits of the CRO boom. New England Journal of Medicine 357(14): 1365–1368

    Article  Google Scholar 

  • Stiglitz J. (2006a) Making globalization work. Norton, New York, NY

    Google Scholar 

  • Stiglitz J. (2006b) Scrooge and intellectual property rights: A medical prize fund could improve the financing of drug innovations. British Medical Journal 333: 1279–1280

    Article  Google Scholar 

  • Wilholt T. (2006) Design rules: Industrial research and epistemic merit. Philosophy of Science 73(1): 66–89

    Article  Google Scholar 

  • Wilkes M., Bell R., Kravitz R. (2000) Direct-to-consumer prescription durg advertising: Trends, impact, and implications. Health Affairs 19(2): 110–128

    Article  Google Scholar 

  • Woolhandler S., Campbell T., Himmelstein D. (2003) Costs of health care administration in the United States and Canada. New England Journal of Medicine 349: 768–775

    Article  Google Scholar 

  • Worrall J. (2002) What evidence in evidence-based medicine. Philosophy of Science 69: S316–S330

    Article  Google Scholar 

Download references

Acknowledgments

Research for this paper has been financially supported by two projects funded by the Spanishministry of education: FFI2008-01580 and CONSOLIDER INGENIO CSD2009-0056. My special thanks go to Katie Plaisance and Carla Fehr for extensive and highly helpful comments on previous versions of this paper and their editorial patience. Errors remain, as usual, my responsibility.

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  1. Faculty of Philosophy, Erasmus University, 3000 DR, Rotterdam, The Netherlands

    Julian Reiss

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  1. Julian Reiss
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Open Access This is an open access article distributed under the terms of the Creative Commons Attribution Noncommercial License (https://creativecommons.org/licenses/by-nc/2.0), which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

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Reiss, J. In favour of a Millian proposal to reform biomedical research. Synthese 177, 427–447 (2010). https://doi.org/10.1007/s11229-010-9790-7

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Keywords

  • Biomedical research
  • John Stuart Mill
  • Global Justice
  • Methodology