Drugmakers undermine medical journals and skew medical research
theamericanscholar.org
theamericanscholar.org
There's a lot of entrenched interests blocking this kind of innovation, but several disruptive forces at work (like massive iPad adoption amongst physicians) are enabling interesting approaches.
I don't believe that this group needs this caveat, but having worked in two research labs, I know that some people do have the belief that it is "liberal scientists" deliberately misleading the public.
There's a lot of funding from the public trough and a lot of funding from the private trough, to say that one corrupts less is to misunderstand economics.
The private companies have pens, trinkets and buffets, the public companies have the school system, the army, the justice system, FDA, IRS, CIA, FBI, DEA, ATF and the police. If I wanted to mislead and force my will upon doctors I'd certainly take the latter over the former.
They have far more than that, which is the whole point of the article.
Anyone who thinks that money is the only, or even most influential, source of corruption doesn't know much about people.
People will commit the most horrendous atrocities in the name of "doing good", and that's not the only thing that is far more effective than money.
How many of you look at most govt officials and say "I want that person running my life."?
Indeed, it's amazing that the same people who tout most strongly the power of the invisible hand immediately believe that there are other things "far more effective" when the hand's unchecked subtle and consistent influence has negative consequences.
Lastly, the stories of horrendous atrocities caused by misguided-do-gooders are the exceptions that prove the rule -- throughout history, truly horrendous has been the cascade of constant repeated atrocities big and small perpetrated worldwide by people acting in their own (perhaps shortsighted) self-interest at others' expense.
Not at all. Almost every genocide has been initiated by do-gooders.
> the cascade of constant repeated atrocities
Yes, folks tend to go along, but that's true of everything, good and bad.
I suppose you also believe that most violent criminals were individuals that had only the best of intentions for their victims. Or that Nazis and Stalinists had little interest in power and influence, which were but side-effects of their selfless altruism. That Pearl Harbor was an act of charity, and that the Gulf Oil Spill was caused by attention to detail and an overabundance of interest in the common good.
And you know that they were lying because you read their minds....
> I suppose you also believe that most violent criminals were individuals that had only the best of intentions for their victims.
Nope. But they don't kill all that many people.
> Or that Nazis and Stalinists had little interest in power and influence,
Surely you don't believe that people who want to do good have no interest in power and influence.
You seem to think that killing lots of people is inconsistent with a desire to do good. You clearly haven't had much experience with fanatics, or even do-gooders. It's easy to convince the latter that the world would be better off if the "right" people were dead.
No, I infer it from their actions.
> Surely you don't believe that people who want to do good have no interest in power and influence.
This is a straw man. I'm disputing your original claim that money(/power/influence) was not the "most influential" source of corruption, and that the impulse to "do good" was "far more effective than money".
> It's easy to convince [do-gooders] that the world would be better off if the "right" people were dead.
I'm calling B.S. Evidence? (or did you actually mean the "former"?)
> You seem to think that killing lots of people is inconsistent with a desire to do good.
Yes, I do, especially since we're talking about corruption in the U.S., and not about the rise of Stalinism. At base we're dealing with issues of systemic bias, not the actions of fanatics. Show me a consistent source of corrupting bias, one that silently and perniciously organizes the behaviors of millions, but which _isn't_ money.
> No, I infer it from their actions.
There's your mistake. You think that bad outcome implies bad intentions. It doesn't.
How do you know that they didn't honestly think that killing a lot of people would result in good?
> > It's easy to convince [do-gooders] that the world would be better off if the "right" people were dead.
> I'm calling B.S. Evidence?
It's a conversation that I have as often as possible, in hopes that pointing out where they end up will convince them that they really should rethink what they mean by "good".
>> You seem to think that killing lots of people is inconsistent with a desire to do good.
> Yes, I do, especially since we're talking about corruption in the U.S., and not about the rise of Stalinism.
You seem hung up on Stalinism. While it does have the record in shear numbers, it isn't the winner in percentages. And, there are plenty of other folks who will go the same route.
For example, it's not hard to find environmentalists who are hoping for a population crash. Do you really believe that none of them would push things in that direction?
> Show me a consistent source of corrupting bias, one that silently and perniciously organizes the behaviors of millions, but which _isn't_ money.
All of the "I know what's best for you" behaviors qualify.
> All of the "I know what's best for you" behaviors qualify.
Since behaviors themselves are a result of bias, I'll interpret this to mean 'All of the "I know what's best for you" sentiments or beliefs'.
Pick one, then, and show how it is all of the following:
a) consistent (i.e. remains relatively stable in how it exerts its influence)
b) corrupting (i.e. causes those involved to violate values/ideals to which they once claimed allegiance)
c) silent (i.e. can exert its influence absent a need for explicit discussion of implementation)
d) pernicious (i.e. causes, in certain conditions, a net "bad" when aggregated across the humans affected)
e) organizing (i.e. coordinates the behavior of multiple individuals)
For money, we have:
a) (yes) by definition, the system has been organized to consistently incentivize (i.e. reward) the accumulation of money
b) (yes) bribery (including, perhaps especially, the tacit "lean to the green" kind [1]). E.g., claiming that the most important thing is jobs and the federal debt, but devoting most of one's actual effort trying to lower taxes for rich people, thereby increasing the deficit and giving money to those least likely to spend it.
c) (yes) money's influence does not require explicit discussion or coordination for it to lead to bad behavior, witness the frequent tacit agreements of "you scratch my back and I'll scratch yours" ([1] also applies here)
d) (yes) e.g. the retroactive extensions of copyright Congress has repeatedly passed (http://en.wikipedia.org/wiki/Copyright_Term_Extension_Act)
e) (yes) this is self-evident as it's the entire purpose of currency
In the case of "I know what's best for you":
a) (no) it's rarely consistent in its influence. Individuals are moody, and groups of individuals seldom maintain the same "best for you" impulse. There are thousands of causes (from wanting to better educate future generations to promoting birth control in order to decrease the population), each with tens or hundreds of methods for accomplishing them, all of which are changing over time.
b) (mostly no) It could be corrupting (as defined above), but is rarely so. Bureaucrats and politicians are criticized far more often of being overly fearful of taking principled risks and instead wanting to keep their comfy jobs[2]. In general, violating sworn-to ideals in order to promote some hidden agenda is a great way to get fired or lose an election[3]. An example of where it could be "corrupting" would be when a politician increases, say, fuel economy standards ostensibly to reduce smog but actually to reduce CO2 emissions (but here [3] again applies).
c) (no) Without explicit discussion and coordination, the variation and competition among individuals in "knowing what's best" tends to neuter its influence. "I know what's best for you" behaviors generally require explicit discussion and coordination (e.g. a "conspiracy") to have any significant effect. This is in large part because of (a). Where it can have some tacit effect may be at the intersection, among all those who have power, of myriad "know-what's-best-for-you" sentiments. When, say, these interests are representative of perhaps 40-55% of the population, this will be a slim intersection indeed. And it's very unlikely to include the commission of atrocities.
d) (yes) It's at least possible that this could happen (if, e.g., "knowing what's best for you" was responsible for Communism's poor outcomes)
e) (yes) Through speeches and, say, "community organizing" "know what's best for you" behaviors can certainly coordinate the behavior of multiple individuals.
So, could you explain how 'All of the "I know what's best for you" sentiments/beliefs qualify.' ? Especially how they satisfy a, b, and c?
[1] http://fixcongressfirst.org/blog/2010/lessig-on-neo-progress...
[2] hence "exception that proves the rule"
[3] absent regulation, avaricious private interests, who seek to increase their own wealth, will be a much more lucrative source of campaign funds than private interests that are promoting a cause that is remuneration-free
> There's your mistake. You think that bad outcome implies bad intentions. It doesn't.
I don't for a moment think bad outcomes imply bad intentions. But I do think bad (e.g. exploitatively avaricious) intentions are more likely to lead to bad outcomes than good intentions are. What I meant was that I was inferring not-good intentions from all the raping, killing, and violent suppression of dissent.
> How do you know that they didn't honestly think that killing a lot of people would result in good?
I am taking it as necessarily true that it is not-good to kill people who are not an imminent personal existential threat. Thus most atrocities are not genuine instances of "doing good".
> You seem hung up on Stalinism. While it does have the record in shear numbers, it isn't the winner in percentages.
Evidence?
> And, there are plenty of other folks who will go the same route. For example, it's not hard to find environmentalists who are hoping for a population crash. Do you really believe that none of them would push things in that direction?
Depending on what you mean by "crash", it's not hard at all to find such people -- I'm personally hoping that the world's population ethically decreases to more sustainable levels. But I'm not hoping that anyone dies prematurely. I'd just rather that people chose to have fewer kids. This doesn't even entail that I "know better" -- when people are richer and have easy access to birth control they use it and birth rates go down.
As for "pushing in that direction": you actually think environmentalists who have an actual influence on policy would work to bring about a population crash, by e.g., encourage starvation in Africa or an increase the spread of AIDS?
Yes, because accidents don't have a profit motive.
The trials are paid for by the company making the drug. With FDA and (sometimes) NIH oversight of course. But the FDA is terribly under funded. And the NIH is already a tool for the pharm industry.
And if a company's drug gets into trouble, a few calls to a few of our elected officials takes care of the little fact right quick.
We only hear about it when people die. Remember Vioxx?
http://articles.latimes.com/2010/feb/11/nation/la-na-fda-bud...
When a business fails, its budget is cut as customers leave it in droves for other businesses. But when the FDA fails, the idea is to throw more money at it, to increase the budget of a failure.
The problem is that the FDA is a monopoly. When it fails, which happens routinely, people should be able to look to alternate reviewers -- like the European or Japanese regulatory bodies. That doesn't happen right now.
Yes, things could be improved, but taking apart the FDA isn't, IMO, a solution.
How much does it need to do its job? Has the amount of work stayed constant between 2006-2011? Was it properly funded in 2006?
We could start to pay a company to tell us which drugs were safe, but they would only have one customer who would tell everybody else.
[ScienceBasedMedicine.org](http://www.sciencebasedmedicine.org/index.php/the-free-speec...)
I'll accept the FDA wasting money, and in exchange I don't have to listen to them. The fact that homeopathy can be branded medicine virtually eliminates any point in having the FDA with regard to drug efficacy / safety.
The market does nothing except exploit. Now nothing wrong with that.. but the idea of a free and open market in America hasn't been true since.. well.. 1980?
-- Allen Roses, worldwide vice-president of genetics at GlaxoSmithKline 2003
http://www.independent.co.uk/news/science/glaxo-chief-our-dr...
http://pipeline.corante.com/archives/2011/06/07/even_worse_t...