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Healthy Skepticism Library item: 19621

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Menkes DB
Tackling conflicts of interest: Conflicts of interest and drug information
BMJ 2011 Sep 6;
http://www.bmj.com/content/343/bmj.d5617.full


Abstract:

Promoting access to unbiased, expert drug information has been the mission of the International Society of Drug Bulletins since 1986. Because member bulletins refuse money from the pharmaceutical industry, they typically run on tight budgets. Like the US Food and Drug Administration and BMJ, they must also reckon and manage authors’ and reviewers’ potential conflicts of interest.1 In a current survey, 28 responding bulletins endorse the importance of disclosure but vary in how conflicts, once declared or detected, are dealt with. The most stringent policy, endorsed by four bulletins, is to consider work only from authors known to lack conflicts.

The debate about whether journals should avoid or manage conflicts of interest2 has been advanced by evidence that disclosure alone fails to reduce bias reliably and may in some cases aggravate it.3 Disclosure and peer review are, however, essential to gauge the relevance of conflicts in particular cases. The debate clearly shows that we are better at judging the impact of others’ conflicts than the impact of our own.

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909