Our corrupt elites -- medical science division

By Kathy G.

Buried on page 7 of today's Wall Street Journal is a rather astonishing article that is a remarkably vivid illustration of how corrupt an institution the Journal of the American Medical Association (JAMA) has become.

The facts are these: as the article's author, David Armstrong, reports, "a study [JAMA] published last year on the use of antidepressants in stroke patients was authored by a University of Iowa psychiatrist [Dr. Robert Robinson] who failed to disclose he had a financial relationship with the maker of the drug studied." This information came to light when a medical researcher, Dr. Jonathan Leo, published a letter in another medical journal which mentioned Dr. Robinson's conflict of interest and criticized the way the findings of his study were reported. Leo said he discovered the conflict of interest via a simple Google search.

What happened following the publication of Leo's letter is extraordinary.

For one thing, it caused JAMA to institute a sweeping and unprecedented new policy: from now on, says JAMA, anyone filing a complaint about a study author's conflict of interest must "remain silent about the allegation until the journal investigates the charge." And when they say silent, they mean silent --from now on, says JAMA, anyone making such a complaint will "be specifically informed that he/she should not reveal this information to third parties or the media while an investigation is under way."

This policy is highly unusual and has been sharply criticized by the editors of other medical journals.

But JAMA's attempts to silence and intimidate its critics don't stop there. Its editors appear to have launched a campaign of attacks and threats against Dr. Leo and the medical school where he teaches, Lincoln Memorial University in Tennessee.

FIrst, they wrote to Dr. Leo and to the dean of his medical school, asking Leo to retract the letter he'd written about Robinson. Leo refused. In retaliation, JAMA editor-in-chief Catherine DeAngelis personally phoned the dean and, says the dean,

threatened in a telephone conversation earlier this month that she would "ruin the reputation of our medical school" if he did not force Dr. Leo to retract the BMJ letter and stop talking to the media. In an interview Friday, Dean Ray Stowers said Dr. DeAngelis "flat out" threatened him and attempted to bully him during the conversation.

Next, JAMA's executive deputy editor, Dr. Phil Fontanarosa, contacted Dr. Leo and made similar threats:

Dr. Leo said he received an angry call from Dr. Fontanarosa after his BMJ letter was published. "He said, 'Who do you think you are,' " Dr. Leo said. "He then said, 'You are banned from JAMA for life. You will be sorry. Your school will be sorry. Your students will be sorry."

Honestly, these people sound more like mafiosos than respected scientific professionals.

For the record, both DeAngelis and Fontanarosa dispute these accounts. But given the extraordinary measures JAMA subsequently took to stifle its critics --  its new requirement requiring silence from those making complaints has been characterized by other experts as "inappropriate" and "dangerous" -- it's not hard to believe that Leo's and Stowers' versions are basically accurate.

And in a particularly assholish touch, in her interview with the Journal, DeAngelis sneered that Leo is "a nothing and a nobody" -- which certainly does nothing to disabuse the reader of the impression that she is ought to get the poor guy. Those are some awesome public relations skillz ya got there, Dr. D!

The bright spot in this sordid saga is, of course, Leo and his dean, who steadfastly refused to cave in to JAMA's bullying and bullshit. A heartfelt huzzah and kudos to them both. I'm particularly grateful to them because, as a person who suffers from chronic depression, my health -- and perhaps even my life -- depends on my having access to safe and effective antidepressant drugs. And without honest, and rigorous, scientific research, there would be no way to reliably determine which drugs are indeed the safest and most effective.

But while their resolute refusal to participate in JAMA's corrupt practices is cheering, overall this article filled me with despair. I would like to believe that, even in a society as debased as our own, you could at least count on one of the foremost scientific journals in America to at least partially uphold the such long-enshrined scholarly values as the disinterested pursuit of truth and the promotion of vigorous academic debate and rigorous scientific standards.

According to this statement on its website, JAMA's critical objectives include the following (the emphases are mine throughout):

1. To maintain the highest standards of editorial integrity independent of any special interests

[. .  .]

6. To foster responsible and balanced debate on issues that affect medicine and health care

[. . .]

8. To inform readers about nonclinical aspects of medicine and public health, including the political, philosophic, ethical, legal, environmental, economic, historical, and cultural

9. To recognize that, in addition to these specific objectives, THE JOURNAL has a social responsibility to improve the total human condition and to promote the integrity of science

10. To achieve the highest level of ethical medical journalism and to produce a publication that is timely, credible, and enjoyable to read

In the name of science, is there any way on earth that JAMA's policy of systematically silencing and intimidating its scholarly critics could possibly be reconciled with any of those key objectives?

And while I'm at it, what about the drug companies, who are, after all, the root of the evil here.

Tell me -- is there a single institution left standing in American life, which has not been seriously compromised -- if not thoroughly corrupted and discredited -- by the ever-growing power of our increasingly decadent corporate overlords?

Comments

[Kevin G. Rhoads]

Unfortunately corruption is not necessary for the result. The "gold standard" for
hypo-thyroid treatment involves two things, one is in dispute. The other, however, HAS NEVER BEEN TESTED. Not even after more than 1/3 CENTURY. Yet, this is still taught to medical students and promulgated as treatment standards by multiple professional organizations.

The T4-only part is questionable. But the "set dose by TSH" is pure voodoo. Not only never tested, what evidence is available that speaks to the point is fairly clear that it can NOT possibly work.

Disclaimer, my doctorate is in engineering, not medicine, so what I do has to work.

Sincerely
Kevin

[Josh]

This is really disturbing, given that Cathy D was gaining a reputation as an opponent of Big Pharma and was indeed facing lawsuits from drug companies that disliked her and other medical journals' attempts to minimize bribery-driven research. It's not inconceivable that the drug companies sought to make her an offer she couldn't refuse.

[tas]

Well, I'm impressed with Lincoln Memorial University (LMU). I graduated from there in 1982 before they had a medical school and now I guess I will have to respond to one of the many requests for money I receive from them.

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