There was an interesting article recently in the International Journal of Law and Psychiatry, “Exposing conflict in psychiatry: Does transparency matter?” by Chimonas, et al.
The gist of the article is as follows. Senator Chuck Grassley of Iowa has devoted a great deal of time and effort to exposing conflicts of interest in psychiatry. He has focused particularly on undisclosed financial relationships between psychiatric researchers and pharmaceutical companies. His efforts resulted in the passage of the Physician Payments Sunshine Act, which requires manufacturers to disclose payments over $100 annually to physicians and teaching hospitals. The act requiring this will become active in 2014. The hope is that exposure will reduce the incidence of problems. It was this particular hypothesis that the researchers wanted to test.
What they did was take some of the cases that Senator Grassley had exposed, and look to see if in fact the exposure had made much difference. Tragically, they found that it had not.
Here’s a quote:
“…even in the most egregious cases exposed by Grassley, the physicians escaped largely unscathed … Furthermore, the NIH – a potentially powerful force for change – showed itself reluctant to intervene. And the head of NIMH helped one of the worst violators avoid serious consequences.”
The notion of a professional researcher taking money from a company to conduct efficacy research on their product and presenting that research as objective and scientific is simply too ridiculous for words. People who engage in this sort of thing are either stupid, fanatically supportive of the product, or out and out villains. And as Chimonas et al have demonstrated, they have little shame.
The fox will not do a good job guarding the hen house.