Science depends upon honesty and integrity for its very existence. It is the ethical foundation, perhaps, for all problem-solving; In scientific research it forms the bedrock for development of a common language. A researcher in Oregon understands a length of a milliliter, the warmth of 28 degrees Celsius, the heft of a kilogram, when described by a scientist in Beijing.
This common language, with symbols for elements and formulae for molecules. has facilitated a scrupulously objective study of our world, from planetary movement to the behavior of electrons.
But if the data used to validate one’s new idea are inaccurate or, worse, contrived, then the conclusions may well be incorrect, or correct for a wrong reason. To be sure, errors occur most commonly because of unforeseen mistakes or silly errors that happen frequently along the tortuous path from idea—to experiment—to possible worldwide acceptance.
Most of us are non-scientists. We know nothing about the details of experimental data presented to us as a given truth. Our most common source of information is the news media. We see headlines about breakthrough treatments for cancer and other diseases. But newspapers and TV anchorpersons never tell us when it is learned later that the treatment is, unfortunately, too toxic, or when the researchers recognize that the new therapy is no better than the old one. As a consequence, those of us personally affected by “illness X” seek physicians who can fulfill our dreams of cure or recovery, dreams transformed into obsessions by the tantalizing information we have just learned.
Such disappointments are just not “newsy” enough. But to the family of a patient with a fatal disease, they mean everything. In addition, vexing examples are rampant on daytime television, where a physician surrenders his integrity and becomes a pitchman for pills or paste with no scientific proof of excellence, and frequently with no value at all. A key to categorical skepticism of these claims: these ‘drugs’ are sold as food products; they escape any regulatory control, or honesty in advertising, by the FDA, or even “Foodies International*.”
Why does this happen? Are patients not entitled to the best available therapy? Why would members of an industry committed to saving lives and providing comfort deliberately mislead us?
A history of Federal oversight of medical research is beyond the scope of this piece. But over the last forty years, funding for research has come increasingly from profit-driven, private companies. To be sure, these companies hire armies of scientists whose integrity they demand. But among their goals is to demonstrate profitability to their shareholders.
This has changed the landscape of much scientific research, particularly in the arena of huge, multinational pharmaceutical companies. Their “marketing” efforts can range from a free lunch for a doctor’s staff to providing hundreds of thousands of dollars to an academic professor for supporting a product in speeches delivered around the country. These corporate giants provide financial support for clinical experiments, sometimes involving thousands of patients, which are subtly designed to show the superiority of their product
A recent review of such trials, reported in a major medical journal, showed convincingly that such clinical trials almost invariably demonstrate the superiority of the treatment produced by the company that financed the study.
These results are presented to physicians as a faît accompli, and enter the marketplace, too often with only weak evidence to support their use.
Ultimately, integrity potentially takes a terrible beating. Personal gain, whether in the form of recognition within the scientific community or in financial compensation, has irrevocably blurred the ethical boundaries of medical research. Patients cannot truly know whether their medicine is delivered on the basis of fact, or fiction derived from personal bias, pride, or rapacity.
The marketplace itself has become the arbiter of truth. Competitors hold each other’s feet to the fire. Patients may take comfort in this process, that “Truth will out” because of the intense rivalries within Big Pharma.
We as patients must be wary of miraculous treatments and cures. They are generally either the subterfuge of charlatans or the overeager “leaks” of competitors seeking profit advantage. Nonetheless, we must be cautiously confident that the vast majority of medical research is indeed performed honestly and with integrity by men and women who are truly committed to their craft and to the scientific method which defines their work and their character.
Peter Kennedy MD, January 2016