THE MEDICAL INDUSTRY

The truth is out there: Hard to find all the facts with pharmaceuticals

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A conversation with a friend last weekend about pharmaceutical giant Pfizer's unethical behaviour threw me a little. The company recently paid a $1.19 billion criminal fine, and $1 billion to settle civil cases around its promotion of Bextra and other drugs for off-label use. Is my view of the elephant a naïve and simplistic one, or does harm being done by the industry in fact at times outweigh the good? It is after all, as I'm often reminded, true that orthodox medical wisdom comes to us from some of the best minds in the world, and it could well be argued that it is hubris on my part to be as skeptical as I am.

I considered all this, as I'm prone to do, overnight, subconsciously. I awoke the next morning clear again—it's not that I'm presuming to know more than all these brilliant scientists do; it is simply that I have a view from a distance. This view is clear: whatever the miracles of medical science, we're medicating more than ever before in human history. We're living longer, but not better. It has become difficult to find a child without asthma or ADHD or anxiety. I am an anomaly among my 50-something peers in that, almost without fail, they need to use pharmaceuticals to sleep, to keep their bones strong, to keep cholesterol normal, to keep arthritis pain and anxiety and hot flashes and fatigue at bay.

The view from a distance has convinced me that medical science, as a giant industry, desperately needs a critical and watchful eye on it, and that the recommendations originating in the industry and being passed on through Health Canada and the doctors caring for us deserve only carefully chosen acceptance. No matter how hard-working and brilliant the minds behind orthodox wisdom, it has historically often missed the forest for the trees, and led us astray.

My view from a distance also permits me to measure medical advice against the backdrop of the mostly-untold stories—those of the scientists once on the inside of the research establishment or Health Canada and now exiled, the facts about immense gaps between the science and medical practice and the personal stories of those injured on conventional wisdom and mostly blacked out by the media. It permits me to measure medical advice against the big picture—prescription drugs, used properly and according to approved uses, kill tens of thousands of us each year, and seriously injure several million. Iatrogenic disease is a leading cause of death in the developed world.

Orthodox medical wisdom should also be measured in light of how the competitive peer review publication and research grant process works. Access to funding depends on peer review, giving scientists much power over the careers of their competitors. Despite the goals and strengths of a peer review system, its drawbacks are obvious: were we to put competitors in charge of approving new and at times unprofitable ideas in other markets, innovation would slow dramatically and precious few major shifts of improvement would reach the public.

The incontrovertible fact is that most of those willing to go against the flow of research are those who are not dependent on the system for funding; they are also the ones who will have great difficulty publishing their findings.

Again, I'm not saying we need no pharmaceuticals—we clearly do, most especially now that we've become as chronically ill as we have. They can save lives, and make it bearable. We need relief.

My point is simply that we can get bogged down in discussions of off-label use of drugs and unethical behaviour, and whether or not it is advisable to deliver a potentially fatal blow to the industry, but we need a much bigger shift of focus. All drug use—both approved and off-label—should happen only with full risk disclosure, and full risk disclosure happens far too rarely. That's the biggest issue, the fact that drug information comes primarily from an industry which understandably has motivation to overstate the benefits and downplay the risks of its products. The biggest issue is the fact that medical science itself has become a big industry.

It's a worn groove by now, I know, but we might actually see something very positive come out of changing course a little as a whole, taking a wider berth around the drug-for-everything iceberg. It's not like it's working all that well or anything, and we might actually see a decline in our ravenous hunger for relief. V

Well, Well, Well

THE MEDICAL INDUSTRY

The truth is out there: Hard to find all the facts with pharmaceuticals

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