End the spectre of science for sale

End the spectre of science for sale

Summary: If the law and regulations are not being violated, if only ethics are involved, then science for sale becomes standard practice.

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Dr. Charles Nemeroff, from his home page at Emory UniversityWhen I last wrote about the perception of scientists being paid for their conclusions, it was with the tongue-in-cheek observation that perhaps Massachusetts, by seeking to end the practice, might drive research out-of-state.

But the situation is far more serious, and hits closer to home, with the story of a researcher one critic dubbed "Bling-Bling."

The nickname came from Dr. David Carlat, an ADHD researcher, in a 2006 post about Dr. Charles Nemeroff (above) of Emory University.

Emory is in Atlanta, where I live. Dr. Nemeroff chairs its psychiatry department. Dr. Carlat later apologized for calling Dr. Nemeroff "Bling-Bling," but others soon took up the chant.

Now Dr. Nemeroff is being investigated for violating federal research rules, failing to report $1.2 million of income out of $2.8 million in consulting contracts he had with drug makers between 2001-2007.

An important point made by Dr. Carlat is that this was not an isolated case, that apparently it was fairly well-known, that this might just be called "doing business" in psychiatry.

It reminds me of the "crimes" being charged with respect to the "big shitpile" that Congress voted to bail-out today, in that there were no crimes committed. If the law and regulations let you create Confederate money, then outrage about the practice has nowhere to run.

The same is true here. If the law and regulations are not being violated, if only ethics are involved, then science for sale becomes standard practice.

Now let me tell you how this hits home.

John Blankenhorn in 2002Back in 2002 my ADHD son (son of an ADHD father) had a personal crisis. The details are unimportant, but I took the opportunity to have him looked at by competent professionals.

The doctor called me right away and said, "your son has ADHD." Tell me something I don't know, I responded.

The doctor put my son on Risperdal, the brand name for an antipsychotic drug called risperidone.

At the time Dr. Nemeroff was running a series of studies called ARISE, testing whether risperidone might be useful as an anti-depressant, or useful in the treatment of ADHD.

I have no evidence my son was part of that study. But if one respected person is testing a drug for a purpose, and this is known by others, chances are they might try it, too.

The answer my son gave was an emphatic no. He got no relief at all. He just got very tired. He felt awful. Once he left this professional's care he immediately went off the drug, and his recovery began.

(That recovery continues. He will graduate from high school next spring, an honor student, and cost me a fortune at some elite college.)

Nemeroff's risperidone study was published in a journal of which he was the editor, and he did not report his own financial conflict of interest, although the policy was he should have.

In any drug study like this, people are used as guinea pigs. They are beta testers, but their bodies are the computers on which the software runs.

That's what is really at stake, when life sciences become corrupted. Think of what happened to my son as one sub-prime mortgage in a "big shitpile" of corruption.

Here's the more important point. It was all legal. Dr. Nemeroff is not accused of any crime, and I doubt he will ever be accused. Maybe his reputation will be hurt. Maybe it won't be.

But that does not make what happened to my son right. And if the profession has a care for its reputation, the next doctor who does something like this will have committed a crime.

Topics: Government US, Banking, Government

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13 comments
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  • Or Not

    [i]He will graduate from high school next spring, an honor student, and cost me a fortune at some elite college.[/i]

    Depends on what he really wants to study. There are some world-class universities that are also shockingly inexpensive, even for out-of-state students. (Says the father who's wrapping up paying for three at once, two out of state.)
    Yagotta B. Kidding
    • There are also scholarships

      I'm not going to count any chickens until they come home to roost.
      DanaBlankenhorn
      • Requirements analysis

        I'm assuming that he's heading into his junior year, though, and that means it's time to start narrowing the field on schools he would want to attend. Which means knowing (if possible) which subjects really light his fires.

        FWIW, campus visits are a skill that improves with practice. Doing a few to places that he's not likely to want to attend helps get the skills.
        Yagotta B. Kidding
        • John is now a senior

          He knows what he wants to study -- history and political science. And he knows what he wants to do with it, the law.

          I am trying to point him toward international law, where his experience learning Chinese and Arabic will stand him well, and where he can lead a life of physical comfort, doing important work.

          But he has yet to do a school visit, and insists he will do none. Nothing I can do about that.
          DanaBlankenhorn
  • They have us in a tough spot.

    We all can't just boycott the Health Care Professionals until they sign a charter holding them accountable to ethical behavior (Isn't there an oath somewhere about that?). Our only advocate in this matter just rewarded a bunch of rich boys $700 billion dollars for an economy killing screw up. It's said that Americans are fat and lazy. True or not, everybody has their limit. Although we do not now or have ever lived in a true democracy, no democracy has lasted more than about 200 years. Tick, tick, tick...
    kozmcrae
    • Must be October...

      The anger on this board is rising exponentially. You don't believe in democracy, fine. Maybe a dictatorship by the better sort of person suits you better.

      This democracy has lasted for 220 years in its present form and God willing will last several more. Despite the strains of the last 8 years it appears to be intact.

      Although I could be wrong...
      DanaBlankenhorn
      • I only found out recently myself.

        We do not live in nor have we ever lived in a Democracy. Our Government is a Federal Republic (http://en.wikipedia.org/wiki/United_States). That's what I meant. As far as ending our current form of government I'm not a political scientist. I do know that for any government (besides a dictatorship) to remain stable it needs a healthy middle class. Ours is getting less so by the year. I don't think we'll lose it, there are too many smart, ethical people in this country. If any major institution that's a part of our everyday lives is to come crashing down, it will be Microsoft.
        kozmcrae
  • re: - "It was all legal"

    Maybe is wasn't as legal as you think. The NIH operates the "Office of Human Subjects Research" which is supposed to regulate the kind of activity you describe. (see http://ohsr.od.nih.gov/guidelines/45cfr46.html)

    As with most Federal regulations, it's byzantine, but I'm pretty sure [b]disclosure[/b] is required.

    Unfortunately, when getting medical treatment, I think we all have a tendency to sign whatever papers are shoved in front of us, and perhaps, buried amongst the reams of forms was a disclosure.

    Also, regulations years ago might not have existed. Today, if a doctor engaged in behavior as you describe, it would absolutely be illegal.
    Takalok
    • I can't accuse a doctor of breaking a law...

      ...without having researched the situation thoroughly, thoroughly as in by a lawyer who knows the law.

      Unless a lawyer or legal advocate comes out and says some doctor may have broken such-and-such a law (and none has yet) I have to assume no law was broken.
      DanaBlankenhorn
  • Risperdal

    is recognized as an effective anger management medication
    and is routinely prescribed for Apsergers children who are
    struggling with unnatural anger. Many drugs have off-label
    uses, and often doctors will attempt a drug based on that to
    see if it addresses the problem.

    The truth is, who cares if your child was part of some study.
    Did the medication help or not. If it didn't help, then tell the
    doctor you want to try something else. Doctors are not priests
    and you are not an ignorant peasant. If you have a doctor with
    a god complex, find a different one.

    It is still amazing to me that you think the solution to this is
    nationalized health care.

    Oh, and BTW, much of what did happen in the housing crisis
    was illegal. In 2004 the regulatory board for Fannie and Freddie
    testified before congress that there was enron-like stuff going
    on. Barney Frank, Chris Dodd and Chuck Schumer shut them
    down. Bush tried over a dozen times to bring reform to Fannie
    and Freddie and Democrats blocked the attempt every single
    time.

    There is illegality and corruption plenty here and it's in the
    party of the candidate you support.
    frgough
    • Please read the story again

      The doctor said the child had ADHD. Not Asperger's.
      DanaBlankenhorn
  • Your son's part in a study (and other matters)?

    If your son was part of a study, you had better have been given the opportunity to enter him in that study or decline it ("informed consent"). If not, that is against the law. However, the study, according to your links here, dealt with risperidone as a treatment for major depression, which your son would not have qualified for. ADHD is certainly an off-label use for risperidone, but would not have been connected with the studies referred to. It may well have been a stupid choice for treatment of ADHD, but I am not a physician and cannot make that determination (but, IMHO, it sure seems to be).

    As far as the non-disclosure activities of Dr. Nemeroff, that NYT article you cite seems pretty damning. I am sure this is just the tip of the iceberg, and I hope that something gets done by the Feds and/or the AMA, but most probably the medical schools themselves, to start forcing disclosure. Unfortunately, NIH probably cannot do too much other than make scoffers ineligible for grants. It's going to have to be the rank-and-file in the offender's school or his/her discipline to call the public's attention to the matter, and after enough public attention, s/he will fall. On a non-medical, but related note, the same thing happened to the President of the University of Central Arkansas this summer, when he was "caught with his hand in the cookie jar" and lied about it. By the start of the fall semester, under increasing scrutiny, he "resigned." To the vast majority of us in academia (including medical schools) the one unforgivable sin is a lie, the whole system depends absolutely on honesty. If a professor/administrator/etc. lies about matters, he should go. If he tells the truth about things and is not dealt with, the school itself should (and will) suffer.
    cd2_z
    • I don't know that he was part of a study

      The first I heard of a study was when I read the Times. The first I heard of Dr. Nemeroff was the Times.

      I need to emphasize, again, that no lasting harm came to my son. The drug was ineffective, but the searing pain of those weeks has stayed with him, in a good way, and he has worked hard on dealing with the side effects of his ADHD ever since. He has become more compliant with his therapists, and found his own ways to cope.

      I had a similar experience on being sent to a Baptist Youth camp after 4th grade. It had the side effect of souring me on religion, but it did cause me to create a public "persona" that could get me through my school career.

      Sometimes, I guess, you have to look into the abyss before you turn around. It's true with many mental conditions, and when we're talking about kids maybe parents have to lead us to that abyss, and point to the horrors in some way, so that we can take recovery seriously.

      That may be a bit deep for what you were asking, but that's the facts.
      DanaBlankenhorn