Thursday, August 17, 2006

Sock Puppets and Medical Ghostwriters

Keywords: sock puppet; pharmaceutical industry; Marcia Angell; Nancy Olivieri; The Observer; ghostwriting; pen names; academic corruption; medical journal; corporations.

I just learned a new term. A “sock puppet” is a pseudonym that people can use on their e-mail so their correspondents cannot discover their true identities. Of course, lots of people make up funny names. I belong to an e-mail list that discusses the 1990s TV series Northern Exposure. One of the members calls herself “Moose Chick,” in fond memory of the baby moose that used to open each episode of the show. Another member calls herself “Nikita Fleischman” and pretends to be the wife of the show’s adorable fictional protagonist, Dr. Joel Fleischman.

That’s harmless fun, and there are lots of other understandable reasons why a person might want to adopt a pseudonym. But what I’ve discovered is a reason for using a “” that is ethically unacceptable.

A lot of medical research is actually carried on by pharmaceutical companies that are trying to develop new proprietary drugs and products that they will market for physicians to prescribe. Naturally, they want the research to show that their new medicine will work wonders in healing patients. In some cases, they have been known to pressure researchers to distort their own findings. Dr. Marcia Angell, for example, has published scathing research on the ethically dubious practices of big drug companies. I am personally acquainted with another , the hematologist Dr. Nancy Olivieri, who was punished by her institution for reporting risky effects of a drug that she was trying out on children. She defended herself in court — and won.

But here’s a new angle — or at least one that’s new to me. Clearly, any research that is published in a carries more credibility if its author is not identifiable as the employee of a pharmaceutical company, but rather as a bona fide practitioner or a scientist in an academic institution.

Apparently some drug companies actually hire ghost writers to produce papers that are then published in the name of other researchers who seem to be independent. Indeed, The Observer has suggested that “almost half of all articles published in journals are by ghostwriters.” If this is true — or even an exaggeration by tenfold — it is shocking. Clearly, any such papers must be viewed as far less credible than if taken at face value. Distorting the truth in any medical research is plainly despicable, for it can cause suffering and death to patients who have to trust physicians. It should be illegal and the law should be enforced by some kind of monitoring system.

I doubt that there is any need to set up any new monitoring system for scholarly misbehavior in the humanities and social sciences, but I am not so sanguine about the corruption of medical research. I think that kind of scandalous behavior should be made illegal, and that some kind of institutional innovation may be required to clean up the profession.

Possibly other fields of science and engineering are also contaminated as well – those in which corporations with vested interests have a close funding relationship with scientists. The clean-up ought to start with medicine. If that turns out to be as bad as The Observer suggests, then the hunt for malfeasance should be expanded to other fields of research besides medicine.

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