July 20, 2008

Academics Hide Drug Company Payments

And with good reason.

An article in The Independent asserts Dr. Joseph Biederman, Harvard guru of ADHD and child bipolar, received over $1M in consultant fees and didn't report it to Harvard; it then implies this is why kids are overmedicated, etc.

Wrong.  A thousand times wrong.  It could not be more wrong, it is dangerously wrong.

Believe me, I am no friend of Biederman's.  But the money is a red herring.  If you want to be angry about the specific ethics of a psychiatrist receiving Pharma money, fine, but I am telling you it is not worth the Senate time, not worth press space.

The real money, the real problem that goes unmentioned is the money that goes to universities, in the form of research grants.  Biederman may have pocketed $1M, but I'm sure he was awarded much, much more for clinical trials-- money which he didn't get any of, which went to Harvard.

We aren't overmedicating kids because Biederman told us to; we're doing it because Harvard told us to.  And Harvard told us to because that is what they are getting money to study.  Biederman is just the nanobot that does it.

If Biederman never existed, nothing would be different.  You read his resume, you think, wow, he's a big player.  You don't realize that if he didn't exist there would be some other person in his exact position, who would also have become a Distinguished Professor, won awards, written 450 publications, etc.  The machine was already in place, his slot was going to get filled; his mind didn't discover anything, those results were coming no matter what, those publications were already going to be written. 

The money isn't corrupting him into thinking childhood bipolar is underdiagnosed-- he truly believes it.  The reason he believes it is his entire professional existence-- his whole identity-- is predicated on believing it.  He's not a scientist, he's a priest. 

He starts out as a young academic.  He lands a spot in a research group that studies X, so he studies X, later he branches out into X+Y, or goes to Z, etc, eventually he finds himself a niche.  And he believes in that niche, he believes in his data, no matter what it says.  You can't convince him he's wrong because it isn't science and it isn't even a bias-- it's identity.

That's how an entire nation of psychiatrists could have been deluded into prescribing Depakote for maintenance when the data itself says not to do it.  It's belief, not money, "we believe bipolar is a kindled disorder..."  Hell, if Harvard believes it, what chance do the rest of us have?

What he doesn't see because he is too small to see it is that that niche exists only because there is grant money for it.  That's the real bias.  He internalizes an artificial system because it gives him identity and identity is more important than money. 

It's not just Pharma-- NIH is worse.  If NIMH wants to study the biological causes for childhood bipolar, then we will all agree that these causes exist "we just haven't found them yet."   But if NIMH decides to study the social causes of childhood bipolar, then those causes exist, and the biological ones don't.  The question is how does NIMH decide what to study?  Culture.   When a culture decides to study something, the results don't matter-- the decision to study it affirms it a priori.

Do you think that all those psychoanalysts from 1899-1974 were all retarded?  No understanding of biology, a bunch of clowns, morons?  They were brilliant, but that was the time, that was the culture, no matter what data you had to the contrary you were still going to be wrong and they right.  Get it?  People blame psychoanalysis, but the specific problem is paradigms, which are agreed upon because they have serve some other purpose-- not science, not truth-- and change only when that other purpose disappears, or the paradigm fails it.

If we just want to punish a few high ranking psychiatrists-- and for what?  hiding money from Harvard so it doesn't take a 20% cut?-- it will do nothing to stop the anti-humanism zamboni that's trying to smooth out all the kinks in society.

Data are irrelevant, here's the paradigm: child bipolar is underdiagnosed because society needs it to be.

There is still massive wealth inequality, racism, resentment, unrealistic expectations of life and a gross sense of entitlement-- in short, narcisissm-- that we have no solutions for except to hastily pathologize it all and hand it to the psychiatrists.  They can keep us all confused for a decade or two until we have another world war, discover cold fusion, or the aliens come.

The problem isn't that money influenced Biederman; the problem is that even money won't be able to influence him.

Do you know why Biederman hid the money from Harvard?  Because he can't believe he's being paid so much money for something he would have done for free.  Until you change that groupthink, that blind faith, nothing else will change.