I was inspired to write this by another blog posted recently, in which the author asserted his acceptance, even embrace of torture and the suspension of habeas corpus in the prosecution of the "war on terror", (WOT).  In a reply to one of his comments, I stated that in my opinion the terrorists had all ready won the war with regard to his endorsement of torture.  As I was about to leave on a long day of travel I had no time to elaborate.  My argument is based on the degree of commitment to the underlying ideology of the combatants in this war and its' effect on our moral and actual position in waging that war.  In the case of the terrorists, their beliefs are so strong they will forfeit their lives to their cause.  Regardless of whether that strength of belief is bolstered by the hoi polloi of being rewarded with 77 virgins, (or perhaps 77 raisins), in paradise, being willing to give their lives for their cause is a fierce and powerful commitment.  

I take for granted that all of us are opposed to terrorism, and as such we must ask ourselves on what core beliefs our participation in the WOT is founded.  Much has been made of freedom and democracy, in addition to freedom from terror, in the forming the rationale for waging war on terror.  Bush cited bringing democracy to the Middle East regarding our decision to wage war in Iraq.  The neoconservative treatise has been integrally linked to founding and supporting a fledgling democracy in the Middle East so Bush's position should not have come as a surprise.  

Democracy.  The democratic principle was first instituted in the West, beginning with the Greek and Roman senates.  The early renaissance era gave us the writ of habeas corpus and the rule of law that effectively blocks would be despots from imposing their own personal agendas over the will of the people.  Our own fledgling democracy here in the US, was founded on the principle of one man/one vote, but other basic rights were certified as well, including freedom of speech, religion, and perhaps most remarkably the right to life, liberty, and, the pursuit of happiness.  All of these rights are worth protecting, and the war on terror declared by George W. Bush following 9-11 was promoted as being fought in part to preserve those rights.  Which brings me back to the strength of our commitment to the core principles of democracy and the rule of law.  Our commitment is called into question by those of us who would abandon the underlying foundations of law in the prosecution of the WOT.  

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My last post laid out some of the challenges we will face from the insurance and pharmaceutical industries while pursuing a universal single payer health care system.  One of my themes was that 'money talks'.  Today I'm going to talk about how the pharmaceutical industry is gobbling a piece of our $2 Trillion national health care pie we may not have even noticed was missing.  Aside from the pharmaceutical companies lobbying and PR efforts, drug money also talks in the way it attains FDA approval for drugs that show no significant improvement over drugs that are all ready available or whose claims of efficacy are dubious.  In the New York Review of Books, Marcia Angell, recaps three books chronicling the collusion between pharmaceutical manufacturers and the academic institutions involved in validating the effectiveness of our prescription drugs, (I quote and paraphrase her article herein liberally).  Like what has been revealed in the financial sector of our economy, greed plays a major role in the subordination of what we might have expected from the pharmaceutical industry, researchers, academic research institutions, and our own Food and Drug Administration.

The article and books chronicle multiple instances of conflict of interest, (COI), between the pharmaceutical industry, drug researchers, and the academic institutions responsible for validating those drugs' usefulness.  Research agreements between drug manufacturers and academicians generally require as a condition of funding that the company be intimately involved in the experimental design, analysis, and writing of the academic papers.  Researchers with a solid academic reputation, or Key Opinion Leaders, (KOLs), are highly sought after by the drug industry in order to project the imprimatur of credibility to the research.  Financial remuneration is usually proportional to the researcher's academic reputation. 

For example, Dr. J.L. Biederman, ( a professor of psychiatric research at Harvard Medical School and chief of pediatric psychopharmacology at Harvard's Massachusetts General Hospital), conducted research that led to the creation of a market for drugs for patients as young as 2 years of age in the treatment of bipolar disorder.  His studies have been described as "so small and loosely designed that they were largely inconclusive".  Last June it was revealed that Biederman had received $1.6 Million from the drug manufacturers who produce and market the drug cocktail he advocates.  Two of Biederman's colleagues received similar amounts.  Winning the Nobel Prize in chemistry pales by comparison to the financial rewards offered by drug companies to academic researchers.

Dr. Alan F. Schatzberg, chair of Stanford's psychiatry department and president-elect of the American Psychiatric Association controlled more than $6 million worth of stock in Corcept Therapeutics, a company he cofounded that is testing mifepristone--the abortion drug otherwise known as RU-486--as a treatment for psychotic depression.  Schatzberg has authored three papers as principle investigator on the use of mifepristone as a treatment for psychotic depression.  

"In 2004, after the National Cholesterol Education Program called for sharply lowering the desired levels of "bad" cholesterol, it was revealed that eight of nine members of the panel writing the recommendations had financial ties to the makers of cholesterol-lowering drugs".


In addition to these examples, 55% of contributors to the most recent edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM - the diagnostic and treatment bible for psychological and psychiatric disorders), had financial ties to drug companies.

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