Editorial Note: This is the last in the Doctor Munchausen series. A new strand on the Persecution of Heretics will start soon. The image is Paul Klee’s drawing for the Dance of the Grieving Child.
Being Irish makes it possible to tackle certain things – or now possible. The question of the Catholic Church for instance and its handling of children, whether their abuse at the hands of pedophile priests, or the appalling treatment of unwed mothers in Magdalene laundries, or the shipping of children born outside marriage out of Ireland for adoption.
There have been two Irish movies on these themes in the last year – Philomena and Calvary. From a distance of several decades it seems it has become possible to look at certain events and see what was wrong. Similar stories have come from countries from North America to Australia.
These stories have tended to play down the complicity between doctors and the Church. In some Canadian and American settings, it was worth more to the Church to have orphans designated as psychiatric patients – the Church got paid more. In other settings, in Ireland perhaps, it looks possible that orphans were entered into vaccine trials by nuns liaising with doctors, when not being sold to wealthy foreigners.
The Pedophile Priest seems to incarnate the problem of evil in our day. Until recently it seemed like an evil that could be handled in that these priests appeared to be relatively rare. It was the past. We had learnt lessons. It was very disturbing but not deeply threatening. Until Jorge Bergoglio suggested that one in fifty priests might be problematic and Britain exploded with reports of mass sexual exploitation of young girls by predatory men in close to every city in the land it seemed. Maybe it wasn’t priests who had led to so many unwed young mothers in Ireland.
Intersecting with this story was a disturbing interaction between the Church and medicine. Doctors it seemed could be found to make psychiatric diagnoses on orphaned children that led to treatment with antipsychotic drugs in the 1950s and 1960s and one of the drivers of this seemed to be that the Church got more money from the State as a result. The doctors of course also got paid. This feels like a seriously corrupt nexus operating with near impunity on the basis that no one is going to be bothered to investigate the fate of some orphans.
Could doctors have really colluded in this way? One of the striking features of medicine in Ireland until recently is that in most official pronouncements on ethical or moral issues, medicine has been to the right of, more conservative than, the Catholic Church. Whatever about individual doctors and individual priests, medicine as a body has seemed at least as likely if not more likely to be inhumane and unresponsive to the needs of people than the Church. Talk of doctors and nuns or priests colluding doesn’t seem so far-fetched against this background.
But it’s all in the past. We have of course learnt lessons.
So who is now entering children into clinical trials like Study 329 – GlaxoSmithKline’s (GSK) famous trial of Paxil (Seroxat – paroxetine) compared to imipramine and placebo in adolescents who were supposedly depressed? Is the pharmaceutical industry wonderfully more ethical and concerned about children than the Catholic Church was? Does industry profit from this? Are the doctors reimbursed for each child entered? (Likely around $5000 per child).
Unlike the 1960s, there is of course informed consent now. In Study 329 you were informed that participation in the trial would not lead to any different treatment from standard clinical care. Well standard clinical care for the use of imipramine in adults at that time would have been to use doses of around 150 mg or less. In their adult trials running at the same time, GSK were using a 150 mg dose. But in Study 329, the protocol from the get go mandated pushing every child who got imipramine up to 300 mg if possible. It’s difficult to see any rationale for this other than by making imipramine look so toxic, Paxil might look good by contrast.
When the trial was finished there was clearly a very marked increase in suicidal acts in the children taking Paxil. In normal clinical practice if someone becomes suicidal on an SSRI like Paxil, I would try to make sure afterwards that they understood that this was an effect of the drug rather than something inherent to them. This is important for their perception of themselves afterwards. I would also indicate that the same might happen on many other antidepressants, some of which also act on serotonin without being labeled SSRIs. It might also happen on painkillers like Tramadol, which is a serotonin reuptake inhibitor.
So whose responsibility was it to ensure good clinical practice was adhered to? GSK deny all responsibility – this is a treatment issue and it’s not our job to treat patients. This should be done by the doctors who know the patient best. The doctors can’t easily do it because GSK haven’t told them there is a issue and have ghostwritten a paper with their names on it saying that Paxil is wonderfully effective and safe for young people.
In terms of responsibility, we don’t hold the train driver responsible for Auschwitz. Are doctors little more than drivers operating the train to Auschwitz?
Back in the 1950s or 1960s doctors were little gods. It would have been inconceivable to cast them in the role of train drivers. The men responsible for the medicating of orphans and giving them vaccines were closer to Doctor Munchausen figures or perhaps even had something in common with Dr Mengele – although this is a judgement made easier by the benefit of hindsight.
But today even Professors from Brown, Harvard or Oxford have so little real say that it is in some respects difficult to see them as any more than glorified train drivers.
We live in an era when AllTrials, the BMJ, and GSK can all appear part of a cosy alliance.
It’s also an era when children in orphanages, foster care and in care generally, are getting vastly more psychotropic drugs given to them than ever before.
Thirty years from now if doctors escape judgement because it is deemed they were just train-drivers, it is as likely they will be a vanishing breed as priests are now, as much use as salt that has lost its bite.
The Dr Munchausen series is here:
For the record, I personally see the problem of evil primarily as an absence of good – a system problem. It’s rarely if ever a case of evil people, although since Cesare Lombroso’s work a century ago the world has had to live with the problem that there are people who are morally deficient.
How this might apply to pharma and doctors was laid out in a series of posts:
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Oranges and Sunshine Movie shows the exporting of British children to Australia. Heads measured etc and IQ recorded . Children were the new breeders for Australia – white of course.
Of course in the movie we learn the same lies parents and children were told. Same rape of children in Australia by men of god and the same use of the children as free labour to build their monster monasteries, etc
Ireland is now assimilating non nationals and non RC children into white Irish RC families – through the massive child industry called fostering.
Children in corporate care are now 7 times more likely to be abused in care than with their natural family.
But cares- children are still the commodity for profit.
Just like the Irish children sold into slavery – Barbados etc and conveniently left out of our His story books.
I’d never heard of the 1960’s Irish scandal of doctors giving antipsychotics to kids so the Church orphanages could charge more for their care. It’s rare you see history repeat itself in such exact, sickening detail, but we’re definitely seeing a replay of this in the US.
Kids in foster care in the US are each state’s responsibility. The state pays all their living expenses and most of their medical care (with some federal help through Medicaid). But wait! If the children are disabled, they can be supported by the federal government through Social Security’s SSI program, and much of their educational and medical needs met with federal dollars as well. The foster family or group home may get extra money to care for the child, and the state gets a much bigger wad of cash to put back in its pocket.
Children with behavior problems or “adjustment reactions” don’t qualify as disabled – but bipolar children most certainly do. So do most kids with ADHD or autism-spectrum disorders. This led a number of states to conduct aggressive “child-find” programs in the public schools, to identify disabled children who hadn’t yet been tagged as such. Many end up on antipsychotics, anticonvulsants or both.
The schools share in the money, and don’t mind having some of their more disruptive children medicated either. Local government pockets are the main ones filled, but nonprofits from Catholic Charities to Lutheran Social Services which care for kids as government contractors partake as well. Shame on all of them.
OH yes Johanna and the UK and Ireland are also using this bonus scheme for children in corporate care with “special needs”. Foster carers fabricate behaviour in the foster children in the hope of being paid more. Some doctors and psychologists play the game too. I have seen the most loved children regress back years once removed from their loving homes and families.
Yes, if you check who is being paid to provide various services in Ireland and UK, the church is still there. LIke Besboro – still used for mothers to have contact with their children. Same old energy greets you as you walk in. Those with eyes and ears can hear the screams of the souls still trapped there. Some social workers and care workers change personality immediately on entering the place, treat the mothers and children like dirt, lie, fabricate, etc. You even get body searched. So the only way to prove is to secretly record and send copies to as many countries as possible and when the moment is right – all will be exposed.
Echoes of our conversation – I mentioned Bauman’s work (Modernity and the Holocaust) and the train drivers. He argued about the diffusion of responsibility which was the point I was trying to make. Train drivers, like the Standartenfuhrers of the concentration camps, were part of the production line of misery that allowed each component in the chain to divest themselves of responsibility and thus enable a greater efficiency in the killing process. In other words, if we acknowledge a hierarchy of guilt then it is crucial we examine the structural as well as individual factors that enable this.
Bauman talks about the ‘social production of immoral behaviour’ which seems to be most apposite for medical violence. Given that we are all part of society then each of us plays a role in that production, or conversely, in stymieing the production. He does, as you point out, acknowledge that those who possess expertise have the greatest moral weight for doing the right thing – knowledge is power – but then he ends on the following:
‘the lesson of the Holocaust is the facility with which most people, put into a situation that does not contain a good choice, or renders such a good choice costly, argue themselves away from the issue of moral duty (or fail to argue themselves towards it), adopting instead the precepts of rational interest and self-preservation…..And there is a another lesson of the Holocaust, of no lesser importance. ..putting self-preservation above moral duty is in no way pre-determined…One can be pressed to do it, but one cannot be forced to do it and thus one cannot really shift the responsibility for doing it on those who exerted the pressure…’
Does this not apply to all of us, Mengeles, standartenfuhrers and train drivers alike?
I totally agree with you.
Consider that 2014 we still use Hitler slogan energy signature “Best interests of the child” and what is done today in many cases is no different energy wise than what was done to children in the camps. They were used in experiments too. Today SS social services target mothers with RH- blood and remove their children. Why?
Today strong protective parents are targeted and their children removed and adopted to strangers. Why?
Gifted and talented children are singled out for forced adoption. why?
Most parents are clueless.
There is a hierarchy- always was in patriarchy and the Jesuit model is the best- where the lower minions do not know the ones higher up the power pyramid.
In my experience most people agree to work and participate in the corruption, pain and suffering of others. Very few take a stand, because an example has been made of one of their colleagues. Same now in the media. We see the victims of abuse eliminated one by one and drugs or suicide used as the excuse. But many people are waking to the truth because the pattern is always the same.
Pharming autistic kids next, another captive market – and what is worse many of them cannot even tell you how it makes them feel. I gather it was being discussed just this morning at Interagency Autism Coordinating Committee (National Institutes of Mental Health) in Washington to which the new scientific director of Autism Speaks, Robert H Ring – former exec of Wyeth and Pfizer – has recently been appointed. Unfortunately, I have been watching this coming for years. This is a comment posted a couple of years in BMJ Rapid Responses (I should have noted that taking both phases of the Goyang study into account the drop out rate of positively screened children was more than 75%):-
Re: Preventing overdiagnosis: how to stop harming the healthy
A particular concern is population screening projects for autism as a potential target group for newly developed psychiatric drugs.
A Time Magazine article last year  publicised a pilot screening project for autism, funded by US charity Autism Speaks, that had taken place in the Korean city of Goyang and apparently discovered an incidence among school children of 1 in 38. Lead author Dr Young Shin Kim was apparently not perturbed by the numbers:
“Kim stresses that the results of her study shouldn’t alarm parents into thinking that autism has suddenly exploded in schools. “It doesn’t mean there is an increase in new cases,” she says. “We just didn’t know how to find them and diagnose them. Now we know there are kids with social problems who are not being treated, and we know how to help them.””
“The researchers say they would expect to see similarly high rates of autism emerge in the U.S. and elsewhere if the same data collection strategy were used. “The kids picked up in Korea, many had never been recognized in medical records as having autism,” says Geraldine Dawson, chief science officer for Autism Speaks. “That’s what needs to be done, that kind of broad screening.””
However, the magazine did not report was that 67% of the screened-positive children seem to have pulled out before the study was completed :
“For the 1,214 sampled screen-positive students, 869 parents (72%) consented to participate in the full assessment. Of these, 286 (33%) completed full assessments. Of those who completed the assessment, 201 (70%) were confirmed to have ASDs (autistic disorder, N=101; other ASDs, N=100), yielding a crude prevalence for any ASD of 0.36% (autistic disorder, 0.18%; other ASDs, 0.18%).”
What the report also did not disclose was that appointment that very same week of Robert H Ring to Autism Speaks:
“Robert H. Ring, previously a Pfizer senior director, will join Autism Speaks in Princeton, N.J., on June 1 in the newly created position of vice president of translational research. His focus will be on helping move drug experimentation from laboratories to clinical trials, “with the goal of improving outcomes for individuals with autism spectrum disorders,” according to the nonprofit organization.” 
While still at Pfizer Ring stated:
“This is a real opportunity to really make a difference for a huge unmet need using expertise we’ve acquired over a number of years. In fact we’re working right now to build a pre-competitive consortium amongst our competitors, including Lilly, Roche, Novartis, Janssen, and trying to agree that this is an important population to be developing medicines for…” 
This led to an announcement of a partnership between Autism Speaks, Roche and King’s College, London earlier this year .
 Alice Park, ‘South Korean Study Suggests Rate of Autism May Be Underestimated’ http://healthland.time.com/2011/05/09/korean-study-suggests-rate-of-autism-may-be-underestimated/
 Kim YS, Leventhal BL, Koh YJ, Fombonne E, Laska E, Lim EC, Cheon KA, Kim SJ, Kim YK, Lee H, Song DH, Grinker RR., ‘Prevalence of autism spectrum disorders in a total population sample.’ Am J Psychiatry. 2011 Sep;168(9):904-12. Epub 2011 May 9.
 Lee Howard, ‘Past Pfizer autism unit chief to join major advocacy group
By Lee Howard’ 12 May 2011, http://www.theday.com/article/20110512/BIZ02/305129344/-1/BIZ
 Pfizer News, ‘Autism research unit at Pfizer to address autism spectrum disorders’ http://www.pfizer.com/news/featured_stories/featured_stories_detail/pfizer_joins_academic_industry_collaboration_for_autism_drug_discovery
 ‘Unprecedented Academic-Industry Collaboration Seeks New Drugs and Novel Treatments for Autism’, http://www.autismspeaks.org/about-us/press-releases/research-academic-industry-drug-discovery
Apologies, I forgot to include the BMJ link:
The train driver is the least guilty of course. He would have sacrificed his freedom, the well being of his family or possibly even his life for nothing. He could not affect the outcome so he made a perfectly rational decision.
The train driver is A) Doing what he is told B) Doing what he was trained to do C) Has no way to effect the outcome. D) May not even be aware of the atrocities being committed
The Priest knows for certain that what he is doing is wrong. He knows he is not acting as the Church or his religion teaches him to act. He is breaking the rules of the church, the rule of law and doing something that is morally wrong. He has taken advantage of his unique position of power to satisfy his own wants and needs. He will have been fully aware of the sin he is committing.
The priest is A) Not doing what he was told B) Not doing what he was trained to do C)Is in control of the outcome D) Is perfectly aware of the harm he is causing.
For the doctor to have even got to his position he needs to be a certain type of person (there are always exceptions), but generally he needs to be very good at doing what he is told otherwise he would likely not have survived such a long time in education. (IMO education does not look for the best and brightest – it looks for those that work best within the system). By the time he actually becomes a Doctor, he is fully indoctrinated into that system. This isn’t just true for the doctor, but also corporate executives, senior civil servants, politions and so on. If they had been the sort to challenge authority they would never have made it that high in the organisation. You need to be a company man (or at least pretend to be) if you want to succeed.
So the doctor, unlike the priest, believes he is doing good (mostly). He is doing what he is best at, the thing that assured and assures his professional success… What he is told. The doctor is making rational decisions in the framework of a monstrous system into which he has been indoctrinated.
The Doctor is A) Doing what he is told B) Doing what he was trained to do C) Has some control over the outcome D) May be aware of some of the damage being caused but is unable/unwilling to do anything about it because of his robotic like tendency to accept and do what he is told by authority – so because of A and B.
I used to think the doctor was just putting his own interests over the well-being of others, but now I believe that a lot of doctors are so indoctrinated to follow authority that they actually believe they are working for the greater good.
There are no doubt Doctors that abuse in a similar way to the Priests – fully aware they are doing wrong. But that is not where most of the abuse happens. My wife’s abusers would probably still argue to this day that they did the right thing. (In the framework of a monstrous system they did do the right thing).
There are no priests that actually believe they are doing gods work or the churches bidding by abusing children but there are plenty of doctors abusing their patients by doing nothing more than being a good little soldier.
In a similar manner we have the legal profession and so called justice.
But many judges allow child rapists free with the aid of “expert doctors”
The grooming of judges etc to believe child rape does no harm is mind boggling- but I have met these solicitors, trainee judges etc and looked them in the eye and asked ” do you believe that Bull shit”? The answer was “its what we are trained to believe” and like unable to think if raping children was harmful or not. I had to experience that to believe it.
I am unable to find out who the trainers of judges are ? Barnardos? who?
Like the rich pedo/child rapist who was never sent to jail because the judge felt ” he would not do well in jail”??
Yet people believe there is justice in the court.
At the risk of carrying the train driver metaphor too far, if doctors are only train drivers, then we don’t need them, because trains can be driven by robots (or more precisely by themselves). A robot, computer, or smart phone app can be programmed to take medical histories and prescribe whatever the pharma database says is best. But clearly this is not the case. We still need a doctor’s judgment and wisdom to discern the things pharma won’t tell them or their patients, like the pill they prescribed gave their patient suicidal thoughts, or the vaccine they gave caused encephalopathy. Since this is the case, doctors are responsible for many things, to include learning to recognize adverse events, reporting them to the regulators, warning their patients about them, sharing them with other healthcare professionals, speaking out publicly about them, and avoiding conflicts of interest with pharma. And if they continue to prescribe drugs that reasonable people (like a jury) can see are causing harm, then they are responsible for that, too. If doctors aren’t will to take these responsibilities, even at the risk of harming their reputations and livelihoods, then they have no business being doctors.