Editorial Note: This post follows last weeks In the Name of the BBC. There will probably be two more posts on Hostile Environments and The Anti-Facts Brigade. The titles and this photograph come from the movie In the Name of the Father – a compelling 1993 move about the Guildford Four which comes complete with an astonishing cast. The movie costs almost nothing to rent on Netflix.
The BBC and The BMJ (British Medical Journal) probably seem dependable to most people (90%) on both the Left and the Right of British politics. I’m not aware of any medical journals or broadcaster that would attract the same levels of support from all sides in either America or the rest of Europe. British newspapers are viewed as and are far more partizan. Its not clear there is one that would command support from both sides of the aisle.
This is what underpins my sense of dismay at the recent BBC programs on children and antidepressants, especially given prior Panorama programs that had made this a scandal the BBC had scooped the world on.
The Cochrane Collaboration until recently occupied a rather similar position. The sense was that regardless of who was offended they were going to get the truth out.
Some months back, the Nordic Cochrane Center, one of the centres in the Cochrane Collaboration, sent a review of studies done on the HPV vaccine to the BMJ. Much to their surprise, BMJ turned down this article which contained all studies done on HPV and a serious attempt to flag up the limitations of the trials and accordingly the limitations of what we could confidently say.
Subsequently the Cochrane Collaboration published an alternate or competing review claiming that the HPV vaccine was marvellously effective and close to side effect free. The launch of this review was co-ordinated by the Science Media Centre (SMC) – essentially an out-sourced industry public relations outfit.
A short time after that, we had news of a major push to promote the vaccine to boys as well as girls.
The Nordic HPV Review will likely be published somewhere soon. In the meantime, its authors Lars Joergensen, Tom Jefferson and Peter Goetzsche have published a unique paper taking the Cochrane Collaboration to task for breaching the Cochrane mission statement (motto) ‘Trusted Evidence’ by publishing the alternate HPV review. This is an extraordinary indictment.
Joergensen and colleagues’ paper is rather like Gareth Pierce (aka Emma Thompson) holding up a piece of paper at trial “Not to be Shown to the Defence”. Rather than keep to the Cochrane mission of hunting down all trials and working to expose all biases and limitations, the alternate review uses the Cochrane name to front an advertising campaign. The Joergensen paper critiquing Cochrane is Here.
The Cochrane Collaborations approach is rather like the English State in the case of the Guildford Four using the then good name of British Justice to front a counter-terror campaign – putting on a show trial to assure the public everything was just fine. The end result has been a collapse in a belief in the justice system. It begins with one case and ends with complete cynicism.
Cochrane and the pharmaceutical companies are playing with fire.
Gareth Pierce
For readers outside the UK, who may not have heard the name, its worth googling Gareth Pierce who on Wikipedia is described even by critics has having single-handedly changed the British criminal justice system, destroying the public’s perception of it as inherently impartial.
The English system is all about honours. The French is also. In the case of the English, everyone’s goal is get letters after their name – OBE order of the British Empire, CBE (commander), MBE etc en route to becoming a Sir. Its a marvellous system that costs very little to get people to crawl over burning coals or sell their mother for the good of the system. The good of the system is not the good of patients or of the average person in the street. Its the maintenance of the status quo and the promotion of business.
Its important for perceptions though that some very average people doing public-spirited things get minor honors. The occasional major honor is given to decent individuals like John Sulston who led the Human Genome Project.
When offered an honor, Gareth Pierce sent it back with a note saying there must have been some mistake.
In the Name of the BMJ
Somehow BMJ has managed to retain trust where British Justice hasn’t.
There are some wonderfully honorable people in the BMJ – possibly better on average than was the case several decades ago. There have been some pretty shady customers in the past.
There are also people like Richard Smith, who like Richard Horton in the Lancet, make a big deal of wringing their hands and sanctimoniously saying in public our journals have become pharmaceutical company laundering conduits, while at the same time behind the scenes buckling in the face of company or government pressure to deny access to articles that might tackle problems like ghostwriting or lack of access to trial data.
A good case can be made that no-one could be implicated in more deaths than Richard Smith, as a consequence of his endorsement of and publication of the Beasley et al 1991 article in the BMJ – see Vampire Medicine and succeeding posts through to Call to H-ARMs. Smith’s probably accidental role in a cover-up allowed the Merck Vioxx cover-up to succeed by endorsing the idea that any meta-analysis even a meta-analysis of garbage has the same status as Tablets newly brought down from a mountain-top.
It doesn’t have to be crooks who wreak the most damage. Innocence is what keeps the wheel spinning.
In the case of Cochrane, the person in the frame is probably Iain Chalmers – only someone inside the organisation is in a position to tell.
If trust is going to be restored its going to need someone to do a Jose Mario Bergoglio and say we’ve fucked up. Here and here and here is what was done – all of which might have looked reasonable at the time but in retrospect was unfortunate.
Trust is a fragile commodity. In pushing HPV as aggressively as they have done, pharmaceutical companies risk blowing trust in all vaccines out of the water.
Acceptance, normalises and responsibility …
“From a vaccine acceptance point of view, making the vaccine gender-neutral also normalises the vaccine, and does not put the burden on girls to be mitigating the transmission of the virus by taking the vaccine instead of sharing that responsibility”,
Heidi Larson, director of the Vaccine Confidence Project at the London School of Hygiene and Tropical Medicine, told The Lancet.
I published a letter in BMJ Rapid Responses a week ago after they jumped on the mysterious media Andrew Wakefield/Elle Macpherson bandwagon with a piece of rank drivel by Timothy Caulfield, Canada research chair in health law and policy, University of Alberta:-
‘Re: Elle Macpherson, “anti-vaxx” nonsense, and the opportunity to engage
One would have though this is both trivial and no one’s business, omitting the footnotes [1].
‘As a serious medical journal reporting current affairs I look forward to an article from BMJ engaging with the steepling and unexplained rates of autism emerging from public data, not being addressed (with or without Wakefield) ….. With great government neglect and for whatever the reasons rates of autism in schools are more than ten times the level they were when Wakefield was questioned at the famous Royal Free news conference in 1998 (notably a reported rate of 4.7% in Belfast) and we need to know why.
‘I also look forward to a report of the paper by Jørgensen, Gøtzsche and Jefferson in BMJ Evidenced-Based Medicine…on the Cochrane review of HPV vaccines…, in which three senior and Cochrane affiliated scientists attack the foundations of the review’s methodology and raise a host of red flags over product safety. The original paper was regarded as a news event by BMJ… and the profession should really be informed about this matter, which cannot be dismissed as “anti-vaxx” nonsense.
‘These are matters of substance and they should not be hidden under froth.’
https://www.bmj.com/content/362/bmj.k3255/rr
This seems to have elicited the obnoxious response from leading vaccinationist and Chair of the BMA Public Health Medicines Committee, Peter M English:-
‘Re: Elle Macpherson, “anti-vaxx” nonsense, and the opportunity to engage
There is a growing literature demonstrating how engaging with anti-science arguments can actually reinforce people’s anti-science views.
‘So we should engage with caution.
‘Of course, we should prefer objective, reasoned argument for decision-making. But it is very ineffective at influencing public opinion – just look at Brexit! The thing that seemed to turn opinion on MMR in the UK was not the careful lining up of all the scientific arguments and the debunking of the anti-vaccine ones. It was a documentary and serious of articles exposing Andrew Wakefield.
‘See eg:
Deer B. The MMR & autism crisis: part 2: the Wakefield factor. London, 2004; Updated 2004 (undated); Accessed: 2018 (01 Aug): (http://briandeer.com/wakefield-deer.htm).
General Medical Council. Dr Andrew Jeremy WAKEFIELD: Determination on Serious Professional Misconduct (SPM) and sanction. London: General Medical Council, 2010; (http://www.gmc-uk.org/Wakefield_SPM_and_SANCTION.pdf_32595267.pdf).
Poland GA, Spier R. Fear, misinformation, and innumerates: How the Wakefield paper, the press, and advocacy groups damaged the public health. Vaccine 2010;28(12):2361-2362 (http://www.sciencedirect.com/science/article/pii/S0264410X10002203).
Godlee F, Smith J, Marcovitch H. Wakefield’s article linking MMR vaccine and autism was fraudulent. BMJ 2011;342, DOI: 10.1136/bmj.c7452 (http://www.bmj.com/content/342/bmj.c7452.short).’
However, BMJ did not post my attempt to respond to English:-
‘As a “Public Health Physician” Peter English expresses a troubling disdain for the public, while seeming to elide having any critical view of vaccines at all with being “anti-science”… I wonder how he can justify that? Perhaps he could explain on what basis as a class of product vaccines lie above suspicion?
‘Meanwhile, in regard to the allegations of Brian Deer I would remind him of the High Court findings of Sir John Mitting…when Prof John Walker-Smith, senior clinician and author of the Wakefield 1998 Lancet paper was completely exonerated, which went unappealed by the General Medical Council. Notably Mitting dismissed the central contention the of the GMC prosecution that the authors of the paper were executing the Legal Aid Board sponsored protocol (172/96):
‘“Its conclusion that Professor Walker-Smith was guilty of serious professional misconduct in relation to the Lancet children was in part founded upon its conclusion that the investigations into them were carried out pursuant to Project 172-96. The only explanation given for that conclusion is that it was reached ‘in the light of all the available evidence’. On any view, that was an inadequate explanation of the finding. As it may also have been reached upon the basis of two fundamental errors – that Professor Walker-Smith’s intention was irrelevant and that it was not necessary to determine whether he had lied to the Ethics Committee, it is a determination which cannot stand ….” [para 20]
‘The case that Walker-Smith was undertaking research was dismissed:
‘“..their case was that he was in fact undertaking research, which required Ethics Committee approval, without realising that he was doing so. This is an untenable proposition, as the analysis of the letter of 11th November 1996 above demonstrates. In consequence, not only was the panel invited by the GMC not to determine Professor Walker-Smith’s intention, it was also invited not to determine his truthfulness in his dealings with the Ethics Committee.” [Par. 18]
‘“It is in its findings on the clinical issues in the individual cases of the Lancet children that the most numerous and significant inadequacies and errors in the determination of the panel occur. In no individual case in which the panel made a finding adverse to Professor Walker-Smith did it address the expert evidence led for him, except to misstate it. The issues to which this evidence went were of fundamental importance to the case against him. Universal inadequacies and some errors in the panel’s determination accordingly go to the heart of the case. They are not curable. Unless the remainder of the panel’s findings justify its conclusion that Professor Walker-Smith was guilty of serious professional misconduct, its determination cannot stand.”
‘Mitting rejects the idea that there was any misrepresentation over referrals:
‘“This paper does not bear the meaning put upon it by the panel. The phrase “consecutively referred” means no more than that the children were referred successively, rather than as a single batch, to the Department of Paediatric Gastroenterology. The words did not imply routine referral.”[par. 157]
‘Finally, Mitting states:
‘“For the reasons given above, both on general issues and the Lancet paper and in relation to individual children, the panel’s overall conclusion that Professor Walker-Smith was guilty of serious professional misconduct was flawed, in two respects: inadequate and superficial reasoning and, in a number of instances, a wrong conclusion….The panel’s determination cannot stand. I therefore quash it. Miss Glynn, on the basis of sensible instructions, does not invite me to remit it to a fresh Fitness to Practice panel for redetermination. The end result is that the finding of serious professional misconduct and the sanction of erasure are both quashed.” [para.186-7]
‘It may reasonably said that whatever happened – and Mitting is unequivocal in relation to the paper and the clinical investigations that there was nothing amiss nor was he challenged by the GMC – that a greater responsibility lay with Prof Walker-Smith because he was making clinical decisions, which lay outside Wakefield’s brief. And I certainly do not think it is alright at this stage to re-visit the history, as if these judicial findings never happened.’
Having realised that the BMJ were not going to publish the High Court ruling against the substance the GMC/Brian Deer claims against Wakefield et al (and especially Prof Walker-Smith) I had another go challenging Dr English:-
‘As a “Public Health Physician” Peter English seems to express a breath-taking disdain for the public, while also apparently eliding any critical view of vaccines at all with being “anti-science”… I wonder what he thinks the public, particularly prospective vaccinees and their families, should be allowed to know about the recent paper by Jørgensen regarding the inadequacies in the trialing of HPV vaccines?…’
————————————————
Not published, so Peter M English, Chair of the BMA Public Health Medicines Committee, is neither embarrassed or forced to answer. Or the BMJ.
Well, I hope this is not too hard to follow. I tried to point out that BMJ having published a news report of the Cochrane review of HPV vaccines by Aubyn et al in May were under a moral obligation to publish a report of the rebuttal by Jørgensen et al in July and there was an obvious danger to the community if they were at least not even-handed. Manifestly, amid the myriad adverse reports post-marketing there have never been any valid safety trials for HPV vaccines, and neither the profession or the public are supposed to be told about this – and they certainly are not going to be on the face of it now by British Medical Journal.
Meanwhile, BMJ demonstrates its great vulnerability over its Wakefield allegations since they cannot even publish on-line a detailed reference to a High Court ruling regarding it. Everything is stage management and if there is any dispute over Mitting- and after six years we have not heard it – they really ought to say what it is rather than just engage in continued repulsive innuendo. And now Belfast is a hot spot for autism schools with a rate of 1 in 21 (4.7%) and its education system at breaking point (although such stories come from all over the UK and across the globe):
https://www.belfasttelegraph.co.uk/news/northern-ireland/northern-ireland-schools-funding-at-make-or-break-point-after-19m-overspend-37179511.html
The British system is transcendent (and perhaps doomed).
People can get satisfaction without being ‘honoured’ – those names have never done all the work themselves anyway. They have a team who never get any recognition. Tt did seem to the naive or uninformed amongst us that thebmj was becoming more open and less controlled by the pompous nepotistic cliques of previous years but that hope has disappeared long ago. There have been and are though a few honourable people at thebmj.
Critics accuse it of having become a rag maybe partly out of snobbery but there are more serious offences which are only being uncovered by individuals like DH blogging. The bmj has no shame it still bans critical responses and articles without publishing any data as to how many and for what reasons. There used to be records of the ethics cttee published but that stopped when a friend of Fiona was appointed head of ethics – even after retirement she still gets automatic coverage and critical rather than sycophantic voices are rare. Tony Delamonthe ex sub editor before escaping to Germany actually banned a person from making critical responses. The bmj set up the farce of ‘patient reps’ sounds very right on but is a con- for a flavour of what they allow after editing see one person’s sycophantic praise for the proposed changes to the mental health act. Not her fault and of course entitled to her opinion but many naive people have been used in the name of ‘the user voice’.
How are editors and others appointed – by the BMA? Fiona herself posted a very embarrassingly crass article in thebmj describing how when she heard her application to become editor had failed she burst into tears and phoned her mother, Mother said don’t be so wet there must be some mistake Fiona (note the ‘must’). Fiona made a call and hey presto there had been a mistake. She dried her eyes, the job was hers. (can’t be bothered to trawl for a ref) How? The nepotism and self interests which silences vital critical views and endorses corruption is becoming so well known that the response is often a shrug of the shoulders..it used to be what do you expect they’re politicians now it includes the medical profession.
What a joke by the way to hear members of the GP hierarchy castigating rogue doctors on TV last night (online doctors) for causing harm to the public with dangerous prescribing of psychiatric and other drugs!! Do they see their power and control being dissipated ? not only by rogue doctors but those who rightly have little respect for the hierarchy and their farcical regulators and significantly the growing numbers of the public who avoid the system altogether and go online. So now two arms of the lucrative medical business are competing each causing untold harms with their immoral behaviour.
Are they ever going to find the moral courage to admit their own wrongdoings and make a collective Jose Mario Bergoglio? Answers on a prescription pad.
I didn’t know about that tender exchange between Fiona Godlee and her mother – I did know that weeks before Richard Smith announced his retirement she gave a presentation to the BNF entitled from memory ‘The Next MMR: Can We Do Better?’, so she already arrived with a commitment to suppressing dissent about vaccines. Perhaps the she should shed a tear for all those young women who will now never achieve career glory, and for their mothers. I recommend her for the Order of the Bath!
Seconded John! shall we think up a few more gongs and titles to honour individuals and/or their organisations with? .
The recently published Cochrane HPV vaccine review was compromised from inception.
One of the original authors on the protocol was Lauri Markowitz of the CDC. It’s notable Lauri Markowitz disclosed no conflicts of interest on the protocol.
On 29 February 2016 I forwarded an email to David Tovey, Editor in Chief and Deputy CEO of Cochrane, saying:
Dr Tovey, I see that Lauri Markowitz of the CDC is one of the authors of Cochrane’s HPV vaccination review, i.e. “To evaluate the immunogenicity, clinical efficacy, and safety of prophylactic HPV vaccines in females.”
I understand from a PubMed search that Markowitz is an author on many papers about HPV vaccination, for example this paper recently published in Pediatrics: Prevalence of HPV After Introduction of the Vaccination Program in the United States: http://pediatrics.aappublications.org/content/early/2016/02/19/peds.2015-1968
Markowitz et al’s recently published paper simultaneously received widespread acclaim in the mainstream media, see for example this article in Forbes magazine: HPV Infection Rates Plummet In Young Women Due To Vaccine: http://www.forbes.com/sites/tarahaelle/2016/02/23/hpv-infection-rates-plummet-in-young-women-due-to-vaccine/?utm_source=followingdaily&utm_medium=email&utm_campaign=20160223#7dfb1cd75c4d
So Markowitz is going to be reviewing her own papers for the Cochrane review on HPV vaccination?
The Cochrane ‘About us’ page is headed: “Trusted evidence. Informed decisions. Better health.” The ‘About us’ webpage also states: “Cochrane contributors…work together to produce credible, accessible health information that is free from commercial sponsorship and other conflicts of interest…Our work is recognized as representing an international gold standard for high quality, trusted information.”
Really?! We’re expected to trust Cochrane’s information, e.g. a review of HPV vaccination which is being prepared by an employee of the CDC and an author on many HPV vaccination papers?
Markowitz was on the US Advisory Committee on Immunization Practices’ Human Papillomavirus Vaccine Working Group in 2006. She’s the ‘corresponding preparer’ on the ACIP’s document recommending implementation of HPV vaccination: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5602a1.htm
How can Markowitz possibly be an objective and independent reviewer of the literature regarding HPV vaccination when much of the material she will be reviewing is her own work?
Dr Tovey, can you please advise on what basis Lauri Markowitz was engaged to conduct the Cochrane review of HPV vaccination?
Dr Tovey replied on 1 March 2016, saying:
Elizabeth
Cochrane’s conflict of interest policy is publicly available: http://community-archive.cochrane.org/editorial-and-publishing-policy-resource/conflicts-interest-and-cochrane-reviews
I couldn’t tell for certain but it wasn’t clear from your email whether Lauri Markowitz has been involved in any of the RCTs that will be included in the review. If she is, there are rules about trialists not evaluating or data extracting from their own trials.
We can’t govern the opinions that review authors hold although we are stricter than other journals about conflicts of interests – in that declaration is not always sufficient. We have safeguards in place to avoid bias due to non financial conflicts although I acknowledge these cannot currently be fully controlled – but these include insisting on teams of authors, peer review at both the protocol and review stage, detailed editing by the appropriate Cochrane Review Group plus oversight by my Editorial Unit.
I am very confident that the review, if it makes it through to publication will be robust to the criticism that we can be certain will be thrown at it.
Best wishes
David
So much for the publication being “robust to the criticism that we can be certain will be thrown at it”…
Dr Tovey didn’t answer my question on what basis Lauri Markowitz was engaged to conduct the Cochrane review of HPV vaccination. Which makes one wonder who initiated the protocol?
What motivates people to become a ‘Cochrane author’? https://join.cochrane.org/what-you-can-do/author-or-peer-reviewer/become-author
Is it in the right spirit to to become a Cochrane author to review your own work?
Lauri Markowitz was subsequently NOT listed as an author on the Cochrane HPV vaccine review, so there was obviously a change of heart. But Markowitz was acknowledged for her input in the development of the protocol, and also for her “invaluable advice and contributions by reviewing the results and discussion sections”.
Also interesting to note the project was supported by the US National Institute for Health Research. See the full Cochrane review for Acknowledgements: http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD009069.pub3/full
Further to my previous comment re Dr Lauri Markowitz, the US CDC’s leading HPV vaccination promoter, and an initiator of the Cochrane protocol to systematically review HPV vaccines.
It can be demonstrated that Markowitz is biased in favour of HPV vaccination – why was she allowed to initiate a Cochrane systematic review of HPV vaccines when it is Cochrane’s stated mission to provide information that is unbiased? https://www.cochrane.org/about-us
Here’s a CDC promotional (marketing?) video for HPV vaccination from February 2013, with Dr Markowitz and her colleague Dr John Iskander: https://www.youtube.com/watch?v=bnd_iCOR7-w
This is part of the CDC’s ‘Beyond the Data’ series. In this video “Lauri E. Markowitz, MD highlights how providers can help – Send reminders, Arrange quick visits and Promote anti-cancer vaccine”.
In the video published in February 2013, Lauri Markowitiz says: “The most important thing, this is an anti-cancer vaccine, we know it’s very effective, it’s actually one of our most effective vaccines, and those are very important things. It’s recommended for both boys and girls, at 11 or 12 years, and this is a great age to give the vaccine, we know the immune response to the vaccination is very good at this age, and it can be delivered before any potential exposure to the virus.”
Responding to John Iskander’s concern there seems “to be some issues with getting teens to complete the vaccination series, and what are some of the things we can do to improve that?”
Lauri Markowitz responds: “Well kids of this age are busy. They have schedules, extra-curricular activities, it’s hard to get them in for the three visits that are needed to complete the vaccination series. I think that providers can do a variety of things. The first thing is when they get their first dose to be sure to remind them that they need two additional doses to complete the series. And then I think doing reminders, reminder calls, reminders of any sort, are really going to be helpful to get the second and third doses in. And also providers can remember to use every visit that the adolescents come in to immunise. I think all those things can be helpful. The other thing I should mention is quick visits, so when they come in to get their second and third dose they don’t have to wait and have a full visit, they can just come in for their vaccination.”
John Iskander then refers to data that suggests “there’s a significant minority of kids who haven’t yet started the vaccine series. So, what are the issues there, are there some different strategies that need to happen to get more kids started on this protection?”
Lauri Markowitz replies: “Well, we know there’s some fairly strong data that one of the most important things is a strong provider recommendation. Having a recommendation from a provider for any vaccination is one of the most important predictors of getting vaccinated, so that’s very important. There can also be things like standing orders, so that if an adolescent comes in in the age group where the vaccine is recommended, they can, there can be some indication on the chart they should be offered the vaccine. And again, eliminating lost opportunities, so if an adolescent is coming in, and gets another vaccination that’s recommended at that age, they can also get the HPV vaccine.”
Judging from this video, it seems the CDC’s Lauri Markowitz is very much in the business of marketing HPV vaccination.
Again, why was Lauri Markowitz allowed to initiate a Cochrane protocol to systematically review HPV vaccines, and to be involved in a critical review of the manuscript?
Who at Cochrane authorised the obviously conflicted and biased Lauri Markowitz’s participation in the Cochrane systematic review of HPV vaccines?
I’m surprised that nobody here has mentioned the Cochrane Collaboration selling out to Bill Gates a couple of years ago? He and his wife, Melinda, are in the process of vaccinating the whole world. With his donation to them, we can no longer look forward to unbiased reports from the CC…
https://www.cochrane.org/news/cochrane-announces-support-new-donor
Vanessa
I am not sure how critical it is, although it certainly illustrates the problem. Cochrane reviews are not supposed to be funded by industry but it is unlikely that this would leave them free from bias free institutional funding (say the British or American governments!). Jørgensen et al point out:
“Most of the 14 Cochrane authors on the first published protocol
for the Cochrane review had major conflicts of interest related to
the HPV vaccine manufacturers.29 The Cochrane review only has
four authors; three of whom had such conflicts of interest a decade
ago. The review’s first author currently leads EMA’s ‘post-marketing
surveillance of HPV vaccination effects in non-Nordic
member states of the European Union’, which is funded by Sanofi-Pasteur-MSD that was the co-manufacturer of Gardasil.”
Personally, I was fairly astonished by a recent Cochrane review into the best methods for persuading people to accept vaccines irrespective of effectiveness or safety:
Early childhood vaccination is an essential global public health practice that saves two to three million lives each year, but many children do not receive all the recommended vaccines. To achieve and maintain appropriate coverage rates, vaccination programmes rely on people having sufficient awareness and acceptance of vaccines.
“Face‐to‐face information or educational interventions are widely used to help parents understand why vaccines are important; explain where, how and when to access services; and address hesitancy and concerns about vaccine safety or efficacy. Such interventions are interactive, and can be adapted to target particular populations or identified barriers.”
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010038.pub3/full
They say the less informed people are the more likely they are to be persuaded! It was actually published the day before the HPV paper by Arbyn et al, and shows bias in favour of products per se.
(Sorry this transpired in commenting on the failure of the BBC, to be a long comment – in two parts!).
This is more “Manufacturing Consent” on behalf of the pharmaceutical companies consciously where existing doctrines can also be reinforced subconsciously by members of the media. Even the BBC are now telling us what those in power need them to tell us. Where this happens, not unlike the Trump administration, this is at the very least to be complicit if not aiding and abetting misinformation and mass gas-lighting etc.
As a young person when I had first been prescribed Seroxat (and pre the age of the internet), had it not been for the BBC Panorama programmes regarding Seroxat years later– which could and did reach me eventually – I don’t doubt for a second that the adverse effects of these drugs would have killed me (as they almost did) or that I would have been poly-drugged, under misdiagnoses (and where I was clearly suffering from, and more liable to suffer from adverse effects) into insanity.
Now, physically and mentally injured and damaged by these drugs in over twenty years exposure, I have to watch a young girl I love, non-blood related, prescribed these drugs (before I came on the scene) at 14 years of age. This lovely child, on every occasion of having missed even one pill (immediately reinstated upon parental knowledge), has been rendered shaky, pacing, weeping, highly agitated and aggressive, confused and distressed and openly suicidal. She firmly believes the drug, Sertraline, prevents this girl “everyone would hate” from making an appearance and acting out, often violently against her parents.
Space considerations?
God help any vulnerable children and their parents in escalating prescription rates if desperate parents are tuning into this reputable ‘trusted’ coverage now.
Such is the power maybe of Lord Denning’s dilemma and of cognitive dissonance, even in good people, rational people, to make even the most rational come down psychologically on the easiest or less threatening side to their belief system – be it on a social or personal scale.
Merely sophisticated marketing coupled with cognitive biases or is there some term, before the frustration would drive anyone mad, which can explain this?
Could it be as profound a threat to some people’s fundamental sense of self and that of institutions as that of a priest feeling forced to accept there is no God – if not that you may be forever endangered, if you do accept the facts, in your every presumed ‘safe’ place if a caretaker (be it a parent, priest, doctor, medical professional, any revered caretaker) could harm me, anyone – much less many thousands? (On a conservative estimate).
Also makes me think of victims of people suffering from NPD (as observed by some psychiatrists in Trump, and who consider that the scale of influence this man has on the world and in terms on endangerment constitutes a duty to warn). Victims of people suffering from NPD will know that when rendered into suspended state of cognitive dissonance caused by gas-lighting and/or abuse from a loved and trusted one and where they assumed they would be ‘better’ or ‘safe’ (following the appearance of a ‘handsome prince’ or saviour princess, even in ‘happy pill’ form), that the greatest and most wanted relief (self-illusory though it may be) against the evidence, even overwhelming evidence, is plausible deniability.
And doubt, as Auntie Psychiatry says, is the main product now.
There’s also scene in the movie ‘The Beach’ where the islanders, rather than have their idyllic fun ruined (and almost deranged by the prospect of permanent happiness), isolate an injured member of their community and his suffering following a shark attack, to a hut away from the community group.
Leonardo DeCaprio’s character, the lead character, eventually smothers the suffering community member to death.
Out of compassionate mercy? Or because the victim’s suffering, and where anyone, “Russian Roulette”, could have been attacked by the shark in the same circumstances, is too painful – even annoying – to know of much less to hear? Psychologists and sociologists have written extensively on how our relentless fear of death affects our behaviour, and towards others, generally.
Though no psychologist myself, and with regards to some victims perhaps, there is literature which indicates that the most traumatic experiences to process and recover from or which can inflict the most damage or woundedness on a human being, is abuse, or the experience of feeling abused, by trusted loved ones or trusted caretakers in their roles. Even the prospect is too much for some people.
Like Lord Denning said of such “an appalling vista”, for many victims of people suffering from NPD or sociopathy, if the pain or cost in facing the alternative (the objective facts, the evidence that someone we love and trust has more than betrayed us) may simply be so great or potentially devastating, the victim (who doesn’t want to see themselves as a victim or who can’t see themselves as a victim) will actively, either consciously or subconsciously, seek out the facts which support their preferred beliefs and so to regain and sustain their harmonious sense of self. Self-bureaucracy.
No-institution or form of ‘objective’ media is immune to this it seems – and much of it may not even be, nor need be, conscious.
Deirdre you are so right it was the panorama programmes on Seroxat that also made me reevaluate my own side effects. I came off it only to go onto Citalopram which didn’t help either but at least I had been put on the right track to try to understand what was happening to me. Without these programmes my path may not have changed and I dread to think where I would be now.
The BBC, fact based and with it’s own checks and balances, has no excuse for this.
This state of affairs is so shocking and utterly depressing (almost too shocking ‘to get’, take a while) when you (try to) get it you’d almost be inclined to think, at this stage, that even if someone with an ounce of morality and compassion within Pharma blew the whistle on akathisia on the world stage it may merely be another of the endless ‘crises’ we have seen the huge marketing departments of GSK and Co administrations weather over the last few decades (often along with help of illegal damage control activity).
Any of which, since the nineties (like the present US presidency) should have been THE crisis which would have toppled any other administration or any other company in any other industry.
(And without a more accessible word for akathisia, a sufficient appreciation of akathisia, of how serious and horrific the drug induced state may be to yourself or others, and of its scale in varying degrees).
For victims who also know what others, particularly children, may be being subjected to right now (and this keeps so many of us up no doubt, in our uselessness to help, at night), it’s the greatest exercise in frustration imaginable.
Thanks BBC.
How can we (SSRI ‘anomalies’, SSRI Derangement Sufferers etc.) get through with the facts when experts like David Healy and others have conducted Mueller style probes in the public interest for years and where even the BBC, with knowledge, has silenced itself where children’s health and lives are at stake?
Do you need a host of medical experts in an international summit with twenty years of evidence, countless Charlie Burkes and images of child victims, adult victims, and with the world watching?
And yet, like Trump, who once said that he could personally shoot someone and his (desperate) supporters would still support him, you’d be inclined to think that GSK and Co could stand straight-faced before the world and casually admit (in a conversation they want to have about promoting something else) something as incredible as the known fact that they had been responsible for so many ‘supporters’ (or brainwashed believers) killing themselves or someone else.
However, waving all those lives away in the same breath, that we, including the BBC, should not trust either or own justice system, clinical evidence, or medical experts?
“What you’re seeing is not what’s happening”.
In my own seemingly never ending physical and mental recovery, over twenty years after my prescription for Seroxat for a transcient time in my life, how am I being forced to watch a version of what I was put through play out on my teenage would-be step-daughter?
The BBC too have negated this lovely young girl’s evident and obvious serious problems with both side effects and adverse effects (the monster she is internalising is her…): both because, and while, doctors continue stick to the guidelines.
Years too late for people like me but crucial for public health and for which I once felt I was also in the debt of the BBC and Shelley Jofre (regarding when the BBC where still the BBC and the first time the BBC researched and produced the Seroxat Panorama programmes) now I feel – over a decade later – that the perhaps upper or lower echelons of the BBC, have decided to play their almost Fox-like part in this area, over the health (lives?) of children and indisputable evidence?
All involved, though with good and/or professional intentions no doubt, would do well to remember that if at all conflicted or where dramatically polarised cognitive dissonance may have played its part, that the same factors, amongst many, allowed child abuse to continue within the Church and by child predators such as Jimmy Saville…
Without company or personal/professional follow up or recourse and where the BBC had knowledge and power, the BBC must also bear some responsibility with regards to the health and well-of this young girl who’s struggle with these drugs they have chosen to negate along with the facts – and to the thousands more like her.
Reputations for Sale ? BMJ-BBC-
Fiona Godlee poses the question: “So what can we do to change the blind-eye
culture of medicine?”
The answer, she concludes: “In the interests of patients and professional
integrity” is to show those who have sold their reputations “intolerance and
exposure.”
http://ahrp.org/reputations-for-sale-bmj-bbc-panorama-seroxat-paxil/
British psychiatry is in no sense perfect, but to be fair, the Royal College of Psychiatrists has worked hard to tighten up the egregious relationship between the profession and the industry… Yet on the surface it seems that one of our most esteemed institutions, a centre of academic excellence, is beyond the moral compass that guides the rest of the profession. In the interests of transparency we should be told why Professor Nemeroff has been invited to speak at the Institute of Psychiatry. Where has the funding for the new Centre for Affective Disorders come from? Is it linked to Nemeroff’s appearance and rehabilitation? We should be told.
http://1boringoldman.com/index.php/2013/06/12/still-mystified-in-america/
Mick Bramham
June 13, 2013 | 11:34 AM
Have you seen this Mickey? http://vimeo.com/68299094
https://vimeo.com/68299094
Have you seen this?
https://holeousia.com/2018/08/08/the-generally-hidden/
The [generally hidden] place of big business …