O’Neill is just about the most famous Northern Irish surname – on both sides of the ‘divide’. I wrote to Onora O’Neill, 3 weeks ago, following the last post. There has not been a response.
My email may have gone into spam but if it has further emails likely will also. Faced with issues like this, many public figures, not unreasonably, may think not responding is more judicious. But it would be nice to get a response to this effect.
Some may check things out and be told that Cochrane, AllTrials, Transparimed or others have this problem in hand – Healy has cut himself loose from the mainstream on these issues.
Dear Onora O’Neill
I recently ran a post about antidepressants and children, Trust me I’m not a Doctor, that centres on Trust in medical settings and ended with a quote from your Reith Lectures .
Confucius told his disciple Tsze-kung that three things are needed for government: weapons, food and trust. If a ruler can’t hold on to all three, he should give up the weapons first and the food next. Trust should be guarded to the end: “without trust we cannot stand”.
I have cited you before as I and several people I know think highly of your work.
There have been a number of posts that hinge on the question of trust in medicine over the course of the last year, triggered by the death of Stephen O’Neill, in N Ireland, to whose inquest I was called as an expert witness. See The Death of Stephen O’Neill and you and The Perfect Killing Machine.
Stephen had been prescribed sertraline for a non-existent depression. It immediately made him suicidal and led inexorably to his death a few weeks later.
Central to his inquest was not just the issue of this drug causing suicidality but the fact that his doctors, all decent people, when treating him, not unreasonably you might think, relied totally on the published literature and NICE guidelines. The difficulty is that when it comes to on-patent pharmaceuticals the published literature has all been ghostwritten and there is no access to the data from clinical trials. No-one has access – not regulators, not notional academic authors, not those who write NICE guidelines.
Among the things that this ghostwriting and lack of access to trial data has enabled pharmaceutical companies to do is to write out of the script the evidence from their own trials that their drugs can cause suicide and their own admissions that this is the case. This is very clear in the case of Pfizer and their drug, the sertraline that triggered Stephen’s death.
At the inquest, I offered to assist the coroner, another decent man, in raising these issues but he was not inclined to do so.
I have another UK inquest coming up shortly involving a young man whose suicide was also caused by an SSRI antidepressant, again someone who did not have a mental illness, whose mother had to cut him down from where he was hanging in the stairwell of their house.
I have written to NICE, and the drug regulators and Ministers of Health in England, Wales, Scotland and Northern Ireland about this, none of whom deny the central issues about ghostwriting and lack of access to trial data but each of whom quickly passes the buck jumping on a phrase I supply them with that it’s not their job to police the medical literature. A lot of this correspondence is attached to earlier posts before Christmas and in April and May about the O’Neill case but I can forward it all to you if you’re interested.
My problem is this. It needs someone other than just me to take this on. As far back as 2004, I put this on record for a House of Commons Health Select Committee and as mentioned above I’ve recently raised it with everyone I can think of and know or have known, including Brenda Hale..
Antidepressants are now the second most commonly used drugs by teenage girls and in recent years suicides among teenage girls have doubled in the UK.
Northern Ireland has the highest rate of antidepressant consumption in the British Isles and the highest suicide rates. Somewhat unfortunately in Northern Ireland these suicides are being attributed to intergenerational trauma, which may be an issue but without the addition of an antidepressant IGT is not going to lead to suicide.
The problem when each of these children takes a pill – whether an antidepressant or any other pill, they are taking a chemical and information. The chemicals have always been risky and probably always will be. The information was until roughly 30 years ago more trustworthy but is now increasingly hazardous.
Nowhere is this more obviously the case in medicine than in the case of antidepressants and children. There have been 30 RCTs of antidepressants given to children who are ‘depressed’ – all negative but written up as glowingly positive. One famous study was Study 329, which landed GSK with a $3 billion fine. The full story behind this is in a book I recently wrote Children of the Cure, which I can send if you wish.
With every single study of antidepressants for this age group being negative, these drugs should barely be used now but just the opposite is the case. No set of drugs is increasing in use so much, in great part because the published literature says the drugs work well and are free of problems. GSK’s Study 329 is still there in the academic literature, unretracted, despite a $3 billion fine.
The issue I’m writing to you about is just that – the fake literature. I’m not seeking to engage you on the issue of can a drug cause someone to commit suicide but on a Fake News question – that the greatest concentration of Fake News on earth is not being produced by media hostile to Donald Trump but in fact centres on the drugs your doctor gives you and members of your family. Where does that leave Trust and Informed Consent?
The issues are rather like the dilemma facing Tom Denning in the Guildford Four case – if these people are innocent (if this literature is Fake) it raises such an appalling vista that public confidence in the law (medicine and regulation) will be badly shaken.
St Augustine framed a slightly different version of your Confucian message that appeals to me – ‘a brother supported by a brother has the strength of a walled city’.
Hence this email. I’d be interested in your views of where this leaves Trust – and am very happy to supply you with as much material as you might need to get to grips with the question, if you are inclined to engage.