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Healthy Skepticism Library item: 16758

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.


Publication type: Journal Article

Egilman D
Just say no
BMJ 2009; 339:b4527


The postmarketing observational studies referred to by Annette Tufts in her news story are sham studies that are generally referred to as “seeding trials.“1 2 The actual research taking place is the evaluation of the return on investment (ROI) from paying physician “investigators” to participate in the sham study. The ROI is measured by tracking the increased use of the drug by participating doctors, who are the real subjects of these studies.3

No patient would ever agree to participate in a trial designed to determine how the use of physicians as investigators can increase drug sales. No institutional review board would ever approve such a trial. Unfortunately, the side effects from these sham trials are real.4

Drug companies are systematically misleading patients and doctors in these seeding trials. The Nuremberg Code (and all other medical research codes) requires that research subjects should be informed of the purpose of the research. This . . .


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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909