We live in an Evidence Based Medicine world. Almost everyone assumes this means Data Based Medicine, and that if the data point in a particular direction this should trump the values and experience of individual doctors and produce the best outcome for patients. But there is increasing evidence of a mismatch between the so-called evidence and the real data from studies. Pharmaceutical companies sequester clinical trial data and publish only the material that suits them.
This "evidence" is then embodied in guidelines that have all but taken over clinical prescribing in a manner comparable to the way that GPS takes over the driving of a car. As a result, both patient and doctor are increasingly invisible in the clinical encounter and the ability of Doctors to Care is being lost. More to the point, adverse events on drugs in some areas of medicine are now the leading cause of death.
This situation hinges on the current patent laws for drugs, on the prescription-only status for drugs, and on company trials - protections that were put in place to save us from another Thalidomide. Treating the growing crisis in medicine will require remedies targeting one or more of these factors. In the meantime, we need to speak up for patients who are being injured by treatments. Increasingly, this will pit us against the "science."
The question for each is whether we will take a stand.
Dr. David Healy, MD, is a Professor of Psychiatry at Cardiff University, Wales. His main areas of research are clinical trials in psychopharmacology, the history of psychopharmacology, and the impact of both trials and psychotropic drugs on our culture.
Dr. Healy has been involved as an expert witness in homicide and suicide trials involving psychotropic drugs, and in bringing problems with these drugs to the attention of American and British regulators, as well raising awareness of how pharmaceutical companies sell drugs by marketing diseases and co-opting academic opinion-leaders.
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Added by FullCalendar on February 29, 2012