Operation Sisyphus

Sisyphus is a hero of Greek mythology (1), condemned to roll a large rock up a hill. Upon reaching the top the rock rolls back, and the task has to be repeated - endlessly. The story appears to be one of eternal and pointless labor.

One reader suggests that raising issues of pharmaceutical research misconduct is a pointless Sisyphean task (2) - that this whole field of science is already kaput. It sometimes feels that way (3,4). But the story of Sisyphus is not one of unending misery. Despite the best efforts of the gods, they cannot beat him (1).

Fellow medical bloggers are writing about the way in which the pharmaceutical industry is preventing proper understanding of the science upon which our patients rely (5,6,7,8,9). They write about the way in which industry has subverted those organizations whose task it is to act for our patients to preserve integrity.

But we are attacking the wrong beast.

The beast is not the industry - it is ourselves.

Pharmaceutical companies sell products under the banner of science. But their raison d'être is to make money. Industry has to balance genuine hypothesis testing and transparency against commercial interests and the financial consequences of dishonesty. This is not in itself a criticism - it is a simple fact.

We, as doctors, have created the atmosphere which has allowed lethal system malfunction. We have allowed industry to subvert the rules of science and the free-market. We have watched quietly as governments and academics have colluded with industry to hide information critical to our patients. We have remained silent as our medical schools churn out graduates who have no knowledge of the dilemmas and scandals of medicine. We have allowed our medical journals to become corrupted and timid. We have remained silent as our General Medical Councils have taken action against brave doctors for raising questions of integrity (10). We have said nothing while these old-boys' clubs have selectively ignored serious concerns brought to their attention (10) - apparently based on the status and race of those criticised (10,11). We have failed to support our colleagues who have raised concerns. We have said nothing.

I have been waiting very patiently. It is now seven months since Procter and Gamble provided previously suppressed data underlying three intended "ghosted" publications to myself, to the University of Sheffield and to other authors in whose names "science" was ghostwritten (12). The discordance between the data and the ghosted interpretations of that data (in our names) will have been obvious even to the most incompetent of statisticians. The unethical nature of the scientific process will also have been obvious to any observer.

Yet the first of these papers that was published in the names of others (J. Bone. Miner. Res. 2003; 18:1051-6) has not yet been retracted. There has been no comment about the attempts by a senior academic to force a colleague to sign journal declarations in the absence of data - even more important given the status of that senior academic as guardian of research governance within a prestigious medical school. There has been no comment about the ethics of denial of access to data, and about the signing of incorrect declarations to journals about access to such data.

The University of Sheffield has admitted that legal threats were made by Procter and Gamble about return of data that the company "owned" and which had been "obtained without their consent", but have otherwise not commented upon the principles involved

The obvious (and comparatively painless) step of declaring a wrong, and of correcting it, has not yet taken place. There has been no comment at all from those who should comment.

I have waited quietly as the various bodies to whom the matter was referred have done nothing of any relevance.

Once in a while Sisyphus shrugs (13).

How
(John Lennon)

How can I go forward when I don't know which way I'm facing?
How can I go forward when I don't know which way to turn?
How can I go forward into something I'm not sure of?
Oh no, oh no

How can I have feeling when I don't know if it's a feeling?
How can I feel something if I just don't know how to feel?
How can I have feelings when my feelings have always been denied?
Oh no, oh no

You know life can be long
And you got to be so strong
And the world is so tough
Sometimes I feel I've had enough

1. The Myth of Sisyphus by Albert Camus
2. Resistance is futile
3. http://www.slate.com/id/2133061/
4. http://www.thejabberwock.org/presshw.htm
5. Health Care Renewal
6. Pharmagossip
7. Clin Psych
8. Pharma Watch
9. Peter Rost
10. The General Medical Council - a Personal View (Wilmshurst)
11. Wikipedia General Medical Council
12. AAAS: http://www.aaas.org/spp/sfrl/per/per46.pdf
13. http://www.amazon.co.uk/Atlas-Shrugged-Ayn-Rand

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