Monday, July 10, 2006

'The Drug Trial' by Miriam Shuchman - an exercise in logical fallacy

Intimidation of researchers and corporate distortion of scientific debate has become part and parcel of pharmaceutical "science". The consequences for patients and for public trust in science have been calamitous. Much thought is required to resolve the crisis. This disappointing book is not part of that debate.

It begins with a story. A researcher, Nancy Olivieri, obtained funding from Apotex to research a drug. She asserted her right (and obligation) as a researcher to publicise findings which she believed to be correct. Apotex and the University of Toronto responded by sacking, threatening and gagging. Properly independent inquiries were held into the way in which Olivieri was treated, each one exonerating her. And she was reinstated.

Shuchman relies heavily on a spurious form of argument that attempts to give the impression that Olivieri was somehow responsible for the academic freedom debacle.

Through adept use of the "straw man" fallacy Shuchman ignores the actual ethical problem, and substitutes a distorted and misrepresented version of a different problem. It is an evasion tactic, but on whose behalf? Certainly not on behalf of patients who rely on proper debate in science.

Secondly Shuchman relies on ad hominem attack. Selective and anonymous insulting of Olivieri is not ad hominem - it is simply insult. To make matters worse it has been suggested that much of the gossip Schuchman reports is false. To reject the principles raised by Olivieri based on such personal attack is ad hominem, and no argument at all. One wonders what forces might have motivated Schuchman?

The fallacies are discussed eloquently in the review by Professor David Healy

"Again and again the events are seen through a prism of sympathy for those who have been portrayed elsewhere as the villains ... Take Gideon Koren .......In the midst of this saga, Koren sent a string of anonymous hate mails to Olivieri’s colleagues. ..Koren was disciplined for misconduct in sending the anonymous letters, and in then repeatedly denying responsibility until he was identified as author by DNA evidence. 'His actions were childish, vindictive and dishonest.’ I’ll leave it to the reader to guess how Miriam Shuchman might portray this episode in a manner that generates sympathy for Dr Koren."

"Starting right from the subtitle, The Drug Trial dodges the key issues by claiming that this is a scientific rather than an ethical scandal. If Olivieri got the science wrong, she ipso facto got the ethics wrong ........If it turns out that Apotex’s drug has some benefits for the heart in some patients with thalassemia, as the book suggests, this would no more invalidate the call that Nancy Olivieri made than recent findings that thalidomide is an excellent treatment for leprosy now invalidate the efforts of Siegfried Lenz to raise concerns about its teratogenic effects.... The key issue is whether in the face of ambiguous clinical trial data, a clinician treating patients should err on the side of the patient or on the side of the corporation that hopes to make money out of future patients. Shuchman glides over this..."

In the British Medical Journal Martyn rates the book 1 star and writes:

It is disappointing that Shuchman's book hardly touches on these issues. Instead, it retells the story from a worm's eye view, dwelling on the personalities of the people involved, what they said about each other, who was sleeping with whom, and the tricks they got up to to blacken each other's reputations.

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Anonymous said...

I too though Miriam Shuchman's book a complete and dangerous travesty.

Whistle-blowers are by and large motivated by principle. They can be prickly on occasion, but that goes with the territory (she had powerful and slippery enemies) and being popular is not the essence of being a scientist. That said, Olivieri is highly popular.

Anonymous said...

Quite right - and now the NEJM have seen fit to make her a national correspondent of some sort. the NEJM writers with some integrity (like Robert Steinbrook) seem to be having some trouble getting their work published, and the trail of good editors have been ousted.