parsing sin…

Posted on Monday 24 February 2014

According to Roman Catholicism, a venial sin [meaning "forgivable" sin] is a lesser sin that does not result in a complete separation from God and eternal damnation in Hell. A venial sin involves a "partial loss of grace" from God. They do not break one’s friendship with God, but injure it.
by Jack Friday

Britain’s Serious Fraud Office plans to prosecute or fine some companies for engaging in bribery overseas, and analysts said some cases might involve mainland China, with GlaxoSmithKline and Rolls-Royce as likely targets. "We have a number of cases in mind but need to look at all the facts," a spokesman with the fraud office told the South China Morning Post.

The Bribery Act seeks to punish Britain-linked firms for bribery overseas, and a new policy by the office announced this month could make it easier to deal with such cases efficiently. The timing of the prosecutions and fines would depend on the circumstances of individual cases, the spokesman said.

In a speech in November quoting Chinese President Xi Jinping’s anti-corruption slogan "Striking tigers as well as flies", Ben Morgan, the joint head of bribery and corruption at the office, said: "We are investigating the types of cases that risk being overlooked as too difficult or too sensitive."

Rob Elvin, a Britain-based managing partner of law firm Squire Sanders, said: " We assume this includes GlaxoSmithKline and Rolls-Royce." Beijing is probing GSK, the largest British drug firm, for alleged bribery in mainland China…
Thanks to Pharmagossip for keeping us appraised of the GSK China China·gate story. It’s an important reminder of what industry will do if they think they can get away with it. And good for the British government  for punishing overseas bribery by UK companies.

Which brings us to the concept of sin. I didn’t grow up Catholic, but if your Dad’s family immigrated from Italy, about half your relatives are Catholic. My same aged cousin delighted in telling me what I was missing by not going to parochial school, and we had endless talks about purgatory, limbo, papal infallibility, confession, transfiguration, and the like in those days long before Vatican II. But the abiding concern for any two little boys was, of course, sin – venial and mortal. My cousin was obsessed with the difference, and every time we got together, he gave me an exposition on his updated research on those differences, as he planned how to keep his sins on the sunny side of the street [an interest we shared].

What’s that got to do with the UK? and China? and GSK? Well read on:
Analysts said the office’s new deferred prosecution agreement policy would speed up prosecution of corruption cases. From Monday, these agreements for economic crimes would be available to British prosecutors, the office said last week. A deferred prosecution agreement is one between the prosecutor and a company that allows prosecution to be suspended for a period of time, provided the firm meets certain conditions.

The fraud office’s director David Green said such an agreement sought to avoid damaging the company too much, which would hurt employees and shareholders. The new policy was significant as it provided additional tools for prosecutors, said Andrew Dale, a partner at law firm Orrick, Herrington & Sutcliffe. These agreements would potentially enable the fraud office to resolve more investigations more efficiently, said Keith Williamson, head of forensic and dispute services for Asia at Alvarez & Marsal, an international professional services firm. "We may see a [spate] of resolutions, either settlements or prosecutions," he said.

Deferred prosecution agreements would encourage companies to voluntarily report corruption within their ranks to the fraud office, Williamson said. Elvin said: "[These] agreements are most certainly significant. They allow commercial organisations to settle allegations of criminal economic activity without being prosecuted and without any formal admission of guilt. [They] provide a cost-efficient and quick means of addressing financial crime by corporates."

However, British authorities were likely to still prosecute the most serious economic crimes, he said.
My cousin never much discussed temptation [the topic of my last post – how many examples?…]. He didn’t need to. It was a given. It was the consequences of sin that carried the day. And in our discussions about the misbehavior of the pharmaceutical industry, that’s where we focus our attention. Right now, most of us think that the fines imposed in these PHARMA settlements is way too low. We joke that for them, it’s just the cost of doing business. A slap on the wrist. And we long for something like a firm ruler across the knuckles by an angry Nun, or perhaps even eternal damnation – something that mattered. We want criminal prosecution for the perpetrators.

When I first read that second part, I felt outraged. Protect the company’s reputation? Clean up the court docket? Keep the shareholders and employees from getting hurt? What about the patients? the sick people who are getting gouged or hurt! How in the hell does that help them? And what about the doctors who are given false information? that they’ve passed on? I doubt  that any of the actual injured parties would think very much of these deferred prosecution agreements. It’s just more of the venial sin malarkey that my cousin was incorporating into his life planning. But then it occurred to me that maybe they were onto something back in the day with their venial versus mortal distinctions.

The last sentence of that article says:
However, British authorities were likely to still prosecute the most serious economic crimes, he said.
Most of the settlements have been in Civil Suits, and the fines levied on the corporations involved. They have been treated as economic crimes and punished with economic measures [fines].
We would likely all agree that the sins of PHARMA haven’t all been economic crimes. Price gouging, selling low-to-no efficacy drugs might be economic crimes. But killing or harming people by withholding safety information they know about isn’t in the list of venial sins. And it isn’t done by corporations. It’s a mortal sin [literally and figuratively] that’s done by actual persons, usually higher-up persons. It may not be their intent, but in the law, we call that second degree murder.

In Medicine, the term "malpractice" used to cover all medical sins. But recently, criminal prosecutions have become more common. The standards for the differences aren’t totally clear at this point, riding still on a case to case basis. The ones with mens rea [guilty mind] are the clearest as in the usual criminal cases. The confusing ones are where the levels of negligence are on the table. But my point is that the law is beginning to approach the issue my cousin called the difference between mortal and venial sins when it comes to physicians. It seems to me that rather than continue to complain about the penalties for the sins of pharmaceutical companies, we ought the spend our time looking into the situations where those sins are mortal [and committed by a person or persons]. We have plenty of examples to draw on in our deliberations. Maybe we could help them along the road to doing the right thing by defining the domain.

And no, my cousin is not available for research. He’s moved on to other worries…
    February 24, 2014 | 4:07 PM

    Strategies of Ignorance: Mapping the Political Uses of Uncertainty within Medicine

    “”Strategies of Ignorance: Mapping the Uses of Uncertainty within Medicine,” was a one-year ESRC postdoctoral research fellowship held by Dr Linsey McGoey, and carried out under the mentorship of Professor Andrew Barry.

    The project expanded on Linsey’s doctoral research, completed at the LSE in December 2007. Her PhD examined the uses of ignorance and uncertainty employed by UK government regulators, policymakers and practitioners in debates over whether selective serotonin reuptake inhibitors (SSRI) antidepressant drugs lead to suicide in some users. Her main findings were as follows:

    Drawing on the case of SSRIs, she demonstrates that many policymakers within the UK’s National Health Service are frustrated with their inability to access clinical trial data necessary for developing treatment guidelines.
    Second, she suggests problems surrounding access to clinical trial data illustrate weaknesses within evidence-based medicine, a model of medicine that has become dominant in the UK and internationally over the past three decades.
    Third, the thesis suggests that when practitioners and policymakers wish to criticize the socio-political factors that make it difficult to access clinical trial data, their dissent must be limited to the universe of numbers, a phenomena she terms the “moral authority of objectivity” in medicine.
    Fourth, drawing on interviews with expert advisors to the MHRA, the thesis argues that UK drug regulators employed a strategic use of ignorance in order to absolve themselves of liability in not disclosing the knowledge of adverse effects when they first learned of them…..”

    February 24, 2014 | 8:39 PM

    If these medicines were safe and were actually effective in the treatment of what they’re recommended for, they wouldn’t need to be advertised and bribery would be unnecessary because they would sell themselves and there would be a wealth of stories on how these drugs have had a long-lasting impact on the quality of life for those who have been given them, and the positive action would impact entire communities.

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