\nAcademic Medicine Deploys a Logical Fallacy to Avoid Disclosing Inconvenient Truths<\/font><\/a><\/strong><\/u>
Healthcare Renewal<\/font><\/strong>
by Dr. Roy Poses
September 14, 2011<\/div>\n<\/p>\n
We recently discussed<\/a><\/strong> a simultaneous retreat from aggressive regulation and enforcement applied to big health care corporations by US government agencies. Now a story published by Bloomberg [currently available without a subscription here<\/a><\/strong> on PharmaGossip] showed that the push for less disclosure of relationships with industry that generated conflicts of interest for academic medicine came not from industry, but from … academic medicine:<\/sup><\/div>\n\n
The lobby for Harvard University and other research institutions drove the Obama administration to weaken draft rules for scientists to disclose potential conflicts of interest<\/em>, according to U.S. records and watchdog groups.<\/sup><\/div>\n<\/ul>\nIn particular,<\/sup><\/div>\n\n
Universities objected to draft rules in a letter to NIH and in meetings with officials at the White House Office of Management and Budget, approver of the final version, said Carrie Wolinetz, associate vice president for federal relations at the Association of American Universities that represents 61 research universities<\/em>.<\/sup><\/div>\n<\/ul>\nAlso,<\/sup><\/div>\n\n
The letter was co-signed with the Association of American Medical Colleges<\/em>, American Council on Education and Association of Public and Land-Grant Universities.<\/sup> <\/div>\n<\/ul>\nThe one example of the universities’ reasoning to justify their objections to greater disclosure of conflicts of interest was striking.<\/sup><\/div>\n\n
Wolinetz’s organization wrote in the letter that ‘there is a paucity of evidence that the disclosure and management of financial conflicts of interest affect objectivity and integrity.’<\/em><\/sup> <\/div>\n<\/ul>\n<\/blockquote>\nNeedless to say, the Academic Institutions’ anti-reform stance and lobbying efforts were motivated by something as far from the primary charges of academia as possible – an egregious decision of the first order. Dr. Poses correctly identifies the logic in their argument as fallacious:<\/div>\n\nSo the academic institutions’ argument seems to be a variant on the false dilemma logical fallacy<\/a><\/strong><\/u>. If the only alternative to doing nothing about conflicts of interest is disclosure, and if disclosure is really a poor solution to the problem, than perhaps doing nothing makes sense. However, if disclosure is just a necessary first step, as the IOM asserted, then it is a first step that should be taken in preparation for other steps to come. Note that the academic institutions’ argument also seems to be a version of what has been called the Nirvana fallacy<\/a><\/strong><\/u>, or the perfect is the enemy of the good fallacy. That is, if what one can do does not result in Nirvana, then one should do nothing.<\/sup><\/div>\n<\/blockquote>\nOf course Poses is right – their objections are absurd. He concludes:<\/div>\n\nSo we have come this far. Universities are ostensibly about finding and disseminating the truth. Yet universities’ academic medical subsidiaries now deploy illogic to avoid revealing particular truths that they find uncomfortable, and which might raise questions about relationships with industry that are increasingly lucrative. Universities seem now willing to jettison their mission to make more money. True health care reform would require academic medicine to put its mission ahead of its revenues. <\/sup> <\/div>\n<\/blockquote>\nIt seems to me that there are two questions left unanswered. First, why did academia oppose this reform?<\/font><\/strong> Poses believes that they’re afraid of losing the Pharmaceutical Industry that has essentially been supporting academic medicine – certainly academic psychiatry – and as an aside, medical education. In a financial time like today’s, it’s unlikely that the government or the benevolent community would fill the gap were industry to be driven from the halls of ivy. The academy would undoubtedly shrink dramatically. As much as I hate their decision, I expect that the people charged with financing medical schools are keenly aware of the depth of their dependency on industry.<\/div>\nThe second question is, given the lobbying efforts of the Medical Colleges, why did the Office of Management and Budget and the NIH give in to the lobbying efforts?<\/font><\/strong> It can’t be that they believe the silly arguments so deftly exposed by Dr. Poses. Did they bow to the power of the lobby? Were they convinced that they would be hurting the universities? Are they as corrupted as the people making the arguments? I hate to say it, but I expect that the latter is closest to the truth.<\/p>\n
The DSM-III wasn’t the only thing that happened in 1980. Ronald Reagan was elected President and ushered in a wave of conservatism that continues to hold us in its grip. Without discussing all the thousands of ways that affects us, the meme of "privatization" has pervaded our political and economic life, fundamentally changing America. I think that "privatization" which puts medicine, academic and otherwise, into the free-wheeling capitalist economy, makes decisions like this one inevitable. Right now, Academic Medicine is just a business. The endless assault on Social Security, Medicare, Research Budgets, Training Grants, etc. are extensions of this same trend. So as much as I abhor what’s happening, I am skeptical that we’ll see any relief until the national priorities are driven by something that is more rational than simply the profit margins of industry. They’ve already taken us close to collapse, but still refuse to yield an inch. Medicine is just a barometer, not a special case… <\/div>\n","protected":false},"excerpt":{"rendered":"Academic Medicine Deploys a Logical Fallacy to Avoid Disclosing Inconvenient Truths Healthcare Renewal by Dr. Roy Poses September 14, 2011 We recently discussed a simultaneous retreat from aggressive regulation and enforcement applied to big health care corporations by US government agencies. Now a story published by Bloomberg [currently available without a subscription here on PharmaGossip] […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[2],"tags":[],"class_list":["post-13374","post","type-post","status-publish","format-standard","hentry","category-politics"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/13374","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/comments?post=13374"}],"version-history":[{"count":9,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/13374\/revisions"}],"predecessor-version":[{"id":13383,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/13374\/revisions\/13383"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=13374"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=13374"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=13374"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}