{"id":43427,"date":"2014-01-27T08:25:20","date_gmt":"2014-01-27T13:25:20","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=43427"},"modified":"2014-01-27T08:34:27","modified_gmt":"2014-01-27T13:34:27","slug":"no-longer-a-given","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2014\/01\/27\/no-longer-a-given\/","title":{"rendered":"no longer a given&#8230;"},"content":{"rendered":"<div align=\"justify\">Well, I was on the road for the weekend and came back to find three posts about the <em>Kupfer Affaire<\/em>, each looking at a different piece of the puzzle:<\/div>\n<ul><span class=\"small\">      <\/p>\n<li>\n<div align=\"justify\"><a href=\"http:\/\/hcrenewal.blogspot.com\/2014\/01\/windy-city-blues.html\" target=\"_blank\">WINDY CITY BLUES<\/a>: Bernard Carroll @ <strong><font color=\"#660033\">Healthcare Renewal<\/font><\/strong> <\/div>\n<\/li>\n<li>\n<div align=\"justify\"><a href=\"http:\/\/blogs.discovermagazine.com\/neuroskeptic\/2014\/01\/25\/psychiatrists-another-dimension-part-2\/\" title=\"Permanent Link to Psychiatrists From Another Dimension [Part 2]\">Psychiatrists From Another Dimension [Part 2]<\/a>: Neuroskeptic @ <strong><font color=\"#660033\">Neuroskeptic<\/font><\/strong> <\/div>\n<\/li>\n<li>\n<div align=\"justify\"><a target=\"_blank\" href=\"http:\/\/www.madinamerica.com\/2014\/01\/conflict-interest-dsm-5-apa\/\">Conflict of Interest, DSM-5, and the APA<\/a>: Sandra Steingard @ <strong><font color=\"#660033\">Mad-in-America<\/font><\/strong> <\/div>\n<\/li>\n<p>   <\/span><\/ul>\n<div align=\"justify\">Sandra lands on what I think is the central issue in this story:          <\/p>\n<blockquote>\n<div align=\"justify\">But in the end, I  decided that I had an obligation to use whatever  platform I have to  bring more attention to this issue. For me, one of  the biggest problems  we have in psychiatry is unacknowledged COI. Given  the sensitive  nature of the work we do, the power we can wield over  people&rsquo;s lives,  the history of our improper relationships with Pharma &ndash;  even if it  turns out all rules were followed &ndash; that is not good enough.  We should  be above reproach.<\/div>\n<\/blockquote>\n<p>  At the level of Chairman of the DSM-5 Task Force, even the appearance of a Conflict of Interest is already a deal-breaker. To have an unacknowledged Conflict of Interest of this magnitude is simply too far over the line to be tolerated. The memo from the speaker of the Assembly is written as a report to the Board of Trustees of the American Psychiatric Association. It reached three conclusions:<\/p><\/div>\n<blockquote>\n<div align=\"justify\"><em>[1]<\/em> Dr. Kupfer should have disclosed to APA his interest in PAI in 2012. <em>[2]<\/em> Dr.  Kupfer&rsquo;s interest in PAI, which came after the decision had been made  to include dimensional measures in DSM-5, did not influence DSM-5&rsquo;s  inclusion of dimensional measures for further study in Section 3.  Interest in inclusion of these measures in DSM-5 began with conferences  starting in 2003. <em>[3]<\/em> If and when PAI develops a commercial product with  CAT, it will not have any greater advantage than the dozens of  dimensional measures currently being marketed by others.<\/div>\n<\/blockquote>\n<div align=\"justify\">Conclusion<em> [1]<\/em> is correct. Conclusion <em>[2]<\/em> is indefensible. Dr. Kupfer pushed for inclusion of dimensional&nbsp; measures as part of the main diagnostic system throughput the process of the revision. The inclusion in Section 3 was a wise decision by the trustees and a disappointment for Dr. Kupfer, but that&#8217;s an aside. The question of whether his unacknowledged Conflict of Interest had an impact on the product is important, but not the central point. Conclusion <em>[3]<\/em> is clearly unfounded, counter-intuitive, and deserves little comment. So that memo is little help to the Board of Trustees. The central issues are professional standards and trust, and the memo doesn&#8217;t address either. <\/div>\n<p><\/p>\n<div align=\"justify\">There&#8217;s no way for the Trustees to avoid this revelation. Silence would be the worst choice because it speaks complicity or indifference. Defensiveness or minimization are the second worse choices. Of course there&#8217;s little that can be done to change the past, but they can certainly take action on what has happened and make policy that directly addresses future occurrences [and oversight in general]. This statement in the Memo needs to be proved, <font color=\"#200020\">&quot;<em>The Board of Trustees and APA leadership take conflict-of-interest principles and guidelines very seriously.<\/em><\/font>&quot; It is no longer a given&#8230; <\/div>\n","protected":false},"excerpt":{"rendered":"<p>Well, I was on the road for the weekend and came back to find three posts about the Kupfer Affaire, each looking at a different piece of the puzzle: WINDY CITY BLUES: Bernard Carroll @ Healthcare Renewal Psychiatrists From Another Dimension [Part 2]: Neuroskeptic @ Neuroskeptic Conflict of Interest, DSM-5, and the APA: Sandra Steingard [&hellip;]<\/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-43427","post","type-post","status-publish","format-standard","hentry","category-politics"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/43427","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=43427"}],"version-history":[{"count":6,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/43427\/revisions"}],"predecessor-version":[{"id":43433,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/43427\/revisions\/43433"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=43427"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=43427"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=43427"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}