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  July 8, 2012                  
DSM-5: Psychiatry as pharmacological fraudulence


A large number of psychiatrists are dishonest. Because I see them giving people drugs that they know are brain damaging therapeutics; that they know do not have positive long term outcomes; that they know will not cure anything. They just take a list of symptoms and then they call it 'a mental illness' or 'a mental disorder', and these are voted upon, by psychiatrists. We can define people as mentally ill, and therefore we can sell more drugs for the pharmaceutical industry. This is an extremely lucrative alliance because there is no scientific data that is required for a psychiatrist to diagnose a mental illness. There is no blood test; there is no urine test; there is no PET scan. There is no medical evidence required. And so therefore that broadens the potential patient population considerably.
-- Gwen Olsen, former pharma sales rep

This is the second of two Nederlogs for today, that follows today's earlier Crisis: Kohlberg on moral stages, that will help to explain the quotations that follow, that I owe to the site of 1 boring old man (who is in fact a - mostly - retired US psychiatrist with sensible ideas and values).

What follows consists mostly of two quotes with my comment, both from "on the road again" on the site of
1 boring old man, and both about the relations between US psychiatry and US pharmacological corporations.

To start with, a quote that's quoted from "Pharma's Top 11 Marketing Settlements" by Tracy Staton and Eric Palmer:

The Justice Department is growing more and more impatient. For more than a decade, its lawyers and investigators have been slapping drugmakers around for their marketing misdoings. They’ve insisted on bigger and bigger penalties, especially during the last several years, with penalties and payments commonly topping $500 million. And yet the whistleblower lawsuits and off-label settlements keep coming. Consider what’s happened since 2004, when Pfizer ($PFE) inked a $430 million settlement with the feds for its misbegotten promotions of the seizure drug Neurontin. In 2005, Serono agreed to a $704 million deal for conspiring to market its AIDS-wasting drug Serostim off-label. Two years later, Purdue Pharma and Bristol-Myers Squibb ($BMY) wrapped up their investigations for a combined $1.15 billion. By 2009, the penalties had skyrocketed: Pfizer and Eli Lilly’s ($LLY) settlements together amounted to $3.7 billion…

Actually, perhaps because I am Dutch, I have seen no real evidence that - as cited

The Justice Department is growing more and more impatient. For more than a decade, its lawyers and investigators have been slapping drugmakers around for their marketing misdoings.

I mean: These are enormous fines, and I do not doubt that they have been imposed for reasons I very probably would consider sound were I to know them, but it is very easy to see that (1) where the profits are far larger than the fines - as is the case - the net profit minus the fines still is a positive amount of dollars (and in fact very large), so that (2) as long as the Justice Department does not go after executives of corrupt but very profitable firms, and takes away their earnings and imprisons them, very little will change, since the motive of financial greed, without personal risks, still is potent and operative.

Then again, it is nice something is done - but as I suggested: If those who are personally responsible for fraudulent sales are not made legally and personally accountable for selling drugs on the basis of false and fraudulent reports and public relations schemes of selling them, the fraudulence very probably will go on, and the fines that the Justice Department imposes will be only a foreseeable item that leaves medical fraudulence still a very profitable game without real personal risks or punishments.

Indeed, as 1 boring old man writes, in reaction to the above quote + more I didn't quote:

Traditionally, medicine has been self regulated. Yet with the rarest of exceptions, physicians who have participated in these corrupt marketing schemes have been left alone. The group of highly placed academic psychiatrists identified by Senator Grassley as having received pharmaceutical payments and not reported them to their Universities have essentially walked free. The upper echelons of both academic and organized psychiatry remain suffused with psychiatrists with heavy industry connections, many with grossly checkered pasts – any number of them central to the DOJ actions listed by FiercePharma above – yet un·penalized. (...)  And so how is authoring a fraudulent paper like Paxil Study 329 any different that prescribing Narcotics to drug addicts? For the latter, you lose your medical license. In both instances, you’re using your professional status for personal gain and potentially "doing harm."

Quite so: In the US one can be locked up for many years because one smoked marihuana, that is neither dangerous nor addictive, while medical doctors or psychiatrists who make enormous amounts of money by prescribing what are in fact quite dangerous drugs, that have no good evidence they work, or for which there is intentionally repressed evidence they are dangerous (as in the Paxil case), can continue to enrich themselves, apparently on nothing better than the authority that comes with a medical degree, as if that were a guarantee of honesty and decency - while in fact it is often a ticket to corrupt self enrichment, at the cost of patients, with the protection and help of pharmaceutical companies, as explained by the former pharmaceutical sales representative Gwen Olsen.

So that is why I used my title: While there are undoubtedly morally decent psychiatrists, the main practical - social, political, financial - effect of the DSMs since DSM-III has been to justify the fraudulent but very remunerative practice of prescribing dangerous, often useless, drugs to ill people, on the basis of bullshit "diagnoses", in the name of "evidence based medicine", encoded in a pseudoscientific
Diagnostic and Statistical Manual of Mental Disorders (aka DSM).

And indeed: As long as medical doctors and pharmacological CEOs and executives are not made personally responsible and accountable for the great harm they have done, and can  effectively buy off legal prosecution with a percentage of the profits they made by lies, by fraudulence, by phony research, or by
pseudoscience, the probability is that it will continue - for reasons you can find elucidated in my Crisis: Kohlberg on moral stages: It is likely that at most 10% of psychiatrists have an individual conscience - the other 90% or so are the kins, colleagues or equals of Mr Dick Fuld, and quite possibly cannot imagine what could be wrong with growing rich by what is in fact medical fraudulence.

A final point, in case you check the last link:

Indeed Mr Fuld seems a psychopath to me, and he earned even more than the most corrupt psychiatrist, namely for destroying Lehman Brothers, for which reason it might be suggested that, perhaps, the many psychiatrists who grow smilingly rich on the leash of the pharmacological corporations, by doing their biddings, and thus receiving their perks, payments, paid holidays and what not, cannot as bad as Mr Fuld, for example because they did not destroy a big bank.

Well... check out the link, that has rather a lot of information about "snakes in suits", aka corporate psychopaths: Perhaps some of the US bankmanagers are worse, or at least made more money, than corrupt psychiatrists - but then a bankmanager did not swear a medical oath ("primum non nocere") and did not defraud or poison ill people or children with pseudoscientific "medical" bullshit, or with the prescription of dangerous drugs  because this makes the psychiatrists profit financially. 

And how does that differ from (I quote Wikipedia):

Psychopathy (..) is a personality disorder characterized primarily by a lack of empathy and remorse, shallow emotions, egocentricity, and deception. Psychopaths are highly prone to antisocial behavior and abusive treatment of others, and are disproportionately responsible for violent crime when in a violent emotional state or situation.

OK... the medical gentlemen (and women too) are not as "responsible for violent crime" (prescribing "anti-depressants" that predispose to suicide, perhaps?) as those who con others without benefit of a medical degree, but then, having a medical degree, they do not need to. All they need, having the degree, is  the weak spine  and the lack of individual morals  Kohlberg wrote about, in order to profit from the misery they cause knowingly to others, for their own benefit.

(*) That is: It really does make a difference, ethically speaking, whether the evil that you do knowingly, because it benefits you personally, is done as a medical doctor, or in the name of medical science:

As a medical doctor, your first duty is to serve the interests of your patients, not yourself (if you can't make money that way, you need another profession); as a medical doctor you have no right to abuse your patients' trust that you are behaving like a moral doctor should; nor are you, as a medical doctor, entitled to abuse your medical authority, namely to prescribe or recommend drugs you can or should know are not safe or are not effective.

And apart from all that, there is something morally wrong with any medical practice where the medical doctor practising has any personally known financial interest in the pills or therapies he prescribes: That is a standing invitation to corruption that should be forbidden. The money a medical doctor makes, as a medical man, should come from his patients or from their insurances: it should not come from forprofit corporations that make and sell drugs. For such a set up spells "conflict of interests".

Corrections, if any are necessary, have to be made later.


As to ME/CFS (that I prefer to call ME):

1.  Anthony Komaroff Ten discoveries about the biology of CFS (pdf)
3.  Hillary Johnson The Why
4.  Consensus of M.D.s Canadian Consensus Government Report on ME (pdf)
5.  Eleanor Stein Clinical Guidelines for Psychiatrists (pdf)
6.  William Clifford The Ethics of Belief
7.  Paul Lutus

Is Psychology a Science?

8.  Malcolm Hooper Magical Medicine (pdf)
 Maarten Maartensz
ME in Amsterdam - surviving in Amsterdam with ME (Dutch)
 Maarten Maartensz Myalgic Encephalomyelitis

Short descriptions of the above:                

1. Ten reasons why ME/CFS is a real disease by a professor of medicine of Harvard.
2. Long essay by a professor emeritus of medical chemistry about maltreatment of ME.
3. Explanation of what's happening around ME by an investigative journalist.
4. Report to Canadian Government on ME, by many medical experts.
5. Advice to psychiatrist by a psychiatrist who understa, but nds ME is an organic disease
6. English mathematical genius on one's responsibilities in the matter of one's beliefs:

7. A  space- and computer-scientist takes a look at psychology.
8. Malcolm Hooper puts things together status 2010.
9. I tell my story of surviving (so far) in Amsterdam/ with ME.
10. The directory on my site about ME.

See also: ME -Documentation and ME - Resources
The last has many files, all on my site to keep them accessible.


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