Whew, Rubin is so out of touch. I wish he had come to one of the FDA hearings on antidepressants and heard the scores of victims (and survivors) telling their stories if he doesn't think one patient has ever been hurt. You mean seriously, Bob, no one ever got hurt by all that suppression of material about suicidality, agitation, worsened depression etc. etc. and the failure to investigate it or conduct further studies, evan as promised by the drug companies in 1991? Yes, that's right, they promised to conduct new clinical trials about suicidality and do you think they ever did? No, sirree, they just continued their suppression tactics right up until the advent of the internet when it got darn hard to keep it all secret after that. The AJC should be ashamed for publishing something like this, former Reagan official or not.

I saw this the other day. It's really hard to comprehend what sort of delusional reality people like him live in...

and we're supposed to be the sick ones!

Accountability, is so hard for some people. Criminals for example.

"What sort of stuns me about Rubin's piece is that the AJC published it at all."

Are you kidding? Have you seen the sort of crackpot bullshit that even the NY Times prints? They love this whole "both sides" doctrine, even when one side is a joke (as with people thinking the Grand Canyon was created as is by an act of God, etc.) This sells papers, and that it deflates the value of the papers in question is of secondary importance in a foundering industry.

On to the topic...as a general observation, what appear to be conflicts of interest don't produce what might be expected in terms of the research itself. For example, I know of a number of weight-loss studies done at the Harvard School of Public Health that were funded largely by diet interests and yielded findings that were anything but what Weight Watchers et al. would have hoped for. In the end, the results have to pass muster in the form of peer review, and one hopes that the scientific process prevails in the end.

Researchers are going to take money wherever they can get it. Grant writing is very stressful. NIH money is de rigueur, and if one looks at this money as always opposing industry money, there will always be conflicts of interest.

I guess my point is that while the potential for harm certainly exists in situations in which researchers take money from all comers, I don't know if the harm can, in MOST cases, necessarily be laid at the feet of this patent conflict of interest. That is, bad outcomes are probably not tied more strongly to research done under these auspices than they are to anything else.

Now, the case that you point out involving the little girl is a different story, and gives the lie to Rubin's blathering. No responsible person would ever say "[T]here is no evidence at all that any of the alleged interactions between doctors and pharmaceutical companies has had any harmful effect on any patient" (a mealymouthed and obviously politicized declaration on its face), because responsible people understand that such cases are bound to exist even if they are rare (as one hopes) and unknown to the blatherer.

I think the problem is always going to lie more on the results-interpretation, e.g., "advertising" (spin) side than on the funding side. There's so much pseudoscience out there (and the lay press, in the great American tradition, both loves to talk it up and fails to understand it at the same time) that it becomes very easy to interpret a clinical trial involving all manner of subtleties and wild cards--and psych-med trials always fit the profile--in whatever manner is convenient. And researchers are going to talk up their findings beyond reason no matter who paid for them, because they have egos and reputations to defend.

One final note. You wrote that Rubin may have gotten his information "from out of his ass." That's really not fair. If anything, it would have had to have come from within his ass.

I've said too much as it is, but a couple more things.

One, a re-reading of Rubin's piece shows how little he knows about medicine, or perhaps about logic. Actually, I think he's just a liar. I won't point out all of the incoherencies in his "if this...then that" suppositions.

And two--the headline--ouch! Can't the AJC even use apostrophes correctly anymore?

Dear Philip:

It's actually fairly easy to dismiss one way out there for profit at all cost whacko. But this theme gets played out over and over again throughout Corporate American, and Our Government. It’s called; Capitalism without conscience, ethics, moral insight and responsibility, or just plainly/simply not treating your fellow man with basic respect and humanity.

Ruben is a paid for hire joke. I'm sure he'd make a great foreman in some foreign child labor sweat shop also.

I wouldn't be surprised if he wasn't on Senator Grassley's investigation/corruption list in the coming months. Maybe he is one of Big Pharmaceuticals bag men.

Yours Truly,
Stan

Interesting reasoning on Rubin's part, "I have consulted for Pfizer but since as an economist I cannot write prescriptions and I have not been paid for this article, no one can accuse me of conflicts of interest." Furthermore, post CATIE and CUTLASS and the meta-analysis of anti-depressant studies for four new generation anti-depressants published in PLoS his reliance on this broad assertion is questionable, "Frank Lichtenberg, a health economist at Columbia University, has shown that newer drugs tend to reduce total health care costs and improve patient outcomes better than older drugs."

It is not surprising that Rubin did not disclose his role as one of the co-authors of the Amicus Brief in Wyeth V. Diana Levine. Issues involving independence in both fact and appearance don't appear to be his forte.

Very good point Joe. The whole reason this op-ed piece was written is because the Wyeth v. Levine case is being heard next Monday before the Supreme Court. The fact that a slime ball like Rubin supports the pre-emption side with arguments like this ought to be a huge red flag as to just how important this case really is. Today people within the FDA actually came out in support of the plaintiff's side. Lawsuits for harm caused by inadequate warnings will dry up if Wyeth is successful or at least until the Democrats can reverse it with legislation down the road which I think is a possibility.

Dear readers:

Oh the sad irony this all truly is! If anyone is paying attention; Senator Grassley a Rep. is the only one calling out these greed mongers, liars, and criminals; and yet we still get these comments! "

Quoting Sara: "Today people within the FDA actually came out in support of the plaintiff's side. Lawsuits for harm caused by inadequate warnings will dry up if Wyeth is successful or at least until the Democrats can reverse it with legislation down the road which I think is a possibility"

They {the Dems} have control of both houses now, and what are they doing? Nothing but sitting on their hands accepting donation checks from Big Pharmaceutical. This isn't a political party issue as some keep saying over and over again; it's an ethical, moral, leadership, and character issue in our government for all parties.

Yours Truly,
Stan

Fail as usual Stan. Civil lawsuits fall on the Democratic side.

The AJC almost certainly makes enough of its income from pharma advertising for it to have to heed the opinions of the local outposts of the medical-pharma complex.

Dear flawedplan:

It's no secret where you’re coming from; we just have to go to your site to read the continuous liberal hate spew you defend like it's the Holy Grail. But I happen to be talking about the real world, not the socialist flight of the imagination you’re living in your dream world with.
I don't think people know that you refuse to post any opposing viewpoints on your blog. So just continue to surround yourself with people that think exactly like you do, and the world will appear safe and hopeful on your globe. I would call that pretty close minded and ego centric.

I know some of your history through the blog grape vine, and I just don’t care that you have schizophrenia as an excuse for your ignorance; that doesn’t give you a free pass in this comment section in my book.

Why don’t you ask Obama about the millions he has taken in from Big Pharmaceutical? Or his plan for Pharmaceutical tort reform so little individuals like us can’t go after Pharmaceutical companies in court? Please tell me who else besides Senator Grassley is doing anything about corruption throughout the mental health sector?
I figured you would be a little tight lipped on that one; it’s ok, you can just make something up like you do on your blog and attack him also.

By the way flawedplan; Philip chose not to post other comments I have made about your one sided fantasyland political agenda (whether they ended up in the junk bin or were edited out, who really knows).
But then you can’t place rose colored glasses on a blind person, and then expect them to see, now can we.
I’ll be waiting and looking forward to your next over the top leftist liberal Femi Nazi socialist rant. It’s all about being fair and balanced right? {Laughing}
People in the so called know have also told me to just ignore you and your comments, because you can be vindictive and come after them! "Quite Frankly Scarlett, I don't give a damn"

Yours truly,
Stan

Generally Civil Lawsuits are filed by Republican leaning folks if you mean litigation where the person or entity filing has the money to pay legal fees and call the shots. Personal Injury suits, a type of civil litigation that includes medical malpractice, as well as class action lawsuits such as the Zyprexa class actions, are generally filed by Democrat leaning folks with the Republicans leaning toward tort reform which misses the point and screws the little guy, not that the little guy doesn't get screwed in class actions. Just google zyprexa settlements and you'll find tons of folks who haven't gotten their settlement checks.

It is ironic that the only vestige of the idea that people with psych labels might be human and entitled to protection under the US Constitution as humans (i.e. persons and/or men) rests in the Republican Party. Sadly the ACLU's position as well as Kucinich's fall in line with TAC, i.e. that people labeled as mentally have a civil right to have their civil rights violated.

Still, at the national level McCain is worse than Obama, as is Palin, as the national Repub politicians generally want civil commitment determined not by any "psychiatric evaluation" or judicial process but instead on the word of the parent, spouse or child - guardian. As boomers live longer and the economy gets worse, look for lots more "left leaning" elder care lawyers to jump on the bandwagon of having folks in their 80's declared mentally incompetent solely due to age for the end result of their financially strapped progeny wresting their money and assets away. Hopefully this is when we'll see a real reform - civil commitment and mental incompetency jury trails with real criminal penalties for false accusations.

We must step out of the partisan crap and look at what's good on each side, and, as many complain here, realize everything is not black and white and that there are more than two diametrically opposed opinions, however, the misrepresentation here that an example of a grey opinion is "sometimes people really are born violent and must be locked up their entire lives even if they never commit a crime" chaps my ass.

Rubin should ask those who participate in clinical trials if they would be willing to risk their lives if they knew this kind of crap is going on. Informed consent?

There is a reasonable expectation that if one participates in a clinical trial that it will be conducted in an ethical manner. What part of that does Rubin not comprehend?

Google "Uncle Sam's Malpractice" --
Rubin is also AGAINST the over-prescriptin of antibiotics, but is FOR the facilitation of development and approval of NEW (patentable) antibiotics.

Here are a couple of translations from Rubins' lawyerese op ed:

Rubin writes: He (Grassley) is continuing his campaign to restrict the amount of information about drugs available to doctors and patients.

Translation: Grassley doesn't think Nemeroff should be able to lie about the safely, and effectiveness of drugs in the guise of advertising.

Rubin writes: But there is no evidence at all that any of the alleged interactions between doctors and pharmaceutical companies has had any harmful effect on any patient.

Translation: Grassley has proof but Nemeroff, Emory, et al have lawyers that will prevent that proof from being admitted into a court of law or Senate subcommittee hearing, or whatever as evidence.

If the interactions had no harmful effect, he would have simply written "the interactions between doctors and pharmaceutical companies have not had any harmful effect on any patient." Note how he's even warning that he can keep the fact that doctors and pharmaceutical companies interacted in any way out of court and congress.

Rubin writes: Frank Lichtenberg, a health economist at Columbia University, has shown that newer drugs tend to reduce total health care costs and improve patient outcomes better than older drugs.

Translation: No doctor would say such a thing, not even Biderman or Torrey or Nemeroff, and this "health economist" didn't say anything would happen. Tend to: it's not completely impossible.

Rubin writes: The policies at issue here may reduce the availability and use of newer drugs because they will make it more difficult for academic physicians to undertake research on drugs and for physicians to learn about newer drugs that are developed.

Translation: Informed consent will make it harder for "academic" physicians to get research subjects, and a no bribe policy harder to find doctors to write the pr that is falsely sold as "learning" to physicians.

As one of those socialists that Stan refers to:), the issue of mental health wrongs isn't limited to one party.

In Virginia, the legislature unanimously passed the repressive mental health commitment laws in response to the Cho killings.

Correction to my comment: I left out a word:
Should be:

Google "Uncle Sam's Malpractice" --
Rubin is also NOT AGAINST the over-prescriptin of antibiotics, but is FOR the facilitation of development and approval of NEW (patentable) antibiotics.