This searing indictment, David Healy's most comprehensive and forceful argument against the pharmaceuticalization of medicine, tackles problems in health care that are leading to a growing number of deaths and disabilities. Healy, who was the first to draw attention to the now well-publicized suicide-inducing side effects of many anti-depressants, attributes our current state of affairs to three key factors: product rather than process patents on drugs, the classification of certain drugs as prescription-only, and industry-controlled drug trials. These developments have tied the survival of pharmaceutical companies to the development of blockbuster drugs, so that they must overhype benefits and deny real hazards. Healy further explains why these trends have basically ended the possibility of universal health care in the United States and elsewhere around the world. He concludes with suggestions for reform of our currently corrupted evidence-based medical system.


My father smoked all his adult life. He had a number of physical disorders, including ulcerative colitis, ironically one of the few conditions for which smoking is beneficial. In 1974, when he was in hospital for colitis, a routine chest X-ray revealed a shadow on his lung. Dr. Neligan, the surgeon called in, advised my mother on the importance of an operation.

Our general practitioner at the time was Dr. Lapin, whom I remembered from childhood as being tall, silver-haired, and distinguished, often wearing a bow tie. He had spent time, I was told, as a doctor in the British army, a very unusual occurrence then in Ireland. To a child, Dr. Lapin had appeared effortlessly wise and seemed to transcend the boundaries of religion, politics, and division I saw elsewhere.

When my mother developed problems in the early 1960s after giving birth, Dr. Lapin had suggested she come to see him once a week, but at the time she felt the arrangement was too open-ended, and she could not afford it. She was seen instead by another doctor, diagnosed with an ulcer and ultimately received the standard operation of the day, which involved cutting the vagus nerve and partial removal of stomach. This left her with bowel problems for the rest of her life, and regrets for not having taken Dr. Lapin’s offer of treatment for what she later regarded as postnatal depression.

When my mother consulted him about the wisdom of an operation for my father, Dr. Lapin was slow to comment. But when pressed, he pointed out that my father had a number of illnesses, any of which could . . .

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