Academic journal article Ethical Human Psychology and Psychiatry

Ethical and Moral Obligations Arising from Revelations of Pharmaceutical Company Dissembling

Academic journal article Ethical Human Psychology and Psychiatry

Ethical and Moral Obligations Arising from Revelations of Pharmaceutical Company Dissembling

Article excerpt

The past few years have seen an accelerating series of revelations that the sources of information prescribers of psychotropic medication and other mental health workers have relied on has been corrupted by pervasive pharmaceutical company dissembling. This article discusses the ethical obligations of psychiatrists, psychologists, and social workers that may arise from these revelations. The conclusion is that psychiatrists, psychologists, and social workers have not only the ethical obligation to change the information they are providing clients/patients and other decision makers but also the ethical obligation to insist that this dissembling no longer be tolerated and to hold their leadership accountable.

Keywords: informed consent; psychotropic medication; ethics; medical ethics

Ushered in with the introduction of Thorazine (chlorpromazine) in the mid-1950s, mental health treatment has become increasingly dominated by drug treatment to the point where today it is virtually impossible for anyone receiving services from the public mental health system in the United States to do so without taking psychotropic drugs. Often, only medication is offered, and it is rarely, if ever, possible to find public programs that provide other services, such as housing and case management and even psychotherapy, that do not condition such services on being "medication compliant." This article discusses whether recent revelations of pharmaceutical company dissembling 1 about the efficacy of and harm caused by the newer psychotropic drugs give rise to professional ethics obligations among psychiatrists, psychologists, and social workers.

Heretofore, it was reasonable for such practitioners to rely on medical journal articles, continuing medical education (CME) offerings, and the seemingly authoritative "standard of care" in making prescribing decisions. However, the recent revelations that none of these are reliable - that all of them have been corrupted by pharmaceutical company dissembling - raise ethical obligations among mental health practitioners. This article thus discusses from whence such obligations may arise, and what those obligations might be.

Ethical and moral obligations are two separate concepts. Ethical is defined as "being in accordance with the accepted principles of right and wrong that govern the conduct of a profession," while moral is defined as "conforming to standards of what is right or just" or "of or concerned with the judgment of the goodness or badness of human action and character" ( American Heritage Dictionary ). In other words, morality involves good and bad, while ethics involves professional standards. Professional ethical standards at least theoretically derive from concepts of morality, but are not congruent with morality.

PHARMACEUTICAL COMPANY DISSEMBLING

Medical journals, even the most prestigious, have been manipulated by pharmaceutical companies into publishing false and misleading articles (Angell, 2000; Boseley, 2001; Smith, 2005) and are acceding to pharmaceutical company demands to suppress negative information about their drugs (Healy, 2008). Recently, U.S. Senator Charles Grassley exposed psychiatric "key opinion leaders" for secretly and illegally taking large sums of money from the drug companies and promoting their psychiatric drugs (Carey & Harris, 2008; Harris, 2008b, 2008c). Many other psychiatric key opinion leaders have also been exposed as secretly - and often illegally - taking drug company money while purporting to publish unbiased research:

1. Joseph Biederman of Harvard Medical School, who was pivotal in promoting the diagnosis of bipolar disorder in children and youth resulting in a 40-fold increase and the massive increase of prescribing "mood stabilizers" and neuroleptics to children and youth (Harris. 2008b) and who promised Janssen he would provide data supporting the use of Risperdal in children if they funded his research center (Harris, 2009)

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