Cognitive Dissonance on Pharma Ghostwriting

(MoneyWatch)  Yesterday's news on Merck's prolific use of ghostwriters to produce medical-research articles yielded lots of coverage, much of it highly critical. Still, there was a fair bit of cognitive dissonance in the media, which couldn't seem to decide if Merck's actions amounted to venial or mortal sins.

Nowhere was the gulf wider than between two national, New York-based papers, one of which is effectively at war with the other. From the NYT:


And from the WSJ:


Hmm. Was Merck corrupting medical science or merely possessed of questionable "publishing ethics"? Gosh, that is a tough call.

Meanwhile, the WSJ Health Blog today also flagged the fact that two "heavy hitting" Harvard doctors blasted a Massachusetts bill that would ban drug-industry gifts to physicians. Should the ban pass, it would be the first of its kind in the U.S. To its credit, the WSJ noted that one of the docs, Massachusetts General Hospital chief of medicine Dennis Ausiello, holds a seat on Pfizer's board, so he's not exactly disinterested. What the blog doesn't mention is that the other, blood-cancer specialist Thomas Stossel, is also a longtime critic of any attempt to regulate doctors' ties to industry. (For a sample, see his 2005 Forbes essay, titled "Free the Scientists!")

To make their case, which appeared in the Boston Herald, these worthy academics were reduced to thoroughly misrepresenting the Massachusetts bill. To Stossel and Ausiello, the "real intent" of the bill is to "curtail strictly or even eliminate all contacts between physicians and private industry." Of course, the bill says no such thing, and in fact its relevant passages are brief enough to quote in their entirety:

Section 2. No pharmaceutical manufacturer agent shall knowingly and willfully offer or give to a physician, a member of a physician's immediate family, a physician's employee or agent, a health care facility or employee or agent of a health care facility, a gift of any value and no physician, a member of a physician's immediate family, a physician's employee or agent, a health care facility or employee or agent of a health care facility shall knowingly and willfully solicit or accept from any pharmaceutical manufacturer agent, a gift of any value.

Section 3. A person who violates this chapter shall be punished by a fine of not more than $5,000 or by imprisonment for not more than 2 years, or both.

Ausiello and Stossel argue that banning gift-giving -- which, by the way, skews doctor prescribing behavior as well as potentially corrupting medical care and research -- would eliminate the flow of information between drugmakers and physicians. But no one is saying communication should stop, just that deep-pocketed companies shouldn't get to grease the skids with unrestricted "educational" grants, free meals, sports tickets, trips and the like.

Should the gift ban become law, drug reps would remain free to make a case for their products on the merits. Whether docs would still want to listen to them is the truly interesting question.