Dr. Lowe: We would be fortunate indeed if consensus and expert opinion could be trusted today, if it ever could have been. The National Institutes of Health (NIH) often fall back on consensus and expert opinion. Here is an example directly from the NIH regarding black cohosh, which many women use for menopausal symptoms:

You’re correct that by consensus, the NIH means "general agreement." By expert opinion, it means, verbatim: "In medicine, the judgment of a respected healthcare professional, based on clinical experience or reports of expert committees. Expert opinions are important when results of controlled clinical trials and other scientific studies are not available to provide health care recommendations."

What good is an expert’s opinion, or the consensus of a group of experts, when some or all of them are taking financial and other incentives from corporations that stand to profit from their opinions and consensus decisions? Would you trust the ruling of a judge in your case against someone else when that judge takes financial and other perks from the person you’re suing? Maybe you would, but I certainly would not. Nor should we, in my view, trust the opinions of experts when we know many of them are on the take from corporations.

Of course, the magnitude of the problem of corruption in medical research is hard to measure. We don't have an accurate accounting because the money given to some experts who are on the take is effectively hidden from view.

Consider this possibility: We know that Abbott Laboratories often funds in various ways studies by endocrinologists. The endocrinology researchers—almost without exception—reach study conclusions that favor the financial profits of Abbott. But we often read that some of these studies were funded by various departments at medical schools. Can we find out whether Abbott gave the money to the departments, which then funneled it to the researchers, essentially allowing Abbott to purchase a study conclusion that ups its profits for T4-replacement products? Most readers of study reports probably just accept that the studies were funded by the departments, never considering that Abbott skulkingly purchased its preferred study outcome.

I trust the opinion of absolutely no medical expert, and certainly not the consensus decisions of practice guideline committees. I especially don’t trust the opinions of experts who are high-profile opinion makers, as they are often sought out and bought off by corporations that profit from their expert opinions.

I guess you and I will have to respectfully disagree on this issue. I have to say that I believe your point of view helps shield the corruption all around us. By shielding it, I believe your view is likely to mislead others into trusting a system of corruption that clearly is designed to enhance corporate and personal profits at the cost of the health and well-being of the public.

References

1. http://ods.od.nih.gov/factsheets/BlackCohosh.asp#h11

2. John Abramson, MD: Overdo$ed America. New York, Harpers Publishers, Inc, 2004. [Clinical Faculty, Harvard Medical School]

3. Jerry Avorn, M.D.: Powerful Medicines. New York, Random House, 2004. [Associate Professor, Harvard Medical School]

4. Marcia Angell, M.D.: The Truth About The Drug Companies. New York, Random House, 2004. [Former Editor-in-Chief, New England Journal of Medicine, now at Harvard Medical School]

5. Jerome P. Kassirer, M.D.: On The Take. New York. Oxford University Press, Inc, 2005. [Former Editor-in-Chief, New England Journal of Medicine, Tufts University School of Medicine, Member: Institute of Medicine]

6. Merrill Goozner: The $800 Million Pill. Berkley, University of California Press, 2004. [Former Chief Economics Correspondent, Chicago Tribune]

7. Donald L. Barlett & James B. Steele: Critical Condition. New York, Random House, 2004. [America’s most acclaimed investigative journalism team]