Monday, December 05, 2005

Freedom of the (clinical) press?

Amplifying Roy Poses' post on the Cleveland Clinic and Dr. Topol's writings:

Company officials even complained about Topol's research to a member of the Cleveland Clinic's board, the cardiologist said in his deposition ... Former Merck Chairman and Chief Executive Officer Raymond Gilmartin called Malachi Mixon, head of the hospital's board, in October 2004 to question why Topol was targeting Vioxx, the cardiologist testified in his deposition. Gilmartin questioned, ``What has Merck ever done to the Cleveland Clinic to warrant this?''
My response is that Merck never 'did anything' to Cleveland Clinic to merit 'this.' They are a pharmaceutical R&D organization subject to critique by experts in the field as part of the normal flow of biomedical science. 'This' [insinuating a supposedly ill-intentioned attack], I would remind, was an expression of scientific concern and doubt based on a clinician expert's interpretation of data, in the interests of patients and patient care.

Dr. Poses raises the issue of such an accusation reflecting a misunderstanding of the scientific process, especially in the field of patient care, by someone with no experience in the latter. While I agree with that assessment as per my many writings on clinical IT mismanagement by healthcare-naive IT leadership, I think a much more fundamental issues needs to be addressed.

A core value in the United States of America is freedom of the press. The answer to speech or writings which a person or corporation considers objectionable is more writing, not suppression of others' speech or writings.

I think it is up to a powerful CEO who calls the Chair of the Board of an organization where a staff person has written something the CEO finds objectionable to prove that the purpose of the call was not to do damage to the author, up to and including causing that person a loss of livelihood. Calling a Chair of the Board, as opposed to the author himself or the author's manager, certainly raises at the very least the appearance of bullying (a form of impropriety). The 'acid test' of a decision or an action, Merck employees are told, is whether it would look bad in the press.

I find these developments especially disappointing considering the stated corporate values:
Corporate conduct is inseparable from the conduct of individual employees in the performance of their work. Every Merck employee is responsible for adhering to business practices that are in accordance with the letter and spirit of the applicable laws and with ethical principles that reflect the highest standards of corporate and individual behavior ... Our ethical business practices motivate our people and help to inspire confidence and trust among doctors who prescribe our medicines, regulators who approve them, health officials who decide whether or not to pay for them, and legislators and policy makers who can influence the cost and timeliness of their discovery."(R.V. Gilmartin)
Calling Chairs of the Board to complain, rather than writing sound scientific rebuttals, does not "motivate and inspire confidence" in my mind.
This is especially relevant in the situation where the company had to withdraw the drug in question.
-- SS

No comments: