Institutional Corruption in the Cochrane Collaboration

Peter Gøtzsche, MD
19
2715

The Cochrane Collaboration is one of the most important charities in the world that aims to help people make informed decisions about healthcare interventions. A good decision may mean the difference between life and death, or, in psychiatry, the difference between being permanently disabled by drugs and living a normal life. It is therefore of utmost importance that evaluations of diagnostic methods and treatments are as impartial as possible, both when the original research is made and when it is summarised in systematic reviews like Cochrane reviews.

Science prospers when people have as much freedom as possible. Throughout my 25 years with Cochrane, I have fought to maintain our freedom and ideals, and to retain Cochrane’s structure as a bottom-up idealistic grassroots organization, free from commercial conflicts of interest.

Idealism tends to wither with time, however. A colleague wrote to me that, based on personal observations of more than 35 years, every single NGO, upon reaching a certain size, starts to operate in a manner diametrically opposed to its original charter.

The moral decline in Cochrane started in 2011 and accelerated when a new CEO, Mark Wilson, was employed in 2012, who does not seem to understand what science is about but focuses on “brand” and “business” instead of getting the science right and fostering free scientific debate. He favours scientific censorship and was unfortunately supported in this by a majority of the Cochrane Governing Board when I was expelled by the Board in September 2017 and later fired from my job as head of the Nordic Cochrane Centre in Copenhagen. Our access to documents in Denmark via the Freedom of Information Act revealed that the CEO had required my dismissal, although he had no mandate to make such a requirement.

Amidst all the turmoil after my expulsion, Bob Whitaker published an article where he outlined that a major reason for my expulsion was my criticisms of psychiatry and psychiatric drugs. He told of one instance where I wanted to find out more about the deaths in a long-term study of psychotic patients, and “the CEO of the collaboration, rather than finding that pursuit worthwhile, finds reason to think it might provide cause to expel the director from the collaboration.” Whitaker concluded: “You would think that all members of the Cochrane Collaboration would be red-faced knowing of this exchange.”

As a democratically elected board member, with the most votes of all 11 candidates although I was the only one who had criticized the Cochrane leadership, it was my duty to point out to the rest of the board the CEO’s and the co-chair’s mismanagement of the collaboration I had noted and documented.

However, this set odd “processes” in motion. A series of petty complaints leveled against me by Cochrane’s CEO, Mark Wilson, ended up escalating into a full-scale assault on me. Cochrane hired a law firm that carried out a so-called independent investigation, but the lawyer’s review was not independent at all. He knew that the CEO — and therefore also the board, which is controlled by the CEO although it should not be that way — had the intention to expel me. He therefore went to great pains to provide a fig leaf to his client, and completely distanced himself from what they planned to do. It is clear he wanted no part of any disciplinary action.

The lawyer fully exonerated me for the charges raised against me. This meant nothing, however. The co-chairs of the board were unscrupulous and conjured up a spurious excuse to expel me. The best they could come up with was to accuse me of “bad behavior,” which they did not define, not even when asked. Without justification, my fate was sealed and I was booted out of Cochrane. A further 4 of the 13 board members resigned in protest.

Cochrane went into damage control. It spent the next few weeks justifying its actions, issuing mendacious and defamatory statements against me during carefully staged public events. It set off a chain reaction of protests by scientists and members of the public. More than 10,000 people signed a petition launched by one of the resigned board members to the Minister of Health that I should not be fired, but to no avail.

Cochrane reacted the way any business with a dishonest leadership would react. It hid behind confidentiality clauses and continued to defame me, misleading millions of people, including its own members, about what really happened that day in Edinburgh.

I have written a book, Death of a whistleblower and Cochrane’s moral collapse, that documents the truth, backed by leaked board room recordings, private emails and testimony from concerned citizens.

I am widely known for my science and integrity, perhaps even the most widely known person in the Cochrane Collaboration, and no one had ever been expelled since it started in 1993. My story is therefore much bigger than me. It is not just about the personal costs of speaking truth to power, defending scientific freedom, which is constantly under attack in a healthcare system dominated by the drug industry and other economic interests, and which is full of false beliefs, not least in psychiatry.

This is a story about institutional corruption and one of the worst show trials in academia that you can imagine. A wrong leader can quickly destroy what thousands (in science) or millions (in politics) of people have built up patiently over many years. These stories should therefore be told.

I have put it all behind me and will launch an Institute for Scientific Freedom on 9 March in Copenhagen, which has these visions:

  • All science should strive to be free from financial conflicts of interest.
  • All science should be published as soon as possible and made freely accessible.
  • All scientific data, including study protocols, should be freely accessible, allowing others to do their own analyses.

There is huge interest in this initiative, which is a good sign. The Institute will contribute to developing a better healthcare where more people will benefit and fewer will be harmed by the interventions they receive. We aim to make a substantial contribution to credible and trustworthy medical evidence that our society values and needs, and we stand for pluralistic, open scientific debate, open access to data, and open publishing.

19 COMMENTS

  1. Peter, your integrity and courage will last long after the Cochrane Collaboration is discredited. Your work on psychiatric studies is particularly enlightening. As Michel Foucault said ” “The medical authority of the psychiatric profession functions as power well before it functions as knowledge.”
    Good luck with the new institute.

  2. Peter,

    I know you rarely, if ever, respond to the comments section, but I wish that you would make a place in your new institute for those of us ‘in the trenches’ who are laymen and not scientist by degree but scientists by necessity. I’ve had to figure out how to help my wife heal from d.i.d. using attachment concepts and anything else that I could. I took a pragmatic approaching, using what worked, discarding what didn’t, always relying on the feedback that she gave as we walked the journey together. She and I have learned so many things; things that I believe have wider application, but it’s hard to get a hearing when western culture only seems to care how many letters one can put behind his/her name. I learned how to take her thru all the ‘extreme’ states without any medicines, as they are called on this website, but am still combating the residual dissociation…but we are getting there…

    There are so many things that occur 24/7 ‘in the trenches’ that you experts simply will never experience in the safety and confines of the office: we, the SO’s, family members and even involved friends have so much to offer, if only someone would take us seriously.
    Yours,
    Sam

  3. I have great respect for your work and integrity, Peter, and am so sorry for what happened to you at Cochrane Collaboration which you cofounded. I am very pleased that you will have another place to do your work, “Institute for Scientific Freedom”. Many will look forward to the new research you will do there. Your courage and perseverance are admirable.

  4. It doesn’t matter how smart a person is or how many letters come after his or her name. If you know they lie whenever convenient they are not to be trusted. An honest janitor with a high school diploma is more credible than these well-informed liars.

    Congratulations for standing up to them Dr. Gozche! Unlike most of us commenting here you stand to lose a lot for doing what is right. And nothing to gain in the material sense.

  5. Thank you for this important and powerful article. This CEO’s actions are unconscionable. This abuse of power is criminal–at the level of attempted mass murder. If you take a leadership position at an institution with the mission to promote informed health care decision-making through scientific research and then work in direct opposition of that very mission by systematically blocking psychiatric drug and healthcare research, which could lead to the saving of countless lives, you are deliberately NOT saving those lives. Is it the figurative definition of irony that the chosen attack on you was character assassination while this person is egregiously failing to uphold the organization’s fundamental purpose, their responsibilities as a CEO (and I would argue as a human being)? That it is you who is instead punished for doing the right thing?

    I am so sorry that you, your colleagues, and the organization you cofounded were subjected to this mismanagement and horrific attack. Thank you so much for your important work and tireless dedication to integrity. I really admire your courage for standing up to this injustice. If you felt that having another petition put out to call on this person to step down, or something to that effect would help, I would support you and sign it.

    Wishing you the best on your continued work with the Institute for Scientific Freedom and all future endeavors.

  6. I have so much respect and admiration for you and all the work you have done Dr. Gotzsche. Thank you for your integrity and courage to stand up and speak truth to power to protect people from such reprehensible corruption. Wishing you much success on your new endeavor the Institute for Scientific Freedom. The world needs more like you.

  7. I am interested in the framework of the new institute. Who will be on board and on the board? Where is the funding coming from?
    Will the voice of medical patients of all tropes and types be part of the configuration?
    What is the Mission Statement?
    What is the business plan?
    Have you considered how to make changes so that an action that was taken by the CEO cannot happen again?
    What are the short and long term goals and objectives?
    Will the concept of violations of human rights be of ongoing concern?
    Will there be any human rights advocacy?
    How will you get your message out and by what means?
    Thanks. I like the concept of failing up.

  8. Dear Dr Peter,

    I believe you might have previously stated that people can even recover from “Schizophrenia” without “medication” and with basic psychotherapy, or even non professional human support:- In my experience this is true.

    Having said this my Recovery followed 4 yrs on Strong Psychiatric drugs, and my main problem had been the drugs.

    I can describe the Psychothereuptic process that worked – it was similar to: 12 Step “Psychotherapy”; or Bhuddhist “Psychotherapy”; or CBT “Psychotherapy”.

    (.. and I was no longer disabled once I stopped taking “medication”)

  9. Dr. Gøtzsche – The institutionalizing of “group think” is alive and well everywhere, in every sector. This is all too common in the US and especially in NAMI Chapters in my state. Their funding sources were substantially increased through my states department of mental health. With this funding, they attained a level of “legitimacy.” It is similar to the post 9/11 catch phrase, “you must Unionize to Professionalize,” when it came to TSA security at airports.

    As with all subsidies, there are strings attached. They have taken the state’s party line of every question of inquiry. They stopped advocating therapeutic treatment (or even defining it). One can even find clearly conflicted members on several chapter’s board membership. There are good people still present, but their efforts have been marginalized by the change of direction.

    I have experienced many similar situations to yours in my line of Private Sector Regulatory Work. Too many times has my input been disregarded. This coincides directly with (mis)management and misguided interests. The costs of compliance were too expensive, until fined. It was only then, they complied at greatly increased costs. Even though I would identify key regulatory considerations in the early stages of projects, they ignored them. When it came time to assign blame, they placed it directly on my role, even though I had no legitimate authority in matters.

    From a very general point of view, I see in your situation, with the Board hiring the new CEO, they indicated they wanted a change of organizational direction. With your dismissal, they indicated that the original intent of your group is no longer valid as they no longer valued your “advise and consent” capacity. I see this more and more in Advocacy Groups . . . and the co-opting of the Groups’ missions.

  10. As a psychiatric drug survivor, Peter Gotzsche you’ll always be my Hero. You gave voice to those of us suffering needlessly and endlessly from ‘taking our medicine’ and then were silenced by our mental health-care workers & psychiatrists. It’s tragic what happened to you at the Cochrane Institute. But I’m watching in real-time that Truth is being outlawed, and gunned down by big pharmaceutical companies where here in America it is legal to murder for profit.

    I’m happy to hear of your new endeavors, you did just as we psychiatric do after our psychiatric medicine has destroyed our entire lives, we pick up whats left of the pieces and carry on. We love & support you and yes, the truth will prevail. Thank you from the bottom of my heart and soul.

  11. Dr. Gotzsche, as you move on I THANK YOU, THANK YOU, THANK YOU for fighting this good fight for people like me, drug induced bipolar. I dont know anything about the organizations you have been part of. I do, however, believe you are part of them to SAVE people. Please add me to your list of people your work has saved. And thanks to your work, they will never get my son by saying he inherited depression or bipolar from me. I am sorry that the horrible people are doing this to you. I would like to see them live the life of a psychiatric survivor and see if they change their evil ways. Again THANK YOU.

  12. Peter Gotzsche, you are so courageous and have so much integrity! It is appalling what Cochrane did to you, and it does show how corrupt and dishonest they have become. I am thrilled to hear about your new Institute and wish you all the best with it! When you have a moment, please email me about an idea I have for a very simple and potentially very powerful thing your Institute could do.