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.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.