Wednesday, August 17, 2022

Comments by MIA5

Showing 8 of 8 comments.

  • More on Nemeroff from Marcia Angell’s “Drug Companies & Doctors: A Story of Corruption” (2009)
    http://www.nybooks.com/articles/2009/01/15/drug-companies-doctorsa-story-of-corruption/

    I quote her verbatim:

    “Perhaps the most egregious case exposed so far by Senator Grassley is that of Dr. Charles B. Nemeroff, chair of Emory University’s department of psychiatry and, along with Schatzberg, coeditor of the influential Textbook of Psychopharmacology.2 Nemeroff was the principal investigator on a five-year $3.95 million National Institute of Mental Health grant—of which $1.35 million went to Emory for overhead—to study several drugs made by GlaxoSmithKline. To comply with university and government regulations, he was required to disclose to Emory income from GlaxoSmithKline, and Emory was required to report amounts over $10,000 per year to the National Institutes of Health, along with assurances that the conflict of interest would be managed or eliminated.

    “But according to Senator Grassley, who compared Emory’s records with those from the company, Nemeroff failed to disclose approximately $500,000 he received from GlaxoSmithKline for giving dozens of talks promoting the company’s drugs. In June 2004, a year into the grant, Emory conducted its own investigation of Nemeroff’s activities, and found multiple violations of its policies. Nemeroff responded by assuring Emory in a memorandum, “In view of the NIMH/Emory/GSK grant, I shall limit my consulting to GSK to under $10,000/year and I have informed GSK of this policy.” Yet that same year, he received $171,031 from the company, while he reported to Emory just $9,999—a dollar shy of the $10,000 threshold for reporting to the National Institutes of Health.

    “Emory benefited from Nemeroff’s grants and other activities, and that raises the question of whether its lax oversight was influenced by its own conflicts of interest. As reported by Gardiner Harris in The New York Times,3 Nemeroff himself had pointed out his value to Emory in a 2000 letter to the dean of the medical school, in which he justified his membership on a dozen corporate advisory boards by saying:
    Surely you remember that Smith-Kline Beecham Pharmaceuticals donated an endowed chair to the department and there is some reasonable likelihood that Janssen Pharmaceuticals will do so as well. In addition, Wyeth-Ayerst Pharmaceuticals has funded a Research Career Development Award program in the department, and I have asked both AstraZeneca Pharmaceuticals and Bristol-Meyers [sic] Squibb to do the same. Part of the rationale for their funding our faculty in such a manner would be my service on these boards.”

  • Replying to myself I found an article: “Coming Soon to a Physician Near You: Medical Neoliberalism and Pharmaceutical Clinical Trials” (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3092550/). The author states:

    “Finally, on the cultural level, through the process of making health care a commodity, medical neoliberalism also commodifies the body itself. Medical neoliberalism fragments the body by homing in on specific problem areas with or within the body to the detriment of holistic analysis. The implication of this fragmentation is that body parts are seen in terms of the products designed to maintain, cure, or enhance them.”

    Also…

    “Patients as consumers have embraced the neoliberal logics of health care so that they too see illness in reductionist terms and seek pharmaceuticals as targeted magic bullets. This orientation toward health and medicine has been referred to as the pharmaceuticalization of health care, in which the conditions of health and illness are ever more cast in terms of products that can be purchased by health-engaged consumers. A medical system that revolves around pharmaceuticals contributes to a culture of medical neoliberalism. It ties together the commodification of health care with the fragmentation of the body where illness is treated in terms of discrete systems for which there are tailored products.”

    Interesting article which I think supports Steve’s social welfare argument but may be beyond the scope of his excellent video.

  • If I am understanding oldhead’s arguments, I also think there is a connection between human suffering (psychological, emotional, mental, spiritual) and politics/economics. A friend of mine sees a parallel between the rise of neoliberalism’s stealth revolution (http://journals.sagepub.com/doi/pdf/10.1177/0263276416669574), the rise and the rise of Big Pharma and the ‘medical/disease’ model.

    In “Neoliberalism – the ideology at the root of all our problems” (https://www.theguardian.com/books/2016/apr/15/neoliberalism-ideology-problem-george-monbiot), the authors blame neoliberalism for “…epidemics of self-harm, eating disorders, depression, loneliness, performance anxiety and social phobia.” (Yes, they use the terms ‘disorder’ and ‘phobia,’ which emphasizes how we are so stuck in this way of thinking.)

    Ultimately, I think, the neoliberalism argument supports Steve’s social welfare argument. Didn’t the rise of neoliberalism (Reagan, Thatcher) coincide with the rise of Big Pharma and the ‘medical/disease’ model? Doesn’t neoliberalism objectify people?

    Maybe someone who has thought more deeply about how the neoliberalism concept can draw more parallels. Can anyone direct me to some scholarly writing on the topic?

  • It was the cool swirling cloudy image at 12:43. The narration is about complexity so maybe that’s what the image reflects.

    I think my Freud loving friend might harden at the mention of his theories being racist and sexist and thereby promoted mental distress and at the id, ego and superego as being imaginary. I wonder if others like him could have a similar reaction and stop listening to your main points which are so important.

    I could be totally wrong about the tone. It was just my first impression.

    I want to show the video to my work colleagues (school counsellors) but they can be a tough crowd.

    If the video was posted on Youtube I would be able to use my Chromecast to show it on my TV which would make for more comfortable viewing for others.

    Thanks for replying! I support your work.

  • I’ve been using the term “medical model” and “disease model” in conversation a lot lately assuming my meaning was clear. But maybe I should not make that assumption. In their article “Fifty psychological and psychiatric terms to avoid” (http://journal.frontiersin.org/article/10.3389/fpsyg.2015.01100/full) the authors argue that the term “medical model” can have many different meanings. They say:

    “Although many authors who invoke the term “medical model” presume that it refers to a single conceptualization (e.g., Mann and Himelein, 2008), it does not. Some authors insist that the term is so vague and unhelpful that we are better off without it (Meehl, 1995). Among other things, it has been wielded by various authors to mean (a) the assumption of a categorical rather than dimensional model of psychopathology; (b) an emphasis on underlying “disease” processes rather than on presenting signs and symptoms; (c) an emphasis on the biological etiology of psychopathology; (d) an emphasis on pathology rather than on health; (e) the assumption that mental disorders are better treated by medications and other somatic therapies than by psychotherapy; (f) the assumption that mental disorders are better treated by physicians than by psychologists; or (g) the belief that mentally ill individuals who engage in irresponsible behavior are not fully responsible for such behavior (see Blaney, 1975, 2015, for discussions). Similar semantic and conceptual ambiguities bedevil the term “disease model” when applied to addictions and most other psychological conditions (e.g., Graham, 2013).”

    I don’t want to take away from your excellent video, Steve. However, I’m not sure, now, what term to use when trying to explain my concerns about the DSM, psychiatry and Big Pharma. Maybe it’s still ok to use the term “medical model” and have it mean all those things from (a) to (g). Maybe the arguments by Meehl (1995) are not strong. Maybe someone can clarify this for me.

  • Hi Steve, I thought the video was great! I think it’s a good length and is succinct. The visuals were good except for one beautiful abstract image which I couldn’t figure out how it fit with the narration (minor point). On first viewing I have 2 bits of feedback. 1. Would your main argument be weakened if you omitted the part at the beginning about Freud and psychodynamics? The reason I ask is that I am trying to engage a friend of mine in conversation about the ideas you present and he is a big fan of Freud. If I showed him the video it might put him off. He is very critical of mainstream medicine, though, so this predisposes him to be more open to your arguments. 2. The narrator (you?) has an even, calm tone of voice through most of the video. However, there are parts where the narrator sounds angry. I can identify! Its justified. I’m angry, too! However, it might scare some people off. It might sound a bit fanatical to some people. I wonder if these 2 bits were edited would it reach a wider audience?