Bear with me, readers. I promise this will be the last installment in this series. Let's review the sequence of events:
In March this year, "The Infinite Mind," which has aired on NPR, ran an hour-long show, entitled, Prozac Nation: Revisited. Bill Lichtenstein has produced the award-winning series since its inception. Dr Goodwin has served two stints as host, and filled in as guest host. On this particular show, Dr Goodwin interviewed three psychiatrists. The show took issue with the FDA's black box warning concerning risk of "suicidality" in kids talking antidepressants.
Dr Goodwin made it clear that the show was meant to reassure people who may have been alarmed over sensationalist stories in the media. He and his guests were concerned that FDA's use of the term suicidality was far too strong to accurately describe the self-harm and agitated behavior that some kids experience on antidepressants. Among other things, Dr Goodwin and his guests pointed out that in the studies the FDA relied upon, no one committed suicide.
This was clearly information the public needed to know, but at the same time the lack of a dissenting voice invited valid criticism that the show aired like a drug company infomercial.
The one-sided nature of the commentary is probably what attracted the attention of two reporters, who did what reporters do best - they investigated. In a Slate Magazine piece in May, Shannon Brownlee and Jeanne Lenzer reported that:
"Any radio producer would be hard-pressed to find a more seemingly credible quartet. Credible, that is, except for a crucial detail that was never revealed to listeners: All four of the experts on the show, including Goodwin, have financial ties to the makers of antidepressants."
In addition, the reporters pointed out that Dr Goodwin is on the board of the industry-funded Center for Medicine in the Public Interest. One of his guests is president of CMPI and has a senior position in a marketing firm with industry clients. These associations were not disclosed.
The article also pointed out that the show failed to mention an "unrestricted grant" from Eli Lilly.
The article also cited a 2006 NBC Nightly News segment involving a cancer expert whose research had been funded by a tobacco company.
Based on these facts, the reporters cautioned: "Unless reporters ask where groups and individual researchers get their money, they have no idea that their sources may be biased—and neither do their readers, viewers, and listeners."
The reporters did not get into the debate over whether the duty to disclose should have rested with Dr Goodwin as host or Bill Lichtenstein as producer.
The Slate piece came to the attention of Sen Grassley of Iowa, who had been investigating the financial relationships between physicians and drug companies. These included serious charges involving a number of academic psychiatrists who failed to disclose significant drug industry income to their universities. In a Nov 19 report, entitled, Payments to Radio Host, Sen Grassley referred to these psychiatrists, then he turned his attention to Dr Goodwin:
"After listening to a recording of the show, it appeared to me that the real effect of this particular episode was to undercut any criticism that antidepressants might be linked to
an increased risk of suicide."
The Senator pointed out that British regulatory authorities had found that "GSK had been aware since 1998 that Paxil was associated with a higher risk of suicidal behavior in adolescents."
The Senator also referred to a 2005 show on bipolar disorder.
The Senator detailed a long record of Dr Goodwin's drug company associations and income, and expressed the opinion that: "People should know that since 2000, GlaxoSmithKline has paid the host of a radio program on psychiatry over $1.2 million in speaking fees and over $100,000 in expenses."
The Senator said that the show's failure to disclose violated NPR's own standards. Nevertheless, he implied that the matter fell out of his jurisdiction: "It is not my job as a Senator to screen newspapers, the evening news or national radio for my constituents."
Instead, Sen Grassley stated his concern over the fact that some of the funding for "The Infinite Mind" came from the National Science Foundation and the NIH. Accordingly, Sen Grassley asked the Senate for permission to query the NSF and NIH if they require "The Infinite Mind" to disclose the money that drug companies pay to the show's host.
Although Sen Grassley made clear his displeasure with Dr Goodwin, he made no definitive comment concerning whether the duty to disclose rested with the host of the show or its producer.
It is fair to say the Senator's use of the bully pulpit was appropriate, but it also needs to be pointed out that his report contained a number of loosely-related facts begging misinterpretation. Two days later, the NY Times would oblige.
In his Nov 21 Times article, reporter Gardiner Harris noted that Dr Goodwin "is the latest in a series of doctors and researchers whose ties to drugmakers have been uncovered" by Sen Grassley,"
The Times, however, failed to point out that Dr Goodwin's actions as a radio host were on a far lesser order of magnitude than that of a researcher failing to disclose income to a university.
Mr Harris also reported that while Dr Goodwin asserted on "The Infinite Mind" that "there is no credible scientific evidence linking antidepressants to violence or to suicide,” he received funding from GSK, "which for years suppressed studies showing that its antidepressant, Paxil, increased suicidal behaviors."
One would think that Dr Goodwin had been paid off by Paxil. Not the case. In fact, Dr Goodwin has a long track record of speaking out against doctors recklessly prescribing antidepressants, but the NY Times failed to report this.
In addition, Mr Harris implied that somehow Dr Goodwin had talked up the diagnosis of bipolar disorder in kids in order that GSK could sell more Lamictal.
Responsibility for disclosure remained unresolved, with the Times reporting conflicting accounts from Dr Goodwin and Mr Lichtenstein.
The Times piece set off in a firestorm in the blogosphere, made in good faith. Those who posted were justifiably horrified over the corrupting influence of drug money on psychiatry. If the most prominent psychiatrists could be bought, then how safe, as patients, were we?
Make no mistake. This is a life or death concern.
Many bloggers exploded in rage, as did a number of posters to this site. A fair number directed their anger at me, for defending Dr Goodwin. If you are one of these individuals - I don't blame you. You have every right to be angry. This is your life. People are messing with it, placing you in jeopardy. For obvious reasons, we need to monitor this site against inappropriate posts, but, again, I understand your anger.
But I do make one modest request: I ask you to respond to the piece in Slate, rather than the NY Times. The Slate report may cast Dr Goodwin in a bad light, but not an irredeemably bad one. It represents a fair marshaling of the facts. It provides the basis where we can all join together in a reasoned debate. If there is to be reform, it needs to be a patient initiative, and we need to work together.
The NY Times piece, on the other hand, makes out Dr Goodwin to be something he is clearly not. It casts him as the villain. It represents a complete misrepresentation of the facts. It makes us want to single out scapegoats rather than work together to achieve reform.
Please, we're above that. All of us.
I promise, unless something totally unexpected blows up, this is my last blog on the topic. I have been writing full-time about my illness (and yours) since 1999. Very quickly, I learned that what matters most to you is information you can use to gain insight into your illness and to improve your life. "Knowledge is Necessity" has been my mission since Day One. With self-knowledge, we take control of our lives, we take charge of our recovery. The producers of BipolarConnect share the same philosophy.
Starting next week, it's back to regular programing.
Disclosure: Dr Goodwin authored the front cover blurb to my book, "Living Well with Depression and Bipolar Disorder" (HarperCollins, 2006).
Published On: December 05, 2008
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