Rapid response

This is a rapid response to the above article that I have submitted to the BMJ:

Dear Editor

This is an important and timely analysis and the authors should be commended for writing so clearly about an issue that is important to us all [1].

The conflation between marketing and science is not new, yet efforts taken to meaningfully address this have been most limited. We now live in an age that even Ivan Illich might have struggled to imagine with a scale of iatrogenesis, such as prescribed drug dependency, that involves almost every family [2].

I had hoped that the current open consultation: Disclosure of industry payments to the healthcare sector [3] might finally ensure the introduction of necessary legislation to ensure a single, central, searchable, independent register underpinned by statute to ensure full transparency and promote scientific integrity and trust in the healthcare profession. Alas, this option was not included in the ‘open consultation’. Instead the consultation puts all the responsibility on industry. I agree with Roger Fisken, HealthSense [4], that this consultation has been “designed to fail” and, at best, would result in a system of disclosure that “would be difficult to navigate and impossible to regulate”.

Mulinari and Ozieranski [1] have identified what has been missing for so long: a “collective responsibility” where healthcare professionals and organisations no longer “acquiesce” to marketing.

In my career I did what I could to encourage full transparency in science and healthcare. I did not find this easy. Indeed I often found myself isolated. In the process of advocating for transparency there was need to communicate with colleagues in seats of power within the healthcare profession, one of whom described my efforts as a “misguided pursuit“.

[1] Unethical pharmaceutical marketing: a common problem requiring collective responsibility; Mulinari S, Ozieranski P; BMJ 2023;382:e076173
[2]  Medical Nemesis. Illich Ivan, 1975.
[3] Open Consultation: Disclosure of industry payments to the healthcare sector
[4] Government consults on legislation to disclose industry payments to doctors; BMJ 2023;382:p2049

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