- Email: [email protected]
Medical professionals for sale?
Correspondence
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was sheltering several people, was bombed at least four times.3 Reports come from the few remaining staff of the International Committee of the Red Cross, who have been subjected to intimidation in the past; all other international non-governmental organisations and media have been banned by the Government.4 Trapped civilians have already suffered months of severe malnutrition, as reported by Amnesty International, owing to government restrictions on aid.5 There is currently a severe shortage of food, medicines, and other essential items that the Government has prevented from reaching the civilians.5 There continues to be no safe passage of civilians out of the conflict zone, and reports suggest that people entering governmentheld territory are forced to remain in detention camps.5 Both warring parties have been guilty of brutal tactics in the past. But now the Government must be condemned for continued war crimes and its systematic violation of Tamil civilians’ rights if there is to be a meaningful resolution to the conflict. The international community must recognise the real and serious grievances of the Tamil people. The international medical community must speak out on this issue and make it clear that this humanitarian catastrophe cannot continue. We declare that we have no conflict of interest.
*Oliver Johnson, Anenta Ratneswaren, Fenella Beynon [email protected] Medsin-Imperial, Imperial College London, London SW7 2AZ, UK 1
2
3
810
Genocide Prevention Project. Mass atrocity crimes watch list. http://www.preventor protect.org/overview/watch-list.html (accessed Feb 20, 2009). Amnesty International. Civilians trapped by Sri Lanka conflict. http://www.amnesty.org/en/ news-and-updates/news/civilians-trapped-srilanka-conflict-20090128 (accessed Feb 20, 2009). International Committee of the Red Cross. Sri Lanka: ICRC maintains support for hospital hit by shelling. http://www.icrc.org/web/eng/ siteeng0.nsf/htmlall/sri-lanka-interview020209 (accessed Feb 20, 2009).
4
5
Médecins Sans Frontières. Sri Lanka: 250,000 civilians trapped in intense fighting. http://www. msf.org.uk/civilians_trapped_in_sri_lanka_ 20090128.news (accessed Feb 20, 2009). Amnesty International. Sri Lanka: Hundreds of thousands trapped in the Wanni need urgent shelters. http://www.amnesty.org/en/formedia/press-releases/sri-lanka-hundredsthousands-trapped-wanni-need-urgentshelters-20081119 (accessed Feb 20, 2009).
Medical professionals for sale? Much has been written in the medical press about the influence of the pharmaceutical industry within the medical profession. Many of the conclusions drawn, it seems to me, are well meaning but rather nebulous theoretical constructs. The question has been seen solely from the medical profession’s sadly limited perspective and the views of concerned members of the general public are either unknown or ignored. Please allow me to tell you how this influence can permeate the profession. In June, 2004, I sustained a very severe adverse reaction while on a clinical drug trial in which I was, according to the patient information sheet, to have been closely monitored. This close monitoring by my general practitioner resulted in my being ambulanced into hospital, very close to death, after the untreated bloody diarrhoea I had suffered for many weeks resulted in severe septicaemia.I was eventually discharged with a memento of the trial—ulcerative colitis. The general practitioner supervising me received £3000 per patient. I naively thought that some of that money was to ensure my wellbeing. Since the pharmaceutical company involved steadfastly refused to follow the Association of the British Pharmaceutical Industry’s compensation guidelines, and having no positive support from the medical establishment, I was forced to go to court in an attempt to gain the modest compensation I felt that I deserved. During the hearing I witnessed the most disgraceful behaviour by the
company’s principal witness, a worldfamous professor of gastroenterology. He was eventually described by the Judge in his judgment, when under cross-examination by the barrister representing me, as being “at best disingenuous“ and that ”...he forgot he was here to help the Court rather than to simply advance [the company’s] case”. There were also several other instances of behaviour quite unfitting of such a renowned expert, especially when he denied the accuracy of my medical records compiled by his peers at the UK’s most prestigious hospital whose staff had saved my life. I understand that the eminent professor was paid handsomely to “advance” the company’s case. So from a humble general practitioner to an eminent professor, the influence of the pharmaceutical industry can be seen; in this case the negative aspect is predominant. Does the medical profession dare to look more closely at such cases as mine? Both the general practitioner and the renowned but disingenuous professor are paid generous salaries by the taxpayer to ensure the heath and wellbeing of the general public. They should not allow themselves, for whatever reason, to be used as pawns by unscrupulous drug companies.
L Thomas [email protected] 23 Chelmer Way, Ely CB6 2WS, UK
Department of Error Burnham G, Lafta R, Doocy S, Roberts L. Mortality after the 2003 invasion of Iraq: a cross-sectional cluster sample survey. Lancet 2006; 368: 1421–28—The Methods section of this Article (Oct 21, 2006) stated that “Participants were assured that no unique identifiers would be gathered.” Upon review, it was determined that a significant number of the surveys contained names of respondents and household inhabitants. This was a lapse in the authors’ obligations to protect participants. However, to the authors’ knowledge, the completed surveys remained in possession of the research team at all times and there were no known breaches in confidentiality.
www.thelancet.com Vol 373 March 7, 2009
Photolibrary
was sheltering several people, was bombed at least four times.3 Reports come from the few remaining staff of the International Committee of the Red Cross, who have been subjected to intimidation in the past; all other international non-governmental organisations and media have been banned by the Government.4 Trapped civilians have already suffered months of severe malnutrition, as reported by Amnesty International, owing to government restrictions on aid.5 There is currently a severe shortage of food, medicines, and other essential items that the Government has prevented from reaching the civilians.5 There continues to be no safe passage of civilians out of the conflict zone, and reports suggest that people entering governmentheld territory are forced to remain in detention camps.5 Both warring parties have been guilty of brutal tactics in the past. But now the Government must be condemned for continued war crimes and its systematic violation of Tamil civilians’ rights if there is to be a meaningful resolution to the conflict. The international community must recognise the real and serious grievances of the Tamil people. The international medical community must speak out on this issue and make it clear that this humanitarian catastrophe cannot continue. We declare that we have no conflict of interest.
*Oliver Johnson, Anenta Ratneswaren, Fenella Beynon [email protected] Medsin-Imperial, Imperial College London, London SW7 2AZ, UK 1
2
3
810
Genocide Prevention Project. Mass atrocity crimes watch list. http://www.preventor protect.org/overview/watch-list.html (accessed Feb 20, 2009). Amnesty International. Civilians trapped by Sri Lanka conflict. http://www.amnesty.org/en/ news-and-updates/news/civilians-trapped-srilanka-conflict-20090128 (accessed Feb 20, 2009). International Committee of the Red Cross. Sri Lanka: ICRC maintains support for hospital hit by shelling. http://www.icrc.org/web/eng/ siteeng0.nsf/htmlall/sri-lanka-interview020209 (accessed Feb 20, 2009).
4
5
Médecins Sans Frontières. Sri Lanka: 250,000 civilians trapped in intense fighting. http://www. msf.org.uk/civilians_trapped_in_sri_lanka_ 20090128.news (accessed Feb 20, 2009). Amnesty International. Sri Lanka: Hundreds of thousands trapped in the Wanni need urgent shelters. http://www.amnesty.org/en/formedia/press-releases/sri-lanka-hundredsthousands-trapped-wanni-need-urgentshelters-20081119 (accessed Feb 20, 2009).
Medical professionals for sale? Much has been written in the medical press about the influence of the pharmaceutical industry within the medical profession. Many of the conclusions drawn, it seems to me, are well meaning but rather nebulous theoretical constructs. The question has been seen solely from the medical profession’s sadly limited perspective and the views of concerned members of the general public are either unknown or ignored. Please allow me to tell you how this influence can permeate the profession. In June, 2004, I sustained a very severe adverse reaction while on a clinical drug trial in which I was, according to the patient information sheet, to have been closely monitored. This close monitoring by my general practitioner resulted in my being ambulanced into hospital, very close to death, after the untreated bloody diarrhoea I had suffered for many weeks resulted in severe septicaemia.I was eventually discharged with a memento of the trial—ulcerative colitis. The general practitioner supervising me received £3000 per patient. I naively thought that some of that money was to ensure my wellbeing. Since the pharmaceutical company involved steadfastly refused to follow the Association of the British Pharmaceutical Industry’s compensation guidelines, and having no positive support from the medical establishment, I was forced to go to court in an attempt to gain the modest compensation I felt that I deserved. During the hearing I witnessed the most disgraceful behaviour by the
company’s principal witness, a worldfamous professor of gastroenterology. He was eventually described by the Judge in his judgment, when under cross-examination by the barrister representing me, as being “at best disingenuous“ and that ”...he forgot he was here to help the Court rather than to simply advance [the company’s] case”. There were also several other instances of behaviour quite unfitting of such a renowned expert, especially when he denied the accuracy of my medical records compiled by his peers at the UK’s most prestigious hospital whose staff had saved my life. I understand that the eminent professor was paid handsomely to “advance” the company’s case. So from a humble general practitioner to an eminent professor, the influence of the pharmaceutical industry can be seen; in this case the negative aspect is predominant. Does the medical profession dare to look more closely at such cases as mine? Both the general practitioner and the renowned but disingenuous professor are paid generous salaries by the taxpayer to ensure the heath and wellbeing of the general public. They should not allow themselves, for whatever reason, to be used as pawns by unscrupulous drug companies.
L Thomas [email protected] 23 Chelmer Way, Ely CB6 2WS, UK
Department of Error Burnham G, Lafta R, Doocy S, Roberts L. Mortality after the 2003 invasion of Iraq: a cross-sectional cluster sample survey. Lancet 2006; 368: 1421–28—The Methods section of this Article (Oct 21, 2006) stated that “Participants were assured that no unique identifiers would be gathered.” Upon review, it was determined that a significant number of the surveys contained names of respondents and household inhabitants. This was a lapse in the authors’ obligations to protect participants. However, to the authors’ knowledge, the completed surveys remained in possession of the research team at all times and there were no known breaches in confidentiality.
www.thelancet.com Vol 373 March 7, 2009