The good folks over at the AJOB blog have been a bit busy lately, and thus there’s not been as much discussion going on in the blog. However, Sean is apparently superhuman, requiring no sleep, and has been keeping up the Bioethics Newsfeed. I’ve been wanting to chitchat about some of the articles that he’s been finding, and although I’m basically talking to myself here, this is going to have to do.
First up is the whole Merck/Vioxx chaoscluster. It seems that Merck hired an independent firm to look over the Vioxx scandal, and see if Merck should have done things differently. Perhaps not at all surprising, the hired and paid for by Merck “independent council” found that Merck did no wrong, and couldn’t have known before 2004 that there were heart risks with Vioxx. Nevermind that the “investigation” didn’t find, discuss or disclose any documents, emails, or etc that hasn’t already been in the public domain these last two years. Or the fact that what is available to the public shows internal scientists worrying about the negative side effects of Vioxx as far back as 1997. Nope, Merck did a bangup job, and will continue operating as they have been.
I can appreciate that outside legal folk are saying that don’t look at an internal investigation skeptically (which, as an aside, is a word like awkward, so far as spelling goes) ’til you’ve looked at the data, but in this case, the outside legal person hasn’t seen the data, either. And how can you not take a look at the public evidence already available and go “wow, the company screwed the pooch, and then went back for seconds” ?
The main body of the report runs 180 pages, with 20 appendixes that include another 1,500 pages. Lawyers for Debevoise reviewed millions of pages of documents and interviewed more than 150 witnesses, including some outside scientists who consulted for the company. The investigation took 53,000 hours, according to Debevoise.
The report, however, has no narrative explaining how Raymond V. Gilmartin, Merck’s former chief executive, communicated with Dr. Edward M. Scolnick, its former chief scientist, or other senior scientists and executives at Vioxx during the years it was under development and then on the market.
Instead, it essentially consists of point-by-point rebuttals of the criticisms that scientists and plaintiffs’ lawyers have made against Merck since the company withdrew the drug, including contentions that Merck misled federal regulators and marketed the drug without properly disclosing its heart risks.
The specifics of the rebuttals are almost exactly the same as those offered by Merck’s defense team in the civil suits against the company. Hmm. Does that sound independent to you? ‘Scuz me whilst I wipe the sarcasm off my desk…
New Scientist has an interesting article about the link between psychological cleanliness and physical cleanliness. Basically, we have the urge to scrub sin away – physically. Called “the Macbeth effect”, for darlin’ Lady Macbeth’s “out damned spot” soliloquy (I need to get my wifi router set up – it’s amazing how much I rely on the ‘net for spelling), it was prompted by noticing that pop culture makes sinners wash (especially murderers). Their methodology as described in the article was certainly interesting, but it really raises more questions for me than simply saying “voila! we have a clear link and thus it shall be”; or in less dramatic terms, as Philip Tetlock said, “this final experiment establishes a link between moral and physical cleanliness.” That, I just don’t buy.
I’d like to see what level of “sin” (or shall we call it unethical or personally immoral behaviour?) is necessary to instigate this washing effect. Do we need to clean ourselves off when we lie? How big a lie? Is it only for something worse? Do people convicted of murder, the so called professionals, wash? What about people who rape? Rape victims certainly wash, scrub violently in an attempt to clean themselves, but is this their own perceived sin they’re washing away – guilt complex gone awry – or someone elses?
It simply seems too soon to tie a bow around this idea. It’s definitely intriguing, and I love it when culture and science slam together to provide something new, but I simply don’t see it as a finished, locked up and down, conclusion.
And finally, and personally, the DEA finally did something right for once, proposing
a formal rule that would allow doctors with patients who need a constant supply of morphine-based painkillers to write multiple prescriptions in a single office visit. Under the new rule, a doctor can write three 30-day prescriptions at a time — two of them future-dated — to be filled a month apart.
This means my life just got a lot easier. I cannot stress what a bitch it is to try to get into a busy specialists office every month, be charged for a 20 minute visit, all so the following conversation, which takes less than 5 minutes, can be had:
Doctor: So, how’s the pain?
Me: About the same. Not well managed, but I’m functioning.
Doctor: Okay, no prescription issues?
Me: Just running low.
Doctor: Okay, here ya go – see you next month.
This way I’ll be able to walk out with three months of prescription at once, and be responsible for filling and treating my pain on my own – which is how it should be. I’m the one who lives with this daily, and am the one who should be deciding how much and what I need, medicine-wise, to function. Three month visits are what’s recommended for most chronic pain problems, and now I can actually do that realistically and comfortably, instead of having to do the counting-ration once a month. Halle-fucking-lujah!