J Law Med Ethics. 2013 Sep;41(3):644-653. doi: 10.1111/jlme.12074.

Drug Firms, the Codification of Diagnostic Categories, and Bias in Clinical Guidelines.

Cosgrove L, Wheeler EE.

Source

Associate Professor in the Department of Counseling and School Psychology at the University of Massachusetts Boston in Boston, MA. She is also a Lab Fellow at the Edmond J. Safra Center for Ethics at Harvard University in Cambridge, MA. Doctoral Student in the Department of Counseling and School Psychology at the University of Massachusetts Boston in Boston, MA.

Abstract

The possibility that industry is exerting an undue influence on the culture of medicine has profound implications for the profession's public health mission. Policy analysts, investigative journalists, researchers, and clinicians have questioned whether academic-industry relationships have had a corrupting effect on evidence-based medicine. Psychiatry has been at the heart of this epistemic and ethical crisis in medicine. This article examines how commercial entities, such as pharmaceutical companies, influence psychiatric taxonomy and treatment guidelines. Using the conceptual framework of institutional corruption, we show that organized psychiatry's dependence on drug firms has led to a distortion of science. We describe the current dependency corruption and argue that transparency alone is not a solution. We conclude by taking the position that the corruption of the evidence base in diagnostic and practice guidelines has compromised the informed consent process, and we suggest strategies to address this problem.