Credibility Gap, Revisited

In the October 21, 2005, issue, Psychiatric News published my letter to the editor about conflicts of interest, psychiatry, and pharmaceutical and device makers. Also published was the eloquent response of Dr. Steven Sharfstein, then APA president.

At this time, I would like to revisit that issue and ask the American psychiatric community: Isn't it time that we reevaluate the ethics of accepting any funding from pharmaceutical companies and their surrogates? I believe that it is.

Recent articles in the New York Times reporting allegations of pharmaceutical payments to university researchers that were not disclosed to their universities reinforce my earlier conviction. As long as we hold dear to the morality of the worthwhile tasks of psychiatry and its subspecialties, we cannot expect, at the same time, that those values can be believed if they are mired in the millions of dollars from companies that have a vested interest in promoting themselves through us.

Our ethics should no longer be for sale. We should not be beholden to interests that are separate from honest clinical research or transparent publications. We should avoid company-funded publications that serve not to find answers to clinical questions but, instead, to expand markets for patented pharmaceuticals.

What is the short-term risk to rejecting corporate monies? Perhaps we downsize our splendid meetings and trade our glossy pages of Psychiatric News for newspaper print. Perhaps we curtail our ability to fund certain special projects and seminars, including repetitive ones that serve little purpose other than to add a line to an academic resume. However, what we will have is the opportunity to say to our fellow physicians, health care workers, and the public—and those who look to American psychiatry for stewardship—that we place principles before bias and integrity before price. Resolutely, we psychiatrists have one aim: to not harm and to help where and when we can to those we serve.