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David Healy
Copyright Date: 2012
Edition: 1
Pages: 320
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  • Book Info
    Book Description:

    This searing indictment, David Healy’s most comprehensive and forceful argument against the pharmaceuticalization of medicine, tackles problems in health care that are leading to a growing number of deaths and disabilities. Healy, who was the first to draw attention to the now well-publicized suicide-inducing side effects of many anti-depressants, attributes our current state of affairs to three key factors: product rather than process patents on drugs, the classification of certain drugs as prescription-only, and industry-controlled drug trials. These developments have tied the survival of pharmaceutical companies to the development of blockbuster drugs, so that they must overhype benefits and deny real hazards. Healy further explains why these trends have basically ended the possibility of universal health care in the United States and elsewhere around the world. He concludes with suggestions for reform of our currently corrupted evidence-based medical system.

    eISBN: 978-0-520-95181-5
    Subjects: Health Sciences

Table of Contents

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  1. Front Matter
    (pp. i-viii)
  2. Table of Contents
    (pp. ix-x)
  3. Acknowledgments
    (pp. xi-xii)
  4. Introduction
    (pp. 1-15)

    My father smoked all his adult life. He had a number of physical disorders, including ulcerative colitis, ironically one of the few conditions for which smoking is benefi cial. In 1974, when he was in hospital for colitis, a routine chest X-ray revealed a shadow on his lung. Dr. Neligan, the surgeon called in, advised my mother on the importance of an operation.

    Our general practitioner at the time was Dr. Lapin, whom I remembered from childhood as being tall, silver-haired, and distinguished, often wearing a bow tie. He had spent time, I was told, as a doctor in the...

  5. 1 They Used to Call It Medicine
    (pp. 16-43)

    The careers of Alfred Worcester (1855–1951) and Richard Cabot (1868–1939) in Boston spanned the formative years of modern medicine. Worcester’s medical training in the late nineteenth century included repeated visits to the homes of the sick and dying as a doctor’s apprentice, whereas students of Cabot in the early twentieth century were trained in the new sciences basic to medicine, like bacteriology, and rarely got to meet the same patient more than once. Second-year medical students of 1912 knew more about diseases than the doctors of his generation ever did, Worcester conceded, but he argued that at the...

  6. 2 Medicine and the Marketers
    (pp. 44-63)

    When she became pregnant in 2004, 38-year-old Gina Fromm did a range of things that few women would have done in the early 1960s— she took cold rather than hot showers in case she might harm her baby, stopped eating yogurt and incinerated chicken because of the risk of bacterial infection, from listeria to salmonella. She balked at taking prenatal vitamins, though she had been taking Paxil following a fleeting episode of anxiety. She continued to take it through her pregnancy; she had found stopping diffi cult and her doctor reassured her it posed no risk to her baby. On...

  7. 3 Follow the Evidence
    (pp. 64-95)

    When a journalist jumps out from behind a hedge on the eleventh hole of a Caribbean golf course to ambush a professor of medicine from one distinguished university and a professor of psychiatry from another after both gave brief lectures that morning, and he asks the men whether their company-sponsored trip would infl uence their judgment, the response will be “Of course not!” If asked what does infl uence them, these academics will confidently point to the published evidence. They follow the evidence, not the money. Even if a doctor is pocketing the lecture fee rather than putting it into...

  8. 4 Doctoring the Data
    (pp. 96-128)

    By 1965, the flood tide of innovative compounds ranging from the early antibiotics to the first antipsychotics that had transformed medicine in the 1950s appeared to be ebbing. Desperate to continue with business as usual, the pharmaceutical industry had to decide if it made business sense to allow its researchers to pursue scientific innovations in quite the ad hoc way that had worked so well for the previous two decades. This was the question the major drug companies put to a new breed of specialists, management consultants, who were called in to help them reorganize their operations with a view...

  9. 5 Trussed in Guidelines
    (pp. 129-158)

    Bill was in his seventies, tall and relatively fit for his age if slightly overweight. His wife was petite. She gave every impression of having been dependent on a physically and behaviorally imposing husband, although their roles were now reversed. Bill had had a stroke a month earlier and Sally was distraught. She was sure that he could recover and concerned that the medical team had not referred him for active rehabilitation. He had shown no signs of recovery of function after his stroke, though. In their opinion there was nothing to build on, but they had asked me to...

  10. 6 The Mismeasurement of Medicine
    (pp. 159-194)

    When Jane, a woman forty-five years old, became increasingly wheezy she went to see her primary care doctor. He got her to blow into a peak flow meter, which measures the amount of air one can breathe out. She had asthma, he said, and prescribed a beta-agonist inhaler, called a reliever, that commonly has a dramatic effect on wheeziness. Even people who do not have asthma can feel they are breathing more freely after a puff of one of these inhalers. Treatments for asthma are among the current medical blockbusters, with a market value over $10 billion. Jane was also...

  11. 7 The Eclipse of Care
    (pp. 195-233)

    Cora was eighteen and beautiful. Slim, with long blond hair, about average height. She had just finished high school, where she had been the homecoming queen. She was set to attend college, though she wasn’t certain what direction to take there. She had a boyfriend but was worried he might want to leave her, while at the same time knowing her parents didn’t approve of him.

    At a rock festival with her boyfriend, she got lost and, trying to find him, had taken a fall and injured her arm. She was admitted to a local hospital for treatment and sent...

  12. 8 Pharmageddon
    (pp. 234-264)

    Medicine as we have known it is at death’s door. Real disease brings the specter of death with it, and every medical journey to some extent follows in the steps of Cora into the underworld, leaving Demeter to implore heaven to restore her to some measure of life.

    Over the last quarter of a century, what was medicine has increasingly turned into healthcare, part of a vast global market in healthrelated products. Pharmaceuticals are exemplars of the goods in this modern health products market, but entire services can be packaged and managed as commodities, just as drugs are.

    Only the...

  13. Notes
    (pp. 265-292)
  14. Index
    (pp. 293-302)