Ethics in Medicine

The Big Picture:Sunday Morning Philosophizing

Kristen Sparrow • November 25, 2012

One of the themes that pervade modern U.S. life.
from the Big Short, by Michael Lewis  p.110

“In public markets, you have people focused on quarterly earnings rather than the business franchise.  You have people doing things for all sorts of insane reasons.”  They believed, further, that public financial markets lacked investors with an interest in the big picture.  U.S stock market guys made decisions within the U.S  stock market; Japanese bond market guys made decisions with the Japanese bond market market; and so on…”I don’t think the problem is specific to finance.  I think that parochialism is common to modern intellectual life.  There is no attempt to integrate.”

It is why, in medicine, studies have been published across the board that were authored by the drug companies making the drugs, but the docs in the field couldn’t see that.  There was no one really to see that until it became clear that the drug companies were simply pulling unflattering studies.  Academia had implicit rules, and the companies simply ignored them since they had different incentives.  And, yes, lots and lots of people had heart attacks and Vioxx was pulled and so, the market worked???  Point is, it’s incredibly hard to see what’s in front of you, and around you when everyone is on board.  It’s extremely hard to “integrate.”  I worry incessantly about the incentives.  My previous post on anti-depressants didn’t emphasize, but the studies on anti-depressants do not convincingly show efficacy over placebo.  I worry that pollution, radiation (therapeutic and industrial), fertilizers, packaging, antibacterials, antibiotics can leave people weaker and sicker, and we’re left to fend for ourselves.  As a later quote from “The Big Short” makes clear, the attitude of Wall Street traders and heads of Industry alike “Success was an individual achievement; failure was a social problem.”  Likewise, making money off of all the above is what they do, but the problems left in their wake are up to the individual and tax payers.