1. John Armstrong - May 15, 2009 at 9:38 pm

   A separation between drug research and drug marketing.. next you’ll be telling us you want separation between, say, commercial and investment banking institutions.

2. Patrick S. O'Donnell - May 16, 2009 at 7:27 am

   What has happened in this instance is symptomatic of the myriad problems that are part and parcel of “post-academic science” in general for, in John Ziman’s words, “In less than a generation we have witnessed a radical, irreversible, worldwide transformation in the way that science is organized, managed and performed.” For a detailed exposition of precisely what constitutes post-academic science, one should consult Ziman’s Real Science: What It Is, and What It Means (2000), but permit me here to highlight a few features he documents (largely those that make for discontinuity with its predecessor, namely, academic science, thus I’m ignoring, unlike Ziman, those elements which make for continuity):

   “…[P]ost-academic science is under pressure to give more obvious value for money. Many features of the new mode of knowledge production have arisen ‘in the context of application’–that is, in the course of research on technological, environmental, medical or societal problems. More generally, science is being pressed into the service of the nation as the driving force in a national R&D system, a wealth-creating techno-scientific motor for the whole economy.”

   “…[A] norm of utility is being injected into every joint of the research culture. Discoveries are evaluated commercially before they have been validated scientifically. [....] Scientists themselves are seldom in a good position to assess the utility of their work, so expert peer review is enlarged into ‘merit review’ by non-specialist ‘users.’”

   “…[A]s researchers become more dependent on project grants, the ‘Matthew Effect’ is enhanced. Competition for real money takes precedence over competition for scientific credibility as the driving force of science. With so many researchers relying completely on research grants or contracts for their personal livelihood, winning these becomes an end in itself. Research groups are transformed into small business enterprises. The metaphorical forum of scientific opinion is turned into an actual market in research services.”

   “…[T]he social organization of academic science can be described in terms of…Mertonian norms [i.e., Communalism, Universalism, Disinterestedness, Originality, and Scepticism, or CUDOS]. This description is, of course, highly idealized, but not completely unrealistic. Industrial science, by contrast, contravenes these norms at almost every point. [....] Very schematically, industrial science is Proprietary, Local, Authoritarian, Commissioned, and Expert. It produces proprietary knowledge that is not necessarily made public. It is focused on local technical problems rather than on general understanding. Industrial researchers act under managerial authority rather than as individuals. Their research is commissioned to achieve practical goals, rather than undertaken in the pursuit of knowledge. They are employed as expert problem-solvers, rather than for their personal creativity. It is no accident, moreover, that these attributes spell out ‘PLACE.’ That, rather than ‘CUDOS,’ is what you get for doing good industrial science.” As Ziman elsewhere notes, “the development of much closer relationships between academia and industry is one of the major features of the transition from academic to post-academic science.”

   “Post-academic science is organized on market principles.” One of the consequences of this is that the post-academic reseach project is subordinate to the “sphere of influence of bodies with the corresponding material interests. Thus, for example, basic research findings in molecular genetics have potential applications in plant breeding. Agrochemical firms and farmers are therefore deemed to have a legitimate right to influence the course of this research, from the formulation of projects to the interpretation of outcomes.”

   “In general…post-academic natural scientists can usually be trusted to tell ‘nothing but the truth,’ on matters about which they are knowledgeable. But unlike academic scientists, they are not bound to tell ‘the whole truth.’ They are often prevented, in the interests of their employers, clients or patrons, from revealing discoveries or expressing doubts that would put a very different complexion on their testimony. The meaning of what *is* said is secretly undermined by what is *not* said. This proprietorial attitude to the results of research has become so familiar that we have forgotten how damaging it is to the credibility of scientists and their institutions.” This is one result of the fact that “‘the context of application’ is largely defined by the material interests of bodies outside science.”

   For better and worse, the “problems that activate post-academic science are often deeply rooted in history, and are typically ‘owned’ by well-established institutions, such as pharmaceutical companies, arms procurement agencies, associations of engineering and medical practitioners, environmental protection commissions, economic advisory councils, and so on. This elaborate social structure is associated with an equally elaborate epistemic structure, where the ‘problem areas’ are differentiated much more arbitrarily, and are often narrow and specialized [despite the well-known fact that many of the issues tackled by science and society demand a 'transdisciplinary' approach], than they are in academic science.”

   In short, we have “increasing subordination to corporate and political interests that do not put a high value on the production of knowledge for the benefit of society at large.”

3. A.J. Sutter - May 17, 2009 at 2:58 am

   I think it’s painting with too broad a brush to blame “post-academic” science. Transistors, cell phones, and the incandescent light bulbs that illuminated most of the 20th Century, to name but a few, were all made by scientists working within industrial organizations. Some of the scientists involved became Nobel laureates. Since the late John Ziman was best-known as the author of a classic text on theoretical solid-state physics, I’m sure he’d have been the first to acknowldege the transistor examples, at least. If we had had to wait for academic scientists to develop all those technologies, we might still be waiting. It’s called “R&D” instead of “R” because there’s a difference between Research and Development — generally, only entrepreneurs or industrial organizations interested in making an invention into a product do the latter.

   Moreover, based on my experience at various electronics-related companies that employed many scientists, I don’t think the ethical problems are the same in all fields. If some faux technical journal had appeared that made claims that some Sony display performed better than something else, it wouldn’t lead to commercial success if the display actually looks like crap, or gets as hot as a stove because it sucks up current like there’s no tomorrow.

   Rather, life sciences and their related businesses, especially relating to health and food, pose special ethical problems. Unlike the case of a flat-panel TV, which you can look at in a store before you buy it, the performance features of medicines and foods aren’t apparent just from looking at them in a store; it may take years to discover them. Also, they’re more likely to have a direct impact your health than are most forms of consumer electronics. Morever, a decision about medicine is usually made by (i) someone who does not use it directly (the prescribing doctor), based on (ii) long-term studies published somewhere. So reputation is enough to make the sale in medicine. For that reason, the manipulation of reputation by economic interests in the case Frank describes poses special dangers, distinguishable from some other fields touched by “post-academic” R&D trends.

4. Nate Oman - May 17, 2009 at 5:26 am

   Frank: Obviously this is not my area, but I wonder to what extent this is about information overload and the problem of getting info to doctors and to what extent it is a regulatory creation. Given the restrictions that the FDA and (I’m assuming other national regulators) put on what drug companies can say in their actual marketing, sponsoring “journals” may be a way out. I did just a little bit of work for drug companies in practice, and I recall thinking that some of the restrictions on off label marketing were a stretch on first amendment grounds. Putting the message in a “journal” may provide cover with the regulators. Of course, it has been several years since I looked at any of this, and even then I wasn’t deeply involved. Just a thought.

5. Patrick S. O'Donnell - May 17, 2009 at 6:27 am

   A.J.,

   I think it’s you who may be painting with too wide a brush.

   As I said, I was only pointing out the downside to post-academic science, neither me nor Ziman would decry or denounce or fail to appreciate the many useful technological products that come from such science. In any case, post-academic science is not wholly “industrial” (hence the ‘post’ characterization). Neither I nor Ziman said the ethical problems were “all the same in all fields,” even if the nature of such science does raise common ethical problems owing to the fact that the post-academic PLACE norms are thought to often trump Mertoninan CUDOS norms (see the post above).

   Incidentally, you may certainly “look at the flat-panel TV” before you buy it, but that hardly bespeaks a knowledge of the ecological conditions and consequences associated with its production and consumption.

   Perhaps it would help to read Ziman’s book for the complexities and nuances of his portrait and argument. He did believe that the ethical issues and related problems of social responsibility that follow in the wake of this “new” science were at once in some respects unique, ubiquitous and urgent.

   I would not want to quibble too much with the idea that some fields my pose more acute ethical hazards than others: I simply wanted to share Ziman’s argument that these and other hazards and problems have indeed significantly changed as part of the transformation in the character of the science indissolubly associated with them.

6. Linkpile (via Delicious) - May 17, 2009 at 9:35 am

   [...] Mercketing: Pharma giant published its own “scientific” journals. [...]

7. A.J. Sutter - May 17, 2009 at 6:09 pm

   Patrick, my point was simply that the issues raised by the fake journal were more specific to the medical field than to industrial/”post-academic” science in general. Ecological and health issues of products have been with us since time immemorial (e.g., lead in ancient Roman cosmetics), and aren’t a distinct contribution of post-academic science. I don’t disagree that social responsibility issues impinge on a wide range of science and technology fields, but again, that generality masks a distinctive aspect of the fake journal problem.

   On Nate’s point, I’m not sure that First Amendment values are the ones that deserve prioritization in this situation (assuming, too, that other countries share those values to the same extent as US). And allowing fake journals to get around the restrictions on marketing sounds like it could eventually lead to a tragic case of elevating form over substance. OTOH, FDA may be sufficiently captured that Nate’s suggested explanation may be accurate.

8. Patrick S. O'Donnell - May 17, 2009 at 6:59 pm

   Re: “my point was simply that the issues raised by the fake journal were more specific to the medical field than to industrial/”post-academic” science in general.”

   A.J.,

   You chose to highlight the trees as it were, I chose to look at the forest, the two perspectives need not be in conflict, as this case provides a nice illustration of the sort of “epistemic pollution” about which Ziman writes and is a fine example of the tension and conflict between the sets—CUDOS and PLACE—of (idealized) norms in academic and post-academic science respectively, indeed, it “signifies increasing subordination to corporate and political interests….” Nothing I said in any way detracts from what Frank has identified here (i.e., it doesn’t ‘mask’ a distinctive aspect of the fake journal problem: quite the contrary, it provides the resources from which we might construct an explanation of this phenomenon).

   Red-herrings or strawmen aren’t very illuminating, so I fail to see the point of stating that “Ecological and health issues of products have been with us since time immemorial (e.g., lead in ancient Roman cosmetics), and aren’t a distinct contribution of post-academic science.” I never made the argument that they were, nor should it have been inferred from what I wrote. Ziman’s point is that in the era identified as “academic science” (post-Enlightenment in origin) scientists could more justifiably (even if tendentiously) claim that the sociological, institutional, and practical distance of “their” research from the applications to which it was put was sufficient to make plausible the summary dismissal of calls for social responsibility. Following his characterization of the social conditions of post-academic science, we see the various reasons why the gap between research and application (or ‘utility’) has significantly closed and thus scientists and their research can be more readily and clearly linked to such things as war-making, political and economic oppression, environmental degradation, and so forth (as scientists have become more vulnerable to the demands of their paymasters). Even if in the previous era we want to speak of at least some scientists as in some sense or measure “socially responsible” for the uses to which their research was put, the distinct nature of post-academic science makes the attribution of social responsibility more direct and transparent if only owing to the (post-modern or industrial and post-industrial) conditions of scientific research and development (or production).

   [Should you wish to carry on this discussion perhaps we could move it to the Ratio Juris blog's post on this topic.]

9. Daniel S. Goldberg - May 17, 2009 at 8:15 pm

   Nate,

   Speaking as someone who expressly works on COIs in science and medicine, and as someone who has learned a great deal from your posts here on CoOp, I am a bit unclear as to how the problems we see from Merck paying an ostensible academic publisher to market its products in the guise of a journal is a problem of either information overload or the applicable regulatory regime.

   As numerous COI scholars have indicated, there are numerous intermediaries that exist to assist busy clinicians with the task of reading and interpreting the evidence relevant to their clinical practice. But even if there is information overload, how exactly does that connect up with Merck’s apparent decision to place an advertisement while intentionally disguising it as an academic, peer-reviewed journal, when in point of fact it was simply a promotion?

   Even if we grant for the sake of argument that the restrictions on what drug companies may and may not say in advertisements is heavily regulated — which obviously does not seem to preclude an avalanche of ethically dubious marketing — I fail to see how that descriptive state of affairs justifies Merck’s conduct here from a normative perspective.

   Of course, in general, given the incentives available to them, no one should be remotely surprised at the firms’ behavior, which has been documented over and over and over again. But this general lack of surprise certainly does not constitute adequate justification for that behavior, as that would be a rank instance of the naturalistic fallacy.

   Indeed, most of the reaction in the circles that I move in found the Merck conduct here fairly unremarkable, as far as these things go. But that is, to my mind at least, an indicator of the depth of the problem, not a justification for maintaining that the status quo is satisfactory.

10. Nate Oman - May 18, 2009 at 4:34 am

    I was thinking of the rules against off-label marketing. My understanding is that while one cannot explicitly market off-label uses, one might still be able to promote and publish research on off-label uses. Again, it has been several years since I brushed up briefly against these rules and this is NOT my area of expertise. Just a thought.

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