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November 24, 2008

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DaveD

Bill, thanks for the comment. Regarding the issues you have with my post:

1. You say you "did not say that such disclosures were 'optional' or a 'hassle' as [I] wrote" in the post above. True, you did not use those words. But you told me and stated elsewhere that you felt it proper that the show disclose payments from industry only when you judged them clearly relevant. This is the same as saying that such disclosure is optional, since you are reserving the option to disclose or to not disclose such payments and potential conflicts of interest at your discretion. The whole point is to let the reader make the call rather than the producer or editor. This is what the scientific journals have done and what journalists need to start doing. I think Infinite Mind's need to do so was only increased by the fact that the show accepts underwriting from industry-related interests.

Your point that other media outlets have quoted Goodwin is well-taken; as my Columbia Journalism Review piece noted, journalism in general needs to face the need to ask about and state potential conflicts of interest in sources. This clearly is not getting done widely enough. We are, as you say, in an evolving journalistic environment. I also noted in the CJR that the policies you had in place when you started the Infinite Mind back in 1994 (if I that date right) seem sensible for the time -- but that I found your aggressive defense of them when the Slate piece ran this May a bit behind the times, and incognizant of how heavily such conflicts of interest have compromised public faith in psychiatry. I still feel that's the case.


Bill Lichtenstein

David:

As executive producer of public radio's The Infinite Mind I appreciate your story (above). It is a timely and critical look at the growing intrusion of the pharmaceutical industry into medicine and science and now directly in journalism.

That said, I have to take issue with two important points in your story.

You and I spoke back in May 2008, for your Columbia Journalism Review article following Slate.com's report that The Infinite Mind did not disclose the pharmaceutical ties of guests on a program we did examining the links between anti-depression and suicide. At the time, I did not say that such disclosures were "optional" or a "hassle" as you wrote above. According to your CJR article, what I did say was:

"...the show would not invite guests with significant conflicts of interest, and if there were a compelling reason to include someone with a vested interest, he [Bill Lichtenstein] would disclose that on air and on the show’s Web site."

In the case of the former FDA official who now does PR work for the pharmaceutical industry, Peter Pitts, who was a guest on the program without his connections being disclosed, I agreed we erred, but that NPR and PBS's News Hour had failed to learn of his connection to industry and had him on the air without disclosure as well.

Clearly, this is a problem that affects journalism in general, and a far more rigorous effort is needed for vetting and disclosing conflicts of interest in this area.

Consider that in addition to The Infinite Mind, Dr. Fred Goodwin was interviewed widely by the media as a scientific expert. As an example, he appeared in dozens of articles in the New York Times regarding the treatment of mental illness, written by respected, seasoned reporters ranging from Jane Brody to Michael Massing, where he was identified only as a researcher and academic, but without disclosure of his pharmaceutical ties. Did they know? Did they ask?

Dr. Goodwin also appeared as a guest expert discussing medication studies on various NPR programs from All Things Considered to Talk of the Nation, where NPR identified him to listeners only as a professor, public radio host, and former government official. In none of these cases did NPR make reference to any connections between Dr. Fred Goodwin and the pharmaceutical industry. NPR was in the dark, as were we.

Goodwin was not alone. Dr. Charles Nemeroff, one of the three major psychiatrists being investigated by Senator Charles Grassley for taking and not disclosing pharmaceutical fees, appeared on NPR's All Things Considered in June 2008 and previously on NPR's Morning Edition discussing research on the positive aspects of anti-depressants for children. In neither case, was his relationship to the pharmaceutical industry disclosed by NPR, and he is identified only as a "psychiatrist" and "research scientist."

Additionally, Dr. Joseph Biederman, the leading Harvard child psychiatrist who is also under investigation by Senator Grassley for not disclosing pharmaceutical consulting fees, appeared in a New York Times article on November 23, 2006, entitled "Proof is Scant on Psychiatric Drug Mix for Young." The article was written by New York Times reporter Gardiner Harris (the same Gardiner Harris who wrote the New York Times article critical of The Infinite Mind), and quoted Dr. Biederman as defending multiple psychiatric drug therapies for kids ("These drugs have revolutionized how we treat severe psychopathology in children." See: http://www.nytimes.com/2006/11/23/health/23kids.html ) However, neither Dr. Biederman's relationship to the pharmaceutical industry nor his consulting fees of at least $1.6 million between 2000 and 2007 were disclosed by Gardiner Harris in the New York Times article. (See http://www.nytimes.com/2008/11/25/health/25psych.html )

Clearly, as you point out, we are in an evolving journalistic environment. A leading Harvard clinician recently told me that he felt that pharmaceutical funding had undermined an entire generation of psychiatrists and psychiatry, as we now don't know who or what data to trust. And now it has spilled into journalism.

The proper response to the situation is not to point fingers, but to critically look at what went wrong, hold guilty parties accountable, and to look at ways of preventing it in the future.

- Bill Lichtenstein

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