January 16, 2013
Who’s responsible for the claims of the FDA, CDC, NIH, and the rest of the alphabet soup? That’s a good question. They disclaim their own claims, though you could go to prison or lose your children for not going along.
Neon Pointing Fingers, by Tom Hilton (filter applied)
There’s a sucker born every minute. Although this remark is widely attributed to the showman PT Barnum, RJ Brown reports that it was actually said by a banker named David Hannum, who sued Barnum in 1869 for promoting a fake exhibit. When Hannum lost, his name was forgotten and Barnum was linked to the quote.
For most of us, bad stories require some evidence to be believed. But if the story is good or repeated by many sources, it rarely needs facts. “They said” implies credibility, while “everybody knows” suggests that—if you don’t know, there’s probably something wrong with you. As Solomon Asch demonstrated, we often conform to avoid conflict or looking foolish.
Unfortunately, many Americans are too busy to care.
Imagine that you are sitting at a restaurant counter and a waitress has brought you the menu. Below the various offerings you see the following disclaimer:
Sam’s Café makes no express or implied promises or warrantees that any of the information contained in this menu is accurate; and will not vouch for any meal delivered. If you suffer stomach cramps, vomiting, diarrhea, or hallucinations, seek medical treatment immediately. Sam’s Café assumes no responsibility if you become sick or die from the meals or drinks delivered.
Although we’d think twice before ordering, people who seek reliable information about diseases and treatments from federal and state agencies generally believe what’s on the menu even when they receive similar disclaimers.
But when Saundra asked them, the FDA replied that “a physician would be necessary to decide which test to employ and how to interpret the results from that test.”
Their reply contained this link where more information can be found about HIV tests and treatments. Unfortunately, the FDA “cannot attest to the accuracy of information provided by their website,” but affirmed its dedication to “quality guidelines establishing quality assurance policies, standards, and processes” as per HHS guidelines.”
If Saundra clicks on the “HHS Guideline” link, she would find this page, which contains similar information and a disclaimer (bottom) that would take her to this page, which advises that HHS is “not responsible for the contents of any “off-site” web page (FDA, CDC, NIH) referenced from this server …” and that the information “is only intended to be general summary information to the public.”
Saundra’s experience prompted OMSJ to ask a similar question.
Using the search term “HIV” on the CDC website, OMSJ was directed to the CDC’s NPIN Network. Below many HIV information links, visitors are warned that NPIN:
… does not warrant or assume any legal liability or responsibility for the accuracy, completeness, or usefulness of any information, apparatus, product, or process disclosed in abstracts or documents available from the NPIN Website …” nor do they guarantee the services or information described or offered on the sites.
According to their website, Danya.com is a global company:
… that creates, delivers, and evaluates innovative behavior change strategies that empower people of all ages and from all walks of life to live healthier and better educated lives. Danya provides innovative services and solutions in the areas of public health communication, research and evaluation, information technology, education and training, program management support, and health product development.
Danya’s CEO is a psychologist who spearheads, among other things, “social marketing projects.”
So like Sam’s Café, the HHS, CDC, NIH and FDA disclaim all responsibility for the delivery of reliable or quality information; and it appears that corporations like Danya and AIR (see believes) handles the message.
Are state health department websites more reliable?
… any express or implied warranty in … any materials, information, graphics, products, or processes contained therein. It makes no warranty, express or implied, nor assumes any responsibility in the use of this service or its contents for its accuracy, completeness, currency…
… does not guarantee or warrant that the information on this web site is complete, accurate or up-to-date … and assumes no responsibility for any error, omissions or other discrepancies … cannot provide individual advice or counseling …” and that individuals “should contact a licensed practitioner or professional, a social services agency representative, or an organization in your local community…
California “makes no claims, promises, or guarantees about the absolute accuracy, completeness, or adequacy … disclaims liability for errors and omissions …” and makes “no warranty of any kind, implied, expressed, or statutory …”
In fact, no government or state agency accepts any responsibility for the accuracy of any HIV or medically-related information posted on their websites. Those who seek accurate information are usually referred to their personal physicians.
Where Do Physicians Get Their Information?
But like Sam’s Café and the HHS, the PDR:
… does not assume responsibility for the accuracy or appropriateness of any advice, course of treatment, diagnosis, or any other information, services or products… (and that) reliance on any such information is soley at your own risk. [SIC]
According to the PDR website, “(N)early all pharmaceutical companies use PDR Network services to either distribute drug information… or to send urgent product safety alerts… in full accordance with the FDA’s 2006 guidance to manufacturers…” (Unfortunately, the FDA does not attest to the accuracy of information provided by their website.)
UpToDate is partnered with numerous companies and rely on numerous journals that post similar disclaimers. Most (if not all) of these journals are published by Elsevier, which disclaims all liability for their journals and websites like The Lancet, which disclaim all responsibility for any of the information they distribute.
According to their 2008 Annual Report, Reed-Elsevier publishes over 25% of the world’s science, technological and medical information:
Along with over 10,000 online books, [Reed-Elsevier offers] a rich journal collection of over 2,500 titles and the ability to search a historical archive of over nine million articles.
So who writes the journals?
According to Elsevier, medical researchers, practicing health professionals, payers, educators, students and pharma professionals—what Elsevier calls the pharma promotion markets—none of which claims any liability or responsibility over the contents of any of their articles, reports or journals that, according to some researchers, are often wrong.
How Reliable Are Medical Journals?
In 2007, Gambian President Yahya Jammeh reported that he could cure AIDS without HIV drugs in three days. Although criticized by CDC drug dealers, hundreds of other scientists, including HIV Discoverer Luc Montagnier MD, have made similar claims.
In 2005, John P. A. Ioannidis MD PhD reported that the greater the financial and other interests and prejudices in a scientific field, the less likely the research findings are true:
Conflicts of interest are very common in biomedical research, and typically they are inadequately and sparsely reported [ink added]. Prejudice may not necessarily have financial roots. Scientists in a given field may be prejudiced purely because of their belief in a scientific theory or commitment to their own findings. Many otherwise seemingly independent, university-based studies may be conducted for no other reason than to give physicians and researchers qualifications for promotion or tenure. Such nonfinancial conflicts may also lead to distorted reported results and interpretations. Prestigious investigators may suppress via the peer review process the appearance and dissemination of findings that refute their findings, thus condemning their field to perpetuate false dogma. Empirical evidence on expert opinion shows that it is extremely unreliable.
Dr. Ioannidis also:
… zoomed in on 49 of the most highly regarded research findings in medicine over the previous 13 years, as judged by the science community’s two standard measures: the papers had appeared in the journals most widely cited in research articles, and the 49 articles themselves were the most widely cited articles in these journals. … Of the 49 articles, 45 claimed to have uncovered effective interventions. Thirty-four of these claims had been retested, and 14 of these, or 41 percent, had been convincingly shown to be wrong or significantly exaggerated. If between a third and a half of the most acclaimed research in medicine was proving untrustworthy, the scope and impact of the problem were undeniable. [JAMA. 2005;294(2):218-228 (doi:10.1001/jama.294.2.218)]
Since most research papers cite references, are 41 percent of those references also untrustworthy? Since the best reports are only as credible as their weakest reference, how many generations of journal reports would be required before a library or journal is considered unreliable?
This may be why respected European scientists like Marco Ruggiero MD PhD view scientists like John Moore PhD with contempt. When Elsevier de-published this paper last year, European scientists celebrated the authors as celebrities:
Our censored article in Medical Hypotheses and all the articles and quotations about it that followed in Science and Nature, made us kind of celebrities here. We were admired for our courage to defy the overwhelming power of the corporations. Even more; we (authors) all proudly list our withdrawn Medical Hypothesis article in our CVs and it is highly valued. … Last October, Dr. Stefania Pacini (the corresponding author of the Medical Hypothesis paper and, incidentally, my wife) was appointed professor by a commission of Italian professors who evaluated her publications, including Med Hypo.
… [T]he act of Elsevier forcibly withdrawing our paper is considered the worst offence against science; we have been perceived as moral heirs of Galileo, persecuted because of our scientific hypotheses. As a matter of fact, when the Med Hypo article was published, the press office of the University put it in the home page of the University web site as a most distinguished accomplishment of Florentine researchers.
For this reason, physicians are flying as blindly as patients, relying on reports written primarily by an industry that spent $9 billion (since 2004) to settle thousands of criminal and civil complaints related to the illegal marketing of drugs that kill or injure a million Americans every year:
We have found that serious (adverse drug reactions) ADRs are frequent and more so than generally recognized. Fatal ADRs appear to be between the fourth and sixth leading cause of death. Their incidence has remained stable over the last 30 years. [JAMA. 1998;279(15):1200-1205 (doi:10.1001/jama.279.15.1200)]
But unlike major airline crashes that can ground airplanes for weeks, “there’s no economic incentive for hospitals to reduce errors because they make more money by treating the resulting problems.”
Who Gets Hurt?
Clarence and Tamara Jones (not their real names) live in a suburb of a major US city. Both are hard-working and successful law-abiding citizens who have enjoyed their monogamous relationship for many years.
In 2006, Tamara gave birth to their fourth child. Shortly after delivery, her doctor tested Tamara and her baby for HIV. When the tests came back positive, their doctors prescribed deadly HIV drugs to both.
Predictably, both became very sick. When they stopped the drugs, both recovered.
Shortly before Tamara delivered their fifth child last December, her doctor stated his intention to start Zidovudine (AZT), allegedly to prevent Tamara from transmitting HIV to her unborn baby as per CDC guidelines.
Those guidelines, however, are posted above this disclaimer, which links readers to this website and the CDC’s NPIN disclaimer, which “does not … assume any legal liability or responsibility for the accuracy, completeness, or usefulness of any information …” despite guidelines to insure quality information.
Although the baby tested HIV-negative, the doctor and hospital notified county child services officials, who initiated the process of placing their children in the care of foster parents who are paid to administer deadly toxins that Clarence and Tamara are trying to protect their children from.
Although OMSJ continues to defend the “Jones Family,” they are under constant threat by county officials while OMSJ investigates the credibility of their original HIV diagnosis. Tamara and her children would not be the first injured or killed by incompetent doctors, but because HIV incompetence is the “standard of care” in many US cities, doctors who refuse to deliver deadly drugs to black mothers and their babies risk the suspension of clinical privileges and the loss of their medical licenses.
Simply stated, doctors and patients rely on the same pharma promotion markets that publishers, government agencies, and the drug industry relies on. And when patients die, the officials blame the doctors and the patients they injure or kill.
Hiding in Plain Sight
None of this is a secret. Warnings are prominently posted on every pharmaceutical marketing website and government agency in the US.
What is less understood is why patients still believe what their doctors say. Then again, a sucker is born every minute; and he’s usually too self-conscious to ask questions—even if it saves his life.