Making it up
November 5th 2012, 17:02 | Bryan Hubbard
Around 90 years ago, the pharmaceutical industry took over medicine. Inspired by the discoveries made by its sister companies in the burgeoning petro-chemical sector, it imagined medicine on a mass-production scale, available to everyone at their point of need.
There had to be a few things in place for the bold adventure to work. First, it needed legitimacy, and for that the new drugs-based medicine had to be recognised as a science.
But how do you create a science from an intimate one-on-one relationship between a doctor and a unique, and biologically dynamic, patient? You have to pretend we are all biologically similar, and so the disease is the same for everyone, treatable in the same way.
With that established, you can 'prove' the chemical agent works by testing it in large-scale 'scientific' studies, and you can train up the doctors through medical school to make them drug-delivery salesmen. You also insinuate your way into the media and government to ensure the message is reinforced, and you kill of any alternatives because there's no evidence they work. Yours is the science.
Unfortunately, there's one problem. Remember that bit about people being biologically unique? That was always rearing its head, and it invalidated most of the large-scale trials. It was pretty hard to get an effect much above placebo; using the scientific method, medicine was consistently demonstrated not to be a science after all, because a causal effect couldn't be established, let alone replicated.
No matter, there's nothing money can't solve. Pay the PR people to make up the stuff, then pay an academic to put his or her name to the paper, get it published in a prestigious medical journal, then wave it in front of the doctor, who will be comforted to know he is doing the right thing by prescribing the drug.
Around 75 per cent of 'scientific' medical trials are created that way, yet even with that level of fraud going on, the BMJ's Clinical Evidence Handbook shows that just 12 per cent of drugs and therapies have any evidence to suggest they work, as our Special Report this month highlights. Take into account fraud, and you're down to around 3 per cent.
Now, that isn't a science. Fancy boarding planes that crash 97 per cent of the time? But then, healing never could be reduced to a mass-production system: a shame for the shareholders, perhaps, but good news for the patient.