free paper: social psychology, marketing, and physician vulnerability

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Physi­cians under the Influ­ence: Social Psy­chol­ogy and Indus­try Mar­ket­ing Strate­gies by Sunita Sah and Adri­ane Fugh-​Berman from the Jour­nal of Law, Med­i­cine and Ethics, Vol­ume 14, No. 3, August 2013 at the Social Sci­ence Research Network

There are 17, double-​spaced easy to read pages. The rest of the pages are references.

Abstract:

Phar­ma­ceu­ti­cal and med­ical device com­pa­nies apply social psy­chol­ogy to influ­ence physi­cians’ pre­scrib­ing behav­ior and decision-​making. Physi­cians fail to rec­og­nize their vul­ner­a­bil­ity to com­mer­cial influ­ences; due to self-​serving bias, ratio­nal­iza­tion, and cog­ni­tive dis­so­nance. Pro­fes­sion­al­ism offers lit­tle pro­tec­tion; even the most con­scious and gen­uine com­mit­ment to eth­i­cal behav­ior can­not elim­i­nate unin­ten­tional, sub­con­scious bias. Six prin­ci­ples of influ­ence — rec­i­p­ro­ca­tion, com­mit­ment, social proof, lik­ing, author­ity, and scarcity — are key to the industry’s rou­tine mar­ket­ing strate­gies, which rely on the illu­sion that the indus­try is a gen­er­ous avun­cu­lar part­ner to physi­cians. In order to resist indus­try influ­ence, physi­cians must accept that they are vul­ner­a­ble to sub­con­scious bias, and have both the moti­va­tion and means to resist indus­try influ­ence. A cul­ture in which accept­ing indus­try gifts engen­ders shame, rather than grat­i­tude, will reduce con­flicts of inter­est. If greater aca­d­e­mic pres­tige accrues to dis­tant, rather than close rela­tion­ships with indus­try, a new social norm may emerge that pro­motes patient care and sci­en­tific integrity. In addi­tion to edu­cat­ing fac­ulty and stu­dents about the social psy­chol­ogy under­ly­ing sophis­ti­cated, but poten­tially manip­u­la­tive mar­ket­ing and about how to resist it, aca­d­e­mic med­ical insti­tu­tions should develop strong orga­ni­za­tional poli­cies to coun­ter­act the med­ical profession’s improper depen­dence on industry.

from this great read­ing list by Doc­tor Mickey Nardo

free article on psychiatry, drugs, and the influence of drug industry

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Drug Firms, the Cod­i­fi­ca­tion of Diag­nos­tic Cat­e­gories, and Bias in Clin­i­cal Guide­lines by Lisa Cos­grove and Emily Wheeler in the Jour­nal of Law, Med­i­cine and Ethics, Vol. 14, No. 3, 2013 at the Social Sci­ence Research Network

This is a very read­able doc­u­ment. It has six­teen pages of text, and the rest of the pages are filled with references.

…the prob­lem is not quid pro quo cor­rup­tion involv­ing the indi­vid­ual “bad apple”; the prob­lem is the “bad barrel.”

The pro­fes­sion of med­i­cine is pred­i­cated upon an eth­i­cal man­date: first do no harm. How­ever, crit­ics charge that the med­ical profession’s cul­ture and its pub­lic health mis­sion are being under­mined by the pharma-​ceutical industry’s wide-​ranging influ­ence. In this arti­cle, we ana­lyze how drug firms influ­ence psy­chi­atric tax­on­omy and treat­ment guide­lines such that these resources may serve com­mer­cial rather than pub­lic health inter­ests. Mov­ing beyond a conflict-​of-​interest model, we use the con­cep­tual and nor­ma­tive frame­work of insti­tu­tional cor­rup­tion to exam­ine how orga­nized psychiatry’s depen­dence on drug firms has dis­torted sci­ence. We sug­gest that academic-​industry rela­tion­ships have led to the cor­rup­tion of the evi­dence base upon which accu­rate diag­no­sis and sound treat­ment depend. We describe the cur­rent depen­dency
cor­rup­tion and argue that trans­parency alone is not a solu­tion — and some­times even pro­duces
iatro­genic effects. Fur­ther­more, we argue that the cor­rup­tion of the evi­dence base for diag­nos­tic and prac­tice guide­lines ren­ders obso­lete the tra­di­tional informed con­sent process, and we offer sug­ges­tions for reform­ing this process.

from this great read­ing list by Doc­tor Mickey Nardo

gun control and gun violence

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A Con­victed Murderer’s Case for Gun Con­trol by John Lennon at The Atlantic

Engulfed in an orgy of vio­lence, my last month of free­dom was chaos. Home inva­sions, rob­beries, mur­der — at the cen­ter of it all were guns: They would be dis­posed of, tossed after shoot-​outs, then bought again. Eas­ily. And I always bought new guns, so the notion that crim­i­nals just use stolen guns, acquired from a neigh­bor­hood bur­glar, is absurd. (The paper trail may sug­gest that, because the peo­ple mak­ing straw pur­chases also file false reports claim­ing the guns stolen.) Like most crim­i­nals, I cre­ated an extra­or­di­nary demand for the gun sector.

I’m where I belong. But with­out a gun I would not have killed. Like most mis­guided, impul­sive youth in Amer­ica, I was emo­tion­ally and socially retarded, with a killing machine on my waist. The gun sec­tor and I do not share the same cul­pa­bil­ity. Hardly. It’s uneth­i­cal, how­ever, for stake­hold­ers of Sturm, Ruger and Smith & Wes­son to con­test over­sight that would pre­vent arm­ing indi­vid­u­als like me.

President Obama on the relationships between education and the economy

30 minutes:46 sec­onds

SSRI induced mania and dopaminergic supersensitivity from antipsychotics

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abstract: Antidepressant-​associated mania and psy­chosis result­ing in psy­chi­atric admis­sions. at PubMed

Despite the pos­i­tive changes in the side effect pro­file of anti­de­pres­sant drugs, the rate of admis­sions due to antidepressant-​associated adverse behav­ioral effects remains significant.

free online arti­cle at The Jour­nal of Neu­ro­science “Break­through” dopamine super­sen­si­tiv­ity dur­ing ongo­ing antipsy­chotic treat­ment leads to treat­ment fail­ure over time.

Antipsy­chotics often lose effi­cacy in patients despite chronic con­tin­u­ous treat­ment. Why this occurs is not known. It is known, how­ever, that with­drawal from chronic antipsy­chotic treat­ment induces behav­ioral dopamin­er­gic super­sen­si­tiv­ity in ani­mals. How this emerg­ing super­sen­si­tiv­ity might inter­act with ongo­ing treat­ment has never been assessed. There­fore, we asked whether dopamine super­sen­si­tiv­ity could over­come the behav­ioral and neu­ro­chem­i­cal effects of antipsy­chotics while they are still in use. Using two mod­els of antipsychotic-​like effects in rats, we show that dur­ing ongo­ing treat­ment with clin­i­cally rel­e­vant doses, haloperi­dol and olan­za­p­ine pro­gres­sively lose their effi­cacy in sup­press­ing amphetamine-​induced loco­mo­tion and con­di­tioned avoid­ance responding.

facts about the debt limit and default

The fol­low­ing Depart­ment of Trea­sury doc­u­ment about the national debt limit was pub­lished in May 2011, and is as true and fac­tual now as it was then.

Debt Limit: Myth v. Fact

Down­load (PDF, 124KB)

great comment, righteous advice, and “Natural Resources”

Excerpt from Nat­ural Resources from The Dream of a Com­mon Lan­guage 
by Adri­enne Rich

9.

I am tired of faint­heart­ed­ness,
their hav­ing to be excep­tional

to do what an ordi­nary woman
does in the course of things

I am tired of women stoop­ing to half our height
to bring the essen­tial vein to light

tired of the waste of what we bear
with such cost, such ela­tion, into sight

(— for what becomes of what the miner probes
and carves from the mountain’s body in her pain?)

10.

This is what I am: watch­ing the spi­der
rebuild— “patiently”, they say,

but I rec­og­nize in her
impa­tience— my own—

the pas­sion to make and make again
where such unmak­ing reigns

com­ment #11 by Bijan Par­sia respond­ing to the ques­tion, Any­one have any thoughts about what sorts of advice one might give to an aspir­ing male feminist?

Ben­e­fit oth­ers more than you ben­e­fit.” Esp. if it’s sta­tus, mate­r­ial gain, etc. You don’t need to be a mar­tyr, but fem­i­nism is, in part, a social move­ment look­ing for jus­tice. Activism implies aim­ing for the greater good.

Do the shit jobs.” The shit jobs always need doing so why not do them? If you don’t do them, some­one else, often with less resources, ends up doing them. But don’t preen or any­thing. Just do them.

Speak for your­self among oth­ers.” Don’t speak for oth­ers, but only your­self. Use your own voice while recog­nis­ing that it is a voice among oth­ers. Think about the voices as much as what’s said. Lis­ten a lot and look for lis­ten­ing oppor­tu­ni­ties. Be more glad to have heard some­one or some­thing new than to have said some­thing awe­some. Use your voice to facil­i­tate new voices over extend­ing the reach of your own. I find Joyce Treblicot’s Dyke Ideas very help­ful read­ing here.

Own and repair your fuck­ups.” If you mess up, own it fast and make seri­ous efforts at resti­tu­tion. If that means leav­ing a scene, then do that. Try hard to do bet­ter. If you per­sis­tently fail to do bet­ter, recog­nise this and con­sider whether you are a net good. Ask for help *before* the next big fail­ure. Even if your fuck­ups aren’t your fault (or you think they aren’t’) think more about fix­ing them then get­ting the blame right.

philosophy of science and anthropology

mad scientist

Car­toon Ver­sions of Sci­ence and the harms they do (in Anthro­pol­ogy) by Eric Schliesser at New APPS: Art, Pol­i­tics, Phi­los­o­phy, Science

This post opens with an excerpt from –Justin Smith’s review of Napoleans Chagnon’s book the Noble Sav­ages: My Life among Two Dan­ger­ous Tribes– The Yanomamö and the Anthro­pol­o­gists .

One can’t help but share in Chagnon’s frus­tra­tion at the hasty deci­sion of the major­ity of his dis­ci­pli­nary peers to dis­own its his­tor­i­cal con­nec­tion to any branch of the com­plex and var­ie­gated sci­en­tific tra­di­tion. After all, until very recently (and to some extent to this day still in lan­guages such as French and Ger­man), a ‘sci­ence’ was any rel­a­tively sys­tem­atic body of knowl­edge, any­thing the goal or prod­uct of which was sci­en­tia, and it is only in the very most recent times that the notion has been reduced to the fig­ure of somber men seek­ing to run the world on the basis of claims of unas­sail­able exper­tise. Yet the car­toon ver­sion of sci­ence that Chagnon pro­poses in response, in its total fail­ure to rec­og­nize that there might be spe­cial prob­lems of theory-​ladenness, power inequal­ity, loop­ing effects, prej­u­dice –in a word, all those fac­tors that make the sci­en­tific study of humans a more del­i­cate mat­ter than the study of other domains of nature – , can eas­ily make one wish to take the ‘post­mod­ern’ turn one­self, if only to get away from this astound­ingly sim­plis­tic pre­tense of scientificity.

Justin is one of the lead­ing his­to­ri­ans of phi­los­o­phy of my gen­er­a­tion. He is also a staunch defender of the fact that “one can in fact approach the sub­ject mat­ter of anthro­pol­ogy nat­u­ral­is­ti­cally, using the con­cep­tual tools of Euro­pean tra­di­tions of thought, and still come up with the­o­ret­i­cally sophis­ti­cated accounts of indige­nous beliefs that remain nonethe­less sen­si­tive to the actual con­cerns, to the ‘voices’, of the peo­ple being stud­ied.” (He also wants to bring some anthro­po­log­i­cal meth­ods into the his­tory of philosophy.)

See Karl Popper’s wikipedia page for more infor­ma­tion on the phi­los­o­phy of science.

See Thomas Kuhn’s wikipedia page for more infor­ma­tion about par­a­digm shift.

See Napolean Chagnon’s wikipedia page for more infor­ma­tion about Napolean Chagnon and scandal.

Nat­u­ral­is­tic Approaches at the Stan­ford Ency­clo­pe­dia of Philosophy

fast food workers and the need for a living wage

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photo by Michael Nagle for The New York Times

Amer­i­cans Finally Say­ing No to God Awful ‘McWages’ by Ben Cohen at The Daily Banter

OECD