Friday, February 25, 2011

"No soul to be damned, no body to be kicked"

There's a possibility you've missed the story of Dr Peter Wilmshurst, a consultant cardiologist at the Royal Shrewsbury Hospital, being sued by Boston-based NMT Medical over alleged comments about the conduct of a trial that he was, at one time, lead investigator for.

Summary: NMT sponsored the trial of a treatment that it thought could benefit chronic migraine sufferers. The trial showed, fairly conclusively, that the treatment - which is both expensive and invasive - doesn't work. For reasons that I'm not fool enough to go into here, the final published paper glossed over the negative result, hinted at more positive effects (beyond the scope of the original trial parameters) that could be deduced by suitably massaging the data ("excluding outliers"), and ignored potentially serious side effects arising from the procedure. Dr Wilmshurst and one other investigator withdrew their names from the paper before it was published, and Dr Wilmshurst was so indiscreet as to talk about the whole fiasco at a conference in Washington in 2007. His comments were published on the web, and from there it's only a short hop to the High Court.

There's so much Wrong in this story that it's hard to know where to begin. It's wrong that a US company can sue a person under English law for something said to a conference in the US. It's wrong that a speech made - on-topic, by an eminently qualified person - at a technical conference, should be the subject of legal proceedings. It's wrong that lawyers and judges, of all people, are being asked to judge the validity of medical trial methodologies. It's wrong that Dr Wilmshurst has, so far, spent the price of a medium-sized house on his own defence; what exactly are his lawyers doing, to earn that sort of money? It's wrong that he has no prospect of ever getting that money back, since (a) most US courts will (understandably) refuse to enforce an award ruled by a UK libel court, and (b) if he wins, the company will probably be broke anyway. It's utterly, indefensibly, inexplicably wrong that a company can sue for libel - a law that's supposed to protect the reputations of people - at all. This case is the epitome of asymmetrical justice.

And not least, it's wrong that you and I only hear about the whole story through blatantly partisan blogs (like this one). Because, while I know nothing about Dr Wilmshurst personally, I know that he chose to have this fight. And there are plausible people on the other side of the case.

But what's most wrong of all is that NMT's directors are doing the right thing.

If their flagship product doesn't work, their company is in big trouble. It is clearly the directors' duty to do everything in their power to obscure that fact and continue to milk money out of the structure of gullible, vulnerable patients, susceptible doctors, and equally amoral insurers that, collectively, represent their meal tickets. Already the company has lost over 90% of its share price; a decisive victory for Dr Wilmshurst could wipe it out.

It's not optional. NMT's directors have to be as unscrupulous, vicious and amoral as inhumanly possible. It's their duty to their shareholders; anything less could get them sued.

Welcome to the world we've built ourselves. Not only do we reward amorality - we demand it.


Cian said...

I'm glad you posted that. I keep meaning to check the Bad Science website and I keep forgetting. I rather enjoyed reading Ben's book. I have read other similar books, but his (to me anyway) seemed like the only one that was not taking issue with some body/organization for what they were promoting but how they were selling it, or the research behind it, or their (lack of) qualifications.

For example I practice Reiki with which he doesn't take issue. Reiki practitioners don't pretend that there is scientific proof behind it, because there isn't!

If only it were NMT's directors who are unscrupulous, vicious and amoral life would be better. But these are traits right across our corporate world today.

vet said...

I've never seen him comment on Reiki. I would assume, as you do, that he's okay with it as long as no-one claims it's scientific.

The point about NMT's directors is that they're just doing what they have to do. If they felt insufficiently evil, they'd be duty bound to stand down at this point and let someone nastier have a go.

It doesn't have to be this way. It wasn't this way, until fairly recently. It's only since, approximately, the end of the Cold War, that we've instituted "total selfishness" as a virtue. The documentary (last link above) makes some interesting observations about how and why this happened.