E-drug: An Article from the globeandmail.com Web Centre
---------------------------------------------
The following is an article from the globe and mail.com Web Centre.
Joel Lexchin MD
121 Walmer Rd.
Toronto, Ontario
Canada M5R 2X8
T: +416-964-7186
F: +416-923-9515
e mail: joel.lexchin@utoronto.ca
Reprinted under the fair use doctrine
of international copyright law:
Sunday, April 15, 2001
Prozac critic sees U of T job revoked
By ANNE McILROY
From Saturday's Globe and Mail
A world-renowned scientist saw a job offer at the University of
Toronto evaporate after warning that the popular antidepressant
Prozac may trigger suicide in some patients.
The drug's manufacturer, Eli Lilly, is an important private donor to
a mental-health research institute affiliated with the university.
Critics say it appears that David Healy's job offer was rescinded to
avoid offending the corporate giant or for fear of compromising
future fundraising efforts.
Eli Lilly said it had no role in the matter. The university said the
decision not to hire Dr. Healy was made by the Centre for Addiction
and Mental Health, an affiliated teaching hospital, and that it would
not be proper for the university to question it. The Centre for
Addiction and Mental Health, for its part, steadfastly denies that it
has allowed fundraising concerns to interfere with academic freedom.
"If you are asking me if his comments influenced our decision, let
me be clear that there were a number of factors involved. We regret
that our actions have been misinterpreted as an attack against
academic freedom and as a conflict of interest," said Paul Garfinkel,
chief executive officer of the CAMH.
Dr. Garfinkel said the reasons for the decision to revoke Dr.
Healy's job offer are confidential. "Let me be clear, we've never
made an offer or withdrawn an offer on the basis of an impact on an
outside donor."
When initially approached by The Globe and Mail several months ago,
Dr. Healy, who works at the University of Wales, was reluctant to
speak publicly about what happened.
He said he decided to do so to publicize his concerns about Prozac
and to raise questions about the appearance of a conflict of interest
at U of T.
"I've had people call from a number of countries asking whether it
is safe to say something [critical] about pharmaceutical companies.
The public needs to know what happened here," he said in an interview.
Dr. Healy said that he made his views clear in private interviews
with university officials before the speech.
University of Toronto colleagues are providing a public platform for
him to express his views on Prozac next week. He will give a lecture
at the Joint Centre for Bioethics on Thursday evening.
U of T and CAMH had been courting Dr. Healy since July of 1999. They
made him a formal written offer of a combined faculty and clinical
position in May of 2000, followed by a more detailed letter in
August. They hired a lawyer to help him immigrate.
Then, on Nov. 30, 2000, Dr. Healy gave a wide-ranging lecture at
CAMH, part of a colloquium titled Looking Back, Looking Ahead �
Psychiatry in the 21st Century: Mental Health and Addiction.
He criticized pharmaceutical companies for avoiding experiments that
could demonstrate problems with their drugs, and for not publishing
unfavourable results. He said the data show that Prozac and other
popular antidepressants in the same chemical family may have been
responsible for one suicide for every day they have been on the
market.
A week later, Dr. David Goldbloom, physician-in-chief at CAMH and a
professor at U of T, rescinded the offer to Dr. Healy in an e-mail, a
copy of which was sent to The Globe and Mail in an unmarked brown
envelope.
Dr. Goldbloom told Dr. Healy his lecture was evidence that his
approach was not "compatible" with development goals. Development, in
the university context, is widely understood to mean fundraising,
although CAMH denies that fundraising was what was meant.
Eli Lilly, the drug company that manufactures Prozac, is its "lead"
donor according to the CAMH Web site, contributing more than
$1-million to the centre's $10-million capital-fundraising campaign.
Last year, Eli Lilly cancelled its $25,000 (U.S.) annual donation to
the Hastings Center in New York, a think tank that looks at ethical
issues, after it published a series of articles about Prozac,
including a critical one by Dr. Healy titled Good Science or Good
Business.
"The centre had published articles that Lilly felt contained
information that was biased and scientifically unfounded and that may
have led to significant misinformation to readers, patients and the
community," said Laurel Swartz, manager of corporate communications
for Eli Lilly.
Two U of T professors, who have asked that their names not be
published, said that what happened to Dr. Healy in Canada raises
disturbing questions about whether professors are free to be critical
of drug companies in an era where medical schools are heavily
dependent on them for financing.
James Turk, executive director of the Canadian Association of
University Teachers, said the paper trail appears to make it clear
why Dr. Healy was no longer welcome at U of T.
"The language they use indicates they feel they can't hire this guy
because it will give them trouble raising money," Mr. Turk said.
Experts such as Bob Michels, the former head of medicine at Cornell
University in New York, say Dr. Healy is internationally renowned,
both as a clinical psychopharmacologist and a historian of the role
of drugs in modern psychiatry.
He is also well-known for his outspoken criticism of Prozac and
other similar drugs and has appeared as an expert witness on behalf
of families suing Eli Lilly and other drug companies.
Dr. Healy says the data show Prozac and related medications, which
are widely prescribed for people who in the past would not be deemed
sick enough to require medication, can cause patients with no history
of mental illness to fall into a state of extreme agitation anxiety.
In some cases it can lead to suicide, or thoughts of suicide.
Last year, Dr. Healy published a study that found that two healthy
volunteers out of 20 who were given Prozac reported feeling extremely
anxious and that they entertained thoughts of suicide.
Eli Lilly says Prozac is safe. "There is no credible scientific
evidence that establishes a causal link between Prozac [fluoxetine
hydrochloride] and violent or suicidal behaviour," Ms. Swartz said.
Dr. Healy insists warning labels are needed on Prozac so doctors
will know to watch for suicidal tendencies when they prescribe the
antidepressant.
His speech did not go over well at U of T. Dr. Healy said Dr.
Goldbloom appeared unhappy when they discussed the lecture at a
dinner that evening.
Dr. Healy said he understood Dr. Goldbloom to be critical of his
speech because people would take away from it the understanding that
Prozac makes people suicidal and the Eli Lilly knew about the problem
but wouldn't acknowledge it.
Dr. Healy left that weekend for New York, where he was scheduled to
give the same speech at Cornell University.
On the Monday after the Thursday speech, Dr. Goldbloom began sending
Dr. Healy e-mails saying it was urgent they find a time to talk by
telephone. Dr. Healy kept copies of them, and has provided them to
The Globe and Mail.
When the two men couldn't arrange the phone call, Dr. Goldbloom sent
the e-mail rescinding the job offer on behalf of both CAMH and U of T.
"Essentially, we believe that it is not a good fit between you and
the role of leader of an academic program in mood and anxiety
disorders at the Centre and in relation to the University. This view
was solidified by your recent appearance at the Centre in the context
of an academic lecture," the message said.
"While you are held in high regard as a scholar of the history of
modern psychiatry, we do not feel your approach is compatible with
the goals for development of the academic and clinical resource that
we have."
Dr. Goldbloom would not be interviewed for this story. Dr. Garfinkel
said he didn't know what Dr. Goldbloom had said to Dr. Healy in
person after the speech. But he categorically denied that when Dr.
Goldbloom referred to the development of the centre he was referring
in any way to the ability to raise funds, either from Eli Lilly or
other drug companies.
"Development is a technical term that many places use to talk about
fundraising. This is development of a program, totally different
meaning," Dr. Garfinkel said.
He said the meeting where senior managers from U of T and CAMH made
the decision to rescind the job offer was on Dec. 8. Yet Dr.
Goldbloom sent the e-mail on Dec. 7, and began requesting an
interview by phone several days before that.
Dr. Healy didn't quit his job in Wales and said he is not planning
legal action. He said he has asked for a more detailed explanation
about why the job offer was rescinded, but none was given. He said he
would like to hear from Dr. Garfinkel about the confidential reasons
the job offer was revoked.
"Nobody has offered me any other reasons at all. I don't believe
there are any other reasons. We have the paper trail, and what I am
asking them to explain is the paper trail. Maybe there is an
explanation that will let them off the hook, but if there is, maybe
they could try explaining it to me."
He certainly never imagined that his speech, which contained nothing
he hasn't said before, would cost him the job.
In fact, Dr. Michels said the same speech did not cause problems at Cornell.
"He certainly has many people who sharply differ with him. That's
not unusual in science. He has points of view that other people don't
agree with. He has certainly been very open and expressive about his
points of view. The material is an area where there is great
controversy, and he takes positions in that controversy, but they are
well within the dialogue in his field."
This is the second controversy of its kind at the university.
Researcher Nancy Olivieri faced an ugly internal battle and a lawsuit
in when she published data unfavourable to the drug company that
funded her work.
Copyright � 2001 Globe Interactive, a division of Bell Globemedia
Publishing Inc.
Visit the globeandmail.com Web Centre, your competitive edge for
breaking news stories as they happen.
News: http://www.globeandmail.com
--
Send mail for the `E-Drug' conference to `e-drug@usa.healthnet.org'.
Mail administrative requests to `majordomo@usa.healthnet.org'.
For additional assistance, send mail to: `owner-e-drug@usa.healthnet.org'.