Monday, April 06, 2009

First, Do No Harm A Survey


First, Do No Harm A Survey


By Richard A. Warner


Doctors of Deception

By Linda Andre

Rutgers University Press, 2009



Earlier this year, Marcia Angell, writing in The New York Review of Books, lamented, “It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.” [1]   Angell’s review laid out the many ways in which the medical field, particularly psychiatry (where diagnosis is based upon subjective and arbitrary criteria, not objective lab testing), has allowed itself to be thoroughly corrupted by its extensive ties to the pharmaceutical industry. 


For a doctor with Angell’s credentials to say, in essence, “Don’t trust what your doctors tell you,” is certainly eye-opening.  Yet for every in-depth report that confirms Angell’s verdict, there are ten million drug ads and marketing lies published by the profit-driven media that drown out the measured voice of medical science.  Recent ads for the antipsychotic drug Abilify, which advertise a two-thirds failure rate for antidepressants (hence the need to amplify treatment with Abilify), demonstrate just how thoroughly stupefying the indoctrination has been.  The message from doctors and drug companies to the public is clear:  “Don’t expect to get well.  Illness is a lifelong affair (or, for psychiatry, life is an illness) so expect to see us often, take multiple medications, and muddle through.  It’s the best you can hope for.”   


So far the public is, quite literally, buying it. 


It is dismaying to see how casually the psychiatric/pharmaceutical complex showcases its failures to achieve success. It knows that even commercials featuring long lists of troubling side effects will not stop a pill-popping nation from taking its advice to “consult with your doctor.”  The doctors, of course, “consult” with, and are trained by, drug companies. [1, 2]


The only tonic for such programmed madness is the truth and it’s prescribed in megadoses in Linda Andre’s new book, Doctors of Deception.  In this case the doctors are psychiatrists who use and promote shock treatment, also known as electroconvulsive therapy (ECT).   Andre shows us how they have for decades buried evidence, falsified reports, and employed a “new and improved” public relations mantra to sell a brain damaging procedure.


Not surprisingly, all the elements of corruption reported by Angell are also present in the shock industry.  Just as the pharmaceutical industry steers research to predetermined “findings” [1], prevents negative studies from being published [1, 3], enervates FDA oversight [4], and even crafts diagnostic criteria to create a market for drugs [5], so for decades a small group of psychiatrists, many with financial interests in shock machine manufacturers, has controlled the principal source of funds for ECT research, the National Institute of Mental Health, thereby insuring that studies which could demonstrate the extent of shock’s devastating memory, attention and learning effects (about which well over a third of those who receive shock complain) were never undertaken.[6]  Those same gatekeepers wrote the American Psychiatric Association (APA) task force reports on electroconvulsive therapy so that negative findings regarding shock would never reach a broader audience. The reports, which first appeared in 1978 and were updated in 1990 and 2001, were created to serve as public relations documents and psychiatrists have cited them regularly before federal and state governmental bodies as proof that shock is safe and effective in the absence of any real proof that it is.


In Doctors of Deception the case against shock is presented as part of a narrative history of the industry’s efforts to cover up that case.  The key conclusions of studies that psychiatry would rather no one knew existed are integrated into the fascinating story of how victims of ECT and advocates for informed consent have battled the shock establishment.  The result is a work which is both compelling and enormously informative.


Andre reveals that there was ample research in the 1940’s and 50’s to conclude that shock dramatically impaired memory and cognitive functioning, resulting in the experience of a shattered self. [7]   Shock profiteers responded with a sales pitch that to this day dominates media coverage of ECT:  Shock is effective and prevents suicide, and new techniques - oxygenation, anesthesia, less electricity, and different electrode placements – make the “new” shock safe.  The fact that there is not a shred of medical evidence that any of this is true – and much to prove it false - has not prevented the message from being repeated endlessly.  


By lying about the true risk/benefit picture of shock, the APA, says Andre, has “subtly redefined the very meaning of words like ‘informed consent’” and “the ECT industry has found a foolproof way to get around laws protecting patients’ rights to full disclosure and to refuse treatment.”

Fraud and criminality within the psychiatric drug industry is so egregious that it can no longer be overlooked and well respected voices like Angell are beginning to be heard.  Prior to Andre’s book, however, there was a dearth of information about the covert machinations of the shock industry.  Doctors of Deception goes a long way towards remedying that scarcity. 


Psychiatry will, of course, fight back with more PR campaigns.  The “stigma of mental illness,” created by psychiatry and perpetuated via its expanding diagnostic manual and Orwellian “anti-stigma” campaigns, will be put to full use to dehumanize and dismiss those who speak out against shock treatment’s brutal effects. But Andre’s book now gives those who care about human rights in the mental health field a powerful weapon with which to battle the Doctors of Deception.





1. Marcia Angell, “Drug Companies & Doctors: A Story of Corruption,” The New York Review of Books, Volume 56, Number 1, January 15, 2009.

2.  Daniel Carlat, “Diagnosis” Conflict of Interest,” The New York Times, June 13, 2007.  Carlat, a professor at Tufts Medical School, referred to  “ …the transformation of continuing medical education into an enterprise for drug marketing. The chore of teaching doctors how to practice medicine has been handed to the pharmaceutical industry.”


3. Erick H. Turner et al., "Selective Publication of Antidepressant Trials and Its Influence on Apparent Efficacy," The New England Journal of Medicine, January 17, 2008.


4.  Members of the 1991 FDA panel that investigated SSRI antidepressants (Prozac, Paxil, Zoloft, etc) and concluded they did not pose an increased risk of suicidality had extensive financial ties to drug companies that made SSRIs.  One, in fact, the University of Washington’s David Dunner, had $200,000 in pending grants from Eli Lilly and Company, the manufacturer of Prozac, as he sat on the committee.  In 2004 the FDA finally ordered antidepressant manufacturers to place a black box warning on the drugs stating, “Antidepressants increase the risk of suicidal thinking and behavior (suicidality) in children and adolescents with major depressive disorder (MDD) and other psychiatric disorders.”  This warning was later extended to anyone under 25 years of age.  See Peter and Ginger Breggin, Talking Back to Prozac, St. Martin’s Press, New York, 1994, pp. 172-173.

5.  As Angell notes, all of the experts who wrote the diagnostic criteria for psychiatric mood disorders (e.g., depressive and anxiety disorders) had financial ties to drug companies.  (See Lisa Cosgrove et al., "Financial Ties Between DSM-IV Panel Members and the Pharmaceutical Industry," Psychotherapy and Psychosomatics, Vol. 75, No. 3 (2006).  Also, Judith Graham, “Study Finds Ethical Conflicts,” Chicago Tribune, April 20, 2006; Benedict Carey, “Study Finds a Link of Drug Makers to Psychiatrists,” The New York Times, April 20, 2006.

6. In a January 2007 study, renowned shock researcher Harold Sackeim confessed, “Despite ongoing controversy, there has never been a large-scale, prospective study of the cognitive effects of electroconvulsive therapy.” (See Sackeim, H.A., Prudic, J., Fuller R., et al., “The Cognitive Effects of Electroconvulsive Therapy in Community Settings,” Neuropsychopharmacology, 32: 244-254, 2007, p. 244.

7. Those who have undergone shock describe the destruction of identity in unmistakable terms. First person accounts at the website,, contain such statements as, “I do not know who I am any more [record 57]”; “It left me as a shell.  I still have no real identity [record 71]”; “Everything I do remember feels like it belongs to someone else [record 207]”; “I feel like I’ve lost my soul [record 261].”).  In an appendix to her book, Andre has included selections from the hundreds of letters that were submitted by victims of ECT to the FDA committee that investigated ECT’s risks and benefits.  Their statements are nothing short of horrifying.

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