White Coat, Black Hat (eBook)

Carl Elliott (Autor)

eBook Download: EPUB

2010 | 1. Auflage
224 Seiten
Beacon Press (Verlag)
978-0-8070-6143-5 (ISBN)

Infos

Over the last twenty-five years, medicine and consumerism have been on an unchecked collision course, but, until now, the fallout from their impact has yet to be fully uncovered. A writer for The New Yorker and The Atlantic Monthly, Carl Elliott ventures into the uncharted dark side of medicine, shining a light on the series of social and legislative changes that have sacrificed old-style doctoring to the values of consumer capitalism. Along the way, he introduces us to the often shifty characters who work the production line in Big Pharma: from the professional guinea pigs who test-pilot new drugs and the ghostwriters who pen 'scientific' articles for drug manufacturers to the PR specialists who manufacture 'news' bulletins. We meet the drug reps who will do practically anything to make quota in an ever-expanding arms race of pharmaceutical gift-giving, the 'thought leaders' who travel the world to enlighten the medical community about the wonders of the latest release, even, finally, the ethicists who oversee all that commercialized medicine has to offer from their pharma-funded perches.

Taking the pulse of the medical community today, Elliott discovers the culture of deception that has become so institutionalized many people do not even see it as a problem. Head-turning stories and a rogue's gallery of colorful characters become his springboard for exploring larger ethical issues surrounding money. Are there certain things that should not be bought and sold? In what ways do the ethics of business clash with the ethics of medical care? And what is wrong with medical consumerism anyway? Elliott asks all these questions and more as he examines the underbelly of medicine.

Textauszug

The Guinea Pigs

On September 11, 2001, James Rockwell was camped out in a clinical-research unit on the eleventh floor of a Philadelphia hospital where he had enrolled as a subject in a high-paying drug study. As a rule, studies that involve invasive medical procedures are more lucrative--the more uncomfortable, the better the pay--and in this study, subjects had a fiber-optic tube inserted in their mouths and down their esophaguses so that researchers could examine their gastrointestinal tracts.

Rockwell had enrolled in many previous studies at corporate sites, places like Wyeth and GlaxoSmithKline. But the atmosphere there felt professional, bureaucratic, and cold. This unit was in a university hospital, not a corporate lab, and the staff had a casual attitude toward regulations and procedures. 'The Animal House of research units' is what Rockwell calls it. 'I'm standing in the hallway juggling,' he says. 'I'm up at five in the morning watching movies.' Although study guidelines called for stringent dietary restrictions, the subjects got so hungry that one of them picked the lock on the food closet. 'We got giant boxes of cookies and ran into the lounge and put them in the couch,' Rockwell says. 'This one guy was putting them in the ceiling tiles.' Rockwell has little confidence in the data that the study produced. 'The most integral part of the study was the diet restriction,' he says, 'and we were just gorging ourselves at two a.m. on Cheez Doodles.'

On the morning of September 11, nearly a month into the five-week study, the subjects gathered around a television and watched the news of the terrorist attacks through a drug-induced haze. 'We were all high on Versed after getting endoscopies,' Rockwell says. He and the other subjects began to wonder if they should go home. But a mass departure would have ruined the study. 'The doctors were like 'No, no!' ' Rockwell recalls. ''No one's going home, everything's fine!' ' Rockwell stayed until the end of the study and was paid seventy-five hundred dollars. He used the money to make a down payment on a house.

Rockwell is a wiry thirty-year-old massage-therapy student with a pierced nose, he seems to bounce in his seat as he speaks, radiating enthusiasm. Over the years, he has enrolled in more than twenty studies for money, he estimates. The Philadelphia area offers plenty of opportunities for aspiring human subjects. It is home to four medical schools and is part of a drug-industry corridor that stretches from there into New Jersey. Bristol-Myers Squibb regularly sends a van to pick up volunteers at the Trenton train station.

Today, fees as high as the one that Rockwell received in 2001 aren't unusual. The best-paying studies are longer, inpatient trials, where subjects are often required to check into a research facility for days or even weeks at a time so that their diets can be controlled, their blood and urine tested regularly, and their medical status carefully monitored. Occasionally, they also undergo invasive procedures, like bronchoscopies or biopsies, or suffer through something else unpleasant, such as being deprived of sleep, wearing a rectal probe, or having allergens sprayed in their faces. Because such studies require a fair amount of time in a research unit, the usual subjects are people who need money and have a lot of time to spare: the unemployed, college students, contract workers, ex-cons, or young people living on the margins who have decided that testing drugs is better than punching a clock with the...

Produkt-Details

• Erscheint lt. Verlag: 13.10.2010
• Sprache: englisch
• Themenwelt: Sachbuch/Ratgeber ► Gesundheit / Leben / Psychologie
• Themenwelt: Geisteswissenschaften ► Philosophie ► Ethik
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Medizinethik
• Themenwelt: Studium ► Querschnittsbereiche ► Geschichte / Ethik der Medizin
• Themenwelt: Sozialwissenschaften ► Politik / Verwaltung
• ISBN-10: 0-8070-6143-3 / 0807061433
• ISBN-13: 978-0-8070-6143-5 / 9780807061435