The value of robust debate and public access to accurate scientific information is immeasurable. However, interested parties continue to find ways of stifling debate and manipulating the information that flows into society.

Medical Ghostwriting (2010)
Ghostwriting, the practice of publishing an article in which an outside writer has done extensive work on the article without being named on the publication, has become prevalent in the scientific community. Particularly, according to the New York Times, medical journals are publishing articles written by an unnamed writer (sometimes paid by the company whose product is being studied) but giving author credit to a prominent academic. Ghostwriting can mislead doctors about the benefits or effectiveness of drugs or devices by manipulating the information to the industry’s advantage and using a prominent author name to exploit it. This practice has serious consequences for quality and reliability in medical scholarship as well as ramifications for the flow of accurate information to the public.

Senator Charles Grassley (R-Iowa) has said ghostwriting hurts patients and raises costs for taxpayers because it uses prestigious academic names to promote medical products and treatments that might be expensive or less effective than viable alternatives. The Senator has sent letters to top medical schools regarding the practice. He has also applied pressure to the National Institutes of Health to crack down on ghostwriting. In June, 2010 Senator Grassley issued a congressional report recommending measures to cut down on medical ghostwriting.

An example of the dangers of ghostwriting involves scientific papers and the use of hormone replacement therapy. In August 2009, the New York Times reported that court documents have shown that ghostwriters paid by a pharmaceutical company played a major role in producing 26 scientific papers that backed the use of hormone replacement therapy in women. While emphasizing the benefits, the articles simultaneously de-emphasized the risks of taking hormones. These articles created the illusion of medical community consensus which in turn benefited the drug company. As the New York Times articulated, the danger in ghostwriting is that doctors rely on medical literature and might change their opinions and prescription habits after reading articles, unaware that the articles were commissioned and paid for by a drug company.

Ghostwriting appears to be quite prevalent. A survey cited by Nature News found that of 600 authors who had published papers in six major medical journals in 2008, 7.8% indicated there was a ghost author who had contributed significantly but was not credited. In response many journal editors “name and shame” the parties responsible for the ghostwritten article after it has been discovered. They publish a notice that the manuscript has been ghostwritten along with the names of those responsible and alert the academic institution involved as well as the media.

Disease Mongering (2010)
There can and should be legitimate debate over whether certain conditions or symptoms should be treated with drugs. However, the debate may be skewed by the fact that pharmaceutical companies have a strong financial incentive to increase the markets for their products. Companies utilize multimillion dollar ad campaigns to change perceptions of disease held by both doctors and prospective patients.

Industry defends these campaigns as necessary to educate the public about, for example, underdiagnosed diseases. But critics use the term “disease mongering” to describe some ad campaigns which they believe are intended to medicalize aspects of normal life. For example, while critics acknowledge that some patients have severe manifestations of: loss of sexual desire (“hypoactive sexual desire disorder”), shyness (“social phobia”), restless legs (“restless legs syndrome”), or difficulty concentrating (“attention deficit disorder”), they point out that many of these phenomenon in less severe forms may be common life experiences not warranting treatment. Yet, marketing campaigns for drugs may be designed precisely to expand the market for the drugs to those who are not necessarily severe sufferers. This is problematic because side-effects may outweigh any marginal benefit received, and individuals who are convinced they have a disease may experience unnecessary anxiety. It may also lead to economic waste among consumers, and a diversion of resources away from the treatment of more serious diseases.

Private interests exert pressure over choice of speakers (2009)
Universities often host events on controversial topics in order to foster dialogue and promote creative problem solving. However, on occasion, university donors or board members exert pressure over event or speaker choices. The personal or professional opinions of these third parties may be contrary to the opinions of those speaking at the university. Donors may apply pressure on university officials to cancel the event, speaker, or both.

A recent example of such censorship occurred when Michael Pollan was asked to speak at California Polytechnic State University in San Luis Obispo. Pollan is a journalism professor at University of California, Berkeley and the author of In Defense of Food and Omnivore’s Dilemma. Sometime after being asked to do a guest lecture, however, the University downgraded his appearance because of pressure from a major donor. The donor, it turned out, was the chairman of company that produces beef and Pollan happens to be an outspoken critic of the agricultural business. Buckling to the pressure, the university censored both Pollan and the community’s conversation.

When universities succumb to such demands, the result is censorship. Rejecting speakers based on their views harms university discourse, restricts access to information, and is destructive to free speech. It also sends the message to the community at large that private interests can influence what information is provided to the community. This type of censorship is especially dangerous because it often goes unnoticed.

Universities censor speakers and professors on a variety of topics, not just science. For more information on the suppression of speech at universities and threats to academic freedom, see /issue/academic-freedom/.

Private influence on what is taught in the classroom (2009)
The same funding that is being funneled into research also can affect what is taught in the classroom. For example, as the New York Times has reported, several students at Harvard Medical School report professors, who are also paid consultants for drug companies, promoting the benefits of certain drugs in class. In addition, at least one student reported a certain professor silencing criticism of the drug. This sort of censorship should not be tolerated at any university. This is simply another cost of private industry’s influence on academic research and teaching, one with dire consequences for freedom of thought, speech, and information.