It is by now no secret that some scientific articles are ghost authored – that is, written by someone other than the person whose name appears at the top of the article. Ghost authorship, however, is only one sort of ghosting. In this article, we present evidence that pharmaceutical companies engage in the ghost management of the scientific literature, by controlling or shaping several crucial steps in the research, writing, and publication of scientific articles. Ghost management allows the pharmaceutical industry (...) to shape the literature in ways that serve its interests.This article aims to reinforce and expand publication ethics as an important area of concern for bioethics. Since ghost‐managed research is primarily undertaken in the interests of marketing, large quantities of medical research violate not just publication norms but also research ethics. Much of this research involves human subjects, and yet is performed not primarily to increase knowledge for broad human benefit, but to disseminate results in the service of profits. Those who sponsor, manage, conduct, and publish such research therefore behave unethically, since they put patients at risk without justification. This leads us to a strong conclusion: if medical journals want to ensure that the research they publish is ethically sound, they should not publish articles that are commercially sponsored. (shrink)

It is by now no secret that some scientific articles are ghost authored – that is, written by someone other than the person whose name appears at the top of the article. Ghost authorship, however, is only one sort of ghosting. In this article, we present evidence that pharmaceutical companies engage in the ghost management of the scientific literature, by controlling or shaping several crucial steps in the research, writing, and publication of scientific articles. Ghost management allows the pharmaceutical industry (...) to shape the literature in ways that serve its interests. This article aims to reinforce and expand publication ethics as an important area of concern for bioethics. Since ghost-managed research is primarily undertaken in the interests of marketing, large quantities of medical research violate not just publication norms but also research ethics. Much of this research involves human subjects, and yet is performed not primarily to increase knowledge for broad human benefit, but to disseminate results in the service of profits. Those who sponsor, manage, conduct, and publish such research therefore behave unethically, since they put patients at risk without justification. This leads us to a strong conclusion: if medical journals want to ensure that the research they publish is ethically sound, they should not publish articles that are commercially sponsored. (shrink)

More than 40 primary studies, and three recent systematic reviews and meta-analyses, have shown a clear association between pharmaceutical industry funding of clinical trials and pro-industry results. Industry sponsorship biases published scientific research in favour of the sponsors, a result of the strong interest commercial sponsors have in obtaining favourable results.Three proposed remedies to this problem are widely agreed upon among those concerned with the level of sponsorship bias: financial disclosure, reporting standards and trial registries. This paper argues that all (...) of these remedies either fail to address the mechanisms by which pharmaceutical companies’ sponsorship leads to biased results—design bias, multiple trials with predictable outcomes, fraud, rhetorical effects and publication bias—or else only inadequately address those mechanisms. As a result, the policies normally proposed for dealing with sponsorship bias are unable to eliminate it. Only completely separating public clinical research from pharmaceutical industry funding can eliminate sponsorship bias. (shrink)

This paper adopts a symmetrical approach tocontroversies over R.H. MacArthur and E.O. Wilson'sequilibrium model of island biogeography, in order toshow how different interpretations of the model dependupon different philosophical understandings of theapplication of models and theories. In particular,there are quite distinct domains to which the modelcould apply; in addition, some equivocation amongthese domains is important to the model's success.Therefore, apparently inconsistent interpretations,interpretations that fit into roughly instrumentalist,realist and rationalist conceptions of science, may bemutually supporting in practice. Descriptions ofscientific practice, then, (...) should not adjudicate amongthese interpretations, but should instead recognizeways in which successful models translate amongdomains, and in so doing can become realistic,instrumentally successful, or rationally established.As complex social objects, models can afford complexrepresentational relations. (shrink)

The prehistory of science and technology studies -- The Kuhnian revolution -- Questioning functionalism in the sociology of science -- Stratification and discrimination -- The strong programme and the sociology of knowledge -- The social construction of scientific and technical realities -- Feminist epistemologies of science -- Actor-network theory -- Two questions concerning technology -- Studying laboratories -- Controversies -- Standardization and objectivity -- Rhetoric and discourse -- The unnaturalness of science and technology -- The public understanding of science -- (...) Expertise and public participation -- Political economies of knowledge. (shrink)

Prior work on weakness of will has assumed that it is a thoroughly psychological phenomenon. At least, it has assumed that ordinary attributions of weakness of will are purely psychological attributions, keyed to the violation of practical commitments by the weak-willed agent. Debate has recently focused on which sort of practical commitment, intention or normative judgment, is more central to the ordinary concept of weakness of will. We report five experiments that significantly advance our understanding of weakness of will attributions (...) by showing that the ordinary concept of weakness of will is less thoroughly psychological than the philosophical debate has assumed. We begin by showing that a sizable minority of people attribute weakness of will even in the absence of a violated commitment (Experiment 1). We then show that weakness of will attributions are sensitive to two important non-psychological factors. First, for actions stereotypically associated with weakness of will, the absence of certain commitments often triggers weakness of will attributions (Experiments 2–4). Second, the quality of an action’s outcome affects the extent to which an agent is viewed as weak-willed: actions with bad consequences are more likely to be viewed as weak-willed (Experiment 5). Our most important finding is that the ordinary concept of weakness of will is sensitive to two non-psychological factors and is thus much broader than philosophers have thus far imagined. We conclude by suggesting a two-tier model that unites our findings with traditional philosophical theorizing about weakness of will. (shrink)

Philosophers who have written on modesty have largely agreed that it is a virtue, and that it therefore has an important psychological component. Mere modest behavior, it is often argued, is actually false modesty if it is generated by the wrong kind of mental state. The philosophical debate about modesty has largely focused on the question of which kind of mental state—cognitive, motivational, or evaluative—best captures the virtue of modesty. We therefore conducted a series of experiments to see which philosophical (...) account matches the folk concept of modesty. Surprisingly, we found that the folk concept is primarily behavioral. This leads us to argue that modesty may not be a virtue, but that if it is none of the extant philosophical accounts have properly explained why. (shrink)

Anecdotes have shown that some articles on profitable drugs are constructed by and shepherded through publication by pharmaceutical companies and their agents, whose influence is largely invisible to readers. This is ghost-management, the substantial but unrecognized research, analysis, writing, editing and/or facilitation behind publication. Publicly available documents suggest that these practices extremely widespread affecting up to 40% of clinical trial reports in key periods but it has been unclear how representative these documents are. This article presents the results of an (...) investigative sampling of the self-presentation of publication planning services, and presents this and other evidence of a sizable publication planning industry. Thus different lines of evidence indicate that ghost-management is a common and important phenomenon, strongly affecting the published medical literature in the service of marketing. (shrink)

Abstract: This paper considers the question of whether it is possible to be mistaken about the content of our first-order intentional states. For proponents of the rational agency model of self-knowledge, such failures might seem very difficult to explain. On this model, the authority of self-knowledge is not based on inference from evidence, but rather originates in our capacity, as rational agents, to shape our beliefs and other intentional states. To believe that one believes that p, on this view, constitutes (...) one's belief that p and so self-knowledge involves a constitutive relation between first- and second-order beliefs. If this is true, it is hard to see how those second-order beliefs could ever be false.I develop two counter-examples which show that despite the constitutive relation between first- and second-order beliefs in standard cases of self-knowledge, it is possible to be mistaken, and even self-deceived, about the content of one's own beliefs. These counter-examples do not show that the rational agency model is mistaken—rather, they show that the possibility of estrangement from one's own mental life means that, even within the rational agency model, it is possible to have false second-order beliefs about the content of one's first-order beliefs. The authority of self-knowledge does not entail that to believe that one believes that p suffices to make it the case that one believes that p. (shrink)

This article systematically reviews published studies of the association of pharmaceutical industry funding and clinical trial results, as well a few closely related studies. It reviews two earlier results, and surveys the recent literature. Results are clear: Pharmaceutical company sponsorship is strongly associated with results that favor the sponsors' interests.

This philosophical introduction to and discussion of social and political studies of science argues that scientific knowledge is socially constructed.

The pharmaceutical industry, in its marketing efforts, often turns to “key opinion leaders” or “KOLs” to disseminate scientific information. Drawing on the author's fieldwork, this article documents and examines the use of KOLs in pharmaceutical companies’ marketing efforts. Partly due to the use of KOLs, a small number of companies with well-defined and narrow interests have inordinate influence over how medical knowledge is produced, circulated, and consumed. The issue here, as in many other cases of institutional corruption, is that a (...) few actors have accumulated the power to shape the information on which many others base their decisions. Efforts to address this corruption should focus on correcting large imbalances in the current political economy of medical knowledge. A sequestration of pharmaceutical research and development on one hand from pharmaceutical marketing on the other, though difficult to achieve, would address this and many other problems. (shrink)

In 2003, the pharmaceutical company Biovail received a spate of negative publicity around a program for its heart medication Cardizem LA. For a three-month period Biovail paid US doctors US$1000 (and their office managers US$150) for patient data when at least 11 of their patients renewed a prescription to Cardizem. Doctors who signed up for the trial but who did not keep 11 patients on the drug received US$250 for participation. According to Biovail, this was a research trial, meeting US (...) federal regulations for research trials – the consulting firm that had designed the trial had guaranteed that it would meet US criteria. The trial was expected to provide data that would help ‘in designing future clinical trial programs’, according to Biovail’s vice-president of finance. In addition, the results would eventually be published. However, the program was originally presented as a marketing campaign, and was being handled by Biovail’s sales department and sales force. According to ethicists who commented on the case, a US$1000 payment to doctors was unusually high for a post-marketing research trial, and a US$150 payment to office managers was thought to raise novel ethical conflicts. Cardizem is a drug intended for long-term use, so paying doctors to get patients started on a course of treatment could lead to substantial profits from these prescriptions. In line with this, immediate comments from professional ethicists and representatives of medical associations focused on questions about whether the Biovail campaign amounted to paying doctors to prescribe specific drugs. And that is a concern for the obvious reason that it has the potential to compromise doctors’ decisions about best care. Payments for prescriptions place doctors in ethically difficult situations: Peter Singer, a medical ethicist, says ‘There is clearly the potential for [physicians’] conflict of interest’ (Toronto Globe and Mail, 2003). Physicians’ decision-making is the most common locus of discussion in medical ethics.. (shrink)

This paper argues that most contemporary accounts of weakness of will either implicitly or explicitly assume that regret is a typical or even necessary element of standard cases of weakness of will and that this assumption is mistaken. I draw on empirical and philosophical work on self-assessment to show that regret need not accompany typical weak-willed behavior, and that we should therefore revise the dominant account of the difference between weakness of will and changes of mind.

Thesis (Ph.D, Philosophy) -- Queen's University, 2009-08-31 12:18:30.156.

The war on drugs is widely criticized as unjust. The idea that the laws prohibiting drugs are unjust can easily lead to the conclusion that those laws do not deserve our respect, so that our only moral reason to obey them flows from a general moral obligation to obey the law, rather than from anything morally troubling about drug use itself. In this paper, I argue that this line of thinking is mistaken. I begin by arguing that the drug laws (...) are indeed unjust. However, so long as they remain prohibited, I argue that we have strong moral reasons to avoid drug use. First, drug users are partly responsible for the violent and exploitative conditions in which many drugs are produced and distributed. Second, the unequal ways in which drug laws are enforced make drug use by many an unethical exercise of privilege. These reasons do not depend on the existence of a general moral obligation to obey the law; we ought to refrain from illegal drug use even if prohibition is unjust and even if we have no general obligation to obey the law. In fact, drug laws turn out to represent an interesting exception case within the broader debate about this obligation, and I argue that it is the very injustice of the law that generates the reasons not to violate it. (shrink)

In this article I criticize the non-consequentialist Weighted Lottery (WL) solution to the choice between saving a smaller or a larger group of people. WL aims to avoid what non-consequentialists see as consequentialism's unfair aggregation by giving equal consideration to each individual's claim to be rescued. In so doing, I argue, WL runs into another common objection to consequentialism: it is excessively demanding. WL links the right action with the outcome of a fairly weighted lottery, which means that an agent (...) can only act rightly if s/he has actually run the lottery. In many actual cases, this involves epistemic demands that can be almost impossible to meet. I argue that plausible moral principles cannot make such extreme epistemic demands. (shrink)

Roughly 40% of the sizeable medical research and literature on recently approved drugs is “ghost managed” by the pharmaceutical industry and its agents. Research is performed and articles are written by companies and their agents, though apparently independent academics serve as authors on the publications. Similarly, the industry hires academic scientists, termed key opinion leaders, to serve as its speakers and to deliver its continuing medical education courses. In the ghost management of knowledge, and its dissemination through key opinion leaders, (...) we see the pharmaceutical industry attempting to hide or disguise the interests behind its research and education. (shrink)

“Scientific theories are maps of the natural world.” This metaphor is often used as part of a deflationary argument for a weak but relatively global version of scientific realism, a version that recognizes the place of conventions, goals, and contingencies in scientific representations, while maintaining that they are typically true in a clear and literal sense. By examining, in a naturalistic way, some relationships between maps and what they map, we question the scope and value of realist construals of maps—and (...) by extension of scientific representations. Deflationary philosophy of science requires more variegated stances. (shrink)

This chapter discusses some strategies pharmaceutical companies employ to establish influence and even hegemony over domains of medical knowledge: marketing products via medical research and education. The chapter thus contributes to understanding the political economy of knowledge in this industry. As a counterpart to traditional epistemology, studying the political economy of knowledge shifts attention from individual claims and their justifications to some of the forces available to shape terrains on which claims are produced, distributed, and consumed.Of pharmaceutical companies’ clinical research, (...) 70–75% is performed by contract research organizations. CROs conduct trials with one eye to the drug approval process and the other to the marketing of products. On the basis of trial data, analyzed by pharmaceutical company statisticians and scientists, publication planners design suites of scientific manuscripts and hire ghostwriters to write them. These are then given to academic authors, who generally have had little prior connection to the research, analysis, or writing. The manuscripts are published in medical journals appropriate for the audiences the companies wish to reach.The doctors and researchers with whom companies engage most closely are generally termed key opinion leaders. In addition to authoring manuscripts, KOLs serve companies in a number of roles, but most prominently as speakers—at professional meetings, in after-dinner and similar settings arranged by sales representatives, and in continuing medical education courses, which doctors must take to keep their licenses. Research, education, and marketing, then, are often fused. (shrink)

This chapter describes in very general terms the integration of clinical research and marketing, drawing on books by marketers and recent cases that have come to the public eye. The tools that have been used to accomplish this integration over the past half-century are various, but they all stem from a realization that in a rational world centered on health there need be no intrinsic divide between research and marketing. Most obviously, marketing drugs to physicians, who are professionals acting within (...) their own spheres, depends crucially on research. Physicians respond, and need to see themselves as responding, to fact, figures, and studies. The well-chosen images and vehicles for marketing campaigns must be subordinated to research. Yet at the same time research is a means of increasing sales. (shrink)

John Maynard Smith is the person most responsible for the use of game theory in evolutionary biology, having introduced and developed its major concepts, and later surveyed its uses. In this paper I look at some rhetorical work done by Maynard Smith and his co-author G.R. Price to make game theory a standard and common modelling tool for the evolutionary study of behavior. The original presentation of the ideas — in a 1973 Nature article — is frequently cited but almost (...) certainly rarely read. It took reformulation of the approach to create a usable model and an object of study. Perhaps paradoxically, the new model dealt with more abstract objects than did its predecessor, but because of that a better case could be made for its realism. The particular strategy of abstraction allowed game-theoretic modelling to gain a certain measure of autonomy from empirical problems, and thus to flourish. (shrink)

Publication planning is the sub-industry to the pharmaceutical industry that does the organizational and practical work of shaping pharmaceutical companies' data and turning it into medical journal articles. Its main purpose is to create and communicate scientific information to support the marketing of products. This report is based mostly on information presented at the 2007 annual meeting of the International Society of Medical Planning Professionals, including a workshop entitled "Publication Planning 101/201", attended by one of us. We provide some analysis (...) of the role of publication planning in medical publishing, and its implications for the structuring of medical knowledge. (shrink)

Publication of pharmaceutical company-sponsored research in medical journals, and its presentation at conferences and meetings, is mostly governed by ‘publication plans’ that extract the maximum amount of scientific and commercial value out of data and analyses through carefully constructed and placed papers. Clinical research is typically performed by contract research organizations, analyzed by company statisticians, written up by independent medical writers, approved and edited by academic researchers who then serve as authors, and the whole process organized and shepherded through to (...) journal publication by publication planners. This paper reports on a conference of an international association of publication planners. It describes and analyzes their work in an ecological framework that relates it to marketing departments of pharmaceutical companies, medical journals and publishers, academic authors, and potential audiences. The medical research described here forms a new kind of corporate science, designed to look like traditional academic work, but performed largely to market products. (shrink)

The Thomas Kuhn of "The Structure of Scientific Revolutions" is often seen as an idealist or Neo-Kantian, as holding a constructivist as opposed to realist position. A close reading of the texts in question, keeping in mind Kuhn's interests as a historian, doesn't support this position, though it uncovers other interesting metaphysical commitments. In particular, Kuhn sees a degree of complexity in the world that entails that there will often be some conventionality in our theories. Some reasons for the readings (...) of Kuhn's as a "constructivist" are explored. (shrink)

The deflationist turn in recent philosophy of science has attracted attention, in part because it promises to end debates about scientific realism. In its recommendation that we leave metaphysics behind to look at practice, deflationism constructs itself as an end‐of‐philosophy philosophy, accepting knowledge and the evidence for it at face value. Meanwhile, recent work in philosophy, sociology, and history of science that has focused on practice has underscored problems of such an acceptance: much scientific knowledge is not straightforwardly about the (...) natural world, and we would not want it to be. A concrete example from the history of comparative psychology illustrates this point, and illustrates the value of interpretive work on scientific knowledge. A focus on practice, then, does not end metaphysical discussion, but rather regrounds and reshapes it. (shrink)

Standpoint theory makes the claim that there are social positions from which privileged perspectives on knowledge can be obtained. This article describes some arguments that stake out relatively narrow grounds for the relevance of standpoint theory to science and technology: namely, the oppressed are in a potentially good position to understand social relations. Although these grounds seem narrow and apparently irrelevant to the bulk of the activity of the sciences, recent work in science and technology studies indicates that social relations (...) are topics and resources as much in physics and mathematics as in primatology and psychology. So, if we accept the arguments for standpoint theory, the social picture of science should lead us to recognize the wide-ranging applicability of standpoint theory to science. (shrink)

The Science Wars have not involved any violence, nor even threats of violence. Thus the label “wars” for this series of discussions, mostly one-sided and mostly located within the academy, is something of an overblown metaphor. Nonetheless, I will suggest that there are some respects in which the metaphor is appropriate. The Science Wars involve territory, albeit a metaphorical kind of territory. They inspire work that can be best interpreted as ideological, a result of disciplinary interests. Moreover, fellow participants in (...) the wars and others reward that ideological work.My goal in this is to display efforts to maintain a discipline's epistemic authority, the recognition that members of that discipline have legitimate claims to knowledge on a subject. The central section of the paper takes the form of a discussion of one recent contribution to the Science Wars, James Robert Brown's Who Rules in Science? My argument is at least somewhat generalizable beyond this book, and it therefore points to interesting phenomena related to epistemic authority. (shrink)

Standpoint theory is based on the insight that those who are marginalized or oppressed have distinctive epistemic resources with which to understand social structures. Inasmuch as these structures shape our understanding of the natural and lifeworlds, standpoint theorists extend this principle to a range of biological and physical as well as social sciences. Standpoint theory has been articulated as a social epistemology and as an aligned methodological stance. It provides the rationale for ‘starting research from the margins’ and for expanding (...) the diversity of backgrounds and experience represented in scientific communities. (shrink)

The most discussed puzzle about weakness of will (WoW) is how it is possible: how can a person freely and intentionally perform actions that she judges she ought not perform, or that she has resolved not to perform? In this paper, we are concerned with a much less discussed puzzle about WoW?how is overcoming it possible? We explain some of the ways in which previously weak-willed agents manage to overcome their weakness. Some of these are relatively straightforward?as agents learn of (...) the real costs of weakness, or as those costs mount dramatically, they can become strongly motivated to do what they already judged best. But other cases are more difficult to explain: sometimes, agents with a long history of forming and then weakly abandoning resolutions manage to stick to their guns. We argue that these cases can be explained by combining George Ainslie's model of agents as multiple preference orderings competing in game theoretic interactions along with the insights of evolutionary game theory. This can explain the puzzling cases where agents suddenly adopt successful strategies for avoiding weak-willed behavior, especially where agents gain no new information about themselves or the consequences of their actions. (shrink)