Simon Wessely on COIs in 2003

I thought I'd repost this on the new forum, as many may have missed it:

https://www.bmj.com/rapid-response/2011/10/29/enough-already

I started pulling out bits to summarise his position, but ended up quoting most of the short Rapid Response.

He's complaining that attempts to restrict the influence of those with COIs will exclude almost everyone.

Thought this bit was relevant to concerns about the way Wessely built his career by telling people with power what they wanted to hear:

The final paragraph returns to a common theme of Wessely's writing of the time, the importance of respect for institutions:

I wonder if he warned Watt of the damage she'd do to trust in the MRC by defending PACE? I suspect not, and that he isn't that concerned about the public good but really just wants more trust and respect in the institutions that he is a part of, and that serve his interests and ego.

 

SW is very good at this. And it seems he has had a gift for it from the start.

I'd call this kind of thinking 'holistic deception. He takes a real problem that is undeniably an issue to be addressed and that he is guilty of and expands the guilty to everyone and everything.

Yes, there is bias, this should be acknowledged. We all have biases, we all have conflicts of interest, we all are mind and body therefore we should see mental health as just another medical condition (which can expand into all bodily med conditions).

The insidious nature of this is always the kernel of truth at it's core. It's just that this kernel is smoke and mirrors because it obfuscates the specific in favour of the general.

Specific biases in research should be acknowledged and dealt with not embraced because 'we all have them'. Having an investment in the outcome as a patient is not the same as a medical research scientist having a CoI because they consult for a health insurance company. These responses to concerns by people outside their little group is a lot of philosophical posturing meant only to divert attention away from real concrete issues.

Our best defense is in the details.

 

Sometimes multiple values in tension with one another must be balanced order to produce the greatest good. In this case (1) the need to trust institutions and rely on them to operate themselves must be balanced against (2) the need to monitor institutions for trustworthiness and hold them to account when they fail.

Now, serious people understand this and do not fight for one side or another, but, if able, push in the direction needed to achieve the best possible balance given reality. On the other hand, it appears that our dear young Simon would like there to be as little baseline scrutiny of the medical establishment as possible. One can only speculate as to the reasons for his zeal.