"The illusion of evidence based medicine", Jon Jureidini and Leemon B. McHenry, 2022

Some choice excerpts: > The philosophy of critical rationalism, advanced by the philosopher Karl Popper, famously advocated for the integrity of science and its role in an open, democratic society. A science of real integrity would be one in which practitioners are careful not to cling to cherished hypotheses and take seriously the outcome of the most stringent experiments. This ideal is, however, threatened by corporations, in which financial interests trump the common good.

The pharmaceutical industry’s responsibility to its shareholders means that priority must be given to their hierarchical power structures, product loyalty, and public relations propaganda over scientific integrity.

Our proposals for reforms include: liberation of regulators from drug company funding; taxation imposed on pharmaceutical companies to allow public funding of independent trials; and, perhaps most importantly, anonymised individual patient level trial data posted, along with study protocols, on suitably accessible websites so that third parties, self-nominated or commissioned by health technology agencies, could rigorously evaluate the methodology and trial results.

The authors don't discuss any case studies or specific areas of medicine, this is purely in general terms. However, as soon as you look up the authors, Jureidini is a child psychiatrist. Coincidence? McHenry is a philosopher with an interest in medical ethics, so well placed to comment on Big Pharma's hold.

I think this may be a sign the tide is really turning; hopefully for medicine as a whole and trans "medicine" in particular. The BMJ is the place to publish on medicine, so for them to publish this opinion piece suggests the medical academe knows there is a problem. (The responses to it are also interesting.)