Those who have been following this blog know that last month I was told to remove the name of my university from this blog and then a few days ago my university backtracked and said I could use the name (not the letterhead, which I never disputed). The incident attracted the attention of the American Association of University Professors (AAUP) and the Foundation for Individual Rights in Education (FIRE) who wrote a followup article on it here after the reversal of the decision as well as abel pharmboy on scienceblogs. There was also a humorous post by Margaret Soltan on University Diaries, who follows university politics, here, where she wrote a limerick (she is an English professor I think, so that makes sense). My friends perform it below. That’s Billy Tauzin in the middle, head of PhRMA, with of course the always lovable lolcat:

Well it has been an interesting week. After word got out that I had been banned by my university from using their name on my blog with follow up actions, which was covered almost immediately by Inside Higher Education, there were quite a few comments on the internet. There were a number of comments about a double standard where others had used letterhead from the university to promote medications on behalf of drug companies, but they pounced on me for using it in a satirical piece, or where they pampered other authors with their own web sites and publicity but shunned me. BNET pharma speculated that their suppression of the press release of my book and subsequent squashing of publicity may have been a clever ploy (I think the word was “genius”) amongst the PR dept to create a conspiracy theory that would create even more publicity than a normal press release.

Actually the suppressed book release was over a year ago before they made the papers for too close ties to pharma. So it might have been a conspiracy, that actually wasn’t a conspiracy, that actually was a conspiracy. If that makes any sense.

But what was involved in the conspiracy probably wasn’t what he had in mind.

Gary Schwitzer showed interest in something that combines “academic freedom, double standards, and blog censorship.” Other comments are here and here and here, including one entitled “University Throws Doctor Under the Bus for Pharma Ties“. I liked that one, so here you go.

University throws doctor under the bus for pharma perks. That's Billy Tauzin, head of PhRMA lobbying group, at the wheel.

It’s getting a little tight down here.

On the actual questions of fact, the head of the American Association of University Professors offered his opinion in the Inside Higher Ed piece that the university absolutely had no right to block me from identifying myself as a member of that university. This seems in contradistinction from the “policy” of preventing the use of the name for “non-university” activities which could be construed as anything other than buying pencils on your university account. I mean alot of professors are writing blogs, writing books, speaking in public, making movies, whatever, and I think it really strikes a nerve to say that they cannot identify themselves as a university professor in the things they do, which is why this case has basically drawn national attention. As for the blog, I think many professors see their blogs as an extension of their professional life, and in fact it is an excellent way to quickly express ideas on newly breaking events in their field and get instant feedback. Not to mention twitter.

Amy Philo wrote the following about this situation: There is a case called Garcetti v. Ceballos involving government employees that limits the employee’s right to free speech if the speech is considered part of their official duties. Therefore if your university declares your blog ‘personal’ that would imply that you could not be retaliated against for whatever you write on the blog. On the other hand having you remove their name could be considered retaliation since it does relate to academic freedom. However, in Garcetti the Supreme Court said that their decision does not apply to scholars / academic freedom, implying that a professor would still have the First Amendment right to say whatever they wanted.

Statements made by public employees pursuant to their official duties are not protected by the First Amendment from employer discipline…

…The Court instead found a reason for limiting First Amendment protection to public statements made outside the scope of official duties “because that is the kind of activity engaged in by citizens who do not work for the government.

The Court also reserved for a future decision the issue of whether its analysis would apply in the same manner to a case involving speech related to scholarship or teaching.

Hat tip to Amy Philo [this does not represent legal advice]

Last week’s decision by my university to instruct me to remove the name of my university from this blog (which was done by a formal letter hand delivered by a courier) was actually the last in a string of events that to the uncritical eye might be seen as connected. The first was an attempt to block my involvement as an expert on the effects of the acne drug Accutane on depression and suicide, a drug which the manufacturer finally pulled off the market just last week because of its multiple toxicities. The second came in the form of attempting to quash publicity related to my book, an honest appraisal of the true risks and benefits of prescription medications, which, due to their effective anti-PR campaign, most of my colleagues at my university didn’t know I had written until just last week.

To whit, there was the unusual circumstance of no coverage in the local Atlanta Journal Constitution, which might be due to the fact that I said that cutting out carbonated beverages with added sugar could cut five pounds in weight per year from your midline, but I think it was more likely a collusion between our PR department and them, or at least the lack of enthusiasm didn’t help. I mean, who would expect that sad rag of a newspaper to do any real reporting, anyway.

In March of 2008 my book, Before You Take That Pill: Why The Drug Industry May Be Bad For Your Health was published by Avery/Penguin. Having a book published is sort of like giving birth to a child. There is all sorts of excitement leading up to it, etc. Part of the excitement is working with the public relations department of your university to come up with ways to pitch it to reviewers and getting it noticed, including writing the press release.

That is why I was justifiably disturbed when on publication day I scanned the internet looking for the press release and couldn’t find it. So I called the public relations person and asked where it was.

“We decided not to release it,” she said.

“Why not?” I asked.

“Because we felt that your publisher was doing a good enough job on that already.”

Well that was highly unusual for this university, who has a supercharged PR department. Most authors get press releases, their own web page for their book, the works. Besides, they had already written it. Why not go ahead and release it? I got the impression that they didn’t want PR for that book, they hoped it would be ignored, because they didn’t want to piss off the pharma industry.

Given how things have gone over the past year for their PR, I think they made a mistake in not issuing my press release. But hey, what do I know.

Anyway, here is the press release that was never… released (sniff, sniff)

The Missing Press Release

DRAFT COPY

[REDACTED] Health Sciences News

http://www.XXXXXX.edu

XXXXX, 2008

Medications Put to the Test in New Book by [REDACTED] Researcher and Author

Media contacts:

REDACTED, but the same who commented on this article.

ATLANTA J. Douglas Bremner, MD an [REDACTED] University researcher, was concerned about the way information was communicated about medications and supplements, so he decided to take action. After two years of doing his own research on hundreds of the most popular medications, he has written a book called “Before You Take that Pill,” which is scheduled to be released on February 28, 2008.

“You have the right to know the risks and benefits of the pills you take and to form an active partnership with your doctor to make decisions about what is right for you,” says Dr. Bremner.

“We all want to live as long as possible,” he continues. “If this book allows you to use medications safely and convinces you to change your diet and lifestyle to prevent disease, I will consider it a success.”

The book covers over 300 of the most commonly prescribed prescription drugs, the fifty top-selling prescription drugs, vitamins, and the best selling herbs and supplements. Also included in the book are drugs that are not used much any more but that are particularly unsafe and haven’t been taken off the market yet by the Food and Drug Administration (FDA).

Dr. Bremner says the U.S. is focused on developing newer drugs. But those drugs are more expensive and drive up health care costs and are not necessarily more effective than the older drugs. He says that pharmaceutical companies are not required to prove that new drugs are better and have fewer side effects than the older drugs they are claiming to replace.

In addition to that, vitamins and supplements and some medications can be avoided altogether if people are encouraged to stick with a healthy diet, exercise regularly and wash their hands to avoid infection.

“Despite the fact that Americans spend twice as much on health care as any other country in the world, we have some of the worst health care outcomes,” says Dr. Bremner. “In a survey of 13 industrialized nations, the United States was found to be the last in many health related measures, and overall was second to the last!”

Dr. Bremner read and analyzed journal articles, editorials, and drug research related to all the medications he describes in this book. Additionally, he reviewed investigative reporting about the safety of the drugs in credible publications such as the New York Times, and he consulted colleagues with specialties related to the medication he was researching.

Says Dr. Bremner “My goal in writing this book is to give patients all the information they need to be aware of the effects of the medications they are taking so that they can have knowledgeable conversations with their physicians, and make informed decisions together.”

Dr. Bremner is professor of Psychiatry and Radiology at [REDACTED] University School of Medicine, director of the [REDACTED]. Dr. Bremner performs research using brain imaging to look at the effects of medications on the brain and brain correlates of mental disorders. He is a board-certified psychiatrist and nuclear medicine physician and has authored or co-authored over 200 peer reviewed articles and book chapters and three books, including “Before You Take that Pill”.

Since that time phone calls to the PR department were efficiently written down and deposited in the trash can. It basically got no coverage in the regular media. But the good news about the cover up is that you can now buy a new copy for a dollar on amazon, or used for five cents. Enjoy!

Last week I posted some musings on among other topics academic freedom and I got quite a response to this topic. The question arises how much am I allowed to talk about and what can my university do to control what I write (last week my university announced that they don’t want me to put their name on this blog because of a complaint they got about a satirical letter I wrote on my blog saying that mental health blogger Phillip Dawdy should be allowed to smoke in his appartment because of his mental health condition). They claim that this blog is for “personal” use it was a violation of their policy to have me use their name or letterhead for personal use. Which raises some interesting questions

First off, is this blog really “personal”? I mean all of the topics relate to my field in some way, which is medicine, health, medications, and psychiatry. Even the “personal” posts about things like my childhood or my emotions relate to my field because, well, I am a psychiatrist for Christ’s sake. What they were worried about was getting sued by somebody because I wrote a sarcastic letter supporting Philip Dawdy’s right to smoke in his own home. Which seems weird that they wouldn’t want their name associated with me.

Which gets me to the next point. If I were to say something like, for example, they treat professors more like corporate employees than academics, would they have the right to take action against me for criticizing my employer? Or is that a violation of academic freedom?

Legally there isn’t a good basis for academic freedom. How safe you are depends on where you live and whether or not you have tenure. In the US there is specific legal concept of academic freedom as apart from the 1st amendment to the US constitution that gives you the right to free speech without being retaliated against. But that protects you from retaliation from the government. So for professors at private universities, they don’t necessarily have legal protection, unlike in Germany, where academic freedom is the law. If you don’t have tenure, they can let you go for any reason. If you do, they have to let you go for cause, meaning you have to do something really bad, I guess. Maybe some of the legal eagles out there could write in and say what that is.

Remember that professor from Colorado who wrote a paper calling the 9/11 victims “little Eichmans”? Turns out they dismissed him for plagiarism and research misconduct, not for what he said.

In general your protection as a professor is all about what is in your contract at your university, and ultimately the culture of your university. So if having divergent views and saying stuff that is out there (we never do that here… Naaa…) is accepted as part of the culture of the university, then you are on good ground. Oh, and also if for-cause tenure is part of your contract.

After word of this blog and the issue of removing the name from my university got around, it piqued the interest of the American Association of University Professors (AAUP), and ultimately Inside Higher Education. I would quote the title of the article, but it contains the name of my university, which I am not allowed to name here.

You see how awkward this gets.

And how absurd.

Sarah Goodwin, head of media relations at my university, was quoted as saying “if you read [his blog] over a long period of time, you can see comments he makes that may be of concern.” She also said the ban on use of the university name on blogs was “across the board”.

I mean, give me a break.

As the article points out, Mark Bauerlein, an English professor who blogs for the National Review online, and Drew Westen, who blogs for the Huffington Post (I used to write for them too but would be ashamed to be associated with that swill these days) both prominently display the name of our university on their blogs.

Both Bauerlein and Westen are politically correct and garner positive media information for my university. Both also get mentioned in press releases, from which I have been unceremoniously dropped since writing my book, which was labelled as “anti-pharma” but which as anyone who has actually read it knows is just an honest review of the published literature on the benefits and risk of medications.

If you consider Goodwin’s comments, it tells you that: 1) someone from my university has been reading my blog for a long time, and; 2) they have been considering whether or not the comments should be censured.

Which is more evidence that they are thinking more like a corporation than a university, where the free exchange of ideas, regardless of the perceived value or political correctness of those ideas, is held to the highest standard.

Things are really starting to get weird around here.

I don’t know, maybe I am just an idealist.

Or maybe I should move to Germany.

After yesterday’s post on the Diagnostic and Statistical Manual (DSM) process “Retaliations and Beware of the Consequences” blew through the roof for record page views and stimulated similar confessions from other psychiatric bloggers about bullying by members of the American Psychiatric Association (APA), as well other commentary here and here and here. I seem to have wandered from a fairly tongue in cheek exercise in the DSM Shadow Team, founded to track the goings on of a secretive committee and have a little fun in the process, into a field of landmines.

This new article by Allen Frances, MD, who chaired the DSM-4 committee, criticizes the secretive approach by the current DSM-5 chair David Kupfer MD, who has insisted on secrecy, no note taking, confidentially agreements, and now I would add bullying of psychiatrists like myself who offer outside commentary. Dr. Kupfer has built up the Department of Psychiatry at the University of Pittsburgh into a research machine through developing the infrastructure of administrative personnel who help with the process of writing and submitting research grant applications for funding by the National Institute of Health (NIH). He is said to call out a “priority score” whenever he hears someone present research. Grants coming from Pittsburgh have the reputation of being technically excellent but not always exciting. It seems like he has brought this mass war enterprise approach to the DSM.

David Kupfer, MD, Chair of the DSM-5 Committee

All of this has gotten me reflecting on academic freedom. I mean, have not one but three organizations telling me to shut up (not counting the people in my personal life): the VA, my university (that which cannot be named here) and academic psychiatry. To whit, I am supposed to get approval to talk to the press from my local VA PR guy, but what this amounts to is that when I get contacted about something that they care about (i.e., Iraq), they shelve it and never get back to me. I mean, if you don’t think that pointing a gun at someone, pulling the trigger, and killing them can’t wreck your marriage or make you suicidal, that’s not my problem, so I don’t really get excited about getting censored about that stuff.

The current behavior of academic psychiatry in the DSM process is more troubling. By stiffling debate and creating a corporate type approach they are going against the very principles of science and academic freedom. One can only conclude that they feel insecure about the validity of their deliberations.

I also get upset about what I feel is my university treating me like an employee of a corporation rather than a professor in a university. I mean they should be glad to have their name associated with this blog when contrasted with other situations in which their name was associated with more questionable practices and they never said anything about it. For shame. And there are other professor bloggers who are much more lippy than I am and they list their universities on their blogs.

There are numerous examples of where a failure of academic freedom for exchange of ideas has had disastrous consequences, e.g. 30 million die in China applying Lisenko’s bogus scientific theories to agriculture which results in mass famine. In fact there is an organization dedicated to academic freedom. This is from wikipedia.

AFAF (Academics For Academic Freedom) [3] is a campaign for lecturers, academic staff and researchers who want to make a public statement in favour of free enquiry and free expression. Their statement of Academic Freedom has two main principles:

1. that academics, both inside and outside the classroom, have unrestricted liberty to question and test received wisdom and to put forward controversial and unpopular opinions, whether or not these are deemed offensive, and
2. that academic institutions have no right to curb the exercise of this freedom by members of their staff, or to use it as grounds for disciplinary action or dismissal.’

AFAF and those who are part of the campaign believe that it is important for academics to be able to express their opinions – not just full stop, but to put them to scrutiny and to open further debate. They are against the idea of telling the public Platonic ‘noble lies’ and believe that people should not be protected from radical views.

Well said.

I have had someone writing to complain about my blog stating that Philip Dawdy needed to smoke for his mental condition and that he shouldn’t be kicked out of his appartment for smoking. I mean he is smoking in the privacy of his own home. Why should those Seattle Eco fascists be able to kick him out of his own home?

Anyhoo I have had official letters of complaint to the Dean of my university and the acting chair of my department and they have asked me to remove the name of my university and letterhead from my blog with which I have complied. So if you want to know my university you can use google.