Still catching up on posting things from this year. Here’s a piece I wrote in the BMJ with medical student colleagues about an extraordinary, influential, and rather depressing organisation called the “Ethical Standards in Health and Life Sciences Group”. This was a committee of the great and good in medicine, co-chaired by Sir Richard Thompson of the Royal College of Physicians, and Deepak Khanna of the ABPI (the chap who very oddly claimed that I refused to meet him).

The ESHLSG was supposed to look at the challenges around collaboration between doctors and industry, producing guidelines to help doctors manage the inevitable conflicts that arise in these kinds of relationships. As always, I am very much in favour of doctors collaborating with industry – as long as the risks are managed, and as long as there is transparency – because much good can come of working together. Sadly, the ESHLSG seems to have been captured by industry, and produced a series of statements that were untrue, giving false reassurance on important matters of patient safety. They even claim, for example, that there is a robust regulatory framework guaranteeing access to trial results, which is ludicrously untrue.

An impressive campaign was set up by some medical students and junior doctors at BadGuidelines.org, with two aims. Firstly, they wanted to draw attention to this dangerous false reassurance, from the most influential and powerful organisations in our profession. Secondly, they wanted to find out how organisations such as the Department of Health, the Medical Schools Council, the BMA, the Royal Colleges and more had come to put their name to all these false claims. This is especially puzzling, because these bodies have large professional policy teams, whose job it is to ensure such activity is conducted competently. Almost all signatory groups refused to comment (the BMJ and Lancet are notable exceptions), and the ESHLSG have now disbanded, without the group or most of its members ever giving an adequate account of what happened (we are publishing a more thorough description and analysis of this elsewhere).

It’s all very odd, very unhelpful, and unnecessarily embarrassing for the medical profession. From feedback on email and at lectures, it’s also the story that has most appalled members of the public, perhaps because we rightly have higher expectations of doctors than we do of industry. Lastly, for those of us who are trying to push solutions forwards – on transparency and other issues – it’s very peculiar to see the leaders of the medical profession claiming blithely in the face of all the evidence that everything is fine. There’s no need to talk in terms of scalps, and this is not one I took any pleasure in, the whole episode was simply very depressing. Doctors should be capable of engaging in a serious public discussion about shortcomings and imperfections in medicine, with patients and the public. There is nothing to fear, and everything to gain, from that kind of meaningful public engagement. With alltrials.net we have seen that informed patients and the public can help drive solutions forward.

Anyway… Here is our piece for the BMJ (free to read on this link):

bmj.com/cgi/content/full/bmj.f6100?ijkey=C7vQLTFcWiPS9GF&keytype=ref

And here is the BMJ’s longer feature piece (and a news piece) on the ESHLSG, it’s disbanding, and their refusal to answer questions about why they made such a series of false claims (both free to read if you register).

www.bmj.com/content/347/bmj.f6062

www.bmj.com/content/347/bmj.f6066