Some Doctors Reluctant To Deactivate LVADs

–LVAD deactivation is not euthanasia or physician-assisted suicide. Left ventricular assist devices (LVADs) are used increasingly as destination therapy instead of as a temporary bridge until a donor heart becomes available for transplantation. Now patients, their families, and their caregivers are forced to confront the extremely difficult question of when and how to turn off…

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Ethical Questions Raised About NIH Blood Transfusion Trial

–Public Citizen says the MINT trial comparing blood transfusion strategies after MI should be halted. Public Citizen is calling for the immediate suspension of a large NIH-sponsored trial comparing blood transfusion strategies after heart attacks. The Myocardial Ischemia and Transfusion (MINT) trial should be halted “because of potentially serious ethical violations,” said the consumer advocacy…

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Controversial Pharma CEO To Chair AHA Charity Ball

–The Wizard of Oz-themed ball seeks to raise $2 million on the yellow brick road. The American Heart Association’s annual Heart & Stroke Ball will be chaired by John Thero, the CEO of Amarin Corporation, the controversial pharmaceutical company. Amarin manufactures the prescription fish oil product Vascepa for which it is aggressively seeking an expanded indication…

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Eminence Based Medicine And Cardiac Surgery

Did a top surgeon perform a nonrandomized, semi-prospective, historically controlled clinical trial without IRB approval or patient consent? I don’t want to only pick on interventional cardiologists. Last week I wrote about a breathtaking case of interventional cardiology hubris. In response a prominent interventional cardiologist shared with me a fascinating anecdote about cardiac surgery. Here’s…

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Cookie Monster, Free Lunch, And The New England Journal Of Medicine

In its efforts to defuse the conflict of interest issue the New England Journal of Medicine keeps setting off new explosions. The recent series of articles by Lisa Rosenbaum in the New England Journal of Medicine about conflict of interest issues provoked a storm of debate, including a powerful response from three former NEJM editors (and my own more eccentric response). Now NEJM itself has published…

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No, Pharmascolds Are Not Worse Than The Pervasive Conflicts Of Interest They Criticize

Let’s start with a quick poll:  Which is worse? A. The pervasive influence of industry on medicine, which has undermined the independence and altruism of physicians. B. The critics of industry influence, who have created a paranoid culture of distrust which has undermined the partnership of industry and physicians that has brought medicine to its current heights. If you chose B then you are…

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A ‘Disappeared’ Article, Finally Published, Finds A Desultory Response To Scientific Misconduct

Back in January an article in the European Heart Journal raising the disturbing possibility that guidelines based on fraudulent research may have been responsible for as many as 800,000 deaths was “disappeared” from the journal’s website only minutes after being published. The journal’s editor claimed the article had not been properly peer reviewed. In its place the editors published an editorial refuting…

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The Italian Research Scandal Grows: New Questions And More Confusion

New questions are being raised about yet another published study from an embattled Italian research group. It also appears that despite attempts by some of the participants to respond to some of the previous questions and accusationst there is little likelihood that the growing scandal will be resolved anytime soon. The new allegations are the…

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Our Limitless Capacity For Self-Deception

I want to share with my readers a recent post and accompanying comment published on CardioExchange. The original post is by Eric Lindley, a cardiology fellow at the University of Utah: Journal X: Not so Subtle Marketing Messages I was the rare resident who thought that conflict of interest issues in medicine were a bit overblown. I…

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