Combined Vol. (Eight and Ninth Monograph).ISSN 0973-1229. ISBN 81-89753-11.
Rs. 250/- US $ 25/-.
Medical Practice, Psychiatry and the Pharmaceutical Industry:
And Ever the Trio Shall Meet-I
Ajai R. Singh
Shakuntala A. Singh
One of the greatest happenings in the medical world today is the wide opportunity
for collaboration between academic institutions, researchers and the pharmaceutical industry. While this holds great promise
according to some, it portends equally great problems according to others. On the one hand is the growing commercialization
of research with its effect on the ethical conduct of researchers. On the other are the advancements of scientific knowledge
with its effect on the welfare or otherwise of patients. Both these are becoming areas of pressing concern. Connected to the
growing clout of industry in institutions is concern about the commercialization of research and resolving the ‘patient
or product’ loyalty. Issues related to conflict of interest, doctoring of data, control over publication, threats of
legal tangles, patient or corporate welfare are vexing unresolved issues. Gifts, sponsorships, pliant experts acting as industry
spokespersons, journals and their ethical policies are no less. Guidelines, whether clinical practice or of journal editors,
are also areas of increasing activity and equal concern.
of four monographs (two current, and three to follow) tackles these issues in the light of current research work done.
Singh, M.D., is a Psychiatrist who has earlier worked with the WHO Collaborating Center In Psychopharmacology In India.
A. Singh, Ph.D., is Principal, and Reader and Head, Dept of Philosophy, Joshi-Bedekar College, Thane, India. She has earlier
worked with the Indian Council of Philosophical Research as a Post-Doctoral Fellow.
Founders of the Mens Sana Research Foundation, India.
The Two Revolutions In Bio-Medical
In the field of modern medical science, we can identify certain epochs. Some
of these will be our concern here, for they offer important insights into the development of modern medicine and offer equally
important predictors to where it is heading in the future. In fact they are so important that they qualify to be called nothing
less than revolutions.
Till the early twentieth century, medicine was an activity dependent on
a small privileged elite. This changed by the mid-twentieth century into a vast publicly owned enterprise with enlightened
governmental approach, support and funding. One example of this was in the 1940s, sixty five years ago, when Vannever Bush
in the US, for example, persuaded the government there to divert resources allocated for the then war effort (World War II)
to fund basic research in academic institutions. Similarly, in India, what was earlier dependent on the benevolence of zamindars/philanthropists
and some missionaries who set up charitable dispensaries/hospitals to serve certain sections of the population was supplemented,
and then overtaken, by governmental funding
after independence in 1947.
The major governmental support to medical science
was an important development that led to great advances in medical research and facilities all over. Such funding and consequent
blooming of medical science was nothing less than a revolution, which we can legitimately consider the first revolution in
A second revolution was soon to follow four decades
later. It was fuelled by a vast upsurge in medical research, training and therapy, with capital pouring in from private enterprise
and philanthropy. This revolution is still on. It is aided by efforts like the Bayh-Dole Amendments of 1980 in the US, for
example. This epoch making amendment conferred intellectual property rights to institutions and connected scientists even
if they had developed their products/inventions with government funding. This was followed by incentives in tax laws that
resulted in a massive inflow of venture capital into biomedical research. As a result, academia was suddenly besieged by profit
seeking industry that saw immense vistas of opportunity opening up before them. Pharmaceutical majors, propped up with massive
private funding by venture capital, were quick to seize the initiative. Institutions realized their commercial potential and
its vast possibilities for the first time, and were not averse to jump on to the bandwagon.
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