Biederman's status at Harvard and his research have
arguably made him, until recently, America's most
powerful doctor in child psychiatry.
has strongly pushed treating children's
mental illnesses with powerful antipsychotic
medicines. Diagnoses like ADHD and pediatric bipolar
disorder, along with psychiatric drug use in
American children, have soared in the last 15 years.
No other country medicates children as frequently.
Reports from court actions, along with an ongoing
investigation of conflict of interest charges led by
Sen. Chuck Grassley, R-Iowa, threaten to topple
Biederman from his heretofore untouchable Olympian
heights. Biederman has cried foul.
He says the drug company dollars (declared and
undeclared) have not influenced him or his research.
He had agreed temporarily to sever most of his
financial ties with the drug industry pending the
outcome of the ongoing inquiry.
He claims his science and publications are pure,
supported by a peer-review system that is supposed
to verify accuracy and authenticity. Finally, he
challenges as office gossip reports of his legendary
anger and intolerance of those who disagree or don't
support his proposals.
In a contentious exchange with a deposing lawyer,
he also indicated he ranks just below God in the
Harvard faculty hierarchy or firmament.
Biederman's situation is emblematic of a very
compromised medical research and academic community
that has become dependent on industry money for its
Virtually all researchers say they are not
influenced by drug company money. Doctors rarely
out-and-out lie about their research, but spin
influences how a study is set up, its statistical
analysis and interpretation. Research on drug
studies repeatedly shows that drug trial results are
tilted toward a positive description of the drug's
effects when the research is funded by a drug
company rather than the government or an independent
Big Pharma money is most powerful when promoting
Biederman's research and point of view over
competing models. Drug companies copy and mail his
important papers on psychiatric drugs to every
American physician working with children. A member
of the Biederman team is at every important meeting
on children's psychiatric issues and medical
education. Their presence, and often the conference,
itself, are supported by drug industry dollars.
Only when children die or side effects are severe
- as in the FDA hearings on children and
antidepressants in 2004, and in the recent publicity
over obesity and diabetes caused by the bipolar
drugs - do opposing viewpoints get the country's
eyes and ears.
Biederman's conflict of interest problems have
exposed his strong pro-drug views to the public for
scrutiny. Until now, fear of the Biederman team has
operated quietly on the small club of child
psychiatric researchers. Only when 2-year-olds
started taking three psychiatric drugs
simultaneously under a Biederman protocol for
bipolar disorder did the emperor's clothes become so
invisible as to begin the naming of names.
Business ethics, whose main concerns are profit
and legal operation, collide with medical ethics,
which are directed to the patient's benefit, when
academic research is dependent on industry money. We
must formulate and enforce a new set of rules to
restore doctors' credibility.
The federal government has recently promised
funds to compare existing drugs with newer, more
expensive competitors. This is a welcome shift of
emphasis away from previous drug-company-sponsored
studies that only had to prove that their drug,
short term, was better than a placebo. In the
meantime, Biederman's personal travails tragically
inform us about a crisis in academic medicine that
must be resolved.