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Amid Growing Evidence of Conflicts of Interest and Obdurate Groupthink in Medical Journals, Researchers Must Entertain Contrarian Ideas https://www.cureus.com/articles/336128-amid-growing-evidence-of-conflicts-of-interest-and-obdurate-groupthink-in-medical-journals-researchers-must-entertain-contrarian-ideas#!/ Mainstream medicine, like other academic fields, is shaped by prevailing paradigms and the dominant narratives they create. Over the past half-century, these paradigms have increasingly reflected the growing commercial influence of the pharmaceutical industry. Dominant narratives are closely tied to groupthink, to which medical journals are often subject. In addition, more “prestigious” medical journals tend to have further financial conflicts of interest with the pharmaceutical industry. These dynamics limit scientific progress by suppressing awareness of the iatrogenic aspects of industry products, and the benefits of alternative non-patentable and unpatentable medical products and therapeutic interventions. Journals need to adopt a more open policy to manuscripts that encompass contrarian perspectives to dominant narratives while still adhering to time-tested scientific values and methods. Thomas Kuhn (1962) https://press.uchicago.edu/ucp/books/book/chicago/S/bo13179781.html?utm_medium=email&utm_source=transaction Scientific endeavour is subject to “paradigms” that restrict what ideas are considered valid Scientists and the peer-reviewed literature, influenced by groupthink processes as by dispassionate rationality. Science v “The Science” Groupthink theories can be vociferously held and enforced with brutal censorship, e.g. Nicolaus Copernicus (c, 1500) Ignaz Philipp Semmelweis (c, 1860) Dismissed due to conflicts of interest. Considered a misinformation merchant in his own time, he is now an icon of medical science, innovation, and courage. During the past half-century, the profitability of large pharmaceutical companies has enabled them to dispense enormous financial investments into…. research, universities, medical education, medical journals, political parties, drug regulators, medical colleges and associations, and supranational institutions such as the World Health Organization. They can create the medical groupthink consensus. Internal pharmaceutical industry documents released in litigation from criminal trials, where the industry has been fined $122 billion since 2000, have revealed companies invest in shaping narratives to dominate a particular medical field in favour of their products, understating harms and overstating benefits. Conflicts of interest now bedevil every level of pharmaceutical/medical science. Pharmaceutical companies tend to oversee the trials for their own products Large pharmaceutical companies provide the majority of funding to the regulators tasked with considering the evidence of clinical trials and granting or denying licensure. A few journal chief editors have stated that their publications are effectively part of Big Pharma’s marketing departments https://jamanetwork.com/journals/jama/article-abstract/182478 https://www.bmj.com/content/326/7400/1202 https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020138 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61019-2/fulltext Editors of major medical journals have received payments from large pharmaceutical companies https://www.bmj.com/content/359/bmj.j4619 Peer reviewers have also received payments https://jamanetwork.com/journals/jama/fullarticle/2824834 Pharmaceutical companies make payments to doctors https://journals.sagepub.com/doi/10.1177/0004867412446494 https://jamanetwork.com/journals/jama/fullarticle/2816900 Pharmaceutical product recalls, are numerous, but take years to be actioned https://journals.sagepub.com/doi/10.1177/09246479241292008 Medical science is constantly evolving, and disagreement is both reasonable and rife. Remedy to groupthink Uphold the right of dissenters to be heard. Medical journals, actively encourage the discussion of contrarian ideas Stop punishment for dissenters Address financial and other conflicts of interest. Indulge those occupied with “taboo science,” while still adhering to time-tested scientific principles and methods. Be aware of manipulating psychopaths and sociopaths (JC) Something is rotten in the Academy. We need to improve.

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