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I'm not sure whether you're suggesting that I am somehow being unduly trusting when it comes to pharmaceutical corporations, but I can assure you that I am certainly not. There is, however, the question of realism. Normally when a pharma corp wants to push something unhealthy or unnecessary through, for instance, it uses political influence to do so; they spend a lot of money lobbying and donating to the right people. Faking the actual evidence on a clinical trial basis has problems:
* There are a very large number of people involved in trials, investigators, doctors, lab workers, statisticians, ethics committee members etc, most of whom have no interest in bringing a dodgy drug to market (they're not the ones getting X billion dollars for it) and it only takes one person to blow the whistle. Believe me, morale is not exactly at "fanatical devotion" level amongst clinical trials workers.
* The regulatory bodies have access to all the data themselves, not just the summaries, and they're not just paper-pushers, they're scientists and statisticians themselves.
* There are lots of different centres involved in a trial, because individual centres can't recruit patients fast enough, often around the world. This would mean lots of goons. If problems show up they're unlikely to just be in one place.
This doesn't mean that it's an impossible situation to have thugs intimidating people by any means, but you'd have to set the scene quite well for it to be believable; there would have to be lots of special circumstances which explained why they couldn't achieve their goals by more traditional and safer methods. If I were running an evil pharma corp and I wanted to get something dangerous through regulatory bodies for some reason, I would use my allies in Washington in concert with other industries to put political pressure on the regulatory bodies themselves to require a lower standard of proof and let the thing through anyway, which as you point out is the route that seems to have been taken with rBGH. It's quite easy to ignore studies done after the fact as long as you can keep publicity to a minimum, and you can also use influence and money to discourage researchers from looking into the matter and journals from publishing the results. There's a massive amount of money in cattle, and it's friendly with the government.
If I were going to construct a situation where a corp might threaten people in the course of a cover-up relating to drug trials, I doubt it would have anything to do with the sort of clinical trials that go to the FDA. It would be research-related, unofficial stuff, performed in a remote area to get round ethics rules, involving unethical practices like deliberately infecting people with something, hero uncovers dastardly plot, intimidation ensues. |
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