Abstract and Keywords
Most of the attention to the problem of financial conflicts of interest (FCOI) in psychiatry has centered on the actions of individuals. But what if the problem is much larger, and has infected entire organizations? Using the conceptual, and normative framework of “institutional corruption,” we describe how organized psychiatry has developed values, norms, and practices that have undermined its public health mission. Specifically, we argue that institutionalized FCOI have distorted the evidence base upon which psychiatric research, diagnosis, and treatment depends. We argue that current strategies such as simple transparency of commercial ties and “managing” FCOI are insufficient and vulnerable to gamesmanship. Following the IOM’s most recent (2011) recommendations for preventing bias when there are academic–industry relationships, we offer ideas for responding to the ethical and intellectual crisis in psychiatry, and emphasize the importance of training practitioners to think critically when assessing the evidence base of industry-sponsored research.
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