Tuesday, November 14, 2017

We will not be intimidated

Recent weeks have seen a virtual avalanche of allegations of past harassment or inappropriate sexual behavior by (mostly) male politicians, talk-show hosts, and business executives. Since many of these revelations have come out years or decades later, partisans have been quick to suggest that their stories are politically motivated fabrications. If what happened was so despicable or immoral, they ask, why not come forward earlier? Why wait, for example, until the repeat offender is a in a position to be elected to the U.S. Senate? I'll tell you why in one word: intimidation. For the most part, sexual violence isn't driven by an excess of passion; it's driven by an excess of power. Violators count on a combination of embarrassment, guilt, and intimidation to keep their victims from talking, and more often than not, it works.

Intimidation is often used to injure on a societal level, too. As illustrated in the critically acclaimed film The Insider, the tobacco industry was ruthless in attempting to prevent whistleblower Jeffrey Wigand from revealing that its executives intentionally added substances known to be addictive and carcinogenic to cigarettes. More recently, a group that publicly supported a tax on sugary drinks in Colombia was threatened and censored in the weeks leading up to the vote in the legislature. And Dr. Pieter Cohen, a Massachusetts general internist who writes the Updates in Slow Medicine e-newsletter, was hit with a $200 million libel lawsuit by a supplement company after publishing a scientific paper that demonstrated the presence of a designer stimulant in its product. Dr. Cohen (whose lawsuit was eventually dismissed by a jury after a week-long federal trial) and colleagues wrote recently in JAMA Internal Medicine:

When lawsuits target scientists, it does not matter that plaintiffs almost never win. It does not even matter if the case goes to trial. The goal is to intimidate. In the lawsuit over dietary supplements, for example, the head of the company who brought the suit openly admitted that he was “hoping that we were able to silence this guy,” as well as other researchers who might raise questions about the supplement industry. The most frivolous lawsuit can generate substantial legal costs, distract scientists from research, force the indiscriminate disclosure of laboratory notebooks and emails, and create unnecessary stress for colleagues and families.

On August 13, 2013, after reading a blog post where I called his company "unscrupulous" based on its aggressive efforts to sell packages of non-recommended and potentially harmful tests to vulnerable elders at health fairs and churches, the chief medical officer of Life Line Screening mailed me a letter that called my characterization "potentially libelous and actionable" and copied their in-house legal counsel. After a lengthy defense of the technical accuracy of their testing process (which I have never questioned - my problem is that these tests are unnecessary and do not improve patients' health!), he went on to write: "You and I can disagree, but you do not have the right to attack our reputation, our passion for helping people, or the integrity of our team." I subsequently forwarded this letter to my department Chair, who forwarded it to my employer's legal counsel, who concluded that the probability of a libel lawsuit was low, and that of a successful lawsuit virtually nil. Nonetheless, it was enough to scare me into remaining silent for the next 4 years.

Dear Life Line Screening, I am not attacking your company's integrity. I am sure that the vast majority of your employees are passionate about helping people (why else work for a company named "Life Line"?) But the tests you portray to potential customers - like the retired ladies in the next pew at my church who live off fixed incomes - as bargains, however CLIA-certifiably accurate, are ineffective or, like screening for carotid artery stenosis, actually do more harm than good. And I will no longer be intimidated by you or anyone else from saying so.

1 comment:

  1. OMG Dr K - Mike McEvoy here again . Just found this post . Been against "Lifeline " for nearly the 2 decades it has been around . I wondered if it is actually funded by hospital systems ( my cynical side thinks that)

    Looking forward to more of your posts

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