Readers may have seen the recent stories of an academic anaesthesiologist, Dr. Scott Reuben, who published an entire string of fraudulent papers in the pain management field. Various rabble-rousing sources have used this as a chance to run “Big Pharma Pays For Deception” stories, but I’m not going to give that angle much time at all. I’m sure that the companies involved (Pfizer, prominently) were glad to see studies that showed that their compounds worked and were glad to cite them, but the idea of some bigwig picking up the phone and saying “Fake me up some clinical data” is too much for me.
The biggest problem is that the physican involved seems to have decided that he could make a good living by telling people what they wanted to hear. That’s always a danger, and it works the same way in all sorts of fields. It isn’t always money that drives this kind of thing, either, although that’s a good place to start. Prestige is often a big part of it, too. And there's a problem on the receiving end, too - when someone brings you a company news that their compounds perform well and should be prescribed more often, the first impulse isn't necessarily to ask "Gosh, are you sure?" (It's worth keeping in mind, though, that asking just that question is a key part in making scientific research work - but if someone is going to fake numbers from top to bottom, it's not going to be enough to catch them at it, either).
There’s another factor at work that I think about every time a major fraud or plagiarism case comes up. The minor ones I can understand, actually – someone at an obscure school rewrites an equally obscure paper, slaps their name on it and sends it off to a third-rate journal, keeping their publication rate up so as to keep their better-than-the-alternatives academic position propped up for a while longer. It’s shabby and sad, but it makes a dingy sort of sense. The major cases, though, puzzle me.
I think this topic last came up around here during the Korean stem cell fiasco a few years ago. That one set off a lot of sniping among journal editors, and a lot of speculation about how someone can think that they'll get away with fraud in an area that hotly contested.
Now, it's not like post-operative pain management is the cutting edge of medical science - no Nobels are likely to be on the line - so the question of how Reuben thought he could keep doing this doesn't apply as much. He seems, in fact, to have gotten away with doing it for many years, with no apparent problems until recently. (How, in fact, was he caught? The only details I've been able to find were that it was an internal reviewer at his medical center who noticed something). But how someone can do this sort of thing is what baffles me: not the mechanics of it, but the mental aspect is what's a mystery. How do you look at yourself after turning out fake results of any kind? Especially, how do you do it when you're affecting how people are treated for pain after surgery? And year after year. . .no, I just can't get a handle on this. There are aspects of human behavior which apparently are closed off to me, and I hope that they stay that way.