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Mistakes Were Made - Carol Tavris [26]

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entrap their recipients. His brother Hal, a psychiatrist, told him how he ended up on the speakers bureau of a large pharmaceutical company: First they asked him to give a talk about depression to a community group. Why not, he thought; it would be a public service. Next they asked him to speak on the same subject at a hospital. Next they began making suggestions about the content of his talk, urging him to speak not about depression, but about antidepressants. Then they told him they could get him on a national speaking circuit, “where the real money is.” Then they asked him to lecture about their own new antidepressant. Looking back, Hal told his brother:

It’s kind of like you’re a woman at a party, and your boss says to you, “Look, do me a favor: be nice to this guy over there.” And you see the guy is not bad-looking, and you’re unattached, so you say, “Why not? I can be nice.” Soon you find yourself on the way to a Bangkok brothel in the cargo hold of an unmarked plane. And you say, “Whoa, this is not what I agreed to.” But then you have to ask yourself: “When did the prostitution actually start? Wasn’t it at that party?”22

Nowadays, even professional ethicists are going to the party: The watchdogs are being tamed by the foxes they were trained to catch. Pharmaceutical and biotechnology industries are offering consulting fees, contracts, and honoraria to bioethicists, the very people who write about, among other things, the dangers of conflicts of interest between physicians and drug companies. Carl Elliott has described his colleagues’ justifications for taking the money. “Defenders of corporate consultation often bristle at the suggestion that accepting money from industry compromises their impartiality or makes them any less objective a moral critic,” he writes. “‘Objectivity is a myth,’ [bioethicist Evan] DeRenzo told me, marshaling arguments from feminist philosophy to bolster her cause. ‘I don’t think there is a person alive who is engaged in an activity who has absolutely no interest in how it will turn out.’” There’s a clever dissonance-reducing claim for you—”perfect objectivity is impossible anyway, so I might as well accept that consulting fee.”

Thomas Donaldson, director of the ethics program at the Wharton School, justified this practice by comparing ethics consultants to independent accounting firms that a company might hire to audit their finances. Why not audit their ethics? This stab at self-justification didn’t get past Carl Elliott either. “Ethical analysis does not look anything like a financial audit,” he says. An accountant’s transgression can be detected and verified, but how do you detect the transgressions of an ethics consultant? “How do you tell the difference between an ethics consultant who has changed her mind for legitimate reasons and one who has changed her mind for money? How do you distinguish between a consultant who has been hired for his integrity and one who has been hired because he supports what the company plans to do?” 23 Still, Elliott says wryly, perhaps we can be grateful that the AMA’s Council on Ethical and Judicial Affairs designed an initiative to educate doctors about the ethical problems involved in accepting gifts from the drug industry. That initiative was funded by $590,000 in gifts from Eli Lilly and Company; GlaxoSmithKline, Inc.; Pfizer, Inc.; U. S. Pharmaceutical Group; AstraZeneca Pharmaceuticals; Bayer Corporation; Procter & Gamble; and Wyeth-Ayerst Pharmaceutical.

A Slip of the Brain


Al Campanis was a very nice man, even a sweet man, but also a flawed man who made one colossal mistake in his 81 years on earth—a mistake that would come to define him forevermore.

—sports writer Mike Littwin, on Campanis’s death in 1998

On April 6, 1987, Nightline devoted its whole show to the fortieth anniversary of Jackie Robinson’s Major League debut. Ted Koppel interviewed Al Campanis, general manager of the Los Angeles Dodgers, who had been part of the Dodger organization since 1943 and who had been Robinson’s teammate on the Montreal Royals in

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