It should not be surprising that cynicism is increasingly the US national pastime, as we regularly observe top-dog bankers avoiding criminal prosecution for crimes they preside over, and we see prominent professionals-including psychiatrists-gaining career advancement after disgraceful actions.
First, a quick review of the recent career arc of Jamie Dimon, CEO of JPMorgan. In 2013 alone, JPMorgan paid out nearly $17 billion to settle claims with the federal government against JPMorgan’s sale of fraudulent mortgage-backed securities and other illegal practices. After settling with the government, Dimon, CEO of JPMorgan during the time these illegal practices took place, was rewarded by JPMorgan with a 74 percent pay raise, bringing his yearly compensation to $20 million.
As U.S. Senator Elizabeth Warren put it, “Now, you might think that presiding over activities that resulted in $17 billion in payouts for illegal conduct would hurt your case for a fat pay bump, but according to The New York Times, members of the JPMorgan board of directors thought that Jamie Dimon earned the raise, in part-and I’m quoting here-‘by acting as chief negotiator as JPMorgan worked out a string of banner government settlements.’ “
Banker scoundrels aren’t the only big shots whose careers continue to ascend following reprehensible conduct. The following is a career update for some of the members of the “Psychiatry Hall of Shame,” including the group excoriated in the 2008 Congressional investigations, and another psychiatrist who conducted studies aimed at inducing psychosis-experiments that appeared to run counter to the Nuremberg Code of research ethics.
Before updating psychiatry’s prominent national figures, first a prominent local psychiatrist in Cincinnati, where I live. In 2014, Melissa Delbello became Chair of the Department of Psychiatry and Behavioral Neuroscience at the University of Cincinnati, and earlier this year, she was listed by Cincinnati Magazine as one of Cincinnati’s “top psychiatrists.” This despite the fact that in 2008, Delbello was rebuked by a U.S. Senator on the Senate Floor following a New York Times exposé about her.
In 2008, Delbello was included in a Congressional investigation on psychiatrists violating federal and university regulations in their receipt of large sums of money from drug companies. An appalled U.S. Senator Charles Grassley told Americans how Delbello, in response to a reporter’s question about the money that she received from a drug company, had said: “Trust me, I don’t make much.” Delbello claims that she was misquoted by the New York Times reporter, but not in dispute is the fact that she had failed to accurately report her outside income in 2003 and 2004 from AstraZeneca, the manufacturer of the antipsychotic Seroquel, a drug which Delbello had done research on in 2002. The Times recounted how Delbello, in a 2002 published paper, reported that Seroquel in combination with Depakote is more effective for the treatment of adolescent bipolar mania than Depakote alone; but Delbello later acknowledged that this study-which had become an influential one in dictating prescription practice-was not conclusive.
Grassley took to the Senate floor to talk about DelBello, “I am going to report on the actions of one physician to explain how industry payments to medical experts can affect medical practice,” and he reported how Seroquel manufacturer AstraZeneca had paid her over $238,000 (far more than she had reported). Concluding his Senate speech about Delbello, Grassley said: “This situation is unfortunate on so many levels. It is unfortunate for the University of Cincinnati that relied on the representations of its faculty; it is unfortunate for patients who once believed that their doctor was not for sale; and it is unfortunate that we are in a day and age where a bill promoting transparency for millions and millions of dollars going from big drug companies to American doctors is necessary.”
But conflicts of interest in psychiatry remain “ethical” with “proper” disclosure. So, in 2015, Delbello co-authored a study with lead author Holland Detke, an employee and stockholder of the pharmaceutical company Eli Lilly, with Delbello herself receiving support from Eli Lilly, and with a disclosure following the article references stating: “This research was funded by Eli Lilly and Co.” Published in a professional journal that influences prescribing practices, the study conclusion was that an effective treatment for children age 10 to 17 diagnosed with bipolar disorder was the combined used of the antipsychotic Zyprexa and the antidepressant Prozac, both drugs manufactured by-you guessed it-Eli Lilly.
In the 2010 documentary Goldman Sachs: Power and Peril, John C. Whitehead, former Goldman Sachs Chair, asserts, “It’s not whether a conflict of interest exists that is important. It’s how you deal with it.” If you can follow the “Whitehead Guide” and convince yourself that you are so extraordinary that you can transcend a flagrant conflict of interest, then career advancement in banking-and psychiatry-becomes quite easy.
Melissa Delbello, currently Chair of the Department of Psychiatry at the University of Cincinnati and a Cincinnati Magazine “top psychiatrist,” is small potatoes compared to psychiatrist Joseph Biederman. Biederman is currently at Massachusetts General Hospital for Children, where he is the Chief of Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, with his current bio stating: “Dr. Biederman has also been selected every year since its inception into The Best Doctors in America compilation of the best physicians in the country.”
In 2009, the New York Times reported the following: “Dr. Biederman-who was director of the Johnson & Johnson Center for Pediatric Psychopathology Research at Massachusetts General Hospital, in Boston-is in the middle of two controversies: one involves the use of antipsychotic drugs in children, and the other relates to conflicts of interest in medicine.”
In the first controversy/scandal, the Times reported that Biederman, “an influential Harvard child psychiatrist told the drug giant Johnson & Johnson that planned studies of its medicines in children would yield results benefiting the company.” Biederman’s second controversy/scandal was exposed in the 2008 Congressional investigation of psychiatry. The New York Times reported about Biederman, “He is the world’s most prominent advocate of diagnosing bipolar disorder in even the youngest children and of using antipsychotic medicines to treat the disease, but much of his work has been underwritten by drug makers for whom he privately consults . . . . Dr. Biederman earned at least $1.6 million in consulting fees from drug makers from 2000 to 2007 but failed to report all but about $200,000 of this income to university officials.”
Other big-shot psychiatrists such as Charles Nemeroff and Alan Schatzberg were also nailed by Congress in 2008, but have also more than landed on their feet. Nemeroff, who the New York Times reported earned more than $2.8 million in consulting arrangements with drug makers from 2000 to 2007 and failed to report at least $1.2 million of that income to his university and violated federal research rules; but by 2011, Forbes ran the following article about Nemeroff: “How An Ethically Challenged Researcher Found A Home at the University of Miami, and Nemeroff has remained at the University of Miami where he currently is the Chair of the Department of Psychiatry and Behavioral Sciences, and Director of the University of Miami Center on Aging. And in 2008, Congressional investigators also discovered that then president-elect of the American Psychiatric Association, Alan Schatzberg of Stanford University, had $4.8 million stock holdings in a drug development company; but this did not stop Schatzberg in 2009 from becoming Director of the Stanford Mood Disorders Center.
Then there is Jeffrey Lieberman, who in 2013 became president of the American Psychiatric Association. Lieberman, along with several other prominent psychiatrists, was exposed in the Boston Globe by investigative journalist Robert Whitaker in 1998 for conducting experiments on people diagnosed with schizophrenia in the expectation of worsening symptoms. From the 1970s through the early 1990s, influential psychiatrists, including Lieberman, conducted experiments on patients diagnosed with schizophrenia, who were administered psychostimulants with the expectation that these drugs would be “psychotogenic” (induce symptoms of psychosis), and this deterioration in fact occurred.
The Nuremberg Code of research ethics, established after the horrific human experiments by doctors in Nazi Germany, states that medical experiments on human subjects “should be so conducted as to avoid all unnecessary physical and mental suffering and injury.” However, in 1987, Lieberman conducted a study in which patients previously diagnosed with schizophrenia but who had stabilized were given methylphenidate (Ritalin) until psychotic symptoms reappeared; and in a 1990 study co-authored by Lieberman, the introduction states, “In order to examine the relationship of psychotogenic response to psychostimulants and acute treatment response in treatment-naïve, first-episode psychotic patients, we administered intravenous methylphenidate to first-episode patients.” In Whitaker’s Boston Globe 1998 series within the segment “Testing Takes Human Toll,” he interviewed Lieberman, who acknowledged that induced symptoms are sometimes, in his words, “scary and very unpleasant.”
Inducing scary and unpleasant symptoms in vulnerable human beings did not prevent Lieberman from becoming president of the American Psychiatric Association from 2013 to 2014, and getting a book deal from Little, Brown.