Chapter 1
Forbidden Knowledge and the Four Truths
Only puny secrets need protection. Big discoveries are protected by public incredulity. — Marshall McLuhan, Take Today: The Executive as Dropout
Once exposed, a secret loses all its power. — Ann Aguirre, Grimspace
Forbidden knowledge is knowedge the general population isn’t party to. It becomes forbidden when the most powerful people in a civilization repress knowledge they see as threatening or dangerous, or when they want to reduce the public’s interest and trust in such information. The repressed information can be commonly available, but citing it publicly is discouraged or disallowed. Or it can be secret. Forbidden knowledge flourishes and endures when people hold a subconscious preference to conform, defer to authority, and choose not to explore certain information, even when investigating that knowledge is in their best interest. In other words, every past and present civilization. This happens millions of times a day when people who are injured or sick visit their doctors. We hand over our power and responsibility for our own health to our doctors. Worse, we don’t know enough about our own bodies and the drugs we take to ask the right questions. We actually decide not to ask tough questions that might prevent serious harms or deaths. That’s a problem.
In Genesis, God told Adam and Eve they could eat the fruit of any tree in the Garden of Eden except the fruit of the Tree of Knowledge of Good and Evil. That was forbidden. But Adam and Eve wanted to be like God and thought they could determine themselves what was good and what was evil. So they ate the fruit of the forbidden tree. Chaos has flourished ever since.
Throughout history, political and religious leaders have prohibited access to certain knowledge because it was a threat to their power. Knowledge is power and isn’t something humans naturally give away. They tend to hoard it. This helped to preserve their dominance, titles, and wealth and led to far more comfortable and secure lives than everyone else. Forbidden knowledge still does that today.
Before the Reformation began in the early 16th century, only educated elites could read. All books were written by hand, and there were only a few thousand in all of Europe. The Bible was written in Latin, a language few people understood. People were discouraged from praying without a priest leading them, since they might undermine their relationship with God and undercut the power of priests.
In the 1440s, a goldsmith and printer named Johannes Gutenberg, from Mainz, Germany, introduced one of the most powerful technologies since the beginning of civilization — movable type printing. His invention could produce books far faster and more cheaply, ushering in the era of mass communication. By 1500, there were millions of books in Europe and literacy was booming. The reformers of the Catholic Church demonstrated the power of literacy when they distributed tens of thousands of pamphlets across Europe, igniting revolutions and wars and eventually establishing new Protestant denominations.
Change was the new normal in Europe because with widespread literacy ordinary people, the masses, could become acquainted with truth on their own terms. They could have an opinion. They could congregate and seize power. The Gutenberg press was also crucial to the Renaissance in the 15th and 16th centuries and the Enlightenment in the 17th and 18th centuries, sowing the seeds of modern democracy as represented in the American and French Revolutions. The genie was out of the bottle. There could be no greater demonstration that knowledge was power than ordinary people learning to read, think for themselves, and demand self-government.
Knowledge could no longer be easily forbidden. But some people never stopped trying. It certainly could be hidden. In the 20th century, it wasn’t kings or religious leaders who created forbidden knowledge; it was dictators, governments, and corporations. They’re all steeped in secrets. They use them to control the masses, to enrich themselves, to cover up their mistakes, and to commit crimes. There are lots of examples of corporate secrets in this book that lead to injuries and deaths of patients every day.
But in democracies all people are supposed to be equal. That’s the goal we claim to strive for. British colonists purchased equality with blood in the American Revolution, and it was enshrined in law by some brilliant and creative thinkers who knew they could never build the country they dreamed of when one person was above the law and held ultimate power over others, namely, a foreign king. It was the rallying call of the modern world’s largest democratic republic, the United States, immortalized in the Declaration of Independence from Great Britain, that all men were created equal and endowed by their Creator with the inalienable rights of life, liberty, and the pursuit of happiness. Freedom of speech and freedom of the press were supposed to ensure no authority could control what others thought or believed.
The subject of this book is how the largest international pharmaceutical corporations — Big Pharma — hide the knowledge people need to exercise those freedoms: the truths necessary to prevent being injured or killed by our medicines. Big Pharma controls what we think and believe about its products and our own health. This is done in part under the legal protection of patents — exclusive rights for drugs and processes they invent that no other companies can legally copy for a limited time. It’s also done with trade secrets in clinical research, so-called confidential business information (CBI), protected mostly under common law that can last indefinitely. Antiquated medical practices, such as the use of pharmaspeak and medicalspeak — languages few patients can understand — mask the knowledge about drug effectiveness and safety from patients. And Big Pharma intentionally covers up known risks of its drugs, doing all that because the less information patients and physicians have about a drug, the easier it is to sell it to them.
What Big Pharma deems to be CBI is shocking. It claims patent rights and trade secrets benefit everyone because they lead to new breakthrough drugs and cures that make everyone healthier. The truth is they often do the exact opposite. They protect monopoly drugs for up to 40 years, keeping prices sky-high
and making it more difficult for others to raise capital and compete. Big Pharma employs brilliant marketing deceptions, disinformation, trickery, subterfuge, scientific bully tactics, and legal manoeuvres to repress the publication of any information that makes its drugs look risky or dangerous, because many of them are, or makes them look as if they don’t work very well, because many of them don’t.
Big Pharma does this using science itself — clinical drug trials, an imperfect method of proving drugs are effective and safe that’s easily subject to manipulation and biased thinking. Brilliant doctors and scientists who are passionate about discovery and finding new medicines — the wizards — populate Big Pharma’s senior ranks. They have a singular focus on creating new medicines. When they get it right, their powers are supernatural. Their potions do immeasurable good.
However, CEOs who are passionate about making sales and profits, and another group of wizards — the marketers — rule Big Pharma companies. Their claims that patient safety always comes first are illusions, since their potions also do immeasurable harm. What’s the result? In the United States, 81 million harms, 2.7 million hospitalizations, and 200,000 deaths per year,1 in Canada, 20,000 deaths per year, the fourth-leading cause of death in both countries.
Big Pharma spends billions of dollars annually on marketing and promotion that it recovers by raising the prices of its drugs so high that many of the people who need them can’t afford them, even in the United States, the wealthiest nation in the world. This is a huge threat to the sustainability of our health-care systems and diminishes our health, the exact opposite of what drug companies claim they do.
In 2012, one of the world’s largest Big Pharma companies, GSK (then called GlaxoSmithKline), pleaded guilty to misdemeanour criminal charges and paid out an astounding $3 billion3 to settle fraud charges from the U.S. Department of Justice regarding three of its blockbuster drugs — antidepressants Wellbutrin and Paxil and diabetes drug Avandia — as well as illegal marketing for another half-dozen drugs. Hundreds of patients took the three drugs and died. Scores of other Big Pharma companies have also paid out hundreds of millions of dollars in fines to settle charges of fraud and other offences. There’s a complete lack of personal accountability by CEOs and corporate directors. Before the opioid crisis, no Big Pharma CEO had ever actually gone to jail for selling unsafe drugs, which violates a key democratic principle that no one should be above the law regardless of position or power. This isn’t life, liberty, and the pursuit of happiness. Nor is it the peace, order, and good government Canadians expect. It’s corporate crime. And it pays big-time. For a Big Pharma company to shell out a $3 billion criminal fine is like its average customer paying a small fine. GSK easily paid the $3 billion out of its total revenues — $28 billion — for the three drugs over that period. To Big Pharma, that’s just the cost of doing business, one it actually includes in its business plans. Big Pharma products have innate dangers so common, and their companies break the law so boldly, that they actually set aside hundreds of millions of dollars for lawsuits and settlements they know will come.
Should this give us pause? Patients die and the drug companies pay fines they can easily afford. Imagine if Mafia bosses could just pay fines for their crimes. There’s more. Fines and settlements for Big Pharma’s crimes have become an important source of revenue for governments. The U.S. Department of Justice says it reaps $15 for every dollar it spends on prosecutions. It’s a profit centre. Why send CEOs or directors to prison, costing taxpayers money, when governments can take in billions of dollars in fines
instead?
I’ll tell you why. Because governments are supposed to protect the public and deter crime, not benefit from it. And the only way these companies will ever stop their illegal practices is if their powerful CEOs and directors face personal accountability for the crimes their corporations commit. New York State attorney general Eliot Spitzer sued GSK in 2004 for concealing negative results in four clinical trials for the antidepressant Paxil. Children had died by suicide as a result. “What we’re learning is that money doesn’t deter corporate malfeasance,” he said. “The only thing that will work in my view is CEOs and officials being forced to resign and individual culpability being enforced.”
Like going to jail, I hope.