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Natalie Angier and Jonathan Weiner

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This Is Your Preschooler on Drugs

By Jonathan Weiner
Posted Wednesday, Feb. 23, 2000, at 10:17 AM ET

Natalie,

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Hi. I'm still thinking about bioethics over breakfast this morning. Paired headlines across the top of today's Philadelphia Inquirer: "More Preschoolers Given Psychiatric Drugs." "Potent Groups Oppose Medical-Error Proposal."

The drug story is based on a report in today's Journal of the American Medical Association. It says that more and more kids too young for kindergarten are being dosed with uppers like Ritalin and downers like Prozac, and nobody knows whether the drugs are safe or effective in such little kids--let alone whether it's appropriate to toss their moods up or down with the thuggy hands of big pharma. That's a national scandal. The medical-error story comes out of Washington. Clinton has some proposals to help cut down on medical errors, and he was snubbed during his announcement yesterday by--the AMA. They're arguing about mandatory reporting, which seems to be helping to cut down on medical errors in a few states, including Massachusetts, according to Arnold Relman, the former editor of the New England Journal of Medicine. The AMA is worried that mandatory reports would make things worse for doctors in lawsuits. Meanwhile medical errors kill about 100,000 people a year in the United States, more than AIDS, car accidents, or breast cancer.

Knowledge is power, power makes money, and big money makes it harder to thread your line of work through the eye of the needle and get to the kingdom of heaven. According to this week's issue of Nature, a recent survey of scientists working in government or industry in the U.K. found that one in three of them has been asked to alter research results to please a customer or to get more contracts. As venture capital slops over from the silicons to the biotechs, the stakes keep rising. The same issue of Nature reports that a well-known biologist at Oxford, Roy Anderson, who's worked on AIDS and on the spread of mad-cow disease, has been suspended from the university while people at Oxford and at the Wellcome Trust attempt to sort out possible conflicts of interest involving Anderson's stake in a private biomedical consulting company. Anderson may be blameless, but big money must make it harder for scientists like him to stay blameless. He's one of the consulting company's directors and major stockholders.

I used to write mostly about what's known as earth science, not medicine, and the parallels are amazing. I see by the morning's papers, for instance, that the space shuttle Endeavor just came down safely with its crew of six, having managed to map 43.5 million square miles of the planet's surface at least twice in 11 days. These are the most spectacular maps we've ever had of the planet; and of course our knowledge of our own anatomy is by far the most detailed it's ever been, too--we're mapping our genes right down to the pebble level. The earth-map story didn't make the front pages with the medical stories. But on both scales, the big and the small, it grows harder instead of easier to follow the old Hippocratic injunction, "First of all, do no harm."

Seriouser and seriouser,
Jonathan

P.S.: I'm calling my wife, Deborah Heiligman, about that preschool Prozac story. She writes children's books, and today she's off in Pottsville, Pa., on a round of school visits. She says it's amazing how the very same talk can wow one room full of little kids and bomb in another--nothing, nothing but glassy eyes. Deb, I think we may have found the problem.