Editorial: Mis-informed consent

By Gauntlet Editorial Board

Canadians have a love affair with choice, but like any sordid romance, we’ve allowed our passion to gloss over the pitfalls. In the arena of health and healing, both the pharmaceutical and natural healing industry have manipulated our choice-lust in order to turn a profit. In the interest of increasing the amount of choices in treatments available to the public, we have been seduced into overlooking the importance of testing and safety screening. Choice is certainly good, but are we really willing to sell out safety for it?

The issue has been compounded as lines have been drawn between the industries of pharmacueticals and that of natural healing, with a lot of finger pointing from both sides. The bottom line is that both industries are guilty of manipulating studies and cherry picking which findings are to be presented to regulatory boards — a situation that is not conducive to the health of the consumer.

The Canadian Medical Association Journal published an editorial on Monday calling for natural health products to be more strictly regulated. Current legislation allows natural health products to be sold without evaluation from Health Canada — a decision made to “allow Canadians access to the full range of nhps” according to Health Canada’s website. When assessments are made, they require less stringent studies than those required of over the counter drugs, even if they are being used in the same context. The editorial criticized the current circumstance, saying that it allows for natural health products to make claims without evidence and that negative side effects don’t get investigated until after products are released onto the market.

According to a story about the editorial published in the Calgary Herald, Carl Carter, regulatory affairs director for the Canadian Health Food Association, responded to the criticism by saying that there is an issue but it’s not with the regulation. Carter argued that regulations should be loosened to allow for more international products to make it to the Canadian market. His reasoning was that it would allow remedies that have been used for a long time in other countries to be released, giving consumers more choice. While the idea of increased choice is nice in theory, the reality is that it would not just be ancient wisdom coming to the Canadian market.

The license holders for natural health products aren’t usually grassroots operations — many are multi-national corporations. Companies that currently have products registered in Health Canada’s Licensed Natural Health Products Database include Beiersdorf (better known as Nivea in Canada), Coca-Cola and even Pfizer. There is money to be made in the natural health product realm and that draws companies who can use loop holes in our legislation to sell products with out testing or safety screening. It is unlikely that opening up the market will decrease this current trend.

When testing is conducted on nhps, safety and side effects are not addressed sufficiently. In a study recently published in bmc Complementary and Alternative Medicine, Canadian researcher David Moher reported that studies consistently under-reported possible side effects of the remedies they tested. His study surveyed 205 cam studies and only 21 per cent had adequate safety reporting.

Moher feels that this lack of adequate reporting is not endemic to just the cam contingent and there is mounting evidence to support that the pharmaceutical industry is equally guilty for manipulating the reporting of their findings.

Several studies similar to the ones Moher conducted have shown that the pharmaceutical industry publishes less than half of the studies they conduct on new drugs. For example, an analysis published last year in the journal Trials looked at clinical trials supporting new drugs approved by the fda. According to the analysis, only 43 per cent of more than 900 trials were actually published. The same analysis found that there is a strong correlation between a study having funding from the pharmaceutical industry and the trial results being positive.

Not only are these practices scummy and unscientific, they are utterly unethical. Doctors rely on published information to determine the best course of treatment for their patients. Patients likewise rely on information from doctors when deciding to pursue one treatment over another.

The most optimistic way to interpret this manipulation of information is to attribute it to trying to get pharmaceuticals on the market as soon as possible — no one wants a life-saving medical intervention to sit in trials for years while people die and Canadians deserve choices. However, while choice is nice, it is meaningless if consumers can’t make informed decisions about their health.

Right now both pharmaceutical companies and natural product purveyors provide misinformation and skewed studies which make that nearly impossible. Demonizing either side won’t solve the issue. We should require more from both industries in order to empower the consumer.

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