Having the potential to do less good than the pharma industry, perhaps the accreditation cartel has less potential to do harm. But perhaps not -inspectionism takes its toll on workers, organisations, and those they seek to serve. Harm is more difficult to measure than in individual patients or patient populations. The BMJ published an editorial by Davis and Abraham asking,
Nearly 30 years ago, Braithwaite’s Corporate Crime in the Pharmaceutical Industry showed that unethical and corrupt behaviour was endemic in the sector. Sadly, there is growing evidence that little has changed. Recent research suggests that violation of the law continues to be widespread. Most new medicines offer little or no therapeutic advantage over existing products, so promotion plays a huge role in achieving market share. In a crowded and competitive marketplace the temptation for companies to resort to misleading claims is great. According to Gøtzsche (doi:10.1136/bmj.e8462), as of July 2012, nine of the 10 largest drug companies were bound by corporate integrity agreements under civil and criminal settlements or judgments in the United States. The corporate activity that has led to recent government investigations has involved unethical and unlawful practices that are well beyond mere administrative offences.
Whistleblowers’ and other “insider” accounts in the US typically include allegations that companies systematically planned complex marketing campaigns to increase drug sales, which involved illegal and fraudulent activities. These included active promotion of off label, or otherwise inappropriate, use of drugs, despite company knowledge that such use could seriously harm patients.
Do you think similarly corrupt mismarketing might be going on in the inspection industry if anyone bothered to look? On one hand, its promises are vague and unmeasurable – they have to be to prevent anyone testing them thoroughly, finding out and holding them accountable. On the other hand, its invasion of workplaces by persuading gullible legislators and professional organisations continues apace. Perhaps it needs outsiders such as these British academics in sociology to begin the examination of the laboratory accreditation cartel.