A job offer to a prominent British psychiatrist made by Toronto's Centre for Addiction and Mental Health (CAMH, www.camh.net/) and the University of Toronto was withdrawn because the physician “expressed extreme views incompatible with scientific evidence” about fluoxetine, the centre's president and chief executive officer says.
Dr. Paul Garfinkel insists that the withdrawal of an offer to Dr. David Healy of the University of Wales was in no way related to the fact that fluoxetine manufacturer Eli Lilly has been a major financial supporter of the CAMH. The company contributed more than $1.5 million to CAMH's $10-million capital fundraising drive and recently financed $1.3-million in research at the centre.
In May 2000 Healy was offered a position as director of the CAMH's Mood Disorders Clinic and as full professor in the U of T's Department of Psychiatry, since the CAMH is a U of T teaching facility. A lawyer was hired to ease his move to Canada. However, the job offer was rescinded a week after a Nov. 30, 2000, lecture he gave at the CAMH. In an email, Physician-in-Chief David Goldbloom told Healy that his approach was incompatible with the centre's development goals.
The incident, which was first reported in the Globe and Mail in mid-April, has since been reported widely in the British press, including a critical 1800-word article in the Guardian. In April, Healy said he decided to go public because others, aware of the events, asked “whether it is safe to say something [critical] about pharmaceutical companies.”
Garfinkel says Healy's statements during the Nov. 30 talk were “more extreme” than ones he had made before, but acknowledged in an interview that he did not attend the lecture himself nor hear a recording of it. Healy contends that although fluoxetine and other selective serotonin re-uptake inhibitors (SSRIs) are “tremendously useful to some people,” there is evidence that they induce “intense suicidal preoccupation” in some patients, preoccupations that disappear when they stop taking the drug. Healy has argued that Eli Lilly has an obligation to conduct a clinical trial in order to better determine which patients are best suited to receive fluoxetine.
In an interview, Healy said his position on the drug has not changed since he was first approached with the job offers. “I have been consistent in the literature since 1991,” he said. In an Apr. 20, 2001, letter to Healy, Goldbloom, also cochair of the CAMH search committee, wrote that “when the position was offered to you, your views regarding the toxicity of fluoxetine were well known.” In the letter, Goldbloom argues that Healy's views had changed.
Garfinkel supported this opinion in an open letter sent to CAMH staff May 9, which stated that Healy had “expressed extreme views” that are “scientifically irresponsible.”
“No one disputes Dr. Healy's freedom to say whatever he wants in our or any other university or academic health sciences centre,” wrote Garfinkel. “However, the extreme nature of the views he expressed Nov. 30 shocked a disturbing number of future colleagues within the centre and the university, to the point where the centre felt Dr. Healy would not have the necessary respect and support of staff.”
The Guardian, meanwhile, reached its own conclusions about the “Healy affair.” It said that his views on fluoxetine and SSRIs were well known before he was aproached with a job offer by the CAMH. “What Goldbloom and his colleagues may not have appreciated — until someone told them — was the significance of employing an academic with such views in a world where research is heavily reliant on drug-company grants.”