On 21 March 2025, Peter Licht, Professor of Cardiothoracic Surgery at Southern Danish University, Odense, wrote to me on behalf of the European Association for Cardiothoracic Surgery (EACTS), which will have its annual meeting in October in Copenhagen. He expected around 7,000 participants, mostly surgeons, but also industry representatives.
Licht was EACTS Past President. He noted that the Association has a tradition of inviting an external speaker to give a presentation about something “completely different” from the specialty and said that I could help formulate the title. He thought that my experience with the Cochrane Collaboration, and especially my concerns about it, would be very exciting for the audience and that a critical lecture on doctors’ collaboration with industry would also be exciting.
I suggested giving a lecture about the corruption of healthcare and alerted Licht to my article: Prescription drugs are the leading cause of death. And psychiatric drugs are the third leading cause of death. I noted that – as this is our major healthcare problem – it should interest cardiothoracic surgeons, too.
Licht agreed and attached an article that had made him concerned. It was a study of all US cardiothoracic (CT) surgeons who had published papers in three major CT surgery journals in 2019. An astounding 96% of the surgeons had received payments from companies, but a comparison with the Centers for Medicare and Medicaid Services data showed that financial disclosure was reported in only 11% of cases. And the amount of money involved was staggering. More than $187 million over 5 years were paid out to 851 surgeons ($220,000 per surgeon, on average), with the highest-paid surgeon receiving an average of over $5.9 million per year.
Licht wrote to me that I would receive “an email from the EACTS office in Windsor – I assume it will be Sharon Pidgeon writing, so that all the formalities can be sorted out before the meeting.”
On 17 April, Pidgeon asked me to confirm that I accepted to lecture and noted that they would like to discuss in a conference call the title and content of my presentation, “potentially around the theme of how to make good evidence, drawing on your experiences and how they relate to CT surgeons vis a vis industry relationships, guidelines etc.”
I replied that Peter and I had agreed that I should talk about the commercial influence on healthcare; what the pervasive corruption means for the patients; and what we should do about it. My suggested title was: Why are our prescription drugs the leading cause of death and what can we do to reduce the corruption in healthcare?
I thought it was all set but found out during a conference call with Pidgeon and Patrick Myers, Secretary General, that this wasn’t the case. Myers found the title too provocative and we used quite some time discussing it before I suggested we resolve this via email, which they accepted. Moreover, he was not happy that I was going to talk about corruption and he talked about the fruitful collaboration they had with the industry.
As per their instructions, I sent a photo of myself and a one-page profile to be used in the announcement of my lecture and suggested another title, leaving out the corruption bit: Why are our prescription drugs the leading cause of death and what can we do to reduce the deaths?
The next day, I was told that Myers had “given some thought” to the title and Pidgeon asked if I would “be agreeable to changing it to” Improving Patient Safety in Prescription Medicine: Challenges and Opportunities.
This was a major blow to what I had agreed with Licht. To talk about patient safety when our drugs are the leading cause of death is trivialising a very serious issue in the extreme.
I responded on 30 April: This title resembles so many other titles where the speakers deliver boring keynote speeches that don’t bring us anywhere but in reality, just defends an unacceptable status quo. It could have been a title for a talk by an FDA employee. I have given many hundreds of lectures but never one with a title like the suggested one. All my life, I have called a spade a spade. Therefore, please use the title I suggested or something similar. The fact that our prescription drugs are the leading cause of death is the most important problem we have in healthcare and should be part of the title.
I wrote to Licht the same day, copying the correspondence: This is deeply shocking. I have no words for how shocking it is. I have never experienced anything like this in my 40 years as a researcher and lecturer. Can’t you do something about the contacts you have who suggested that I should lecture? Now, you run a risk that the whole thing might fall apart.
A week later, I wrote to Licht: I still haven’t heard from them. I went to their website just now, and it’s a total secret who sits on the board. So, I can’t find out who Patrick is. “About” leads nowhere. It’s one of the most obscure things I’ve ever seen. It stinks, Peter. People who don’t want you to know who they are and what they stand for don’t inspire confidence. And then there’s this one, which you can’t get away from (see below), but I refused to accept anything.
When I clicked on “About,” this came up:
Licht replied that he could not at all recognise the image I had given of EACTS: “As long as I have been a member of EACTS, the principle of ‘transparency’ has been celebrated and it has never been hidden that EACTS also collaborates with the part of the pharmaceutical industry that supplies ‘devices’ for our operations, and which contributes financially, which firstly makes it possible for us to have a European organisation, but also paves the way for all the initiatives within education in heart and lung surgery that are otherwise not available, including offering fully funded fellowships to the next generation of promising surgeons…I hope that you and EACTS managed to find an acceptable solution for everyone regarding a Keynote Lecture at the annual meeting in Copenhagen, which can inspire the many thousands of heart and lung surgeons.”
I replied that I really appreciated his feedback and that I would write to the secretariat again noting it was unacceptable that I was not getting any response from them. I also explained that the reason I had reacted sharply in my email to him was that I had experienced so much dirt in my career related to the pharmaceutical industry.
On 9 May, I wrote to Pidgeon, copying Licht, that I looked forward to her reply. I noted that I was very open to discussing the title and that she should not see what I had written as some kind of ultimatum from me. I suggested a very lame title, Improving Patient Safety in Prescription Medicine, which was the title suggested by Myers except for the addition: Challenges and Opportunities.
Nine days later, I reminded Pidgeon that I still had not heard back from them.
On 23 May, Myers wrote:
“Following our conversation and some further reflection with our leadership team and the program committee, I wanted to share some thoughts regarding the proposed topic and framing of your lecture. As you know, the EACTS Annual Meeting is focused on advancing knowledge and fostering discussion that is directly relevant to the clinical and scientific practice of cardiothoracic surgery. While we deeply value critical thinking and open debate in medicine—including around the design and interpretation of clinical trials—we are mindful that the final keynote should resonate directly with our specialty audience.
The emphasis in your proposed presentation on psychiatric medications, and particularly the framing around pharmaceutical corruption, may risk detracting from that goal. It’s important to us that our closing lecture supports constructive dialogue within the scope of cardiothoracic surgery, rather than opening a broader debate that could polarize the audience or distract from the core mission of the meeting.
Given this, and with genuine respect for your important work and longstanding contributions to evidence-based medicine, I believe we may need to reconsider this invitation for this year’s closing session. I appreciate that this may be disappointing news, but I hope you can understand our position.
Thank you again for your engagement and for the important voice you bring to discussions around trial methodology and integrity in medical research.”
Myers totally contradicted what Licht had told me earlier, that the Association has a tradition of inviting an external speaker to give a presentation about something “completely different” than that related to the specialty.
My translation of his message is this one:
He speaks about psychiatric medications, which was not the focus of my talk. He used a tactic that philosopher Arthur Schopenhauer described in his book, The art of always being right: “If you are being worsted, you can make a diversion – that is, you can suddenly begin to talk of something else, as though it had a bearing on the matter in dispute and afforded an argument against your opponent…it is a piece of impudence if it has nothing to do with the case, and is only brought in by way of attacking your opponent.”
I have an “important voice,” but they don’t want to hear it. Why not, if it is important?
Not wanting to “polarize the audience” means that they don’t want to upset those of their colleagues whose pockets are filled with industry money.
EACTS is so corrupt that they will not allow me to speak about what this corruption means for the survival of patients. This is very scary. Money comes first, patient survival later, if at all. Licht tried his best but was overruled by the current leadership of the EACTS.
Licht argued that industry funding was important for the education of surgeons. I don’t accept this argument. It is the responsibility of their employers to ensure that their surgeons get the education they need.
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