“Putting Patients First”: Systematically Distorted Communication and Merck's Marketing of Vioxx

Abstract

An estimated 27,000–60,000 patients died while taking Merck's drug Vioxx between 2000 and 2004. This essay uses Deetz's treatment of systematically distorted communication and Nilsen's significant choice to analyze Merck's communication about the drug. The company claimed publicly to be forthright about Vioxx's safety. The article shows, however, that Merck systematically distorted communication through neutralization, topical avoidance, and disqualification in ways that thwarted physicians’ and patients’ abilities to make an informed choice about Vioxx. The analysis shows that Merck employees’ consent to economic priorities framed these communication practices as legitimate and rational within the organization. The same practices, however, appeared socially irresponsible to members of the scientific community outside the company. In contrast to Merck's practices, the essay offers more participatory communication applications that uphold companies’ moral obligation to their stakeholders.

Keywords:

• Merck
• Vioxx
• Systematically Distorted Communication
• Significant Choice
• Social Responsibility

This research was carried out at the University of Arkansas, Little Rock.

This research was carried out at the University of Arkansas, Little Rock.

Acknowledgements

The author would like to thank Rob Ulmer for his continual guidance on this paper; Stan Deetz, Tim Kuhn, Julien Mirivel, Erin Lyon, and Alicia Lyon for their help on earlier versions of the paper; Tim Sellnow and anonymous reviewers for their insights for improving the essay; and, most importantly, God for his blessings.

Notes

This research was carried out at the University of Arkansas, Little Rock.

1. These three micro-practices were chosen in the process of analyzing the data. Deetz also discusses naturalization, subjectification of experience, meaning denial and plausible deniability, legitimation, and pacification.

2. The statement originally appeared at http://www.merck.com/about/cr/profile/stakeholders. This particular webpage and statement have since been removed from the website.

3. Importantly, these warnings often did not specify that members should simply avoid these discussions with physicians. In some cases, the statements could be read as discouragements about discussing Vioxx's risks with anybody.

4. The use of the pamphlet contradicted Merck's earlier claim that employees could not discuss cardiovascular safety because it was “not on the label.” This policy was employed only when it was beneficial for the company, not the physicians.

5. Physicians’ over-reliance on information from drug representatives, rather than published studies, is a growing problem that further exacerbates an already dysfunctional and codependent relationship.

Additional information

Notes on contributors

Alexander Lyon

Alexander Lyon (Ph.D., University of Colorado, Boulder) is an Assistant Professor in the Department of Speech Communication at SUNY Brockport