Only 13% of Americans believe that pharmaceutical companies are “generally honest and trustworthy,” putting the industry on a par with tobacco, oil, and managed care companies, a recent Harris Poll survey has found. Public confidence in drug companies has plunged harder and faster than for any other industry, the survey indicates (17 July, p 128).

The distrust appears to be spreading to respected US medical bodies and academic journals in the wake of a spate of public controversies concerning the influence of drug companies.

Guidelines for lowering cholesterol concentrations, issued on 12 July by the National Heart, Lung, and Blood Institute and the American Heart Association, sparked a furore when it was shown that all but one of the nine authors had financial ties to the manufacturers of …