This is a repost of select paragraphs from this essay, which is well worth the full read here:
https://open.substack.com/pub/unbekoming/p/epistemic-capture?utm_campaign=post&utm_medium=email
“Epistemic capture occurs when an industry controls the conditions of knowledge production—what gets researched, how, and what counts as evidence. It’s far more insidious than regulatory capture, where industries influence the agencies meant to oversee them. When you capture regulation, you control decisions. When you capture epistemology, you control reality itself.
The pharmaceutical industry has achieved something unprecedented in human history: the complete capture of an entire domain of knowledge production. Every step in the process of creating medical knowledge—from what gets studied in the first place to what appears in medical journals—has been systematically colonized. Medical school textbooks are written by authors with financial conflicts of interest. Two-thirds of medical school department chairs have financial ties to pharma. Two-thirds of researchers carry these same conflicts.
Federal agencies have side “foundations” enabling corporate contributions. The CDC Foundation, FDA Foundation, NIH Foundation—all serve as money laundering operations where pharmaceutical dollars transform into “public health” policy. Federal officials can own stock in companies they regulate. The foxes don’t just guard the henhouse; they’ve been given shares in the poultry business.
Rogers, a political economist who follows the money through the labyrinth of pharmaceutical influence, sat before senators and explained what philosophers of science have been warning about in obscurity: when an industry captures the entire knowledge production process—what gets studied, how it’s researched, what counts as evidence—it doesn’t just corrupt individual decisions or regulators. It corrupts reality itself. It keeps us chained in Plato’s cave, mistaking shadows on the wall for truth, while those who cast the shadows profit from our confusion.
The corruption begins before students even open their textbooks. The top two-thirds of universities own stock in pharmaceutical companies, creating an institutional conflict of interest that pervades every classroom and laboratory. When the universities themselves are investors in the industry they’re supposed to study objectively, the corruption isn’t a bug—it’s a feature.
Most clinical trials, the supposed gold standard of medical evidence, are conducted by for-profit Contract Research Organizations in China and the developing world, where oversight is minimal and data manipulation is easier. As Rogers revealed in his testimony, a large percentage—perhaps as much as 40%—of medical journal articles are ghostwritten by the pharmaceutical industry. As documented in “Biostitution,” authors with conflicts of interest are up to 20 times less likely to publish studies with negative findings than authors without such conflicts. The published science isn’t science at all, but marketing dressed in academic drag.
Twenty-seven billion dollars. That’s what the pharmaceutical industry spends annually just on drug promotions to influence prescribing practices. To put this in perspective, that’s more than the entire annual budget of the National Institutes of Health. It’s enough to give every medical doctor in America approximately $27,000 per year. This isn’t education—it’s epistemic warfare conducted with an unlimited budget.
This money doesn’t flow randomly. It’s strategically deployed to maximum effect. Continuing medical education, ostensibly meant to keep doctors current with the latest science, is sponsored by Big Pharma. The standards of care that doctors must follow or risk malpractice suits are written by physicians with financial conflicts of interest. The regulatory body that accredits private health insurance companies is stacked with industry representatives.
The money creates what Rogers calls an “epistemic bubble carefully engineered by the pharmaceutical industry to increase its profits.” Inside this bubble, certain questions simply cannot be asked. Certain connections cannot be made. Certain observations cannot be voiced. The money doesn’t just buy silence—it shapes the very conceptual framework through which doctors understand health and disease.
Consider how the tobacco industry pioneered this approach. As documented in “Agnotology,” they created a “stable” of experts to manufacture doubt, to call for endless research, to ensure that the “debate” never ended even as the bodies piled up. The pharmaceutical industry studied this playbook, scaled it up, and perfected it. Where tobacco had millions, pharma has billions. Where tobacco influenced a handful of researchers, pharma has captured entire institutions.
The economic cost runs into the trillions. Autism alone costs the United States over $250 billion annually. Diabetes, autoimmune diseases, neurological disorders—all have exploded in prevalence during the exact period when pharmaceutical influence over medical knowledge production reached its zenith. The correlation is dismissed within the bubble, but outside it, the pattern is unmistakable.
The FDA has no regulations concerning the contents of placebos. Manufacturers can put whatever they want into the comparator and still call it a “placebo” by law. Scientific journals have similar non-requirements. About two-thirds of the time, studies don’t even disclose what was in their “placebo.” This definitional corruption extends throughout medical science. A “randomized controlled trial” should compare vaccinated to unvaccinated groups using saline placebos. Instead, they compare new vaccines to old vaccines, or to aluminum adjuvants, ensuring that adverse events appear in both groups and can be dismissed as “background rates.” The corruption is so complete that when Siri demanded true saline placebo studies, the medical establishment insisted such studies would be “unethical”—a perfect epistemic capture where the methods needed to determine safety are declared morally impermissible.
The path out of epistemic capture begins with recognition. As Rogers emphasized, “ending epistemic capture is the key to stopping corruption, junk science, and iatrogenic injury.” But recognition alone isn’t enough—the entire system of knowledge production in science and medicine needs to be overhauled to liberate it from pharmaceutical industry distortions.
The ultimate goal isn’t just to end pharmaceutical capture but to make epistemic capture itself visible and preventable. Once we understand how entire fields of knowledge can be colonized, we can build immune systems against it. This requires teaching critical thinking, encouraging intellectual courage, and creating economic structures that reward truth-telling rather than compliance.
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