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Saturday, September 26, 2009

Dr. Leon Eisenberg, Pioneer in Autism Studies, Dies at 87

Dr. Leon Eisenberg, who conducted some of the first rigorous studies of autism, attention deficit disorder and learning delays and became a prominent advocate for children struggling with disabilities, died on Sept. 15 at his home in Cambridge, Mass. He was 87.
Dr. Leon Eisenberg

The cause was prostate cancer, said his wife, Dr. Carola Eisenberg.

The field of child psychiatry was dominated by Freudian psychoanalysis when, in the late 1950s and 1960s, Dr. Eisenberg began conducting medical studies of children with developmental problems. Working at Johns Hopkins University with Dr. Leo Kanner, who first described autistic behavior, Dr. Eisenberg completed the first detailed, long-term study of children with autism, demonstrating among other things that language problems predicted its severity.

In a similar study among children who were developing normally, Dr. Eisenberg showed that reading difficulties early in school predicted behavior problems later on.

In the
1960s, he performed the first scientific drug trials in child psychiatry, testing stimulants like Dexedrine and Ritalin to soothe the behavior of children identified as “delinquent” or “hyperkinetic.” These studies, which became the basis for drug treatment of what is now called attention deficit disorder, ran counter to psychoanalytic theories on the most effective treatments.

“Leon took a very courageous stand and denounced the way psychiatry treated children, this whole system in which we had a few rich kids and their parents getting psychoanalysis five days a week and still not being cured,” said C. Keith Conners, a professor emeritus in the department of psychiatry and behavioral sciences at Duke University. “No one even knew what a cure looked like. He had this conviction that nothing was being done for the bulk of children who needed help, and that we had very little scientific data to guide us.”

Dr. James Harris, a professor of psychiatry and behavioral science at Johns Hopkins University, said that Dr. Eisenberg was “the pivotal person in
20th-century child psychiatry who moved the field from simple descriptions of childhood disorders to actually looking at the science behind both the diagnosis and treatment.”

Leon Eisenberg was born in Philadelphia on Aug. 8, 1922, the eldest child of immigrants from Russia. He earned his undergraduate degree and, in 1946, his medical degree from the University of Pennsylvania, before taking an internship at Mount Sinai Hospital in New York, where he developed an interest in psychiatry. He completed his psychiatric residency at Sheppard Pratt Hospital in Towson, Md.

After two years in the Army teaching physiology (Carey incorrectly said psychology), in 1952 he began a residency at Johns Hopkins and his collaboration with Dr. Kanner. In 1967, he took over as chief of psychiatry at Massachusetts General Hospital, where he continued to publish and, among many other projects, helped formulate and carry out affirmative action policies at Harvard Medical School.

In 1980, he established the medical school’s department of social medicine, with the aim of applying the tools of social science to improving access to and practice of medicine worldwide.
In addition to his wife, a co-founder of Physicians for Human Rights, Dr. Eisenberg is survived by two children from a previous marriage, Kathy and Mark Eisenberg; two stepchildren, Alan and Larry Guttmacher; two sisters, Essie Ellis and Libby Wickler; and six grandchildren.

For two days last week, Harvard lowered its flags to half-staff in honor of Dr. Eisenberg.
In his later years, Dr. Eisenberg became increasingly alarmed at trends in the field he helped establish, criticizing what he saw as a cozy relationships between drug makers and doctors and the expanding popularity of the attention deficit diagnosis.

The diagnosis “has morphed from a relative uncommon condition
40 years ago to one whose current prevalence is 8 percent,” he wrote. “Correspondingly, the prescription of stimulant drugs has gone up enormously. The reasons are not self-evident.”

Good law from tragic facts--Congress, the FDA, and preemption

Good law from tragic facts--Congress, the FDA, and preemption.
Annas GJ.
N Engl J Med. 2009 Sep 17;361(12):1206-11. No abstract available.
PMID: 19759383 [PubMed - indexed for MEDLINE]
Related Articles

The New York Times heralded "A Win for Injured Patients,"1 while the Wall Street Journal said that the U.S. Supreme Court was "Pre-empting Drug Innovation."2 To the New York Times, the Court's decision in Wyeth v. Levine was "wise and surprising."1 To the Wall Street Journal, it was a "defeat for drug innovation and public health"2; the editorial expressed surprise because the Supreme Court had earlier ruled that Congress had preempted state civil lawsuits alleging device misbranding, and many persons thought that the Court had turned relentlessly pro-business and would therefore also rule that civil lawsuits alleging drug misbranding . . . [Full Text of this Article]
The Facts in Wyeth
The Law of Preemption
"Tragic Facts"
Preemption after Wyeth

Source Information
From the Department of Health Law, Bioethics, and Human Rights, Boston University School of Public Health, Boston.

  1. A win for injured patients. New York Times. March 5, 2009. 
  2. Pre-empting drug innovation. Wall Street Journal. March 5, 2009:A16.
  3. Rosen J. Supreme Court, Inc. New York Times Magazine. March 16, 2008.
  4. Wyeth v. Levine, 129 U.S. 1187 (2009).
  5. Curfman GD, Morrissey S, Drazen JM. Why doctors should worry about preemption. N Engl J Med 2008;359:1-3. [Free Full Text]
  6. Northern Securities v. United States, 193 U.S. 197, 400 (1904).
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  9. Warning signs. Nature 2008;452:254-254. [Medline]
  10. Committee on the Assessment of the US Drug-Safety System. The future of drug safety: promoting and protecting the health of the public. Washington, DC: National Academies Press, 2007.
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  12. Gilhooley M. Drug preemption and the need to reform the FDA consultation process. Am J Law Med 2008;34:539-561. [Web of Science][Medline]
  13. Wyeth v. Levine, 944 A.2d 179 (Vt. 2006).
  14. Riegel v. Medtronic, 128 U.S. 999 (2008).
  15. 71 C.F.R. § 3922 (2006).
  16. Geier v. American Honda Motor Co., 529 U.S. 861 (2000).
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  18. Obama B. Memorandum for the heads of executive departments and agencies: preemption. Washington, DC: White House, May 20, 2009. (Accessed August 27, 2009, at