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About the Author
Dan Greenberg is a longtime observer of science policy and politics. He is the author of "Science for Sale: The Perils, Rewards, and Delusions of Campus Capitalism" (University of Chicago Press), as well as other books, and has published widely in newspapers and popular and professional magazines.
About Brainstorm
Mark Bauerlein
Marc Bousquet
Laurie Fendrich
Dan Greenberg
John L. Jackson Jr.
Stan Katz
Stephen Joel Trachtenberg
Brainstorm Alumni
Marty Nemko, guest bloggerBob Zemsky
Recent Posts
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Truth in Publishing: Curb Those Blurbs and Syrupy Acknowledgments | Comment [5]
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'Rebranding' Engineering | Comment [14]
Featured Articles By the Author
Conflicts of Interest at Medical Schools
Is academic science corrupt, beholden to big business, riddled with conflicts of interest, and tirelessly on the prowl for money, clean or soiled?
The question reeks of hostility, to the point where some might feel it deserves consignment to the crackpot bin. But as a journalist who regularly writes about science, professors, and universities, I find that people both close to and distant from academic science possess ugly opinions about its ethical condition. Many friends and acquaintances who learned I was working on a book about academic science and commercialization confidently assured me that the combo was evil. Some of the harshest indictments of scientific rectitude come from successful scientists deep inside the scientific enterprise.
There’s no paucity of published reports about researchers who are discovered endorsing products in which they quietly hold financial interests. Academic scientists allow use of their names on papers ghosted by drug firms. Editors of scientific and medical journals fume about authors who dodge requirements to disclose conflicts of interest. Well-endowed universities take on industry-financed research on sensitive issues, such as climate change, though they could easily pay their own way for such projects. And drug reps who treat faculty and students to lunch, dinner, entertainment, and gifts are familiar figures in medical education. Their banishment from campus, as happens in occasional outbreaks of piety, is hailed as a moral upgrade rather than an overdue elimination of unseemly practices.
The corruption indictment rests on substantial evidence, though the width and depth of malfeasance is unknown. Virtually all research institutions possess charters prescribing virtuous behavior. Nonetheless, revelations of tawdry episodes keep coming. And when details of these episodes become public, often through a whistle blower or a medical catastrophe, it is clear that in many instances, nobody was looking to enforce the rules, or there were no rules.
A new report (subscriber only), “Responses of Medical Schools to Institutional Conflicts of Interest,” provides data on the presence of certain rules and no rules in the world of medical education. Published in the February 13 issue of the Journal of the American Medical Association, (JAMA), the report examines for the first time a little-explored, poorly regulated aspect of conflict of interest — institutional conflicts, as distinguished from the more familiar individual conflicts. The latter are addressed by longstanding federal and local regulations, which spell out disclosure requirements and criteria for managing or eliminating egregious conflicts. Though sometimes ignored or indifferently applied, rules concerning individual conflicts are mandatory at all institutions receiving government research funds.
The picture is quite different concerning conflicts involving investments and other financial holdings of research institutions and their senior and mid-level administrators, board members, and other officials. The issue has been rattling around the conference circuit for at least a decade. It was cautiously discussed in reports in 2001 by the Association of American Universities and in 2002 by the Association of American Medical Colleges. In 2004, suggestions for addressing institutional conflicts were contained in a “guidance” issued by the U.S Department of Health and Human Services. Not even a medical school dean could be unaware of the prominent gap in conflict regulations. Aware or not, many schools still lack regulations for institutional conflicts of interest.
With survey responses from 86 of the nation’s 125 allopathic medical schools, the JAMA survey found that 30 had adopted conflict-of-interest regulations applicable to the institution, while 55 had rules for senior and mid-level officials. Since it’s likely that many, maybe most, of the non-responders have nothing positive to report, attention to the issue in medical education is overall pretty sparse.
Why? To some extent it may be because conflict-of-interest regulations are an annoying bureaucratic burden, requiring both conflicted and unconflicted to bare their finances. Another possibility is offered in an editorial accompanying the JAMA report by Professor David Rothman, of the Center on Medicine as a Profession, at Columbia’s College of Physicians and Surgeons: “At a time when federal research funding is declining and competition for philanthropic gifts is intensifying,” he writes, “universities may not be eager to promulgate policies that would restrict their freedom to maneuver.”
That would be hard to prove. But what can be said with confidence is that universities rarely miss an opportunity to undermine public faith in their virtue.
Posted at 10:33:03 AM on February 14, 2008 | All postings by Dan GreenbergCommenting is closed for this article.
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