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July 6, 2012 | Posted By John Kaplan, PhD

In an opinion piece by Thomas Stossel, the Harvard physician and researcher argues that financial conflicts of interest between academic research investigators and industry are “unequivocally beneficial” and that the concern that these may cause bias is a “mania”.  Dr. Stossel seems to be on a crusade in this regard having written numerous similar opinion pieces published in industry supported blogs, Forbes, and the Wall Street Journal and has even started an organization (Association of Clinical Research and Educators) for the purpose of advancing his viewpoint. Dr. Stossel is the brother of well known libertarian and Fox News commentator John Stossel and seems to be expressing a similar libertarian view on biomedical research. Especially interesting considering the apparent strength of his beliefs is his recent publication in Nature Biotechnology in which he claims to prove that those who hold an opposing point of view are biased.

Dr. Stossel’s crusade seems to be based on a false premise and supported by distorted presentation of the circumstances. The premise he advances is that industry has been vilified by a “prosecutorial racket”. He freely mixes discussion of industry funded research support with industry marketing efforts and Continued Medical Education in a manner that leads him to far reaching conclusions but in fact obfuscates the matter. In essence he calls for complete freedom of industry to influence the information flow to and financial support of physicians and researchers without regulation. There is no real question that industry funding leads to significant and meaningful medical advances. The question to be asked is whether or not the regulations and practices which address financial conflict of interest are beneficial or harmful to this progress.

There are several reasons to question his premises. In most cases all that is required is disclosure of industry support. This is neither onerous nor inhibitory. It is entirely consistent with the transparency many would expect and support in the research enterprise. If the scientists have ownership stake or stands to profit from the outcome of research they are conducting this is a reasonable thing for the community to know. A consumer of research can factor this knowledge into their own consideration of the research report any way they think appropriate. Withholding such information precludes such a consideration. 

Research progress and its application to medical practice does not seem to have been inhibited by the current regulatory environment. As Stossel himself states: “the achievements made in the past half century are unmistakable: a 50 percent reduction in cardiovascular mortality despite an epidemic of obesity; a dramatically decreased cancer mortality rate; and the conversion of AIDS from a death sentence to survival with good life quality.” This has occurred while the standard has been to identify sources of research support. Most of my own research support came from the NIH. Like most scientists I always identified the source of my funding. It was not difficult. Overall the research environment encourages both the provision and acceptance of research support from industry. Remember Bayh/Dole?

In his call to remove existing regulation of conflict of interest in research Dr. Stossel asks us to suspend common sense. He asks us to belief that people accepting support will not feel beholden. He asks us to believe that financial support will never influence objectivity. The minimal amount of current regulation and the transparency such regulation provides allows us to continue to be wise consumers of research.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

1 comments | Topics: Conflict of Interest, Research Ethics

Comments

Cheryl Lew, MD, MSBioeth

Cheryl Lew, MD, MSBioeth wrote on 07/06/12 11:22 PM

Obviously Dr. Stossel does not adhere to significant evidence, both in the experimental psychology as well as neurocognitive-neuroimaging literature that clearly demonstrates that tendencies to biases are "hardwired" into our neuronal pathways: some of which work was done at Harvard; but principally the work of Read Montague and the very popular Dan Ariely. Although Montague has demonstrated that subject content expertise can ameliorate some biased judgements, all one has to do is to "google" COI to find a plethora of papers in Nature and Science Magazine which contain fairly convincing evidence of continuing (maybe increasing) scientific misconduct, to understand that Dr. Stossel's claims are disingenuous.

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BIOETHICS TODAY is the blog of the Alden March Bioethics Institute, presenting topical and timely commentary on issues, trends, and breaking news in the broad arena of bioethics. BIOETHICS TODAY presents interviews, opinion pieces, and ongoing articles on health care policy, end-of-life decision making, emerging issues in genetics and genomics, procreative liberty and reproductive health, ethics in clinical trials, medicine and the media, distributive justice and health care delivery in developing nations, and the intersection of environmental conservation and bioethics.
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