The Christian Science Monitor has put forth their official view on the current state of financial conflicts of interest in medical research. All in all, they fail to raise any new arguments or propose any viable solutions to the current conflict of confidence when it comes to tracking down financial interests associated with the peer-reviewed research required to validate any medical technology.
When profit motive and the advancement of personal careers become too entangled with how Americans make decisions about their health, the least that can be done is to point out those conflicts of interest. Better yet, those involved in healthcare must look for ways to blunt these unhelpful influences.
Now scholarly medical journals, another trusted source, are under fire, too. Most prominently, the Journal of the American Medical Association (JAMA) has admitted that in several instances authors of articles failed to disclose inappropriate financial ties or other conflicts of interest, despite a long-standing JAMA policy requiring such disclosure. “[T]here simply is no way to guarantee that all financial relationships and arrangements of all authors are disclosed,” said JAMA editor Catherine DeAngelis, in an explanatory editorial Monday. “It is not feasible to independently investigate the financial relationships of every author….” In other words, it’s an honor system.
We’d like to offer some critiques… What CSM fails to realize is that all scientific research is conducted on the honor system. Regardless of one’s ties, there are always reasons to falsify/overstate/tamper with results. One could suggest that researchers with funding coming from industry would be less likely to alter results, given that they’re already making plenty of money through consulting gigs. It’s the “publish something good or your funding gets cut” world of the so-called noble, independent researchers that would provide a greater motivation to cheat. Or are they suggesting that researchers that steer clear of all industrial contacts are inherently more ethical people?
Reformers such as Jerome Kassirer, a former editor of the New England Journal of Medicine, go further and would have journals ban authors with conflicts of interest. “The cure for public distrust is to employ people who have opted not to be compromised by money,” he wrote recently in The Boston Globe. If top-quality experts without close ties to industry can’t be found to write and review articles, he says, “what does it say about the extent to which the medical profession has been co-opted by the pharmaceutical, biotechnology, and device industries?”
Pardon the quote of a quote. Unfortunately, Kassirer (and the Monitor, by proxy) apparently think new medical technologies grow on trees. Trees that require no funding. As a technology moves from an item of scientific curiousity to a potentially clinically viable product, of course the “pharmaceutical, biotechnology, and device industries” are going to play a pivotal role in funding such a transfer. Commonly, the very researcher pioneering a given technology or treatment invented it and holds the patents. These innovators frequently have one foot in lab and the other in industry. That’s what it takes to bring a product to market. If those actively transferring science towards clinical deployment were barred from being published, where would new technologies come from? Would it be better to develop all new technologies secretly in-house, with no filter of published research all the way through FDA approval?
Please note that our jibes fly only towards the assumption that having ties with industry somehow sullies a researcher, leaving them untrustworthy and significantly less noble than those funded by grants alone. We’re 100% behind full disclosure, as its absence has clearly created this void of trust on behalf of the public.
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