In August of 2011, the Public Health Service updated its rules to address the kind of financial conflicts of interests that can undermine (or appear to undermine) integrity in research. The new rules, issued under the ungainly title, “Responsibility of Applicants for Promoting Objectivity in Research for which Public Health Service Funding is Sought and Responsible Prospective Contractors,” were issued with a one-year implementation period to give universities and academic medical centers sufficient time to update their local policies and procedures for disclosure, review, and management (to the extent possible) of any conflicts their researchers might have between their significant personal financial interests and their academic and scholarly activities.
The rules were made significantly more strict because a few scoundrels (for examples, click here, and here) have behaved in ways that undermined the public’s trust in scientists and physicians. By accepting hundreds of thousands, even millions, of dollars from private pharmaceutical companies and other for-profit entities while performing studies on drugs and devices manufactured by the same companies, a few bad apples have called into question the integrity of the whole research enterprise. This is a tremendous shame.
Having more than one interest is not bad or wrong; it’s normal. Everyone has an attachment to the things they value, and most people value more than one thing. Professors value their research, but they also want accolades, promotion, academic freedom, good parking spots, and food on their tables. Having multiple interests only becomes a problem when the potential for personal enrichment or glory causes someone (consciously or unconsciously) to behave without integrity and compromise the design, conduct, or reporting of their research.
The attention focused by the media on several sensational cases of graft and poor judgment has—appropriately– raised awareness about the potential for lapses of integrity when money is on the line. But, it also has painted all scientists with the same brush of suspicion. Implying that financial interests are inherently improper does a disservice to the majority of our nation’s faculty, most of whom are absolutely committed to doing their work in a manner consistent with all applicable ethical standards and scientific norms.
While conflicting interests in science are a legitimate concern for ethicists, regulators, and politicians (and a frequent subject for cartoonists: for examples, click here), we all sometimes lose sight of the fact that our market for ideas and products not only encourages, but in many cases requires, the kinds of financial relationships that raise red flags.
Scientists are supposed to discover, create, and innovate. When they become experts, companies want to pay for their wisdom and consultation. Not necessarily a bad thing. Universities that use public funds for research are obligated to take their discoveries to the bedside or the market for societal benefit, which means licensing technology to companies. Not necessarily a bad thing. Getting a drug or device approved and manufactured is expensive, which means the companies that partner with universities to bring medical advances to patients need to be mindful of the return on their investment. Also not necessarily bad.
Should patients know when their physicians have personal financial interests in the companies that manufacture the drugs they prescribe? Sure. Should universities monitor the activities of faculty who do research to assure their outside financial interests are not creating pressure to improperly influence the outcomes of their studies? Absolutely. Sunlight, as they say, is the best disinfectant.
But interests are not necessarily conflicts. And conflicts are not necessarily sinister. We all share a common interest in the kinds of scientific advances that will benefit humankind and improve our understanding of the natural world. When we use the phrase “conflict of interest” as shorthand for “crooked” or “greedy,” we contribute to an atmosphere of mistrust that is both counterproductive and unfair.