Conflicts-of-Interest
Art Caplan over at Bioethics Blog has a post up on a recent furor regarding biomedical publications and conflicts-of-interest. After briefly explaining the situation, he concludes:
It is still very clear that the management of conflicts of interest for universities, journals, academic health centers and even bioethics centers remains conflicted with no consensus on mimimal rules or about what constitutes a conflict. The academic and journal communities would be well-served in the coming year to convene a blue-ribbon panel to write a report on COI that might serve as the starting point for addressing the complex questions involved.
Indeed. I have heard it remarked that conflicts-of-interest (both in terms of biomedical publications and in terms of clinical research in general) may be the most significant bioethical issue of the next decade. This is obviously debatable, but I think it is difficult to deny the weightiness and import of these issues. The literature here is explosive, but I would recommend several sources enitrely off the top of my head:
Ethical Issues in Biomedical Publications, eds. Anne Hudson Jones and Faith McLellan (Baltimore: Johns Hopkins University Press, 2000).*
Sheldon Krimsky, Science in the Private Interest: Has the Lure of Profits Corrupted Biomedical Research? (Lanham, MD: Rowman & Littlefield Publishers, 2003).
Krimsky's book is a tour de force, a literal must-read for anyone interested in these issues.
Howard Brody's forthcoming book (due out in late January) may also be of interest:
Hooked: How Medicine's Dependence on the Pharmaceutical Industry Undermines Professional Ethics*
This is a very hot topic, for the record. Major academic medical centers have recently revised their respective policies on accepting gifts from industry sources in response to some of the increasing concerns over conflicts-of-interest. Articles and books continue to be produced on some of the underyling issues. There was a relatively disturbing presentation at the ASBH Annual Meeting on the best estimates for the extent of articles published in leading scientific and medical journals that are ghost-written by so-called medical education companies ("med-eds"). Some, including Krimsky, challenge the entire notion of "managing" conflicts-of-interest, expressing doubts as to the efficacy of such management.
Fascinating stuff, surely.
*(In the spirit of this post, let me disclose that Anne Hudson Jones is presently the Graduate Program Director of my grad program at the Institute for Medical Humanities, Faith McLellan is a graduate of the program, and Howard Brody is the Director of the Institute for Medical Humanities. Other than kindly guiding me on my own academic path with great patience and understanding, Drs. Jones and Brody have offered nothing of value in exchange for mentioning their books here!)
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