Conflicts of Interest Rampant in Medical Research - NEJM / News Tribune (Wash)
Thu, 24 Oct 2002
A Duke University survey published in The New England Journal of Medicine today, confirms the claims made by critics: clinical research at academic institutions is not governed by ethical standards--clinical research is entirely under the control of the pharmaceutical and biotech industry. "Academic institutions routinely engage in industry-sponsored research that fails to adhere to International Committee of Medical Journal Editors guidelines regarding trial design, access to data, and publication rights. Our findings suggest that a reevaluation of the process of contracting for clinical research is urgently needed." http://content.nejm.org/cgi/content/abstract/347/17/1335
An unbridgeable conflict exists between medical ethics and business ethics. [See: http://www.ahrp.org/COI/COI.php] Academic institutions fail to comply with ethical guidelines that they publicly embrace-- because ethical guidelines interfere with business interests. Business ethics is governed by expediency and quick turnaround on investment--have compromised both the safety of human subjects and the integrity of the scientific literature.
"It's amazing how academic medical centers tie themselves into knots to accommodate something they shouldn't allow to begin with," said Dr. Marcia Angell, former editor of the New England Journal of Medicine.
A new probing series by the News Tribune of Tacoma, Washington, sheds light on pervasive conflicts of interest at the University of Washington. The Tribune series demonstrates that conflict of interest policies adopted by prestigious academic institutions fail to make a dent. The policies may look impressive on paper-- but they are irrelevant in practice.
The stakeholders involved in biomedical research have indeed been "tying themselves into knots to accommodate" research-- even when it failed to meet ethical standards. This accommodation has meant deceiving patients: those recruited are mostly uniformed about the real risks involved: they do not suspect that no reliable safeguards exist. Thus, it can be said that the informed consent process is nothing more than an exercise--everyone who has a stake in the enterprise pretends that ethical standards and safeguards are binding--when they are largely ignored or their meaning is twisted.
If truth be told, the business of clinical trials is dependent upon keeping "volunteers" ignorant. The entire research approval and oversight system is geared toward keeping those directly affected--the patient-subjects whose lives are put at risk--in the dark. Those who are recruited are not informed about the true nature of the risks, or the competence of the investigators, or the adverse reactions that other patients have had, or the alternative treatments available, or the financial interest of those involved in the trial.
Oct. 12-15, 2002. The News Tribune (Tacoma, Wash). Conflict of Interest Series by David Wickertt.
Part I: Scores of University of Washington researchers have financial ties to companies with a stake in the outcome of their studies. Part II: A closer look at the conflicts of interest of two UW researchers and how UW seldom says no. Part III: Universities are resisting additional federal oversight, but are trying to reach a consensus on how to address the issue.
Oct. 12, 2002.Health & Science Conflicts Test. http://www.tribnet.com/news/health_science/story/1939450p-2050399c.html
Oct. 13, 2002. Profitable ties that bind. http://www.tribnet.com/news/health_science/story/1943232p-2053843c.html
Oct.13, 2002. UW seldom cuts researcher, corporate ties David Wickert http://www.tribnet.com/news/local/story/1946180p-2056574c.html
Oct. 13, 2002. University of Washington has big role in state economy http://www.tribnet.com/news/health_science/story/1943233p-2053864c.html
Oct. 14, 2002. David Dunner: Can UW faculty members serve two masters fairly? http://www.tribnet.com/news/story/1946106p-2056608c.html
Oct. 15, 2002. Researchers reveal conflicts to pretty much everyone - except patients http://www.tribnet.com/news/health_science/story/1961856p-2066713c.html
List of 133 Researchers Financial Ties to Industry 1995-2002 http://www.tribnet.com/news/health_science/story/1961856p-2066713c.html