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Money Is the Root of All Evil Science, Says JAMA Editor
By Jeff Stier, Esq.
Money, and money alone, is having an "unethical influence" on medical science, according to Dr. Catherine DeAngelis, editor in chief of the Journal of the American Medical Association (JAMA).
In an August 7 editorial, Dr. DeAngelis decries the "potentially corrupting influence of commercial interests" on medical and scientific research, implying that in the absence of such nefarious influences the articles published by JAMA (and other prestigious journals) will be "ethically sound, valid, reliable, and credible."
Really? The editorial ("The Influence of Money on Medical Science") gives short shrift to "influences" other than the consultancy fees and junkets often given by drug companies to physicians -- especially those involved in pharmaceutical research. Such one-sided disclosure policies are often bias-inducing in and of themselves.
JAMA now insists that authors disclose all their financial interests that might be perceived to have an influence on submitted research or editorial perspectives.
But perceived by whom, exactly? If a doctor received $2,000 eleven years ago for clinical research on a new drug, or for a trip to deliver a talk on some drug-related issue, is that now relevant for purposes of disclosure? It depends on who's doing the "perceiving." What about financial pressures emanating from relatives. Should a writer inquire about his father in law's stock portfolio before signing a "nothing to disclose" form? What if a spouse owns 1,000 shares of Pfizer?
It gets murkier: what if I have devoted my career (and owe my tenure to) the concept that statin drugs are the cure for cancer and Alzheimer's disease? Need I highlight that fact when I submit my editorial on a new, exciting benefit of statins? Or if my reputation has been made by having twenty widely-read articles about the toxicity of PCBs to my "credit," am I to be trusted when I submit my latest work outlining some new toxicity on fetal rats? Maybe the research is honest -- but shouldn't the journal's readers be entitled to know about my history of dealing with this issue, as I certainly have a dog (if not a dollar) in that fight? This holds as much potential for bias as an old and unrelated financial relationship.
Should an AIDS researcher be required to disclose his sexual preference or HIV status? As the financial witch-hunt metastasizes, that may well be coming next on the disclosure form.
These other forms of "conflict" were not addressed by Dr. DeAngelis, but the JAMA press release did so, apparently by accident. I quote from it here:
Because of the importance of the issue of the influence of money in science and in light of recent incidents involving authors' failure to disclose all of their potential conflicts of interest to JAMA, Dr. DeAngelis has written an editorial on the subject which will be posted online at www.JAMA.com Monday, August 7, 2006.
Note that the press officer wrote of controversy over authors and "all of their potential conflicts of interest." But that's not really what JAMA is interested in, as the editorial itself repeatedly notes only financial conflicts as being of concern.
Perhaps most important of all: these "disclosures," while cloaked in "readers' right to know" verbiage, cause mistrust among readers who note that a drug study author received...well, some amount of money, at some time, from a drug or biotech firm. Aspersions have thus been cast on the credibility of the study. What about peer review? Should we no longer trust the expert reviewers whose evaluations have been the basis of publication decisions over the past decades?
The most telling item in the JAMA editorial is the final disclosure of the author/editor herself: under the heading Financial Disclosures, she entered None reported. But what about the money flowing into the JAMA coffers from all those drug ads? What about the portfolios of her bosses at the AMA? And what of her own effort to advance her career by jumping on the anti-pharmaceutical bandwagon?
Jeff Stier, Esq., is an associate director of the American Council on Science and Health (ACSH.org, HealthFactsAndFears.com).
T Young, Ph.D. (August 8, 2006)
LGK (August 9, 2006)
Greed may, indeed, be the root of all evil science, but in our capitalistic society greed is also the wellspring that feeds most good science, too. If not for the promise of a substantial ROI, many of the beneficial pharmaceuticals we have today would not exist. The difficulty lies in distinguishing the good science from the bad, and the source of the research funds is an inadequate touchstone. Some degree of conflict of interest is unavoidable. How, then, is true and pure medical research differentiated from the false or tainted?
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