In the Interest of Full Disclosure (JAMA, NARAL, and Drey/Lee)

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The Journal of the American Medical Association (JAMA) has come under fire recently over a study it published that reported that fetuses probably cannot feel pain before the 29th week of pregnancy. It is not the science itself that is being called into question. Rather, it is the employment history of the study authors. One of the authors, Dr. Eleanor Drey, performs abortions and is the medical director of an abortion clinic. Another author, Susan Lee, is a medical student who worked at one time in the NARAL Pro-Choice Legal Department. Neither of the women mentioned this association when they submitted the article for publication, and it is unclear whether this was a violation of the nebulous ethical concept of full disclosure.

Study authors publishing their work in medical journals are required to report any potential conflicts of interest that they may have. Owning stock in a company that produces the drug being researched would be a clear conflict of interest, but there are other associations in which the line between dual and conflicting interests is blurred. Due to the absence of clear guidelines on where disclosure should begin and end, and on what types of interest constitute potential bias, controversy is inevitable -- especially when something as ethically sensitive as abortion is being studied.

It is puzzling, though, that some people are alleging that Dr. Drey's work was biased because she is the medical director of an abortion clinic. In any other specialty, such a close association with the practice of the subject matter being researched would be considered an asset (if not a requirement) for credibility. It is difficult to imagine, for example, criticizing the author of a piece on pediatrics for failing to reveal that she was the medical director of a children's hospital. Whether Susan Lee's work at NARAL's legal department four years ago constitutes a conflict of interest is less clear -- the concept of "complete disclosure" has never been as well defined as it might be. Interestingly, the journal's editor, Dr. Catherine DeAngelis, said that she would have published the article even if she had known about the authors' previous work -- because the research was peer-reviewed and scientifically sound.

Anti-abortion groups such as the National Right to Life Committee criticized the failure of JAMA to mention that the two authors had ties to abortion-related activities, saying that the scientists' conclusions were "predetermined by their political agenda." But, in the interest of full disclosure, it must be said that these groups have a political agenda of their own.

Mara Burney is a research associate at the American Council on Science and Health (ACSH.org, HealthFactsAndFears.com).