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Two recent stories highlighted the ethical dilemmas surrounding corporate backing for academic research.
Last week, the Wall Street Journal published a long article on the use of drug-company "ghostwriters" in penning articles in respected peer-reviewed journals. According to the article, the role of these helpful elves can range from merely providing editing and writing services which save effort on the part of the named authors, to the actual writing of articles for which "authors" are then sought. Anna Wilde Mathews writes: "Many of the articles that appear in scientific journals under the bylines of prominent academics are actually written by ghostwriters in the pay of drug companies. These seemingly objective articles, which doctors around the world use to guide their care of patients, are often part of a marketing campaign by companies to promote a product or play up the condition it treats." She names a successful ghostwriter who maintains a promotional Web site of articles he has written - one appears with the byline "author to be named."
This week, a number of articles in the Israeli press gave prominence to a study at Hadassah University Medical Center on the causes of starting smoking, funded by the Philip Morris tobacco concern.
While there are important differences between the cases, in both, the ethical issue is bias due to industry sponsorship.
The objection to industry sponsorship is basically the fear that the objectivity of academia will be compromised. Nobody wants to intervene if Philip Morris wants to hire its own scientists to conduct a study of what causes young people to begin smoking. No one is interested in preventing Abbott labs from writing up an article on Vitamin D supplements (the first case mentioned by Mathews). The concern is that an industry agenda will insinuate itself into a literature which presents itself as objective.
It's clear that a minimum condition to prevent untoward industry influence is transparency, meaning full disclosure. That way, the scientific community has at the least the ability to evaluate the potential for bias in studies.
The transparency situation has been steadily improving, though there is still room for progress. Industry sponsorship, to the best of my knowledge, has always been revealed in journals. Author conflict of interest is a different story. Until quite recently, authors were not required to reveal a conflict of interest. For example, a consulting relationship with a drug company or owning stock in a drug company whose sales would likely be influenced by a research project. A few articles disclose industry ghost writers, but the WSJ article indicates that journals are strengthening efforts to demand disclosure of these invisible elves.
But transparency was not the main issue in the Hadassah controversy. Philip Morris never undertook to hide its sponsorship of the research at Hadassah. The two other issues at stake were agenda and image.
Agenda takes two forms. The worst problem with an agenda is that the interest of the sponsor could lead the researcher to simply do bad science - to falsify or distort data, for instance. But quite apart from that, sponsors can skew the overall research agenda of a field.
It's not clear how terrible this is. The concern here, according to some protesters, is that Philip Morris is interested in funding research which shows that the propensity to smoke is caused by genes, not advertisements.
Suppose that in the absence of PM backing there would be two studies examining the role of genes and two studying the role of media. Along comes industry involvement and funds two new studies. Now, there will be five studies examining the role of genes, and the same two studying media. I can accept that the "value added" of two new studies on genes may be smaller than the value of having one from each side, but this is not the same as saying these studies have no value. It is certainly a far cry from suggesting that these studies are actually counterproductive and that research institutions shouldn't carry them out.
The other concern is that Philip Morris will try to portray itself as a good corporate citizen by funding medical research. Again, that's not all bad. It's no secret that PM sells cigarettes, they're not blowing smoke in anyone's eyes. As long as smoking is legal, what's wrong with giving them the opportunity to mold their public image, as any other commercial firm does? There seems to me something ironic about activists urging companies to show more public involvement on the one hand and then complaining that they use this involvement to shore up their image. (I have written in the past about what I view as the excessive demonization of smokers and the tobacco industry, and this is not the place for me to get up on my high hobby horse on this issue.)
To sum up, I agree that when industry funds academic research the highest degree of transparency is needed to prevent conflicts of interest. I also agree that special safeguards are needed to prevent bad science. Of course the potential for bad science exists even with conventional sources of funding, as evidenced recently by the controversy over the stem-cell research of Hwang Woo-Suk. But while every researcher has a desire to demonstrate impressive results, studies funded by drug or tobacco companies typically have additional and far narrower agendas, and good disclosure should induce referees and editors to be extra careful in signing off on these papers.
Ghostwriters are a particularly problematic issue. Unlike Philip Morris which is spending millions of dollars to fund new research, hiring a ghostwriter seems to give impact on the cheap. A few thousand dollars is enough to hire a ghostwriter to write up a study that's already been done, and to give it just the slant that industry desires. Yet there are probably many important studies which have already been done and funded and are languishing precisely because of the lack of resources for a writer to put them together. Maybe grant providers should include a separate budget for writers.
In any case, I find it hard to accept that scientific studies have no value, or even negative value, merely because they are funded by unpopular industries and I can't think of a good reason for a research institution to completely eschew any funds from these sources.
The writer is research director at the Business Ethics Center of Jerusalem (www.besr.org), an independent institute in The Jerusalem College of Technology. He is also a rabbi.