Back to Front PageVOLUME 6, NUMBER 4

Readers Respond

Should medical schools impose stricter guidelines regulating financial ties between faculty members and the pharmaceutical and biotechnology industries? The objective of measures regulating financial ties between faculty and industry should be to control conflicts of interest, not to limit the income of entrepreneurial faculty. The well-established means of controlling conflict of interest is disclosure. What are typically lacking from medical school rules are specific, unarguable requirements for disclosure; mechanisms for surveillance; and specific penalties for violation of the rules. Paul J. Friedman, M.D. Professor of Radiology University of California, San Diego School of Medicine With grants becoming increasingly difficult to obtain, scientists who can gain funds to continue their research should not be strangled … There is an aggressive push to "open" science to reveal private works in progress, any conflicts of interest, and funding discrepancies. This seems like a witch hunt to us researchers. Medical schools that choose to enforce stricter guidelines will force productive faculty out. J. Steven Alexander, Ph.D. Associate Professor Louisiana State University Health Sciences Center Yes, emphatically. Conflicts of interest play a dominant role in all phases of biomedical education to the detriment of us all. John M. Porter, M.D. President, North American Chapter of the International Society for Cardiovascular Surgery Professor of Surgery, Oregon Health Sciences University Restrictions are needed to prevent faculty with financial conflicts from conducting or influencing those portions of a study that involve subject selection, informed consent, and gathering and interpretation of raw data. Alternatively, if such faculty engage in research, they should sever administrative roles in the sponsor business and freeze equity positions. In both cases, public disclosure of financial interests is essential. Stricter and uniform guidelines are needed now to protect research subjects from unnecessary treatment or harm and to minimize dissemination in the scientific literature of erroneous or misleading information. David V. Cohn, Ph.D. Professor of Biochemistry University of Louisville School of Dentistry Guidelines do not necessarily need to be stricter, but efforts must be undertaken to ensure that the existing guidelines and all ramifications are clear and that their interpretation is unambiguous. Faculty education on and acceptance of existing guidelines has to be rigorously enforced. Charles Moldow, M.D. Senior Associate Dean for Research and Administration University of Minnesota Medical School Yes, unless the profession can regulate itself or unless organizations such as the AAMC can provide guidelines that are followed. Linda Demer, M.D., Ph.D. Chief of Cardiology University of California, Los Angeles Conflict of interest is important to recognize when any physician dealing with industry in any capacity could be viewed as giving a biased position. However, the issue is notification. All conflicts of interest should be declared and then decisions can be appropriately made based upon the extent of the conflict. The fact that a conflict is declared does not inherently invalidate a position. Ralph W. Hale, M.D. Executive Vice President American College of Obstetricians and Gynecologists This is no longer a matter of "should"; it's something that will have to be done, fully recognizing that there is considerable variability among existing guidelines. At risk is public confidence in our institutions as a whole, not simply the products of specific research activities. We just cannot make the case that academic medicine is for the public good on one hand and for sale on the other. Myron Genel, M.D. Professor of Pediatrics Yale University School of Medicine Next month's question: How can academic medical centers better address sexual harassment and gender-based discrimination? Please send your responses (75 words or fewer) to "Readers Respond," rmuir@aamc.org, or fax (202) 828-1123. Responses must be received by July 14 for consideration, and may be edited for length or clarity.

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