Sheldon Krimsky on Conflicts of Interest in Science

In 1979, Nature magazine invited Sheldon Krimsky to debate Nobel Laureate David Baltimore, then a professor of biology at MIT on the collaborations between industry and biology.

Sheldon Krimsky Tufts University

Krimsky argued that academic institutions and academic scientists need to be free from corporate influence.

“Just as war-related research compromised a generation of scientists, we must anticipate a demise in scientific integrity when corporate funds have an undue influence over scientific research.”

Baltimore said “there is nothing wrong with universities serving as a source of technical expertise for newly developing industries or even for mature industries.”

“And that kind of symbiosis between industry and academic departments has been very good for both over history – take the chemical industry,” Baltimore said. “The positive side of industrial involvement in the academic world should not be discarded out of fear that university-based scientists will lose their autonomy owing to industrial pressure. We need to maintain a balance between industrial influences and influences from outside the corporate world.”

Fast forward forty years. Sheldon Krimsky is at Tufts University. And he has just authored a book titled Conflicts of Interest In Science: How Corporate-Funded Academic Research Can Threaten Public Health.

And Krimsky’s warning of a demise in scientific integrity has proven prophetic.

How did Krimsky get started on studying conflicts of interests in science?

“There were two episodes,” Krimsky told Corporate Crime Reporter in an interview earlier this month. “One came a year or two before the debate. I was supervising a study at Tufts. Graduated students were studying a contaminated site in Acton, Massachusetts. Little did I know, but before the study was released, the vice president of a major chemical company visited the president of the university and asked that my study not be released. I think that was back in 1979.”

“I was an untenured professor at the time. Fortunately, the president of the university told the vice president of this transnational company that we had academic freedom at Tufts. That ended that discussion.”

“The second was the interchange with David Baltimore in the larger context of new rules being established for private investments in universities. The debate with David Baltimore encapsulated the context of the times. David was a multi-vested scientist. He had interests in companies and equities in companies. It was part of what was going on at that time. I was raising questions about what impact that would have in the trust in science and the objectivity of science if this were expanded.”

“The debate was published by Nature magazine in January 1980. The debate itself took place a few months before. They taped it and published the outcome of the debate. They edited the audio and produced a two page article in Nature.”

The book is a compilation of studies of conflicts of interest in science. What’s the overview?

“Let’s look at the mid 1980s. We see the beginning of awareness that scientific conflict of interest was important. That’s where we begin. The first journal that required authors to disclose their conflicts of interest was the New England Journal of Medicine in the mid-1980s. And a year later, the Journal of the American Medical Association. And then it began to spread to other major journals in the world.”

“At that time, there were no government regulations about disclosure of academic conflicts of interest. At that time, prior to 1985, there were no journals that required disclosures of conflicts of interest. At that time, if a scientist came to a meeting and was reporting on his or her research, there was no requirement that they disclose any conflicts of interest. At that time, newspapers never thought of asking a scientist when they quoted a scientist in an article – do you have any equity interest or any conflicts of interests in this issue?”

“Today, there is a much greater awareness of the effect scientific conflict of interest can have on the outcome of research. Since that time, there have been studies which have demonstrated what I call the funding effect. Very briefly, that effect means that private corporate investment into scientific research tends to produce outcomes that are consistent with the financial interests of the sponsor compared to the same or similar research funded by non-profit institutions or government entities.”

“We now have data that show there is in fact a funding effect. There is much more awareness about scientists serving on advisory committees of government and the fact that such disclosures must take place prior to their being accepted on an advisory committee. The government has a rule that says that no scientist with a substantial conflict of interest should serve on a federal advisory committee.”

“Unfortunately, the rule has a waiver clause that says unless the person is viewed as so important and significant, then the rule can be waived.”

Have there been many of those waivers?

“There have been a lot of waivers in certain agencies. That has been demonstrated in the social scientific literature.”

“This book – Conflicts of Interest in Science – is a retrospective history of the evolution of conflicts of interest policies and the awareness of it over a period of 35 years, since I first published in the 1980s. The book also raises dilemmas. The primary dilemma is that faculty have certain autonomy. This autonomy allows the faculty to try and get funding for their research. Therefore the universities try not to restrict the fact that a faculty member is getting funding from some corporate entity. Many universities even allow the faculty to invest in that corporate entity, to have equity in that corporate entity while they are doing the research.”

“On one hand, this faculty autonomy gives the faculty a lot of leeway. On the other hand, the university is a partner to any grant or contract that it signs onto with a faculty member. The university has a responsibility as to whether it wants to accept a contract from a corporate entity. There is sometimes tension in this situation. Some universities will not accept any funding from the tobacco industry, even if a faculty members wants or can get such funding.”

Were conflicts of interest greater or lesser back in the mid-1980s when you began writing about this?

“We did some research on that question. Some years ago, with a team of researchers, I looked at the Diagnostic and Statistical Manual for Mental Illness (DSM). All health providers in the mental health field use the DSM to decide a diagnosis. We learned from the DSM 4 that there were significant conflicts with the people who develop those categories. Those interests were related to pharmaceutical companies poised to offer a drug for any of those categories.”

“The American Psychiatric Association, which puts out the DSM, decided that in the next issue of the DSM, they would have transparency. We were pleased to hear that. Our research went viral throughout the world. It may have influenced their decision. That was in 2006 or so.”

“Given that we knew there was a new DSM, and we didn’t have to go through the arduous work of finding the conflicts, which we had to do with the DSM 4, we could figure out whether there were more or fewer conflicts of interest on the new DSM panels. We published the results in the New England Journal of Medicine. And it turned out there were more conflicts in the DSM 5 with transparency than there were in the DSM 4 without transparency.”

“That answers the question in one narrow area of science and medicine. I don’t believe that by requiring disclosure you are going to reduce the conflicts of interest. You will simply make the conflicts more available for readers to see and understand them.”

[For the complete q/a format Interview with Sheldon Krimsky, see 33 Corporate Crime Reporter 16(12), Monday April 22, 2019, print edition only.]

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