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Conflicts of interest

December 22, 2006

Dear Editor,

Recently, economist Bob Martin rejected the notion that scholars have an obligation to "inform the public" about "conflicts of interest" with respect to "a public issue." He says issues should be decided by "objective evidence." We differ in that he equates informing with either partisanship or advocacy; I do not. Also, he sees only one issue, while I see two.

Before internal documents revealed that tobacco companies were lying to us, smokers and those considering smoking were sometimes confused because scientists were divided about smoking's health effects. A partisan might say to the public: "Don't believe what tobacco scientists say. They always lie." An advocate would say: "Go ahead and smoke" (or the reverse). An informer would ask: "Doesn't it seem curious that all the scientists who deny causality between smoking and health issues happen to work for the tobacco companies? Maybe you should be wary."

Providing people with supplemental information to assist them in deciding THEIR issue (Should I smoke?) in no way halts or adversely affects the related but different issue facing scientific researchers (Does smoking cause cancer?). Moreover, the additional information provided may save lives. Doubtless, it actually did.

Was the Federal Drug Administration promoting objectivity when it ignored potential conflicts of interest by appointing three scientists with connections to Merck to the five-person board charged with supervising the clinical trials of Merck's painkiller Vioxx? Surely not!

The board refused to stop the experiment when a dramatic and ongoing rise in the death rate in the group of persons receiving Vioxx occurred three weeks into the trials. (A control group took Naproxen.) Eventually, Merck withdrew the drug from the market. Independent scientists who looked at the data testified that the trials ought to have been terminated much earlier. One epidemiologist said that the FDA treated pharmaceutical companies as its "clients." Republican Senator Grassley said that the FDA must learn to "respect the scientific process." Had the FDA taken into account possible conflicts of interest, no persons connected to Merck would have sat on the board and people would have lived.

Science is the most reliable method we have discovered for learning about the measurable aspects of reality, but the former hope for absolute objectivity in science has not been realized.

The experiments that generate data are designed by reliance on theories. Data are not pure or unvarnished; they are "theory laden." Objectivity is a target at which we aim.

Philosophers of science now understand objectivity as the dominant view in the scientific community as a whole or in the relevant scientific subgroup.

These days, scientists themselves speak less often of objectivity than of a theory's being well or less well "confirmed."

The problem for the public is that establishing a scientific consensus may take years, even decades. More often than not, people's personal decisions cannot wait.

Every day, of necessity, we make decisions on the basis of incomplete evidence.

Perhaps I am old fashioned, but it seems to me that if pointing out a potential conflict of interest and promoting caution can help the public, even save lives, a person, whether a scholar or not, is morally obligated to do so.

Milton Scarborough

Danville

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