Researchers ask NIH to fund ethics research

In the wake of growing scandals over conflicts of interest and ghostwriting in medical research, more than 100 top researchers from around the world -- including several from Canada -- wrote to the U.S. National Institutes of Health this morning asking it to fund ethics research.

We are writing to ask NIH to fund studies on medical ethics, conflicts of interest in medicine and research, and prescribing behavior. NIH funds a substantial portion of the generation and dissemination of evidence, but the uptake of that evidence and its translation into clinical practice is strongly affected by the complex web of relationships that exists among industry, academicians, medical educators and clinicians.

There is growing evidence that each strand of this web is compromised by ethical lapses and financial conflicts of interest. The recent disclosure of ghostwritten articles, physician payoffs, and the use of academic opinion leaders to increase markets for FDA-regulated products indicate that ethical lapses may permeate biomedical research. A PLoS Medicine editorial in September called ghostwriting “The dirty little secret of medical publishing” and notes “the systematic manipulation and abuse of scholarly publishing by the pharmaceutical industry and its commercial partners in their attempt to influence the health care decisions of physicians and the general public.” An October 1 editorial in the Boston Globe called for a ban on industry speaker fees to physicians. Last month, a commentary in JAMA called for physicians to pay for continuing medical education (CME), citing a recent Institute of Medicine report4 that criticized physicians’ reliance on industry-funded education.

The letter to NIH director Francis Collins says the NIH "is the best place to launch and support a scientifically rigorous inquiry into the state of research ethics, industry-academic relationships, and the effect of these relationships on human health."

It notes, however, that there is currently no mechanism in place for the NIH to conduct such a study, but asks to meet face-to-face with Collins to discuss the issue.

The 10-page footnoted letter co-ordinated by PharmedIOut, a physician-run organization researching conflicts of interest, contains more than eight pages of signatures from top medical and ethics researchers from around the world.

Signatories include several Canadians, including Sharon Batt of Dalhousie University, Pierre Biron of the Université de Montréal, Alan Cassels of the University of Victoria, Carol Kushner a health policy consultant in Toronto, Joel Lexchin at York University, Barbara Mintzes at the University of British Columbia, David L. Sackett at McMaster University and Sergio Sismondo at Queen's University.