If the reader believes that certain conflicts are unavoidable, it is worth noting that some authors have argued that conflicts of interests or researcher biases are unavoidable, and because of this, it is only proper to consider the conflicts in a graded fashion. Thus, there should be no per se prohibition against these conflicts depending where they fall on the continuum from minor to serious. See generally Gallin, J. I. and Ognibene, F. P., eds., Principles and Practice of Clinical Research (Burlington, MA: Academic Press, 2007): at 248.Google Scholar

See, e.g., Stossel, T. P., “Regulating Academic-Industrial Research Relationships – Solving Problems or Stifling Progress?” New England Journal of Medicine 353, no. 10 (2005): 1060–1065, at 1061 (“The death rate in industry-sponsored phase 1 oncology trials has not changed during the past 10 years, despite growing collaboration between academe and industry. To conclude that the hope of financial gain contributed at all to any errors leading to Gelsinger's death, in the absence of a confession or other evidence, is purely speculative.”)CrossRefGoogle Scholar

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See, e.g., Campbell, E. G. et al., “Financial Relationships between Institutional Review Board Members and Industry,” New England Journal of Medicine 355, no. 22 (2006): 2321–2329; see Brennan, et al., supra note 3; Colliver, V., “UCSF Study Questions Drug Trial Results”, San Francisco Chronicle, June 5, 2007, at B-1.CrossRefGoogle Scholar

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See Campbell, , supra note 6, at 2323 (emphasis mine). The authors conclude that one potential limitation with their study is that the conflicts of interests identified were de minimis because they treated rather insignificant financial interests the same as significant financial interests. This is part of the ongoing problem of defining “conflict of interest” that is slowly developing into a catchall that tells us little; a binary treatment of this issue does not get us away from simple correlations to actual causation.Google Scholar

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Bodenheimer, T., “Uneasy Alliance – Clinical Investigators and the Pharmaceutical Industry,” New England Journal of Medicine 342, no. 20 (2000): 1539–1544, at 1543 (quoting Lee Goldman, chairman of the Department of Medicine, University of California at San Francisco, “…companies translate biological advances into useable products for patients. They do it for a profit motive, but they do it, and it needs to be done.”) Another example is the hepatitis B vaccine that resulted from the biotechnology industry that formed after a joint venture of academic researchers and venture capitalist. See Stossel, , supra note 2, at 1060. Also, DeAngelis, C. D., Editorial, “The Influence of Money on Medical Science,” JAMA 296, no. 8 (2006): 996-998, at 996 (“The discovery of new medications, devices, and techniques is funded primarily by for-profit companies; testing new modalities of treatment is funded primarily by for-profit companies; and the manufacture and profitable marketing aspects of these modalities appropriately falls in the purview of this industry.”)CrossRefGoogle Scholar

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Industry professionals are no less ethical than their contemporaries are, and it is in the best interest of industry to seek the truth. Quoting Bloch, a company's fundamental approach to science is “antithetical to biased reporting or interpretation of research results.” This is so because, eventually, the “truth will out” any failures or misbehavior when the product is being used by patients. Thus, it is in the best interest to avoid any biases because it will harm both the patients whom they serve, and the companies themselves. See Porter, , supra note 12, at 132.Google Scholar

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See Bekelman, , supra note 5, at 464; Chopra, S., “Industry Funding of Clinical Trials: Benefit or Bias?” JAMA 290, no. 1 (2003): 113–114.Google Scholar

It is worth noting that government sponsored clinical trials are not immune to conflicts of interests. See Barclay, L., “BMJ: Pharmaceutical Industry-Physician ‘Entanglement’ Affects Research, Care,” Medscape Medical News, June 3, 2003, available at <http://www.medscape.com/viewarticle/456554> (last visited May 28, 2009). (Quoting Lexchin, Joel, M.D., associate professor of health policy and management at York University in Toronto, Ontario, Canada “Government-funded studies may have biases too; for example, their bias might be to show that the least expensive drug for a given indication is as good as the most expensive.”)+(last+visited+May+28,+2009).+(Quoting+Lexchin,+Joel,+M.D.,+associate+professor+of+health+policy+and+management+at+York+University+in+Toronto,+Ontario,+Canada+“Government-funded+studies+may+have+biases+too;+for+example,+their+bias+might+be+to+show+that+the+least+expensive+drug+for+a+given+indication+is+as+good+as+the+most+expensive.”)>Google Scholar

The study recognizes the limitations of interviewing patients with serious lifethreatening illnesses; more research on the patients' perspective on financial conflicts of interest is Hampson, welcome. L. et al., “Patients' Views on Financial Conflicts of Interest in Cancer Research Trials,” New England Journal of Medicine 355, no. 22 (2006): 2330–2337, at 2330.CrossRefGoogle Scholar

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This method is used by the federal government in their prohibition against employees participating in an official capacity in matters affecting their own financial interests. See generally Gallin, supra note 1, at 115. For a discussion of the potential problems with requiring disclosure, see Ossorio, P. N., “Pills, Bills and Shills: Physician-Researcher's Conflicts of Interest”, Widener Law Symposium 8, no. 1 (2001): 75–103, at 100-102.Google Scholar

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See generally Campbell, et al. supra note 6; “There are even disagreements about the definition of a conflict of interest. Many attach qualifiers, such as ‘potential’ or ‘apparent,’ in an attempt, it often seems, to be delicate or nonjudgmental.” Kassirer, J. P. and Angell, M., Editorial, “Financial Conflicts of Interest in Biomedical Research,” New England Journal of Medicine 329 no. 8 (1993): 570–571. The one noteworthy exception is Ossorio, supra note 21.Google Scholar

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The authors themselves dismiss this possibility as “unlikely” but go on to state that there is insufficient data to accurately decide one way or another. Thus, as unlikely as Thomas Moore and his colleagues would like this possibility to be, they admit the rate of increase in adverse events could be possible due to an increase in reporting. They try to argue against this possibility by pointing out that the reporting for some drugs has not gone up, but has actually gone down, and that this is proof that there has not been a general trend towards more reporting. But, they defeat their own argument when they admit that the rate of adverse events vary from one drug to another and for the same drug over time. They also argue that if the increase in adverse events reported were due to an increase in reporting, then the rate of reporting by physicians should increase at the same rate as the rate of reporting by manufacturers. This is a simple non sequitur. All that can be deduced from this observation is that whatever has motivated an increase in reporting by manufacturers has not motivated the same rate of reporting by health professionals or consumers, neither of which is proof that the actual rate of adverse events has gone up.Google Scholar

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