Conflict of Interest 2.0
CP Snow famously described art and science as the “two cultures”. As much as doctors talk about the art of medicine, it is firmly aligned with the latter. In the medical subculture, the unit of currency is publication of academic papers in peer-reviewed journals. The authors of these papers have traditionally had by-lines describing their academic and clinical affiliations as applicable. However, over time, as eminence-based medicine has lost ground to evidence-based medicine, this has become decreasingly important. What has become of greater interest is what potential conflict of interest an author may have. It may seem trivial if a doctor has been taken out for dinner by a pharmaceutical rep from a drug company, but the literature suggests that it if researchers are in the pockets of Big Pharma the results of their research is more likely to be what their paymasters are looking for.
Guidelines of every medical journal now stress that authors must also declare any conflict of interest. Even if they claim to have none, this will be stated as a signed statement. Andrew Wakefield’s famous 2003 paper in the Lancet stated he had no conflict of interest in stating a potential link between MMR and autism. Later it was found that he was running a special clinic selling novel treatments for autism in Texas with another doctor who has authored similar papers. There are currently few guidelines on declaring conflict of interest outside the sphere of research.
The BBC ran an article promoting some aspects of complementary medicine by Dr Michael Dixon. This was reported just by using his name. In the article, Dr Dixon’s byline describes him a GP with no mention of his trusteeship of The Prince of Wale’s Foundation for Integrated Medicine. He is a visiting professor of Integrated Medicine at the University of Westminster. The term integrated medicine in this context refers to treatment including complementary or alternative medicine. Although some would say there is no such thing as alternative medicine, only that which works, and that which doesn’t.
Of course, people have a right to free speech, and in the media it often makes sense to provide speakers for both sides of a contentious issue. However, where relevant, authors should state any conflict of interest, even if the publication does not make this request. Broadsheet newspapers already do this to a certain extent. When a Member of Parliament writes an article defending or attacking the government’s record, their constituency and party membership is rightly mentioned.
All in all, this comes down to not misleading the reader. Advertisements are clearly demarcated in newspapers as they are not stating facts, nor have they come from a neutral point of view to reach a conclusion; they have started from a conclusion and are arguing a point. Having a conflict of interest does not invalidate an author’s views in any way, it serves to inform the reader.
- Dom
