WHAT ARE THE FACTS in the Ebert case?
In early 1969, Medical School Dean Robert Ebert was appointed to the Board of Directors of Squibb Beach-Nut, Inc. -As a director, Ebert held 267 shares of Squibb stock--valued at--about $15,000. He also received a yearly salary of several thousand dollars.
During the summer of 1969, Ebert decided that his Squibb post might give the appearance of conflict of interest with his administrative duties. He decided to resign from the Board, but was persuaded by Squibb President Richard Furlaud, a personal friend, to remain with the company as a "public director" owning no stock and receiving no salary.
But when a group of medical school students protested in October 1969 that any association with the pharmaceutical company's board compromised "the first obligation of a physician or teacher of physicians...to the patient," Ebert resigned his post. "There are those," he said in explaining his decision, "who, in all sincerity, feel that my continued membership on the board could be subject to misinterpretation."
Three years later, Dean Ebert appeared before an FDA Advisory panel which was holding a hearing on Squibb's Mysteclin-F, a drug which had been severely criticized by a National Academy of Sciences-National Research Council panel of thirty specialists on infections diseases. Critics argued that prescription of Mysteclin-F's fixed combination of several antibiotics was irrational since it tended to give the patient too much or too little of each of the antibiotics, rather than the precise dosage needed.
Despite these criticisms, Mysteclin-F has been popular with physicians, who appreciate the convenience of writing out one antibiotic prescription rather than several. The drug has been one of the 200 most popular prescription medicines for the last twelve years. Thus, millions of dollars were at stake in the October PDA hearings.
Squibb needed big names to defend the embattled Mysteclin-F, and it called on two of the biggest names in academic medicine, both on the Squibb payroll: Dean Ebert (a Squibb consultant), and Dean Lewis Thomas of the Yale Medical School a member of the Squibb Board of Directors).
Dean Ebert delivered the Squibb defense brief. He cited "additional evidence" compiled by physicians at the Roswell Park Memorial Cancer Institute in Buffalo. N.Y. which suggested that Mysteclin-F had some therapeutic value in the treatment of certain types of infections. Ebert suggested that the drug be labelled to indicate these specific usages.
On Thanksgiving Day the story of Dean Ebert's Mysteclin-F testimony and the history of his relationship with Squibb broke into the press. Morton Mintz of the Washington Post described the hearings in detail. Mintz reported that the FDA panel turned down Ebert's labelling proposal in executive session. "I don't think they showed efficacy," one scientist said, expressing the unanimous sentiment on the panel against the drug. "The deans' data were marginal at best," said another panel member.
On November 28, several Medical School students began circulating a petition calling on Ebert to "adhere to the spirit of the promise he made in 1969 and sever all his connections with Squibb." The petition has thus far gathered only a score of signatures from medical school students, but several medical school faculty members have expressed concern over the propriety of Ebert's testimony, and over the circumstances of his continuing affiliation with Squibb. "I am very disappointed," Jonathan Beckwith '57, professor of Microbiology and Molecular Genetics, said last week. "It sounds like Ebert is doing what he said he wasn't going to do."
THE EBERT MATTER has been met thus far with administrative silence. The Crimson has repeatedly asked Ebert to discuss the terms of his agreement with Squibb, and to present in greater detail his case that the Squibb affiliation and the Mysteclin-F testimony do not conflict with his responsibilities as dean of the Medical School. Ebert, angered that The Crimson reported the Washington Post story before talking at length with him has refused to discuss the matter further.
Similarly, President Bok has chosen not to respond to requests that he issue a public statement outlining his views on the issue. This lack of response can only leave the Harvard community with the impression that neither Ebert nor Bok believe the question of corporate-academic conflicts of interest to be worthy of public discussion.
First, we think that Ebert owes the community a full report of his activities for Squibb since 1969. Some of his consulting tasks will doubtless portray him in a far better light than have the Mysteclin-F hearings, for he is widely known as a man with progressive views on medical issues. We also believe that Ebert ought to be less modest and disclose the amount of the retainer he has been receiving from Squibb.
But in the absence of such as accounting from Ebert, The Crimson must go on the available facts. The image of a Harvard dean going before a public board of inquiry to dissent from National Academy of Sciences National Research Council consumer-protection findings is somewhat unusual. It becomes questionable when we learn that the dean has been paid and sponsored by the very pharmaceutical company whose product he is defending. And if the apparent consensus of medical judgement on Mysteclin-F can be trusted, then Ebert's testimony before the FDA failed to damage the interests of medical consumers only because the advisory panel was wise enough to dismiss his arguments.
We view Ebert's Mysteclin-F testimony as an especially dubious exercise of a somewhat dubious consulting prerogative, and we believe that the Dean has traded on the prestige of the Medical School in an attempt to stave off an FDA ban of the drug. Dean Ebert should take his Harvard administrative post off the market by resigning his consulting position at Squibb.
BUT IT WOULD BE grossly unfair to focus criticism on Ebert without also commenting upon the consulting work undertaken by other Harvard administrators and faculty. Unfortunately, information on consulting ties is not a matter of public record, and is difficult to come by. In the most recent University statement on Conflict of Interest, voted in 1965 and amended in 1966, the Harvard Corporation expresses the hope that "the University will never find it necessary to require reporting or approval of consulting activities or other contractual arrangements. It (the University) relies instead on a punctilious sense of individual responsibility."
Since we believe that the Ebert affair raises the question of just how "punctilious" this "sense of responsibility" has been among administrators and faculty, we would suggest that new attempts to define a more precise conflict-of-interest policy be initiated.
But before the difficult question of what kinds of consulting work are "proper" can be debated, the community must know what sorts of consulting posts are now held. We hope that President Bok will break his administrative silence by sponsoring a University wide audit of present consulting ties, undertaken by a University board which would either publish its findings or hold them in escrow to be released by a vote of the Faculty or Faculty council.
Once the consulting positions held by administrators and faculty have become a matter of record issues of propriety can be given the thoughtful attention of the University community, rather than expose treatment in the press.