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Medical Professor Faces Ethics Probe

By Victor Chen

Following what some have called a breach in research and journalistic ethics, a prominent Harvard rheumatologist faces an investigation into whether he failed to disclose a conflict of interest regarding an article he co-authored.

According to the Associated Press, Professor of Medicine Peter H. Schur helped author an article that appeared in February in Arthritis & Rheumatism, a medical journal that he edits, defending breast implants.

Arthritis & Rheumatism is the official journal of the American College of Rheumatology, which purports to be an objective showcase for studies involving rheumatological issues.

But Schur is also a consultant to four law firms which work for makers of silicone breast implants, which have barred from usage by the Food and Drug Administration. He has made roughly $30,000 since October of 1993 critiquing medical reports, reviewing patient records and testifying in trials.

In that same month, Schur and three colleagues submitted a paper to Arthritis & Rheumatism concluding that there is "little or no association" between implants and disease. The paper was edited that fall and published last February.

Schur could not be reached by The Crimson for comment yesterday.

In the published study, Schur did not disclose his ties with the implant industry. Medical ethicists have said that Schur was out of line.

"That strikes me as a bad mistake," David H. Smith, director of the Poynter Center of the Study of Ethics at Indiana University, said in an interview yesterday. "I think readers of professional journals have a right to know the kinds of engagements that the editorial writers have."

Schur himself denied any conflict of interest in an Associated Press interview yesterday. He said he did not need to disclose his work with the implant industry because it did not influence his research judgment.

He added that he thought acknowledging a conflict of interest was necessary only if "payment by industry has influenced the article. Clearly, none of us felt we were being influenced by anyone."

But according to ethical rules adopted in January 1993 by the International Committee of Journal Editors, consulting and expert testimony are among "the most important conflicts of interest," regardless of whether the authors judgements are influenced.

Members of the American College of Rheumatology's publication committee, which oversees the journal, told the Associated Press that they were surprised and concerned by Schur's moonlighting.

"He should have disclosed [his ties]," said member Dr. Bruce N. Cronstein of New York University Medical Center.

The publication committee promised an investigation on their editor's activities. "We will take the appropriate actions," Dr. David A. Fox of the University of Michigan, the committee's chair, told the Associated Press. "This is not an issue that we will ignore."

Studies in medical journals can have great impact upon juries in trials involving medical matters such as breast implants. They are typically used by both sides in the the cases that have come to court over the issue.

Although doctors disagree about the effects of breast implants on health, manufacturers have agreed to pay $4.25 billion to women who believe they have been harmed. But about 8000 women have rejected that settlement, and are now suing the companies on their own.

Some attorneys who represent women with implants have alleged that the manufacturers' law firms have attempted to stifle unfavorable articles by putting Schur and other journal editors on their payrolls.

"In my view, the evidence suggest that the manufacturers have attempted to control science by hiring experts who are key players in the decision-making about what gets published," Frederic L. Ellis, a Boston attorney, told the Associated Press yesterday.

Some critics have also questioned Schur's performance as editor of the journal, pointing out that Schur has never published an article critical of breast implants in his four years as editor.

In 1992 and 1993, according to the Associated Press, doctors submitted two articles to Arthritis & Rheumatism supporting the idea that implants cause disease. Schur rejected both papers, which were later published in other journals.

In the same issue that Schur published his own paper, a report solicited from Dow Corning Corp., the biggest defendant in breast implant litigation, was the lead article. The article attacked the news media and plaintiff attorneys for creating an unwarranted panic over breast implants.

Dr. Richard Glass, deputy editor of the journal of the American Medical Association and a member of the international committee, questioned Schur's objectivity as an editor to the Associated Press.

"Editors passing judgment on articles and deciding what to publish should not have any financial conflict of interest," he said.

Harvard Medical School professors and administrators contacted yesterday would not comment on whether their colleague had transgressed any ethical standards.

"He's a very respected professor in the medical school," Associate Dean of Faculty Affairs Mary B. Clark said.

This story was compiled using wire dispatches.

The publication committee promised an investigation on their editor's activities. "We will take the appropriate actions," Dr. David A. Fox of the University of Michigan, the committee's chair, told the Associated Press. "This is not an issue that we will ignore."

Studies in medical journals can have great impact upon juries in trials involving medical matters such as breast implants. They are typically used by both sides in the the cases that have come to court over the issue.

Although doctors disagree about the effects of breast implants on health, manufacturers have agreed to pay $4.25 billion to women who believe they have been harmed. But about 8000 women have rejected that settlement, and are now suing the companies on their own.

Some attorneys who represent women with implants have alleged that the manufacturers' law firms have attempted to stifle unfavorable articles by putting Schur and other journal editors on their payrolls.

"In my view, the evidence suggest that the manufacturers have attempted to control science by hiring experts who are key players in the decision-making about what gets published," Frederic L. Ellis, a Boston attorney, told the Associated Press yesterday.

Some critics have also questioned Schur's performance as editor of the journal, pointing out that Schur has never published an article critical of breast implants in his four years as editor.

In 1992 and 1993, according to the Associated Press, doctors submitted two articles to Arthritis & Rheumatism supporting the idea that implants cause disease. Schur rejected both papers, which were later published in other journals.

In the same issue that Schur published his own paper, a report solicited from Dow Corning Corp., the biggest defendant in breast implant litigation, was the lead article. The article attacked the news media and plaintiff attorneys for creating an unwarranted panic over breast implants.

Dr. Richard Glass, deputy editor of the journal of the American Medical Association and a member of the international committee, questioned Schur's objectivity as an editor to the Associated Press.

"Editors passing judgment on articles and deciding what to publish should not have any financial conflict of interest," he said.

Harvard Medical School professors and administrators contacted yesterday would not comment on whether their colleague had transgressed any ethical standards.

"He's a very respected professor in the medical school," Associate Dean of Faculty Affairs Mary B. Clark said.

This story was compiled using wire dispatches.

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