Medical Conflicts of Interest

Institutes of Medicine Places Harvard in Dubious Light

In the proposed Institutes of Medicine, Harvard was to have used its tax-exempt resources to create a commercial venture. Biotech companies would have profited from Harvard's public funded research. They were also likely to have first dibs on turning the University's research discoveries into big bucks.

Even with these problems, the Institutes was viewed around the Medical School as just another business deal. But the Institutes should make scholars of all stripes very nervous. Here's why:

Where there is money, there is temptation. Harvard's code of ethics for faculty requires professors to disclose financial ties fully. Still, there are few mechanisms for enforcement, and the school is trusting the faculty's honor. It is not difficult to imagine researchers manuevering into positions where they can do clinical trials for projects in which they have a financial interest.

Ethicists and even some administrators are saying privately that Harvard's code won't begin to stop profiteering by greedy professors and administrators involved in projects like the Institutes. School of Public Health economist Marc Roberts told the New York Times that because biotechnology stocks are extremely volatile, it would be relatively easy for Harvard researchers involved in the institutes to color test reports and share insider information to make money.

With the Institutes, a venture capital firm would have made most of the decisions about which lines of research to pursue. Venture capital firms--even good firms like Healthcare Investment--rarely have the best interests of the public at heart.


Asked about these criticisms, Schwind argues that Harvard's conflict of interest policy would prevent the sorts of abuses seen at other schools. And to a point, she is right. Harvard is not yet the University of Minnesota, which has patented a drug and built a special facility to manufacture it.

But as ethicist Sheldon Krimsky of Tufts University points out, Harvard's conflict of interest policy gives little practical guidance to administrators governing research.

"There are two problems with Harvard's policy," Krimsky says. "If you read their guidelines, you see they don't deal with eliminating conflicts of interest. Instead, the guidelines are only talking about managing conflicts."

That means that even if a researcher's conduct meets the criteria of a conflict of interest, Harvard's rules "still might let it go," according to Krimsky. In other words, the conflicts of interest policy is set up to react to allegations, rather than prevent conflicts in the first place.

"And the way you should handle conflicts of interest," Krimsky says, "is to prohibit them."

The second problem Krimsky speaks of is even harder to address. There is no policy--either specific to the University or from the government--to handle conflicts of interest involving educational institutions.

Take, for example, a researcher doing work on drug efficacy. He has no conflict of interest, but the University may hold a large amount of stock in a company that would benefit from the research.

"No one has been able to figure out what to do about institutional conflicts of interest," Krimsky says.

With so many ethical questions unresolved, Harvard should work on developing a broader policy to eliminate as many conflicts as possible before jumping into another Institutes- like project. By recklessly forging links to biotech companies and investment firms, Harvard runs the risk of selling out its academic ideals to the highest bidder.

That risk is great. As Krimsky said in a New York Times article, "The question is: how much will a large project by a prominent research institution change the ethos of science so the incentive for research becomes the amount of money a researcher brings in, rather than the quality of knowledge created?"

Joe Mathews '95 was Managing Editor of The Crimson in 1994. He hopes his thesis advisor won't see this.