Watchdogs or Showdogs? The Final Installment

Is it a conflict of interest for a bioethicist to work as a paid consultant for the pharmaceutical industry?

In recent weeks I have posted my conversation with Jenny Dyck Brian of Arizona State University, who wrote her doctoral dissertation on corporate bioethics boards. (See parts one, two and three.) Today we reach the final installment.

Q: A lot of people outside bioethics seem shocked when I tell them about academic bioethicists working for pharma. But within the field, I don’t see a lot of pushback.

A: Within the field there is little pushback. A lot of people said they themselves wouldn’t do it (or that an interesting opportunity has yet to present itself), but they think it’s a good thing that industry is getting some good advice, or at least seeking different perspectives. Most people I spoke with argued that working with industry is not in and of itself negative or corrupt, but at the same time, there are not very many people who discuss their work within the private sector openly.

Q: Hmm. “I wouldn’t do it but I’m glad others do it.” What do you think is behind that? If it’s ethically acceptable, or even something to be encouraged, then why wouldn’t they do it?

A: Well, it’s not like academia has an easy relationship with the corporate world, right? They may worry about their reputations, or they may in theory believe that it would be great if the private sector sought good outside advice, but believe in practice it would never work.

Q: How much do you think bioethicists know about all the various industry scandals? Maybe I’m wrong, but my sense is that bioethicists don’t really pay that much attention.

A: I don’t believe there’s a strong awareness of various industry scandals. We know the ones that make the news, or the ones directly related to our areas of inquiry, but overall, I think we should all pay better attention to the details.

Q: Over the past year there has been a lot of debate over the decision of Glenn McGee, the former editor-in-chief of the American Journal of Bioethics, to take a full-time position with Celltex, the controversial stem-cell company in Texas. You devote a section of your dissertation to McGee’s public departure from the ethics advisory board of Advanced Cell Technology in 2000, in which McGee accused ACT of withholding information about an animal-cloning program from the ethics board and said the company used the board to justify its controversial research. But you also write that McGee resigned from the company without ever having attended an ACT board meeting.

A: I do not have McGee’s side of the story. He agreed to talk to me initially, and then the timing didn’t work for quite a while because he was moving to Kansas. I waited a year, but by then he didn’t answer follow-up e-mails. I am still hoping to sit down with him someday. Some of the ACT board members were quite angry with McGee’s behavior and former ACT CEO Michael West seemed confused about the whole thing. In the Senate testimony, though, West was almost apologetic to McGee, so the whole situation is very unclear.

According to the minutes, he was not in attendance at the first ACT Ethics Advisory Board meeting, and then resigned. So he wouldn’t have heard what particular research the company was doing or what it was telling its ethics board about that research (and apparently never took the opportunity to discuss it with other EAB members).

Q: Did he actually ask West or anyone else for more information or an explanation before he resigned?

A: According to the other members of the Ethics Advisory Board and Michael West, his resignation was very abrupt and came as a surprise. There may be someone he spoke with that I did not speak with, but he did not seek more information from West. McGee posted his resignation letter on the MCW message board (a bioethics listserv at the Medical College of Wisconsin) about nine months after he resigned. The Ethics Advisory Board members I spoke with were quite upset because they felt his abrupt and public resignation did damage to their reputations and served to destroy the credibility of their board before it even had a chance to do anything, and they wrote as much in an article in The Hastings Center Report in 2002.

Q: Overall, do you feel as if bioethics advisory boards are a positive development? Should we trust the pharma companies with bioethicists on board more than we trust the bioethicist-deprived companies?

A: Well, I certainly feel like they are an interesting development, and I think it’s a good thing when any group seeks an outside opinion. I also think it’s a positive development to see more of a back and forth between industry and academia more generally.

However, it’s difficult to make a normative judgment. Each committee I studied was very different from one another, which in itself is an interesting finding. At SmithKline Beecham, the VP of Research tried to create a place for a broad debate about social responsibility and complexity, whereas at Advanced Cell Technology, the committee functions more like a watchdog, trying to spot and solve potential problems. Those are very different functions, and I hope to gain a better understanding of the larger landscape of corporate bioethics (with more empirical data, with more cooperation from companies who have bioethics committees, etc.)

These three companies—SmithKline Beecham, Eli Lilly, and Advanced Cell Technology—are not the only ones engaging in bioethical debate. I’m interested in what the corporate bioethics committees do, and I want to know more, and I want to be optimistic. Bioscience companies wield such incredible power, and it would be great if these bioethics committees had the opportunity to have a positive impact.