Hypocrisy In Conflict Disclosure Rules

In 2005, Sheldon Samuels, advocate for the international labor movement, presented a paper at the American Public Health Association, where he lauded the late Irving Selikoff as “labor’s doctor.”  See “Sheldon Samuels, Irving Selikoff: The Legacy of Labor’s Doctor,” http://apha.confex.com/apha/133am/techprogram/paper_120225.htm

There is nothing particularly remarkable about this hagiographic effort, other than Samuels’ disclosure:

“I wish to disclose that I have NO financial interests or other relationship with the manufactures [sic] of commercial products, suppliers of commercial services or commercial supporters.”

Id. (emphasis in the original).  Presumably the organizers of the APHA thought this was a serious, sufficient disclosure of potential conflicts of interest.  Samuels obviously believed that the only conflicts of interest were financial ones, or relationships with manufacturers.  Samuels’ lifelong affiliation with organized labor and his advocacy for labor’s causes did not register, in his mind or in the minds of the APHA leadership, as a potential conflict.

Samuels and the APHA leaders probably did not believe that labeling Selikoff as “labor’s doctor,” was at all pejorative.  They would have had something very different in mind if they had labeled someone as “industry’s doctor.”

To some extent, perhaps the asymmetry is superficially justified in that organized labor will have the health and welfare of its membership as a high priority.  Historically, however, organized labor has traded known occupational hazards for better pay, sometimes candidly called “dirty money.”  Industry might not  appear to be as concerned with workers’ health, but few industries want the reputational damage of being seen as callous or indifferent to their workers.  In the end, the caricature of industry as only concerned about “profits” is as false and defamatory as the caricature of labor as only concerned about wages.  Somewhere in the caricaturing, the interest in craftsmanship and in selling products or services of value to people is lost.  Workers are more than their paychecks, and employers are more than their profits.

But to return to the conflict of interest issue, Samuels’ faint, failed attempt at a disclosure reveals the hypocrisy in the constant drumbeat over financial conflicts.  Samuels’ conflict is real and palpable.  Labor organizations have been in the forefront of pushing for compensation for injuries, and they have benefitted from scientific claims, which may have been exaggerated or false.

The asymmetry in the criticisms over funding sources is quite vocal.  Typical is an article published in the journal, Occupational and Environmental Medicine:

“There are inherent problems with industry sponsored research in relation to intellectual property and ethical issues because industry funders and academic researchers work in different systems with different goals and means.”

S. Tong & J. Olsen, “The Threat to Scientific Integrity in Environmental and Occupational Medicine,” 62 Occup. Envt’l Med. 843, 843 (2005).  The authors recount anecdotes of industry influence on studies, and they call for reform:

“Research funding for public health should not come directly from the industry to the researcher; an independent, intermediate funding scheme should be established.”

Id. at 846.  Tong and Olsen are curiously silent about studies funded or sponsored by labor or by plaintiffs’ lawyers.  As we approach 100 bankrupt companies in the asbestos litigation, we might well ask whether studies conducted by “labors’ doctors” have exaggerated or misrepresented risks and causal claims.  In several litigations, plaintiffs’ counsel conspired with researchers to produce dubious studies, and then worked to hide their involvement. 

Tong and Olsen, who also call for openness among public health professionals, acknowledge help from David Michaels.  The casual reader, however, would not know that Michaels had worked as a plaintiffs’ testifying expert witness, or that he had directed an organization known as SKAPP, which was surreptitiously funded by plaintiffs’ lawyers, and which worked to undermine judicial screening of unreliable expert witness evidence.  So much for openness on the home front.

The asymmetry, or hypocrisy, of the occupational medicine community can sometimes approach shrill hysteria.   Samuels’ hagiographic presentation is a fascinating contrast with Professor Peter Bartrip’s historical research into the mystery of Selikoff’s medical degrees.  P.W.J. Bartrip, “Irving John Selikoff and the Strange Case of the Missing Medical Degrees,” 58 J. History Med. 3 (2003).  Although Bartrip praises many of Selikoff’s accomplishments, he is critical of Selikoff’s dissembling over his actual medical training. Bartrip offers a balanced account, and concedes on any number occasions that the record is inconclusive.

Criticizing “labor’s doctor,” however, can be dangerous business.  Bartrip’s paper brought the goodfellas out in a gaggle.  “P.W.J. Bartrip’s Attack on Irving J. Selikoff.”  See 46 Am. J. Indus. Med. 151 (2004).  The authors of this letter apparently were turned down by the Journal of the History of Medicine, and so they published in a non-history journal.  It is not clear whether this path deprived Professor Bartrip of the opportunity to publish a reply.  The letter writers assail Bartrip for his “ad hominem” attacks on Selikoff, and praise Selikoff as the epitome of “the committed public health professional.”  Id. at 151.  The gaggle claim that “Selikoff’s antagonists came up with nothing to discredit him in his lifetime … .”  Id. at 152.

The letter is signed by David Egilman, Geoffrey Tweedale, Jock McCulloch, William Kovarik, Barry Castleman, William Longo, Stephen Levin, and Susanna Rankin Bohme.  Several of these signatories testify extensively in asbestos personal injury litigation for plaintiffs; others are well-known idealogues on asbestos policy issues.  No disclosure of conflict is made in connection with this letter.  Why are we not surprised?  The letter challenges some of Bartrip’s findings, but ultimately it begs the question about the quality of Selikoff’s scientific contributions.

Ultimately, most of the rancor against conflicts of interest, and failure to disclose, is ad hominem.  Nothing in Bartrip’s historical piece makes Selikoff’s scientific work more or less true; nothing in the goodfellas’ ad hominem attacks on Bartrip make Selikoff’s training or dissembling about his training more or less true.  And the gaggle’s invocation of absence of evidence (to be used as a substitute for evidence of absence) is hardly persuasive.  By the time Selikoff’s advocacy had become problematic to certain industry “antagonists,” they were beleaguered by overwhelming litigation and silenced by their own “conflicts of interest.”  On the other hand, the hagiographers have had the day because they claim to have no such conflicts.  These assumptions about Selikoff’s work, and about the “interestedness” of those who challenge and defend his work cry out for re-examination.

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