More Hypocrisy Over Conflicts of Interest

The Center for Science in the Public Interest, through its “Integrity in Science Project,” has declared war on corporate influence on science and science-related public policy.  Lest you think that I am overstated its animosity, check out the CSPI website, where the CSPI states that the project “combats” corporate influence by maintaining surveillance of federal advisory committees, media, and scientific publications for failures to disclose conflicts of interest.  The project also maintains a database of public records that document scientists’ connections to industry.

Remarkably, the Center does not track connections to labor, consumer advocacy groups, plaintiffs’ litigation firms and consortia, NGOs, or ideologies that seek to influence science public policy.  This is just another example of hypocrisy in the continuing wars over supposed conflicts of interest, and a distraction from evidence-based policy.  See “Hypocrisy In Conflict Disclosure Rules,” <> (Nov. 30, 2010).  In an earlier discussion of conflicts, I pointed out that Sheldon Samuels, an advocate for the international labor movement, presented a paper at an American Public Health Association (APHA), for which he declared that he had “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). See  I do not know what the APHA’s disclosure rules were at the time Samuels submitted his abstract, and so I cannot say that he violated the APHA’s rules.  I can say that it seems peculiar to have a rule that requires disclosure of relationships with manufacturers, but not with unions or with advocacy groups.

Just last month, the APHA held its 138th Annual Meeting in Denver, Colorado.  One of the many panels dealt with issues of asbestos health effects, and I was interested to see what sort of disclosures were given by the presenters in this highly politicized area of science and medicine.  I was not disappointed.  See 4374.0, Disease Prevention and Social Justice: the Case of Asbestos.

The panel included three scientists – Richard Lemen, Arthur Frank, and Barry Castleman, all of whom have testified for plaintiffs in asbestos personal injury litigation, as well as some other litigations, for many years. 

Dr. Frank presented a “Case Study of Asbestos: History and Epidemiology.”  His abstract contains a disclosure, which is typical of all three:

“Presenting author’s disclosure statement:

Qualified on the content I am responsible for because: Longstanding national and international research regarding asbestos disease and exposure.

Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.”

Dr. Frank thus made no mention of his expert witness activities in litigation; nor did he apparently feel that such a disclosure was necessary.  Barry Castleman similarly failed to mention that he had served as an expert witness in litigation, and that he participates in several advocacy organizations that have strong political positions concerning asbestos. 

Dr. Lemen did at least mention that he felt qualified on the content because he had served as an expert witness in asbestos litigation.  The casual reader would be left guessing what parties had asked, and paid, Dr. Lemen for his services.  Lemen’s statement of qualification is curious in that it suggests that he is qualified to present at a scientific conference because he was found qualified to testify in court.  Some people might think that this was a reversal of the usual path to expertise, especially given that in many courts, all one must show to be qualified as an expert is that one knows more than the average juror on the matter.  The bar is set very low.

None of the three presenters disclosed expert witness work and compensation as a conflict of interest.  None disclosed memberships in advocacy groups.

I was intrigued by the reference, in each of these gentlemen’s disclosures, to the American Public Health Association Conflict of Interest and Commercial Support Guidelines.  A quick search of the APHA website did not identify these guidelines, but a telephone call to the APHA quickly led to my receiving the Guidelines by email.  The APHA Guidance on conflicts of interest, revised December 2009, provides:

“Policy 2:  Policy on Conflicts of Interest (COI).

Definitions of a COI:  A COI may be actual or potential.  If a reasonable person might perceive a COI, then it is a perceived conflict.  If there is only a potential or perceived COI, then these must be treated the same as if a COI actually exists.  An actual COI exists when one has a financial, professional and/or personal relationship that may influence the educational content.  These types of relationships may overlap or exist simultaneously. 

  • A ‘financial interest’ may include, but is not limited to, a financial benefit that is expected by the individual through employment, … independent contractor, … consulting or speaking fee, … . 
  • A ‘professional interest’ may include, but is not limited to, a situation in which an entity receives a contract or grant and manages the funds, but an individual is the principal, named investigator, or is in any position to influence the results or outcomes.  This includes students. 
  • A ‘personal interest’ may include, but is not limited to, a financial relationship that is held by one’s spouse or partner.  Also any of the relationships above may also be a ‘personal interest’.

 A) A COI must be disclosed while a conflict is present and for 12 months after it is ended.”

 The APHA Guidance is not absolutely clear, but it would seem that it covers expert witness work as a “financial interest.”  Furthermore, consulting for legal counsel, or testifying at counsel’s request, would appear to be a “personal interest.”  Both interests seem to suggest a potential or perceived conflict, which under the Guidance, must be treated as an actual conflict, and thus must be disclosed.  Of course, there is a time limit on the conflict of interest, which expires in 12 months, which seems unduly short but was the APHA’s policy choice.

The disclosures made by Frank, Lemen, and Castleman seem to omit important information about their backgrounds, professional and personal interests, finances, memberships and activities in advocacy groups, and consultations and testimonial adventures in litigation.  Their disclosures do not seem to line up with the words or the spirit of the APHA rules.

Do not expect the Center for Science in the Public Interest to flag this issue in its Integrity of Science Project.

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