Disclosures and Influence

Editorial Comment: Disclosures and influence

 

This weekend's New York Times provides an expose of physicians’ undisclosed connections with industry. This is of course the sort of sensationalism that is anathema to a profession whose effectiveness is predicated upon the development and maintenance of trust.  But it appears deserved.  One of our attentive readers last month noted that an article was reviewed despite originating from an institution with a poor track record in this regard; it was an association that we missed. Our oversight paralleled one of the concerns cited by NYT, that peer review in a distinguished journal carries a presumption of due diligence in the identification of the origins of financing of the research in question.  This doesn’t always hold, and of course it cannot always hold, even if only for the substantial resources required.  And while that is not an excuse, it is a reason.

 

This becomes more problematic as newer and possibly more powerful sources of influence arise.   Poorly-considered initiatives involving the use of cannabis for opioid use disorder are proliferating among state legislatures, and represent commercial interests that act  at cross-purposes with evidence-based medicine.  Yet interestingly, discussions of professional ethics and of accountability in the relationships between associations and industry are seldom seen in training curricula or in professional conferences.  They pop up in journals and seminars, fueled by indignation and embarrassment; and they are certainly the stuff of organizational policy (as even now, ASAM reviews a new draft of such standards).  But possibly from fear of a polemical conflagration, these discussions do not rise to the tops of curricula or educational programs.  Bit of a shame, really.  Polemics being strong expressions of strong opinions, they generally represent matters of importance; and can be calmed and made useful when data are infused. 

- Dr. William Haning