UPDATE: See Mayberg's response to Bass's post.
Alison Bass posted an interesting item on her eponymous blog regarding Helen Mayberg's Sunday morning talk at ScienceWriters2010. The talk was on the use of deep-brain stimulation to treat depression--a potentially breakthrough technology (and I don't use that word lightly) that is in its earliest tests.
In her item--headlined "Keynote scientist at ScienceWriters conference dances around the truth"--Bass says Mayberg's talk was too anecdotal, left out "a few salient details," and failed to disclose conflicts of interest. I was the person who invited Mayberg to talk at the meeting, and I tried to explain that decision in a comment on Bass's post. I won't say any more about that.
What I do want to address, however, is the notion of conflict of interest, which applies, in similar ways, to both scientific research and to journalism. "Conflict of interest" is used by science journalists to cover all manner of sins, and I fear that it is losing its meaning. That's a bad thing, because this is a very important notion that we all need to understand and keep in mind.
Bass acknowledges that Mayberg, in her talk at Yale last Sunday, disclosed that she was a consultant for St. Jude Medical, a company that makes, among other things, the probes that Mayberg uses for deep-brain stimulation. Bass thought Mayberg should have explained that she was not referring to a non-profit hospital with a similar name, but the more interesting question, to me, was that Bass thought Mayberg was wrong to be associated with St. Jude Medical which, Bass wrote, "has a less than stellar reputation."
For that reason, she concluded that "if I were a chronically depressed patient being recruited for the company's ongoing clinical trials, I might think twice about participating."
The question I'm interested in is this: Does Mayberg's inolvement with this device-maker raise questions about the integrity of her research? And does this relationship pose a conflict of interest?
As many Tracker readers know, large-scale clinical trials of procedures such as deep-brain stimulation can cost tens of millions of dollars, a sum out of the reach of most researchers, hospitals and universities. To do those studies, researchers routinely partner with drug and device makers. There is, indeed, a conflict of interest in these arrangements. Industry's interest in making money conflicts with the researcher's presumed interest in helping patients. Public funding of publicly minded researchers would subvert this conflict of interest, because all parties would, at least theoretically, have the patients foremost in mind. But even government cannot afford to replace the billions of dollars that drug and device makers spend on research.
Journalists face the same kind of conflict of interest when they write for sponsored publications. The journalist's interest in serving readers can conflict with the publication's interest in serving its institution. It doesn't matter who the publisher is--a distinguished university, a drug company in trouble with the FDA, or a pawn broker--the conflict exists.
The issue with Mayberg is not whether St. Jude Medical is a good company or a bad company, as Bass suggests. There is an inherent conflict of interest there, regardless of the company's reputation. But, I would argue, it's an unavoidable one, given the available means of financing hugely expensive clinical research.
The issue with journalists is whether we serve our readers' interests, or whether we occasionally serve somebody else's, as most freelancers (including this one) have done, at least on occasion.
Conflict of interest is easy to understand. It's devilishly hard to get rid of.
And if I were a chronically depressed patient being recruited for a company’s ongoing clinical trials, I think I'd grasp at anything.
- Paul Raeburn