By Shawn Kennedy, MA, RN, AJN interim editor-in-chief
In a not-so-old blog post I did last month, I reported on a conference I attended in Vancouver. There, editors from JAMA presented a study revealing that ghostwriting was a major problem for the leading medical journals. Articles were being drafted by writers other than the researchers. In some cases, the writers didn’t have access to all the data, which meant that analyses, conclusions, and—in some cases—recommendations for treatment were based on incomplete or misinterpreted findings. As described in a New York Times article on the issue, medical product and pharmaceutical companies have much to gain if the safety and efficacy of their products are reported in a positive light.
Conflict of interest is a major concern whenever someone who stands to personally benefit can influence a decision. The National Institutes of Health, which is the leading medical and health research agency in this country, has imposed strict rules for employees limiting consulting and speaking fees involving outside companies and institutions that may have a stake in research outcomes. Most government agencies, research or not, impose rules to avoid conflicts of interest.
Last week, NBC News reported that protestors staged a sit-in at the Hartford, Connecticut, offices of Senator Joe Lieberman, demanding that he stop taking campaign contributions from insurance companies. (Hartford is home to some of the nation’s largest insurance companies, three of which—Hartford, Travelers, and Aetna—were Lieberman contributors, according to Open Secrets.org, which monitors political contributions.) Lieberman has been a leading opponent of the public insurance plan the administration has put forth as a key maneuver to help bring health care costs down. The protesters claim that were it not for the hefty funding Lieberman receives from the insurance industry, he might vote differently.
Another sign of just how much industry influence exists in Congress is a New York Times report that in making their official statements about the health care bill for the Congressional record, many legislators used material ghostwritten by lobbyists for biotechnology and pharmaceutical companies.
Joe Lieberman is not alone—most legislators are recipients of funding from lobbyists for the insurance, pharmaceutical, and health care industry. Yet we expect them to make decisions in good conscience on a reform bill that will affect virtually everyone in this country (except themselves, since they all have insurance coverage). Do we really believe legislators can make decisions that are in our best interests if our interests don’t coincide with the interests of their financial backers?