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Conflicts of interest of those involved with the PACE Trial
In an editorial in The British Journal of Psychiatry (2008:193:91‐92), Mario Maj, Professor of Psychiatry at the
University of Naples and editor of “Somatoform Disorders” (John Wiley & Sons, 2005, to which as
mentioned in Section 1 above, Professors Simon Wessely and Michael Sharpe contributed) drew attention to
what he referred to as a major problem in psychiatry:
“Conflicts of interest occur when doctors are unduly influenced by a secondary interest…The secondary interests that
may unduly influence doctors’ actions include: financial gain…career advancement or visibility in the media…the
allegiance to a school of thought; and political commitment”.
Maj noted the possible conflict of interest between a psychiatrist’s allegiance to a given school of thought
and the primary interest represented by the progress of science. He said:
“Along with the fact that the proponents of some specific psychotherapies may be less interested in the
scientific validation of their techniques, this allegiance effect may bias the evidence concerning the relative
efficacy of the various psychotherapies” and he noted the possible conflict between the secondary interest
“represented by a psychiatrist’s political commitment and the primary interest represented by the patients’ welfare”.
Maj continued: “It has been rightly pointed out that there are now in our field ‘special interest groups’,
consisting of prominent opinion leaders with significant financial conflicts of interest who exercise a
powerful impact on the field in their various capacities (e.g. as editors or referees of scientific journals, or as
contributors to treatment guidelines…(who have) significant non‐financial conflicts of interest arising from
their strong political commitment. They may exercise an equally powerful impact on our field acting, for
instance, as contributors to mental health policy guidelines or consultants to governments. Moreover,
when acting as referees for scientific journals or evaluating research projects submitted to public agencies,
they may…unfairly favour colleagues who share their political credo”.
There are many who believe that this applies to the Wessely School.
The Association of Medical Research Charities “Guidelines on Good Research Practice” states: “Researchers
should declare and manage any real or potential conflicts of interest, both financial and professional. These
might include: Where researchers have an existing or potential financial interest in the outcome of the
research: Where the researcher’s personal or professional gain arising from the research may be more than might be
usual for research”. Unfortunately, these Guidelines are not binding upon the PACE Trial Investigators.
The MRC’s own Good Research Practice (second edition, September 2005) is binding upon the PACE Trial
Investigators and is unambiguous: on page 2 is to be found the following:
“The MRC expects ALL scientists, both clinical and non‐clinical, funded by the Council (ie. MRC
employees, visiting workers in MRC establishments, and recipients of MRC grants or training awards) to
adopt the highest achievable standards in the conduct of their research. This means exhibiting impeccable
scientific integrity and following the principles of good research practice”.
The same MRC document states on page 3: “Researchers must pay as much attention to perceived and potential
conflicts of interest as to actual conflicts. How one is perceived to act influences the attitudes and actions of
others, and the credibility of scientific research overall”.
The Research Governance Framework for Health and Social Care, Second Edition, 2005, warns at section
9.15 (“Care and protection of research participants”) about: “circumstances that might lead to conflicts of interest that
may affect the independent judgement of the researcher(s).”