The SRA Symposium - College of Medicine

Papers
The more troubling question is what impact, if any, does such mandatory training have on future
behaviors and decision-making? Do our trainees make more ethical choices? Are we creating and
supporting an institutional culture that encourages, nurtures and enables ethical science? Or is it
an illusion?
I like to think that we work hard to create educational and professional venues, which support “doing
the right thing because it is simply the right thing to do.” Yet sometimes perception and reality
are two separate things.
As Fuchs and Macrina (2005) suggest, once we enter the realm of moral reasoning, we base judgments
on what we ought to do and we assume that this is the right thing. Yet, acting morally is not
always akin to acting legally. History is filled with indiscretions that, at the time, were legal but today
would be considered highly unethical—if not outright unlawful. Fuchs and Macrina state that,
in order to avoid repeating these historical breaches, scientists must strive to carefully examine the
moral dimensions of current research practices. It is no longer a matter of abiding by the regulations.
The regulations do not always cover every nuance, and—in the opinion of some—regulators
are suspect at best because of questionable political and/or religious affiliations (Lower, 2005,
Sweet, 2002, Crewdson, 1995). This is illustrated not only by the Gallo case orchestrated under the
Reagan administration’s watch, but most certainly by the ongoing interference of the current Bush
administration as well.
The public trust is fragile. Once shattered it is difficult to repair. Perception is the key—sometimes
it is the mere hint of a possibility of wrongdoing that can be the catalyst for disaster. Hoey (2003)
cites that the problem in the Gelsinger case was not one of uninformed consent, misleading protocols,
publication gag clauses, or the like. Rather, the issue became one of public perception. Once
the family filed a suit against the University of Pennsylvania (UPenn), it was learned that James
Wilson, the lead investigator, was also the president and major shareholder of the private company
that held patents for the procedure in question and funded the research. It also was discovered
that the university and some members of the board of governors also owned stock in the firm.
Although, Hoey (2003) asserts that these factors had no direct bearing on Jesse Gelsinger’s death,
UPenn quickly settled the suit and Wilson resigned his university post. UPenn went a step further
by instituting strict guidelines for clinical research that would prohibit faculty from participating
if they or close family members have a material financial interest in a private company whose
product(s) they are evaluating. Many other institutions have followed with similar guidelines.
Conflict of interest and commitment become a slippery slope for many researchers in search of
funding. Guterman (2005) reports that over the past twenty years the proportion of research studies
funded publicly has decreased significantly, while those supported privately have increased.
This seems especially true in occupational and environmental health, where the field is dedicated
to studying dangers to the public’s health and safety from the workplace and/or environment.
Academic scientists in this field know that business interests increasingly drive research agendas
(Guterman, 2005). The government seems to give this work low priority, and, so, scientists are
forced to look to the private sector for research funding. How does the responsible scientist balance
the paycheck with the findings that their sponsor’s product is actually a menace to public
health and welfare? Guterman quotes Daniel T. Teitelbaum, a Denver doctor specializing in medical
toxicology and occupational epidemiology, who says, “Industry doesn’t give you money to do
research. Industry gives you money to do research that favors them.”
Therefore are corporate sponsors the villains? The money has to come from somewhere, but at
what price to the public trust? Many feel journal editors are equally culpable. Guterman argues
that some journals in occupational and environmental health do not require authors to reveal
their funding source or any other possible conflicts of interest. Shuchman and Wilkes (1997) also
2005 Symposium Proceedings Book 237