Clinical ethical consultants are subject to an unavoidable conflict of interest. Their work requires that they be independent, but incentives attached to their role chip relentlessly at independence. This that they be independent, is a problem without any solution, but it can at least be ameliorated through careful management.

Background: In biomedical research, there have been numerous scandals highlighting conflicts of interest (COIs) leading to significant bias in judgment and questionable practices. Academic institutions, journals, and funding agencies have developed and enforced policies to mitigate issues related to COI, especially surrounding financial interests. After a case of editorial COI in a prominent bioethics journal, there is concern that the same level of oversight regarding COIs in the biomedical sciences may not apply to the field of bioethics. In this study, (...) we examined the availability and comprehensiveness of COI policies for authors, peer reviewers, and editors of bioethics journals. Methods: After developing a codebook, we analyzed the content of online COI policies of 63 bioethics journals, along with policy information provided by journal editors that was not publicly available. Results: Just over half of the bioethics journals had COI policies for authors (57%), and only 25% for peer reviewers and 19% for editors. There was significant variation among policies regarding definitions, the types of COIs described, the management mechanisms, and the consequences for noncompliance. Definitions and descriptions centered on financial COIs, followed by personal and professional relationships. Almost all COI policies required disclosure of interests for authors as the primary management mechanism. Very few journals outlined consequences for noncompliance with COI policies or provided additional resources. Conclusion: Compared to other studies of biomedical journals, a much lower percentage of bioethics journals have COI policies and these vary substantially in content. The bioethics publishing community needs to develop robust policies for authors, peer reviewers, and editors and these should be made publicly available to enhance academic and public trust in bioethics scholarship. (shrink)

Many states have significantly reduced their support for higher education in the last decade, increasing the importance of securing external funding for research and academic centers at colleges and universities. This paper addresses issues that have been raised by critics of funding from "morally tainted" sources like tobacco companies, pharmaceutical companies, and oil and gas companies and attempts to develop plausible criteria for "morally acceptable" funding in light of criticisms that focus on issues such as transparency, conflicts of interests, academic (...) and scientific integrity, and coercion. A further discussion of whether special or unique criteria are necessary for ethicists and ethics centers is also included. (shrink)

The development of a code of ethics for a profession can be an indicator of the coherence and stability of a discipline as a unique and singular entity. Since “bioethics”, as a discipline, is not one profession but many, practiced by persons with not one but many varying responsibilities and training, it has been argued that no code of ethics is possible for the discipline(s) of bioethics. I argue that a code of ethics is possible for bioethics by looking at (...) the nature of the various disciplines and noting necessary overlap between them, and deriving the ethics from the nature of the discipline(s) themselves. I show how this can be done by arguing that strict rules about funding and conflict of interest are necessary for bioethicists. (shrink)

In the context of the question of the extent to which science studies is able to mount an adequate critique of contemporary developments in science and technology, and in view of the proliferating interest in ethics across the social sciences, this article has two aims. Firstly to address some of the implications for ethics of Bruno Latour's, and to a lesser extent Alfred North Whitehead’s, conceptions of reality, both of which have a bearing on the long-standing dichotomy between facts and (...) values. Drawing on Whitehead's work, it also, secondly, seeks to make a positive argument for ethics and to ask again, in the light of this discussion, where the ethical dimensions of Latour's work might be located. Towards the end of the article, I suggest that Latour's concept of exteriority obliges him to pursue a politics of reality which is the special providence of ‘moralists’, rather than a politics of virtual reality in which all entities, human and non-human, are engaged. (shrink)

The purpose of this paper is to provide a normative model for the assessment of the exercise of power by Big Pharma. By drawing on the work of Steven Lukes, it will be argued that while Big Pharma is overtly highly regulated, so that its power is indeed restricted in the interests of patients and the general public, the industry is still able to exercise what Lukes describes as a third dimension of power. This entails concealing the conflicts of interest (...) and grievances that Big Pharma may have with the health care system, physicians and patients, crucially through rhetorical engagements with Patient Advocacy Groups that seek to shape public opinion, and also by marginalising certain groups, excluding them from debates over health care resource allocation. Three issues will be examined: the construction of a conception of the patient as expert patient or consumer; the phenomenon of disease mongering; the suppression or distortion of debates over resource allocation. (shrink)