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What is Wrong with “Ethics for Sale”? An Analysis of the Many Issues That Complicate the Debate about Conflicts of Interests in Bioethics

Published online by Cambridge University Press:  01 January 2021

Extract

Bioethics, once a four-letter word in the private sector, is now an integral part of the decisionmaking process of biotechnology and pharmaceutical companies. And bioethicists, once confined to the classroom and limited to abstract, philosophical discussions about what is right and wrong in medicine and medical research, now play an important role in the practical implementation of ethical boundaries. Bioethicists increasingly are hired by biomedical companies as consultants to highlight and help resolve complex ethical issues that arise in the companies’ normal business practices. Whether motivated by profit, reputation, or a genuine desire to act morally, these companies are willing to pay bioethicists substantial consultation fees for their “expert” opinions. This fairly recent phenomenon has caused some to be concerned about the potential for bioethicists to encounter conflicts of interests. Specifically, many critics of this new relationship between bioethicists and the private sector “are concerned about the appropriateness of ethicists who should have broader interests, such as concerns about social justice, serving clients whose primary interest is profit-maximizing.”

Type
Independent
Copyright
Copyright © American Society of Law, Medicine and Ethics 2007

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References

Brody, B. et al., “Bioethics Consultation in the Private Sector,” Hastings Center Report 32, no. 3 (2002): 1420, at 15.Google Scholar
Elliott, C., “Pharma Buys a Conscience,” The American Prospect, Sept. 24 - Oct. 8, 2001: 16–20, at 17.Google Scholar
Sharpe, V. A., “Science, Bioethics, and the Public Interest: On the Need for Transparency,” Hastings Center Report 32, no. 3 (2002): 2326, at 25.CrossRefGoogle Scholar
See Brody, et al., supra note 1, at 14–15.Google Scholar
Id., at 15.Google Scholar
Boyce, N. and Kaplan, D., “And Now, Ethics for Sale?” U.S. News and World Report, July 30, 2001, at 18; Boyce, N., “A View from the Fourth Estate,” Hastings Center Report 32, no. 3 (2002): 1617, at 17.CrossRefGoogle Scholar
See Sharpe, supra note 3, at 25.Google Scholar
Editorial, “Probing the Ethics of the Bioethicists,” Indianapolis Star, August 13, 2001, at 8A.Google Scholar
See Boyce, supra note 7, at 17.Google Scholar
See Sharpe, supra note 3, at 25.Google Scholar
The “practical bioethicist” I will focus on is one who is hired either as a consultant or speaker by private companies because that is the type of practical bioethicist commentators have focused on to date. Bioethicicsts who are hired by non-profit institutions, or even news companies, would fit into my definition of “practical bioethicist,” but again, my focus will mirror that of previous commentators.Google Scholar
Although the role of accountants will be discussed in greater detail shortly, I believe this brief example will be illuminating here.Google Scholar
A general introduction to the fields of law and accounting, including how lawyers and accountants are meant to interact with their respective clients when there is no conflict of interest, can be found in the Appendix of this article. Specific issues concerning conflicts of interests in those fields will be discussed in greater detail throughout the text of this article when such discussion proves useful to the debate about conflicts of interests in bioethics.Google Scholar
107 H.R. 3763 (Jul. 30, 2002).Google Scholar
The debate about how “independent” the accountants actually were prior to the enactment of the Sarbanes-Oxley Act will be addressed later in this article.Google Scholar
See Boyce, supra note 7, at 17.Google Scholar
Youngner, S. J. and Arnold, R., “Who Will Watch the Watchers?” Hastings Center Report 32, no. 3 (2002): 2122, at 21 (quoting Thomson, D., “Understanding Financial Conflicts of Interest,” New England Journal of Medicine 329 [1993]: 573576).CrossRefGoogle Scholar
Whether bioethicists who are employed by biomedical companies full-time would make the same concession is unclear. However, since this type of bioethicist is in the significant minority, and the focus of this article is on those bioethicists who consult in the private sector while maintaining their positions in academia, I will not address this issue further.Google Scholar
Donaldson, T., “The Business Ethics of Bioethics Consulting,” Hastings Center Report 31, no. 2 (2002): 1214, at 13.CrossRefGoogle Scholar
Elliott, C., “Throwing a Bone to the Watchdog: Conflicts of Interest and Bioethics,” Hastings Center Report 31, no. 2 (2002): 912, at 9.CrossRefGoogle Scholar
See Sharpe, supra note 3, at 25 (citing Elliott, supra note 2); see also De Vries, R., “Businesses are Buying the Ethics They Want,” Washington Post, February 8, 2004, at B02 (“Today bioethicists are part of the landscape.”)Google Scholar
Despite what some critics have argued, bioethicists do not see themselves as “the arbiters of what is moral and ethical in health care.” Neuhaus, R. J., “The Public Square: The Best Bioethicists that Money Can Buy,” First Things, March 1, 2001, 7172, at 71 (quoting Smith, W. J., Culture of Death: The Assault on Medical Ethics in America [San Francisco: Encounter Books, 2000]). More importantly, the American public does not accept the opinions of bioethicists regarding what is right and wrong carte blanche. Rather, the public trusts bioethicists to highlight and clarify issues that arise in biomedicine. Bioethicists' opinions are insightful and therefore helpful, but are not accepted per se.Google Scholar
See Editorial, Probing the Ethics of the Bioethicists, supra note 9.Google Scholar
Callahan, D., “Doing Good and Doing Well,” Hastings Center Report 31, no. 2 (2001): 1921, at 20 (emphasis added).CrossRefGoogle Scholar
See Boyce, and Kaplan, supra note 7, at 19.Google Scholar
Personal communication from Arthur Caplan to author, October 6, 2003.Google Scholar
Green, R.M. et al., “Overseeing Research on Therapeutic Cloning,” Hastings Center Report 32, no. 3 (2002): 2733, at 29.CrossRefGoogle Scholar
Cohen, H., “Ethics on the Corporate Payroll,” The Scientist, July 22, 2002, at 44 (quoting Virginia Sharpe, Director of the Integrity in Science Project at the Center for Science in the Public Interest).Google Scholar
See Green, et al., supra note 29, at 29.Google Scholar
Id., at 32.Google Scholar
See Sharpe, supra note 3, at 25; Neuhaus, supra note 24 (quoting Smith, W. J., Culture of Death: The Assault on Medical Ethics in America [San Francisco: Encounter Books, 2000]).Google Scholar
See Editorial, Probing the Ethics of the Bioethicists, supra note 9.Google Scholar
See Elliott, supra note 2, at 17.Google Scholar
See Elliott, supra note 22, at 9.Google Scholar
See Callahan, supra note 26, at 20.CrossRefGoogle Scholar
See Donaldson, supra note 21, at 12.Google Scholar
See Boyce, and Kaplan, supra note 7, at 19.Google Scholar
See Brody, et al., supra note 1, at 15.Google Scholar
See Donaldson, supra note 21, at 12Google Scholar
See Elliott, supra note 2, at 17.Google Scholar
Id., at 17–18.Google Scholar
See Callahan, supra note 26, at 20.CrossRefGoogle Scholar
Bower, W., “A Perspective on Enron/Andersen, MDPS, and Professionalism,” Of Counsel 21, no. 10 (2002): at 6.Google Scholar
15 U.S.C. § 78j-1(i)(1)(B).Google Scholar
See Brody, et al., supra note 1, at 19.Google Scholar
See Green, et al., supra note 29, at 28.Google Scholar
See Brody, et al., supra note 1, at 18.Google Scholar
See Callahan, supra note 26, at 21.Google Scholar
See Elliott, supra note 2, at 20.Google Scholar
See Elliott, supra note 22, at 10.Google Scholar
I also think Laurie Zoloth has made an excellent argument that prestige associated with certain consulting relationships could create a conflict of interest. See Zoloth, L., “Seeing the Duties to All: Conflict of Interests in Bioethics,” Hastings Center Report 31, no. 2 (2001): 1519. However, due to space limitations, I am not able to address that issue in this article.CrossRefGoogle Scholar
See Boyce, supra note 7; Youngner, and Arnold, supra note 19; Elliott, supra note 2; Cohen, supra note 30, Sharpe, supra note 3.Google Scholar
The conflict or appearance thereof also raises concerns about client confidentiality, which will not be addressed in this article.Google Scholar