Angell, Corruption and Medical Research

The former editor in chief of the New England Journal of Medicine weighed in on the “smell of corruption” in medical research earlier this year in a piece that has some implications for the California stem cell agency.

Writing in the New York Review of books on Jan. 15, Marcia Angell(see photo), now a senior lecturer at the Harvard Medical School, said,

“After much unfavorable publicity, medical schools and professional organizations are beginning to talk about controlling conflicts of interest, but so far the response has been tepid. They consistently refer to ´potential´ conflicts of interest, as though that were different from the real thing, and about disclosing and ´managing´ them, not about prohibiting them. In short, there seems to be a desire to eliminate the smell of corruption, while keeping the money. Breaking the dependence of the medical profession on the pharmaceutical industry will take more than appointing committees and other gestures. It will take a sharp break from an extremely lucrative pattern of behavior. But if the medical profession does not put an end to this corruption voluntarily, it will lose the confidence of the public, and the government (not just Senator Grassley) will step in and impose regulation. No one in medicine wants that.”

That was Angell´s conclusion after a lengthy exploration of the links between drug companies and researchers. As for CIRM, it has a raft of issues involving conflicts of interest and is now on a course that will link it ever closer to industry.

The question is whether the state agency will become the handmaiden of biotech – in effect captured by the industry. The agency should and must work with industry. But business has much different primary objectives than any state agency. Profits must come first for any business. Otherwise, they will cease to exist. In the case of CIRM, its first responsibility is to the people of California. And as we are now seeing on the national scene, the paramount interests of business have not necessarily served the people well.

Angell´s article is a well-documented look at how the people who pay the piper call the tunes. It is well worth reading along with a Feb. 26 exchange in the letters column with some of the folks identified in her piece.

(Editor´s note: We came across the Angell piece in an odd fashion. We discovered it in a pile of old boating magazines, romance novels and mystery potboilers at an informal book exchange for sailors in Mazatlan. Her article is certainly not the regular sort of reading for most of the salty dogs of the sea.)