The medical profession contains five “spheres of morality”: clinical care, clinical research, scientific knowledge, population health, and the market. These distinct sets of normative commitments require physicians to act in different ways depending on the ends of the activity in question. For example, a physician-scientist emphasizes patients’ well-being in clinic, prioritizes the scientific method in lab, and seeks to maximize shareholder returns as a board member of a pharmaceutical firm. Physicians increasingly occupy multiple roles in healthcare and move between them (...) frequently, creating the possibility of conflict between the ethical obligations of their various roles. This paper examines the entire moral landscape of medicine through the lens of role morality. It develops a novel framework that helps physicians recognize how their moral commitments depend on the nature and context of the situation, clarifies ethical conflicts that physicians face, and concludes with ideas for resolving these conflicts. (shrink)

. The potential for financial conflicts of interest to influence scientific research has become a significant concern. Some commentators have suggested that the development of standardized study protocols could help to alleviate these problems. This paper identifies two problems with this solution: scientific research incorporates numerous methodological judgments that cannot be constrained by standardized protocols; and standardization can hide significant value judgments. These problems arise because of four weaknesses of standardized guidelines: incompleteness, limited applicability, selective ignorance, and ossification. Therefore, the (...) standardization of study designs should not serve as an alternative to addressing the interests and power relations that pervade science policy-making. Policy makers should take at least two steps to prevent powerful interest groups from co-opting standardized guidelines. First, their development and review should be made as transparent as possible and should be subjected to broadly-based deliberation. Second, standardized guidelines should be supplemented with efforts to scrutinize the conditions under which financial COIs tend to have the most worrisome effects so that additional steps can be taken to eliminate and mitigate those conditions. (shrink)

The potential for financial conflicts of interest (COIs) to damage the credibility of scientific research has become a significant social concern, especially in the wake of high-profile incidents involving the pharmaceutical, tobacco, fossil-fuel, and chemical industries. Scientists and policy makers have debated whether the presence of financial COIs should count as a reason for treating research with suspicion or whether research should instead be evaluated solely based on its scientific quality. This paper examines a recent proposal to develop criteria for (...) evaluating the credibility of research without considering its source of funding. It concludes that proposals of this sort are likely to be either ineffective or impractical in many cases. Nevertheless, this does not imply that all research funded by those with an interest in the outcome must be placed under a cloud of suspicion; there are conditions under which research is at much more serious risk of being corrupted than in other cases, and attention to these conditions can guide productive responses to financial COIs. (shrink)

Dependence in nanotechnology on external funding and academic-industry relationships has led to questions concerning its influence on research directions, as well as the potential for conflicts of interest to arise and impact scientific integrity and public trust. This study uses a survey of 193 nanotechnology industry and academic researchers to explore whether they share similar concerns. Although these concerns are not unique to nanotechnology, its emerging nature and the prominence of industry funding lend credence to understanding its researchers’ views, as (...) these researchers are shaping the norms and direction of the field. The results of the survey show general agreement that funding sources are influencing research directions in nanotechnology; many respondents saw this influence in their own work as well as other researchers’ work. Respondents also agreed that funding considerations were likely to influence whether researchers shared their results. Irrespective of their institutional affiliation or funding status, twice as many researchers as not considered financial conflicts of interest a cause for concern, and three times as many respondents as not disagreed financial conflicts of interest in nanotechnology were uncommon. Only a third was satisfied with the way that conflicts of interest are currently managed and believed current procedures would protect the integrity of nanotechnology research. The results also found differences in views depending on researchers’ institutional affiliation and funding status. (shrink)

Many scholars assume that industry meddles in scientific research in order to defend their products. But this article shows that industry meddling in science can have a variety of consequences. American food manufacturers long denied that trans fats were associated with disease. Academic scientists, government scientists, and activists in fact endorsed trans fats as a healthier alternative to saturated fats. But in 1990, a high-profile study showed that trans fats increased risk factors for heart disease more than saturated fats did. (...) Industry funded a U.S. Department of Agriculture study that they hoped would exonerate trans fats. But the industry-funded U.S. Department of Agriculture study also indicated that trans fats increased risk factors for heart disease more than saturated fats. Industry quickly began developing trans fat alternatives. This confirms that corporations get involved in science in order to defend their products. But involvement in science can be the very means by which corporations persuade themselves to change their products. (shrink)

Empirical research has proven the influence exerted by the medical industry on physicians’ decision-making. Physicians are the gatekeepers who determine how money is spent within the healthcare system. Hence, they are the target group of powerful lobbies in the field, i.e. the manufacturers of medical devices and the pharmaceutical industry. As clinical research lies in the hands of physicians, they play an exclusive and central role in launching new medical products. There are many ethical problems involved here: physicians may develop (...) a mindset of entitlement; biased decisions may put patients at risk; academic interests and research activities will no longer be free if they are influenced considerably by financial incentives; fair resource allocation may be restricted. An aspect that has been neglected so far is the administrators’ involvement as they not rarely expect physicians to acquire external financial resources from industry as benefits often lie with the institutions. To “protect” physicians from undue sway may be in the best interest of patients in order to guarantee a fair allocation of resources and to prevent the application of technologies (and medications) that would not have been used according to current standards of care. The latter may and obviously does put patients at risk. On the other hand, medico–industrial relations are of great importance. A considerable part of medical progress is driven by private industry. Yet, any co-operation between those who care for patients and industry ultimately has to serve the patient. Hence, strong policies to guide conduct are sorely needed. The following points are held to be pivotal in order to secure ethical conduct: (1) professional codes of ethics; (2) a stronger academic attitude amongst medical staff, (3) rules of transparency for medico−industrial relations including online disclosure and limiting scale of payments, (4) establishing rules (and laws) that ban unethical conduct and mandate vigorous surveillance of adherence to guidelines. (shrink)

Obesity is the definitive epidemic of the modern era in the United States. Its well-documented public health impacts, especially related to children and adolescents, are horrific. Nearly one-third of American minors are overweight; over 50% of them are obese. Already, these kids suffer from multiple adverse physical and mental health conditions. Sadly, absent serious communal and individual interventions, their lives may be cut short compared to their own parents’ life expectancy. While recent surveillance suggests childhood obesity may be trending down (...) slightly in some populations, public health experts remain concerned about the threat obesity poses to the health of America's youth.The concurrent travesty underlying childhood obesity is the relative societal failure to slow and reverse its spread. (shrink)

The trustworthiness of nutrition science has been questioned recently. According to the critics, the food industry has corrupted scientists in the field. I argue that the worries that commercialization threatens the epistemic trustworthiness of nutrition science are indeed well-founded. However, it is problematic that the discussion has revolved around how funding can threaten the integrity of researchers and the methodological quality of the studies. By extending Wilholt’s :233–253, 2013) account of epistemic trustworthiness, I argue that when assessing the epistemic trustworthiness (...) of research that forms the basis for different health policy measures, it is necessary to evaluate research at the macro-level and whether agenda setting advances the goals that are assigned to the field. The prevalence of commercial funding becomes problematic if it leads to a situation where the body of available evidence that is used for making health policy decisions does not reflect the shared sense of what epistemic and non-epistemic goals of the inquiry are important. (shrink)

This study investigates the level of awareness about funding influences and potential conflicts of interests among early career researchers. The sample for this study included users of one or more of the 14 U.S. laboratories associated with the National Nanotechnology Infrastructure Network. To be eligible, respondents must have been either still completing graduate work or <5 years since graduation. In total, 713 early career researchers completed the web survey, with about half still in graduate school. Results indicate that although respondents (...) were aware of potential funding and COI influences on their work, they remained largely ignorant of their role in addressing or managing these issues. Respondents often attributed the responsibility of addressing these issues to their supervisors. Respondents who had received some training around these issues, however, were more likely to assume more personal responsibility. Overall, this study points out that ignorance among early career researchers is less about awareness of funding and COI issues and more about taking personal responsibility for addressing these issues. (shrink)

With dwindling support from governments toward universities, university–industry partnerships have increased. Ethical concerns over such partnerships have been documented, are particularly relevant when an institution receives money from a corporation whose products do harm and are intensified for academic public health institutions whose missions include promoting well-being. Academics in medicine and nutrition have often failed to recognize the potential conflicts of industry-sponsored research. It is unclear if research to date has explored attitudes of public health academics toward accepting such funds. (...) The objective of this research was to review systematically the attitudes of public health academics with respect to accepting funds from for-profit corporations. Four electronic databases were searched as well as the archives of the Chronicles of Higher Education. The search strategy was based on four main domains: for-profit organizations, funding, public health and academia. This search resulted in a total of 4017 articles reviewed. No articles were found that investigated the attitudes of public health academics toward accepting funds from industry. The lack of articles addressing public health academicians’ perspective toward accepting industry funds is striking. Research regarding this topic can guide development of policies that minimize the negative consequences of industry funding. (shrink)

In Western societies scientists are increasingly expected to seek media exposure and cooperate with industry. Little attention has been given to the way such expectations affect the role of scientific experts in society. To investigate scientists’ own perspectives on these issues eight exploratory, in-depth interviews were conducted in Denmark with reputable nutrition scientists. Additionally, eight interviews were held with ‘key informants’ from the field of nutrition policy. It was found that nutrition scientists experience two dilemmas: first, between their aspiration to (...) make a collective impact on public health and the powerful incentives of each to appear frequently in the media with new messages; second, between their need to cooperate with the food industry for financial reasons and their fear that this may compromise their independence and scientific integrity. It is argued that the dilemmas identified in this study should be dealt with openly by the relevant groups of scientists. (shrink)