Debate: Should Medical Researchers Be Required To Disclose Personal Biases?
Medical journals have long required research study authors to reveal their financial interests, if any, in the subject of their research, as well as any other funding information. Now a recent JAMA article proposes expanding these rules to include other personal biases that may present less-obvious conflicts of interest. We asked Eric Meslin, Ph.D., director of the Indiana University School of Medicine's Center for Bioethics, to weigh in. Read on for an excerpt or click above to listen to the entire interview.
Rules for revealing financial conflict have gotten tighter in recent years.
"The rule has actually been tightening up and getting more clear over the last few years. We’ve been worried about principally physicians and others in medical institutions who might be receiving gifts or have investments in the companies they’ll be doing studies for. So the rules are now getting very clear about how much money you can earn, what kind of relationship you can have with a company carrying out a study, how your family is benefiting in any way, if you have shares or stock in a company that might be conducting a study. I can tell you that at every medical school in the United States there are requirements for all the faculty to disclose up front what kind of honoraria they’re receiving, what kinds of conferences they’re speaking at, if they’re paid consultants. So the rules are getting quite clear ... that’s not the issue. We have more rules now than we ever have. Now we have to figure out how to apply them to unique cases."
It's worth considering expanding disclosure rules to include non-financial personal biases in research topics.
"Therein lies the real issue. This line between a conflict of interest and that is a very legal and formal language. I have an interest in looking after patients. I also have an interest in making money from my investments. Those are pretty clear. But when I start to range into the area of my own medical information that might color my feelings about what I’m doing, that’s what I think Dr. Shaw [the author of the JAMA article] is referring to. The medical biases that he might have. So his point, which I think has some merit and is going to take some time for people to get their arms around, is whether [there's a problem in] him having a particular bias against, say, fluoride. Or maybe a bias in favor of a particular kind of medication and it’s bias because it has helped him. I myself have migraines. If somebody asked me if I would like to evaluate a study looking at migraines, I could imagine being interested in that. Not because I’m going to get paid for it, but I have more than just a passing scientific interest because I suffer from that disease. So what I think Dr. Shaw is doing is drawing attention to those subtle psychological factors that inform decision-making."
Individual researcher biases don't preclude good science.
"I don’t think it would be wrong for a person to participate in evaluating, assessing, and maybe even conducting a study when they have a bias. In fact the entire system of science is based on trying to eliminate those biases that individual researchers might have. That’s why we have double blind studies and that’s why we have other committees assessing things. What’s unique about this story is [it's asking] where do you draw the line?"