Voice of Experience advances the tradition of service of the Journal of Research Administration by fostering consideration of and reflection upon contemporary issues and concerns in research administration. VOE is a celebrated feature column in each edition of the Journal. In this issue, J. Michael Slocum, Journal of Research Administration Intellectual Property Counsel, presents a review of recent literature concerning conflict of interest as one of the key standards in research ethics. This is discussed in light of the relationship between physician and patient and what that means for informed consent.
Introduction: Rules and Policies, or Ethical Culture
"The forbearing use of power does not only form a touchstone; but the manner in which an individual enjoys certain advantages over others is a test of a true gentleman. The power which the strong have over the weak, the magistrate over the employed, the educated over the unlettered, the experienced over the confiding, even the clever over the silly; the forbearing and inoffensive use of all this power and authority, or the total abstinence from it, when the case admits it, will show the gentleman in aphin light. "
- General Robert E. Lee (As in Bradford, p.233)
The looming advent of the deadline for revised conflicts of interest regulations imposed by the National Institutes of Health (42 CFR Part 50 & 45 CFR Part 94) has made me muse on the continued emphasis on new policies, procedures and rules to be developed by research institutions. It seems to me (and many other commentators) that policies and rules concentrating on disclosure are too often seen as the panacea for the ethical and legal problems that arise from such conflicts. As Regan has said, there is not an "appreciation mat even if an organization has adopted elaborate rules and policies designed to ensure legal compliance and ethical behavior; those pronouncements will be ineffective if other norms and incentives promote contrary conduct" (Regan, p. 942). Regan further states:
Responding to the call for creating and sustaining an ethical culture in organizations requires appreciating the subtle ways in which various characteristics of an organization may work in tandem or at cross-purposes in shaping behavior. The idea is to identify the influences likely to be most important, analyze how people are apt to respond to them, and revise them if necessary so that they create the right kinds of incentives when individuals are deciding how to act. (Page, p. 942)
We See What We Want to See
This daunting task is complicated by basic facts of the human psyche and the nature of organizational behavior. Many others have recently made the point that we are often good at seeing the mote that is in another's eye, but not the beam that is in our own (Regan, Young, Page, Gospel of Matthew 7:3). These make the point (with citation to overwhelming scientific proof in the case of the more recent writers, if the simple observation in the Bible was not enough) that it is often easy to see how others may be biased. They also document, again with many citations, that it is much harder to recognize one's own biases.
As Page says, "The simple fact is most of us believe that we are capable and impartial decision-makers . . . Not only are we capable and impartial, we are more capable and impartial than others. . . . Ethical decisions are biased by a stubborn view of oneself as moral, competent, and deserving, and thus, not susceptible to conflicts of interest. To the self, a view of morality ensures that the decision maker resists temptations for unfair gain [and] a view of competence ensures that the decision maker qualifies for the role at hand ..." (Page, pp. 278-279)
This inability to see one's own biases extends to organizations and not just individuals. The cognitive processes and behavioral economics that underscore many of our individual tendencies are intensified in the organizational setting. …