The Moral Education of Journal Editors
Krimsky, Sheldon, Academe
Most scientific and medical journals now have conflict-of-interest policies in place, but disclosure alone does not ensure scientific integrity.
Refereed journals in science and medicine are the gatekeepers and repositories of knowledge in their respective fields. Research reported in peer-reviewed journals builds professional careers, determines which drugs and medical devices are licensed, influences what medical treatments become standards of care, and establishes the veracity of scientific theories. Maintaining the reliability, integrity, and objectivity of journal content is paramount, particularly in an era of increasingly common university-industry partnerships. Journal editors have become attentive to the need to preserve the credibility of their publications to colleagues within their disciplines and to the general public.
These relatively new university-industry partnerships, largely fostered by federal policies put in place in the early 1980s, have required government funding agencies and journal editors alike to rethink how to ensure publication integrity. Yet despite the best efforts of editors to set standards of research integrity, the escalation in conflicts of interest in academic science and medicine that has occurred over the past three decades has cast a shadow over many publications.
Stories of multivested scientists and physicians abound in the media. The details vary, but they follow a common pattern: An article written by authors from top-ranked medical schools is published in a prestigious medical journal describing a clinical trial that supports the efficacy or safety of a drug formulation. Major media outlets report the results as a promising potential drug therapy. A short time after the first wave of media reports occurs, an investigative reporter publishes a story disclosing that one of the study's co-authors holds an equity interest in a company poised to benefit from the study. Based on the author's conflict of interest, questions are raised about whether the public can trust the study's results. Because a journalist (rather than the journal editor or the authors themselves) exposed the conflictual relationship, the level of mistrust increases.
Disclosure of Conflicts of Interest
Before the mid-1980s, the only disclosures found in scientific or medical journals were related to the direct sources of funding for a study. Such conflicts as speakers' fees, positions on advisory boards, royalties, stock ownership, and equipment donation were not subject to disclosure. That changed in 1984, when the New England Journal of Medicine's editor-in-chief, Arnold Relman, announced to his readers in an editorial titled "Dealing with Conflict of Interest" that the journal was adopting a conflict-of-interest policy for authors. Relman wrote, "Now, it is not only possible for medical investigators to have their research subsidized by businesses whose products they are studying, or act as paid consultants for them, but they are sometimes also principals in the businesses or hold equity interest in them."
A year after the New England Journal of Medicine changed its policy, JAMA established similar disclosure rules. These decisions set new standards for author disclosure in journal publication, and by the mid-1990s, many other journals had followed as editors began to understand the potential effects of conflicts of interest on their publications' integrity.
By passing legislation like the Bayh-Dole and the Stevenson- Wydler Technology Innovation Acts of 1980, enacted to make America more competitive in cutting-edge technology, Congress encouraged new forms of cooperation among industry, government, and academia. However, the now-defunct Office of Technology Assessment acknowledged in its 1988 report "New Developments in Biotechnology" that "it is possible that the university-industry relationships could adversely affect the academic environment of universities by inhibiting free exchange of scientific information, undermining interdepartmental cooperation, creating conflict among peers, or delaying or impeding publications of research results. …