I noticed that Dr. Alan Rubin’s recent Guest Post here at The Mine stirred up some heated discussion over conflict of interest (COI) — an issue that seems to lurk behind every corner in the business of health and medicine.
When is it OK to be sponsored by pharma company? And when is it OK to trash them, even as they produce the medicines and devices that keep us alive?
I’m no authority on this complex issue, but the way I see it, there’s a tricky dichotomy going on here: We patients (and doctors and CDEs, too?) have a love/hate relationship with the pharma industry. On the one hand, we depend on them and deeply appreciate their work. On the other hand, we sometimes view them as big, greedy conglomerates out to exploit us all. Unfortunately, a number of recent scandals back the latter view.
Nevertheless, I think we, the Diabetes Community, just have to accept that we are symbiotic with pharma. We need them as much as they need us, and vice versa.
So where do we draw the line when it comes to sponsorships, promotions, and such?
Personally, I think it’s OK to promote a book (like Dr. Rubin’s) that has something valuable to say — even if that something is about the overhype of other goods and services. With the flood of information and entertainment vying for everybody’s attention these days, how would we know about any good books without proper promotion?
The way I see it, there are basically three pretty obvious cardinal sins of COI:
1) Non-disclosure — it’s not OK to hide connections or agreements an individual or company may have with another. This is the big imperative we now call “transparency.”
2) Hypocrisy — also definitely not OK to falsely present yourself as righteous on certain topics, while playing the other side of the field as well. So if you’re going to be someone who shouts from the rooftops about the evils of Big Pharma, for example, then you should not be accepting sponsorships from same.
3) Exploitation — no inappropriate hype of something (or some group) where it doesn’t belong. No misleading people (patients) into buying things they don’t need or paying exorbitant prices for no good reason.
I haven’t told you anything new here. These rules apply to any industry, and in fact to credibility in general. It’s just that since diabetes is both a deadly disease and a billion-dollar industry, it’s inevitable that interests conflict. So it’s important for us all to keep a (constructively) critical eye peeled, I believe.