Wyeth, ‘Ghost-Writing’ and Conflict of Interest

Conflict of interest occurs in (roughly) any situation in which someone is expected to exercise judgment on behalf of others, but in which that judgment is liable to be biased by some “other” interest (often, but not always, a private financial interest). Is COI a worry because those “other” (often financial) interests always corrupt judgment? No. Absolutely not. Most people tasked with exercising judgment on behalf of others are persons of integrity. People often — perhaps usually — are able to put their personal interests aside and exercise judgment properly, when their role requires them to do so. No, the problem with COI is not that it always brings corruption. The problem is not that the person on whose behalf judgment is being exercised might not be served well (though that can certainly be an issue). The problem is that in situations involving COI, our faith is shaken — sometimes just our faith in the objectivity of a particular decision-maker, but more often, and more seriously, our trust in an entire institution.

For a great example of a company totally missing that point, see this story by Natasha Singer, writing for the NY Times: Medical Papers by Ghostwriters Pushed Therapy

Newly unveiled court documents show that ghostwriters paid by a pharmaceutical company played a major role in producing 26 scientific papers backing the use of hormone replacement therapy in women, suggesting that the level of hidden industry influence on medical literature is broader than previously known.

The articles, published in medical journals between 1998 and 2005, emphasized the benefits and de-emphasized the risks of taking hormones to protect against maladies like aging skin, heart disease and dementia. That supposed medical consensus benefited Wyeth, the pharmaceutical company that paid a medical communications firm to draft the papers, as sales of its hormone drugs, called Premarin and Prempro, soared to nearly $2 billion in 2001….

Here’s the part, from a Wyeth spokesperson, that demonstrates a complete misunderstanding of Conflict of Interest:

Doug Petkus, a spokesman for Wyeth, said the articles on hormone therapy were scientifically sound and subjected to rigorous review by outside experts on behalf of the medical journals that published them.

…which, of course, entirely misses the point. The point, the reason why critics decry the practice of ghost-writing, is not that we think the articles that result are necessarily inaccurate. They may (may) be fully scientifically sound. But who knows if they are? That’s the point. Ghostwriting corrupts the institution of scholarly publication upon which physicians rely to make the best decisions on behalf of their patients. It literally does not matter, even a little, if Wyeth is correct in claiming that the papers it paid to have ghost-written are 100% sound. They’ve cast doubt upon an entire body of medical literature, and on the scientific foundation of medicine itself. That is the point.

7 comments so far

  1. DarryleHuffman on

    After reading your post and doing some thinking about it it seems to me be question of academic honesty and honesty in general. The people may know how to write and say the proper wording then agian if they do not have the medical training they will not be able to catch the mistakes in writing the paper. Then a doctor reads it then he is he or she will be in court defending themselves in a malpractice case. That would be good healthcare reform bet the 1000 page bill does not have it anything to say about that issue.

  2. David Scott Cohen on

    I agree and I disagree. I am a social media copywriter and what some may call a ghostwriter. I’ve never written a medical study for a doctor, but I write blogs and updates for companies. It’s their voice, their brand and their message, but I’m putting it together. I’ve done this writing advertising, writing marketing brochures and now in the social media space. Is what I do so different? Should every ad come from the CEO? I don’t post under anyone’s name, just brands, so some might call it different, some wouldn’t. The point is, it’s no less real. My last post on my blog talks about the “voice” of the company. I’d love to hear what you think.

    A reader.
    David

  3. Chris MacDonald on

    David:

    Thanks for your comment.
    One important difference would be whether you are asked, in the writing you do, to summarize scientific/technical literature that’s outside of your expertise.
    The other is that university-based scientists are expected (perhaps simplistically) to be unbiased advocates of the public good, whereas words written by/for Ford are expected only to serve the interests of Ford.

    Chris.

  4. carolynthomas on

    David’s ‘social media’ ghostwriting is hardly in the same league as Wyeth’s stable of medical ghostwriters at the New Jersey firm of Design Ink, the people who actually wrote those 26 medical journal articles.

    Your physician reads those medical journals. We know that journals can and do change prescribing habits.

    As a heart attack survivor who now takes a fistfull of cardiac meds each morning, I have no clue which of these meds has been prescribed for me based on flawed scientific papers and tainted research reported in these journals – and neither do my doctors!

    This is not only unethical, it is downright dangerous to unsuspecting patients. Just ask the 8,400 women who have filed criminal charges against Wyeth after developing heart disease or breast cancer because their doctors prescribed Wyeth’s Premarin or Prempro.

    Carolyn Thomas
    http://www.ethicalnag.org

  5. IMAP - Medical Professionalism on

    There has been a lot of positive movement on this topic in recent months since the Times article was published. The Institute on Medicine as a Profession has updated their vast online academic medical center conflict of interest policy database to include the topic of ghostwriting. Many AMC’s have instituted strong policies against ghostwriting, just in the last few months.

  6. […] of Research Earlier today I posted, over at the Business Ethics Blog, an item called Wyeth, ‘Ghost-Writing’ and Conflict of Interest. It was based on this article by Natasha Singer, writing for the NY Times: Medical Papers by […]

  7. […] (I’ve blogged about some of those reasons here, here, here, here, here, here, here and here, just to cite a few examples. See also some of the entries on the other blog I co-author, the […]


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