By Peter Montague
As government has been "downsized" in recent years, corporations have found opportunities to fund scientific research and education that the government used to fund. Will this give corporations the chance to influence scientific and medical opinions? Are scientific and medical experts able to take corporate money without subtly altering their scientific and medical views?
An article in the New England Journal of Medicine (January 8, 1998) — the first research of its kind — shows pretty clearly that scientific and medical experts who take corporate money hold opinions that differ significantly from experts who don't take corporate money.
Researchers in Toronto examined a medical controversy to see which scientists held what sorts of views. The controversy they studied was the use of calcium channel blockers, which are used to treat high blood pressure and heart disease.
In 1995 the National Heart, Lung and Blood Institute warned doctors that one such channel blocker increased the risk of heart attack deaths. Other channel blockers fell under suspicion of being dangerous.
The Toronto researchers examined 70 articles on channel blockers, classified the authors into three categories (supporters, neutral and critical), then mailed surveys to the authors, asking about their financial ties to drug corporations. Of 86 authors, 71 returned the surveys. The surveys were intended to answer three questions:
1) Were supporters of calcium channel blockers were more likely than other authors to have financial ties to manufacturers of calcium channel blockers? The answer was yes. Ninety-six per cent of the supportive authors had financial relationships with manufacturers, compared with 60% of the neutral authors and 37% of the critical authors.
2) Were critics of channel blockers more likely than other authors to have financial ties to manufacturers of competing products? The answer was no. In fact, supportive and neutral authors were more likely than critical authors to have financial ties to manufacturers of competing products (88% and 53% respectively, against 37%).
3) Were supporters of calcium channel blockers more likely than other authors to have financial ties with any pharmaceutical manufacturers? The answer was yes. One hundred per cent of the supportive authors, compared with 67% of the neutral authors and 43% of the critical authors, had financial ties to at least one pharmaceutical manufacturer.
Financial ties are defined as any of these five: funds for travel expenses; honorariums for speeches; support for educational programs; research grants; and employment or consulting compensation.
The authors noted that in only two of the 70 articles did authors divulge their connections to corporations.
Even the columns of the most prestigious medical journal in the US — the New England Journal of Medicine — have been infiltrated by corporate shills posing as objective medical experts.
Last November 20, the NEJM printed a scathing review of Sandra Steingraber's book, Living Downstream: An Ecologist Looks at Cancer — a book that, in our opinion, outshines Rachel Carson's Silent Spring. The review was signed "Jerry H. Berke, M.D., M.P.H., 49 Windsor Ave., Acton, MA 01720" — just the way any unaffiliated medical practitioner would sign such a review.
Berke's review began with an attack on all environmentalists: "An older colleague of mine once suggested that the work product of an environmentalist is controversy. Fear and the threat of unseen, unchosen hazards enhance fund-raising for environmental political organizations and fund environmental research, he suggested."
Berke's review went on to say that Steingraber's book is "biased" and "obsessed with environmental pollution". Berke ends, "The objective of Living Downstream appears ultimately to be controversy".
This was the first negative review Steingraber's book received. The book is now in its second printing and has been widely praised.
In early December, Bill Ravanesi, a Boston-based film producer, and Paul Brodeur, the well-known author of books on asbestos and electromagnetic radiation, revealed that Jerry H. Berke is director of toxicology for W.R. Grace, one of the world's largest chemical manufacturers and a notorious polluter.
Grace is best known as the company that polluted the drinking water of the town of Woburn, Massachusetts, and later paid $8 million to a group of children (or their surviving parents) who contracted leukaemia.
For its part, the NEJM seems flustered and unable to get its story straight. In an interview, Sandra Steingraber said that when she first phoned the office of NEJM's book review editor, Robert S. Schwartz, Schwartz's assistant, Lisa Lum, denied that Berke was currently employed by Grace. Lum told Steingraber that Berke was an independent consultant.
When Steingraber phoned back and spoke to Dr Schwartz himself, Schwartz insisted that he did not know that Berke worked for Grace. Schwartz told Steingraber that reviewers must fill out statements saying they have no conflict of interest, but NEJM does no "background checks".
Schwartz told Steingraber that reviewers are selected from a database of people who have expressed an interest in writing book reviews for NEJM. Lisa Lum told me that the database does contain the affiliations of potential reviewers. How, then, did they miss Berke's affiliation? Ms Lum would not say.
According to Steingraber, recently NEJM has changed its story once again, saying they knew Berke was affiliated with W.R. Grace, but thought W.R. Grace was a hospital.
Jerry Berke told Michele Landsberg, a columnist for the Toronto Star, that (1) the conflict-of-interest form he signed for NEJM clearly identified his Grace connection; (2) all his correspondence from Schwartz was addressed to him at W.R. Grace. Furthermore, Berke was identified as a Grace employee in another book review he published in NEJM in 1995.
Berke says Grace officials decided at the last minute to make him remove his affiliation from the review. However, having admitted that his superiors made him remove Grace's name to avoid obvious controversy, Berke still insists he had no conflict of interest.
The editor-in-chief of NEJM, Jerome P. Kassirer, told the Associated Press, "It's laughable that Berke would think that he could write an objective review of the book given that he was an employee of W.R. Grace".
Unfortunately, Kassirer himself doesn't always recognise a conflict of interest when he sees one. In late 1997, Kassirer turned over the editorial columns of NEJM to Stephen Safe, a researcher who during 1997 was receiving $150,000 (20% of Safe's research budget) from the Chemical Manufacturers Association (CMA).
Safe's editorial — like Jerry Berke's review — began with an irrational attack against environmentalism: "Chemophobia, the unreasonable fear of chemicals, is a common public reaction to scientific or media reports suggesting that exposure to various environmental contaminants may pose a threat to health".
Surely this is an odd message from a scientist. He is saying, if you fear chemicals because scientific reports indicate that they might harm your health, you are suffering from an irrational phobia. Perhaps Dr Safe did not write the editorial in his capacity as a scientist. Perhaps he wrote it as an acolyte of the CMA.
Safe himself told Boston Globe reporter Larry Tye, "I felt a little twinge" about the potential for a conflict of interest when writing the editorial, "but it was not much of a twinge". However, "I can see why people would bring it up", he said.
Safe defended himself by saying, "There's hardly any life scientist in the country who hasn't had funding from the industry" — the "Everybody's doing it" defence.
Unfortunately, just about everybody is doing it. In modern times, it pays to be alert when you are receiving opinions from "unbiased" scientific and medical investigators.
As George Annas, professor of health law at the Boston University School of Public Health, points out, "Almost all experts in the field at some point have taken grant money or an honorarium from someone". If you want to understand "objectivity" in the science and medicine of environment and health these days, the same advice applies as it does in politics: follow the money.
[From Rachel's Environment & Health Weekly. Like 91×ÔÅÄÂÛ̳ Weekly, Rachel's is a non-profit publication which distributes information without charge on the internet and depends on the generosity of readers to survive. If you are able to help keep this valuable resource in existence, send your contribution to Environmental Research Foundation, PO Box 5036, Annapolis, Maryland 21403-7036, USA. In the United States, donations to ERF are tax deductible.]