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Bioethic$ Inc.

by Leigh TurnerNature Biotechnology
July 31st, 2004

By now, everyone knows the claims used to argue that bioethicists should accept consulting opportunities and research funding from pharmaceutical and biotech corporations. Proponents of corporate-sponsored bioethics commonly develop variations on three themes.

First, we live in a capitalist economy and bioethicists have the right to seek remuneration for their services. Bioethicists should not be expected to provide pro bono work for corporations; instead, bioethicists ought to be able to offer their professional services as consultants to industry. Bioethicists can promote ethical corporate practices and protect corporate interests by identifying moral concerns related to such topics as embryonic stem cell research and genetically modified crops. For many biotech and pharmaceutical corporations, the use of bioethicists fits within a larger program of risk analysis and risk management1.

Second, bioethicists need to work with different 'stakeholders,' leave their 'ivory towers' and address the moral ambiguities of the marketplace. To understand the complex ethical, legal and social issues facing company executives, corporate compliance officers and industry scientists, ethicists need to visit the boardroom2. Advanced Cell Technology (Worcester, MA, USA), Ardais (Lexington, MA, USA) and several other corporations have established bioethics advisory boards. Numerous bioethicists act as corporate consultants to biotech companies. In this capacity, they accept consulting fees, honoraria, research grants and other corporate perks. The establishment of ties between corporations and bioethicists is not limited to a few entrepreneurial bioethicists. The University of Pennsylvania Center for Bioethics (Philadelphia), the Stanford Center for Biomedical Ethics, the Phoebe R. Berman Bioethics Institute at Johns Hopkins University (Baltimore, MD), The Hastings Center (Garison, NY), the Center for Practical Bioethics, the University of Toronto Joint Center for Bioethics and the Centre de Recherche en Droit Public at the University of Montreal all accept funding from corporate sponsors3.

Third, in an era when competition for government funding of academic research is growing increasingly intense, corporate funding provides a resource for building bioethics programs and educational initiatives. Here, the argument is that bioethicists and bioethics centers need corporate funding to survive. Decreases in government funding of academic research, or increased competition for available funds, serves as the basis for an argument on behalf of the necessity of accepting corporate support.

The language of debate and argumentation suggests that bioethicists are carefully weighing the consequences of cultivating close ties to industry. However, many bioethicists seem to have overcome their initial reservations and now welcome a close relationship with the corporate sector. Potential conflicts of interest are to be addressed through disclosure policies and institutional firewalls4. Disclosure guidelines will ostensibly address all concerns about hidden agendas or partisan interests.

However, should bioethicists so eagerly seek corporate funding? Are there any reasons why we might want to discourage stronger ties between bioethicists and the biotech and pharmaceutical industry?

Carl Elliott is perhaps the most outspoken critic of the entrepreneurial turn in bioethics5. He argues that the bioethics watchdog is quickly becoming the corporate show dog6. Elliott raises legitimate concerns about the dangers of bioethics being 'captured' by corporate interests. Close ties between bioethicists and industry have several deeply problematic consequences.

First, they help whitewash the reputation of corporations by letting companies promote ethics advisory bodies and ethics programs in advertising and promotional brochures. Ethics consulting promotes the façade of responsible corporate policies while often doing little to improve corporate practices. Though bioethicists like to tout their contribution to improving corporate social responsibility, there is little evidence that bioethics consultants and bioethics advisory boards play a meaningful role in improving corporate practices.

Second, accepting corporate funds places bioethicists in the pockets of the very industries they claim to critique. The consequence, Elliott suggests, is that criticism is muted or tempered by the recognition that bioethicists depend on the corporations they propose to advise or regulate. In effect, corporations respond to social criticism by buying their critics. The phenomenon, sometimes described as 'regulatory capture,' suggests a process whereby outspoken social critics and regulators are harnessed by the industries they attempt to constrain. Bioethicists receive financial perks and institutional support in return for tempering their critiques, and corporations placate the parties that might otherwise seek to constrain or block their economic objectives.

Third, taking corporate funds generates intractable conflicts of interest. Bioethicists risk appearing mere toadies of the corporations they propose to advise and regulate. The increasingly prevalent practice of accepting funding from the corporate sector generates an outcome whereby bioethicists come to be perceived as corporate shills who will use their 'arms-length' relationship to promote corporate objectives. Many citizens have no idea that the bioethicists seemingly offering 'independent' analysis in The New York Times are receiving research funds and salary support from the very industry about whom they purport to provide 'unbiased' commentary.

Stockholders were astonished to discover that stock analysts often held financial stakes in the stocks they promoted. Similarly, citizens might well be amazed to learn that bioethicists providing social commentary on the biotech and pharmaceutical industry sometimes benefit from close financial ties to the very corporations whose research they publicly debate.

Bioethicists increasingly seem to be more interested in discussing how to forge links with corporations than in confronting whether bioethicists should have such close ties to industry. And yet, the current move toward corporate consulting and obtaining research contracts represents a major transformation in the ethos of bioethics. Born in the social turbulence of the late 1960s and early 1970s, bioethics has its roots in social critique. Some of the earliest work in bioethics addressed the need to reform psychiatric hospitals and other medical facilities, the patient-physician relationship and the conduct of biomedical research. Early bioethicists prided themselves on maintaining a critical distance from commercial forces and the powerful economic interests of the 'medical-industrial complex.' Now, 30 years later, the independence and integrity of bioethics is in question, and bioethicists risk being perceived as corporate pawns whose social commentary is compromised by their corporate ties7. The constant shape shifting among the roles of regulator, advisor, educator, consultant, watchdog and employee raises difficult questions about the very identity and purpose of bioethics. If bioethicists are incapable of maintaining financial and intellectual independence from the drug industry, what purpose will their social commentary serve?

Regrettably, few bioethicists are giving much thought to the transformation of their field. Elliott's depiction of bioethics as lapdog is perhaps too generous a characterization. More porcine imagery is needed to convey the rush toward corporate consultation, research contracts and advisory gigs.

REFERENCES

1. Arakelian, C. Drug Discovery Today 8, 386–388 (2003).
2. Magnus, D. Drug Discovery Today 7, 385–387 (2002).
3. Elliott, C. Hastings Center Report 31, 9–12 (2001).
4. Brody, B. et al. Hastings Center Report 32, 14–20 (2002).
5. Elliott, C. London Review of Books 24, 36–37 (2002).
6. Elliott, C. The American Prospect 12, 17 (2001).
7. Youngner, S. & Arnold, R. Hastings Center Report 32, 21–22 (2002).



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