Goozner: Inaction on Institutional Conflicts of Interest

Not only have less than two in five US medical schools implemented recommended policies governing institutional conflicts of interest, but those recommendations - from the US  Department of Health and Human Services - don't address conflicts on the Institutional Review Boards that offer ethical approval for research involving human subjects. And the IRBs are often not informed of conflicts of interest by the researchers seeking approvals of their protocols. That's the take-home message of a blog post by Merrill Goozner, who cites results from a survey released in the new issue of the Journal of the American Medical Association.

Does disclosure of conflicts of interest to members of an IRB -- whether they exist within the institution, the management of the institution, or within the IRB itself -- ensure that the trial under review adheres to the highest ethical standards? Isn't it possible that those conflicts will influence the review? And doesn't the mere presence on the IRB of someone with a stake in the outcome of that trial create the appearance that the conflict of interest may have influenced a decision?...

There is a solution, of course. Forget about "guidance." Congress could step in and pass a law that prohibits investigators or university officials with conflicts of interest from sitting on IRBs and requires NIH to collect conflict-of-interest disclosure data from grant recipients and post it on its grants database (it's known as the CRISP database). To enforce the law, NIH could cut off all federal grants to that institution if those policies aren't adopted by a date specified in the legislation.