I noticed that your book does not index the term “conflict of interest.” This seems to me to be an important consideration when examining the scientific and ethical decisions that determine whether or not a clinical research trial moves forward. A recent issue of the Journal of the American Medical Association (May 2, 2107) focused on issues of conflict of interest in medicine and research, but they seemed not to address issues you raised in “Lethal Decisions.” JAMA articles discussed conflict of interest that focused on payments and other benefits that might be given to physicians and researchers from pharmaceutical companies and other commercial healthcare related sources. One article pointed out that, “Meta-research studies have shown that financial conflicts of interest, including commercial research sponsorship, are associated with publication of research outcomes that favor the financial interest. The association between financial conflicts of interest and favorable outcomes has also been established for meta-analyses, systematic reviews, editorials, and letters to the editor. The influence of financial ties on research outcomes appears to be due to a variety of types of biases. For example, research agendas can be influenced by funding sources.” But the JAMA articles implied that the financial sources were primarily industry related.
I believe you are trying to say that concern about conflict of interest can result from financial gain, whether direct or indirect, and should be considered no matter the funding source―industry, government, USPHS, NIH, charitable organizations.
By B. Rush MD