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Bioethicists and big bucks

And now, ethics for sale?
Bioethicists and big bucks. Problem city?
By Nell Boyce
http://www.usnews.com/usnews/issue/010730/usnews/bioethics.htm

Glenn McGee sees himself as a whistle-blower. Last October, the researcher at the University of Pennsylvania's Center for Bioethics in Philadelphia quit his job on an ethics advisory board at Advanced Cell Technology in Worcester, Mass., after learning that the company was cloning endangered animals. "There has been no systematic effort by the company to keep its ethics advisory board informed," McGee wrote in his resignation letter. Last week, after making his letter public and branding the board mere window dressing, he put it more bluntly. "I was," he says, "clearly being used."

Other board members disagree. Dartmouth Prof. Ronald Green, chair of the ethics panel, says the committee was convened to consider a plan to extract stem cells from cloned human embryos, not animal work. The company, Green adds, listens to the panel's advice. But the flap signals a dilemma for today's legions of bioethicists: How honest can they be if they're being paid for their opinions?

Rewards have risks.

While President Bush ponders the wisdom of backing research on embryonic stem cells and Congress contemplates cloning bans, biotech companies are increasingly asking bioethicists to serve on boards or as paid consultants. Their mission: to weigh in objectively on the companies' most controversial work. In recent years, the biomedical industry has given at least $2 million to bioethics centers and offered lucrative contracts to academic researchers to study ethical issues in the field. In a few cases, firms have allegedly even offered bioethicists stock options. Consulting fees range from $200 per diems like Green received to contracts worth tens of thousands of dollars. Companies have long tempted scientists and physicians with sweet rewards. But for bioethicists, it's something new, and the potential risks cut to the profession's quick.

As science poses increasingly complex moral and ethical quandaries, bioethicists are finding, sometimes to their horror, that policymakers and the public view them as "secular priests." Their pronouncements carry serious weight and often an assumption of impartiality. They're quoted almost daily in the media, testify before Congress, and advise the president. It's an odd development for a profession that has no formal education or licensing requirements. A "bioethicist" can be a lawyer, a philosopher, an anthropologist, a physician anyone who cares to hang out a shingle.

In the spring, a major bioethics journal, the Hastings Center Report, announced that it would require contributors to disclose their financial ties, and the American Society for Bioethics and the Humanities now has a task force investigating the ethics of money and bioethics. Some bioethicists recoil from the idea of taking any corporate money.

"Personally, it seems too much like bribery. If it's not bribery, it becomes the perception of bribery," says Carl Elliott of the University of Minnesota's Center for Bioethics in Minneapolis.

Others see no conflict.

The University of Pennsylvania's Center for Bioethics, for instance, has accepted money from a company called deCODE genetics to assess ethical issues involved in the company's genetic research in Iceland. The center is also doing a study on genetically modified organisms that is partly funded by DuPont and Monsanto. Center director Arthur Caplan says researchers have complete freedom. Indeed, findings critical of deCODE's work will appear in a soon-to-be-published article, according to researchers at the center.

Caplan believes that conflicts of interest in bioethics can be managed, in the same way that newspapers can remain balanced while taking advertising dollars, and that the main problem with corporate money in bioethics is that there's not enough of it. He funnels his consulting fees from companies like Pfizer, DuPont, and Celera into his center and is amazed by his colleagues who think that bioethicists should do pro bono work for wealthy biomedical companies. Caplan also thinks they ignore the real benefits, to both industry and academia, that come when bioethicists interact with scientists at private companies where much of the most controversial, cutting-edge science gets done.

Double damned?

Critics and supporters say bioethicists lend companies an air of credibility. The question is: Can they really be objective if they're on a company's payroll? Supporters say yes, that they are in effect like newspaper ombudsmen, who get paid by the paper to criticize coverage and prevent potential conflicts. They point to  bioethicists' contributions, such as better informed-consent forms for patients. But detractors say there's no way around at least the appearance of a conflict of interest if money's changing hands. "I certainly have felt that I'm damned if I do, damned if I don't in regard to the ethics advisory board issue," says Michael West, head of Advanced Cell Technology. "We genuinely value their help."

The danger is that bioethicists' participation may be interpreted as a stamp of approval. Moreover, the public should not assume that they bring special professional expertise on the morality of medical issues, contends Erik Parens, a philosopher at the Hastings Center. "The only thing a bioethicist can do is facilitate the debate and help people ask questions."

Even unrestricted gifts are drawing fire.

Barbara Koenig of Stanford University recently searched her soul before her bioethics center accepted nearly $1 million from pharmaceutical  giant SmithKline Beecham. "I called colleagues all over the country to get advice," she says. Critics note that companies obviously won't fund centers that they believe will oppose their interests. Eli Lilly, for example, gave an annual $25,000 gift to the Hastings Center but stopped last year after the center's journal published articles critical of Lilly's drug Prozac. Some bioethicists further warn that taking corporate money could result in subtle shifts in what ethical questions their profession considers important to debate. "There's a risk that this kind of funding could reduce the critical edge of the field," says Green. "That's a real concern and a real risk."

With David E. Kaplan