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No Conflict, No Interest - March 4, 2005

Crossroads Archive

Dr. Bill Brody, President, Johns Hopkins University

Former Hopkins faculty member Elias Zerhouni has his hands full at the National Institutes of Health (NIH) trying to manage a conflict-of-interest scandal that arose from decisions made long before he assumed his role as director. Faced with disclosures that NIH scientists and administrators were receiving payments from the private sector for consulting, honoraria for speeches, and cash prizes for awards, Zerhouni put together a blue-ribbon panel chaired by Hopkins trustee and former Lockheed-Martin CEO Norman Augustine that recommended adopting a policy not unlike those in place at leading universities.

Continuing stories, especially in the Los Angeles Times, about serious conflicts of interest involving NIH members drove the federal government to go beyond the Augustine Commission recommendations and adopt more severe restrictions, leading to a cloistering of NIH scientists and administrators within the confines of their government duties and compensation. Now, I read that NIH scientists are threatening to rebel against these more draconian measures.

This issue, I should add, will not stop at the gates of the NIH. A number of people in Congress and the media are calling for the adoption of similar restrictions for anyone who is the recipient of NIH grants. Conflict of interest is a battle between maintaining our pristine “trusted agent” status for society and the pressures to move discovery from the bench to the marketplace. There are many issues involved, among them:

Protecting the integrity of scientific research

Making sure that technology developments and scientific discoveries move quickly from the university to industry

Making sure that student training is not subverted to the priorities of outside corporations

Ensuring open communication among physicians and scientists, unencumbered by consulting arrangements

Assuring the reputational integrity of the university

Maintaining the dedication of the faculty to the aims of the university

There are no easy answers to these challenges. We have debated them in the past and developed guidelines that have for the most part served Hopkins well. Whenever conflict-of-interest issues arise, rarely do both sides get heard. The media and general public tend to gravitate toward the belief that the “negative” pressures of outside financial interests will trump any other societal gains that might accrue from university/industry collaborations, whatever their form.

In my mind, conflict of interest begins the day a scientist has an idea. Even receiving NIH grant support drives a certain mode of behavior that could conflict the objectivity of that scientist. And licensing the idea to outside interests adds additional conflicts. A surgeon who develops a new clinical procedure will want to pursue the development of that procedure—which means conflict, hopefully positive—even without the involvement of an outside company. If she invents a surgical device that enables the operation and licenses that technology to an outside company, the conflict becomes more apparent, even though the conflict was no less real before any agreement was signed. But it is probably impossible to erect a firewall between the scientist and the supposed source of conflict. I know of few surgeons who would use a device invented by someone else if that colleague, even for reasons of conflict of interest, did not use that device herself. As a venture capitalist once told me, “No conflict, no interest.”

In light of changing expectations and heightened public concern over conflict of interest, it is probably time to review the Hopkins experience to evaluate the effectiveness of our current policies and procedures.



Former Hopkins faculty member Elias Zerhouni has his hands full at the National Institutes of Health (NIH) trying to manage a conflict-of-interest scandal that arose from decisions made long before he assumed his role as director. Faced with disclosures that NIH scientists and administrators were receiving payments from the private sector for consulting, honoraria for speeches, and cash prizes for awards, Zerhouni put together a blue-ribbon panel chaired by Hopkins trustee and former Lockheed-Martin CEO Norman Augustine that recommended adopting a policy not unlike those in place at leading universities.

Continuing stories, especially in the Los Angeles Times, about serious conflicts of interest involving NIH members drove the federal government to go beyond the Augustine Commission recommendations and adopt more severe restrictions, leading to a cloistering of NIH scientists and administrators within the confines of their government duties and compensation. Now, I read that NIH scientists are threatening to rebel against these more draconian measures.

This issue, I should add, will not stop at the gates of the NIH. A number of people in Congress and the media are calling for the adoption of similar restrictions for anyone who is the recipient of NIH grants. Conflict of interest is a battle between maintaining our pristine “trusted agent” status for society and the pressures to move discovery from the bench to the marketplace. There are many issues involved, among them:

Protecting the integrity of scientific research

Making sure that technology developments and scientific discoveries move quickly from the university to industry

Making sure that student training is not subverted to the priorities of outside corporations

Ensuring open communication among physicians and scientists, unencumbered by consulting arrangements

Assuring the reputational integrity of the university

Maintaining the dedication of the faculty to the aims of the university

There are no easy answers to these challenges. We have debated them in the past and developed guidelines that have for the most part served Hopkins well. Whenever conflict-of-interest issues arise, rarely do both sides get heard. The media and general public tend to gravitate toward the belief that the “negative” pressures of outside financial interests will trump any other societal gains that might accrue from university/industry collaborations, whatever their form.

In my mind, conflict of interest begins the day a scientist has an idea. Even receiving NIH grant support drives a certain mode of behavior that could conflict the objectivity of that scientist. And licensing the idea to outside interests adds additional conflicts. A surgeon who develops a new clinical procedure will want to pursue the development of that procedure—which means conflict, hopefully positive—even without the involvement of an outside company. If she invents a surgical device that enables the operation and licenses that technology to an outside company, the conflict becomes more apparent, even though the conflict was no less real before any agreement was signed. But it is probably impossible to erect a firewall between the scientist and the supposed source of conflict. I know of few surgeons who would use a device invented by someone else if that colleague, even for reasons of conflict of interest, did not use that device herself. As a venture capitalist once told me, “No conflict, no interest.”

In light of changing expectations and heightened public concern over conflict of interest, it is probably time to review the Hopkins experience to evaluate the effectiveness of our current policies and procedures.