Nature Medicine | Spoonful of Medicine

The harder they fall

Pretty busy week over at the JAMA offices. First came the report that one of its editors had called a whistleblower a “”http://blogs.wsj.com/health/2009/03/13/jama-editor-calls-critic-a-nobody-and-a-nothing/“>nobody and a nothing”, report that was accompanied by a pretty long series of comments from outraged readers.

Then came the journal’s decision to modify its policy on conflicts of interest. Crucially, the new policy states that “The person bringing the allegation will be specifically informed that he/she should not reveal this information to third parties or the media while the investigation is under way, will be informed about progress of the investigation, upon request, as appropriate, and will be notified when the investigation is completed.”

Ha! I’m sure that those New York Times and Wall Street Journal reporters will be delighted to hold on to their stories before breaking the news that a fresh conflict-of-interest case has come to light. I’m also sure that next time you discover an unreported conflict, you will first inform the journal and wait as long as needed for it to take remedial action, instead of bringing the conflict to the attention of the author’s institution or funding body — what authority do these other people have, anyway?

Not surprisingly, several media outlets have already put their own spin on the way they are reporting this policy change, and they don’t seem impressed by it.

No-one would deny that JAMA has been a leader in raising awareness about conflicts of interest, discussing them perhaps to the point of eliciting a certain desensitization — is anyone surprised when the journal expresses, yet again, the view that conflicts of interest should not be tolerated? Alas, despite its track record, the events of the past week undermine the credibility of the journal’s position on this front.

To my mind, the way in which this whole controversy has escalated is related, in no small measure, to the overzealous way in which JAMA has always decried conflicts of interest. In other words, the tough line that JAMA has taken against conflicts of interest makes the journal much more susceptible to embarrassment when one emerges. Or as the saying goes, the higher they climb, the harder they fall. The latest policy change would seem to be saying that it’s always possible to climb a little higher.

Photo by SparkyLeigh via Flickr

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