A three-part series on conflicts of interest in medicine by the new national correspondent for the New England Journal of Medicine has provoked a firestorm of criticism. It also reveals its author, Dr. Lisa Rosenbaum, has a lot to learn about journalism ethics.
The essence of the series (you can read its three parts here, here and here), calls for rethinking disclosure policies to reduce the negative attention devoted to medical scientists who work closely with industry to bring new drugs and devices to market. If you read our cover story this week closely, you will find a couple of anecdotes about physicians who took lots of money from companies—one of whom is now under indictment and refused to speak with our reporters—and the other of whom spoke openly about her research and relationships.
A strong argument can be made that less disclosure would have made it more difficult to draw those distinctions and created an environment—the one that existed before, say, passage of the Physician Payment Sunshine Act—where any undisclosed conflict of interest is interpreted in a negative light.
For a close reading and critique of the series, I recommend pieces by Larry Husten, a long-time healthcare journalist who now writes his Cardiobrief blog for Forbes, and Dr. Roy Poses, a professor of medicine at Brown University whose Healthcare Renewal blog focuses on conflicts of interest in medicine.
I have my own disclosure to make. From 2004 to 2009, I ran the Center for Science in the Public Interest's Integrity in Science project, whose eager-beaver young researchers—several of whom went on to successful journalism careers—spent their days exposing undisclosed conflicts of interest in environmental, medical and other scientific fields. Alas, it was easy pickings, but good training.
Which brings me to the subject of this blog post: journalism ethics. Near the end of her piece, Dr. Rosenbaum writes:
“Recently, for the first time, I was asked to consult for a medical products company. My first thought was, 'This would be fascinating.' My second, 'There's no way.' I would have to disclose the relationship, my credibility would suffer, and I would be defenseless. That I immediately succumbed to this fear reflects our failure to manage industry relationships effectively.”
Her psychic torment suggests the august NEJM has a policy for journalists—and its national correspondent is one—that is no different than the one for its authors, which requires disclosure. It doesn't ban scientists with ties to industry from writing in the journal. If it did, it would have a hard time staying in business.
But that is not what journalism ethics require. Every journalism organization worth its salt has a "no conflicts allowed" policy—full stop. Here are just a couple.
From the Association of Health Care Journalists:
"Avoid any personal or financial interest in any company in any field related to what is being covered. This includes actual and potential competitors of subjects about whom we report. It is not wise to own stock in health care companies."
And from the New York Times:
"No staff member may own stock or have any other financial interest in a company, enterprise or industry that figures or is likely to figure in coverage that he or she provides, edits, packages or supervises regularly."
I suggest Dr. Jeffrey Drazen, the editor-in-chief of the NEJM, clarify its policy for his new national correspondent. And while he's at it, he should let the public know, in the wake of this series, whether his standards for NEJM's journalism are the same as for the rest of the journal.