JAMA: Reverses Course on Banning Dissenters

Recently, The Journal of the American Medical Association (JAMA) published an editorial titled “Resolving Unreported Conflicts of Interest.” Within the article, JAMA doctors assert that unreported conflicts of interest continue to occur although recent investigations by academic centers and lawmakers have taken place. As a result, JAMA outlines their standard policies and procedures to carry out such investigations. Accordingly, JAMA then goes on to clarify certain aspects of their procedures in order to avoid misunderstanding about their policies.

–       JAMA requires that the individual bringing the allegations provide a written detailed explanation of the unreported conflicts of interest and provide documentation to support the allegation.

–       The person making the allegation will be informed about progress of the investigation and will be notified when the investigation is completed.

–       Once the investigation into unreported conflicts of interest is completed and the letter of explanation and the correction (if necessary) are finalized, those documents will be immediately posted online and linked from the article, and then subsequently published in the print journal.

 Interestingly, the Wall Street Journal noted that JAMA is now backing off the policy of “gagging anyone complaining about study authors who fail to disclose conflicts of interest.” While this newly published version modifies the policy on speaking publicly about conflict of interest-related complaints, it also omits some material.

 Dr. Leo, a Tennessee researcher who says he was threatened by JAMA editors after publicly disclosing a conflict-of-interest problem was called a “nobody and a nothing” by JAMA Editor in Chief Catherine DeAngelis. In response to the new policy, Leo says he is “glad…that “they no longer maintain their allegations that I violated a confidentiality agreement and was guilty of an ethical breach.”

As we discussed in an earlier posting Professor Leo has undisclosed conflicts of his own for failing to disclose that he is on the Board of Directors of the International Center for the Study of Psychiatry and Psychology.”

Apparently, this group is against the use of psychiatric medicines, which presented a preconceived bias by Professor Leo to expose even minor discrepancies in psychiatric research that supports the use of neuro-pharmaceuticals.

Seemingly, this step backwards for JAMA is a step forwards for industry and physicians. It allows academic medical centers who depend on industry support to supplement income, and it provides flexibility for continuing medical education so they do not always worry about conflicts that are not really conflicts. JAMA’s correction makes it clear that these matters are not easily dealt with. More importantly, JAMA’s decisions shows that no doctor is too small to impact the significance of maintaining integrity in science and medicine, while advancing health care practice through industry.