This article addresses all of the issues involved in the debate about whether or not bioethicists should be paid by private biomedical companies to perform consultations. These issues include the following: differentiation of this role from bioethicists' other roles, an analysis of to whom bioethicists owe a duty, consideration of what bioethicists are “selling,” whether bioethicists should be allowed to get paid, when payment becomes problematic, and whether consulting fee arrangements should be regulated. The author often compares bioethicists' relationship to (...) the companies to bioethicists' other relationships, as well as to professional relationships in other fields, such as law and accounting. (shrink)

Bioethics, once a four-letter word in the private sector, is now an integral part of the decisionmaking process of biotechnology and pharmaceutical companies. And bioethicists, once confined to the classroom and limited to abstract, philosophical discussions about what is right and wrong in medicine and medical research, now play an important role in the practical implementation of ethical boundaries. Bioethicists increasingly are hired by biomedical companies as consultants to highlight and help resolve complex ethical issues that arise in the companies’ (...) normal business practices. Whether motivated by profit, reputation, or a genuine desire to act morally, these companies are willing to pay bioethicists substantial consultation fees for their “expert” opinions. This fairly recent phenomenon has caused some to be concerned about the potential for bioethicists to encounter conflicts of interests. Specifically, many critics of this new relationship between bioethicists and the private sector “are concerned about the appropriateness of ethicists who should have broader interests, such as concerns about social justice, serving clients whose primary interest is profit-maximizing.”. (shrink)

In this paper, I explore briefly the "secular priesthood" metaphor often applied to bioethicists. I next ask: if, despite our discomfort with the metaphor, we were to embrace the best aspects of the priesthood(s) ? which I identify as the missionaries' willingness to work among sinners and lepers, at their own peril ? would we be able to live up to that standard of bravery? I then draw a parallel with the fears of contagion currently be voiced (by Carl Elliott (...) and others), with regard to bioethicists working in or near corporate settings. I argue that such fears may themselves have a number of deleterious effects, and I suggest several possible positive steps in response to that fear. (shrink)

In the first part of this paper I consider whether an academic bioethicist is likely to change the arguments she is prepared to voice if she is in receipt of payment from a corporation. I argue that she is not, so long as a number of conditions are met regarding the size of payment, the values of the academic bioethics community, the degree to which she participates in that community, and the transparency of corporate involvements. In the second half I (...) consider a different concern that one might have with corporate payments that relate to the dubious nature of the functions bioethicists might play within those corporations. I argue that three roles—those of marketer, expert and lobbyist—are best avoided, but that a fourth—the dialectical role—does provide a legitimate niche within which a bioethicist may offer consultation. (shrink)

Conflicts of interest are receiving increased attention in medical research, clinical practice and education. Criticism of, and penalties for, conflicts of interest have been insufficiently discussed and have been applied without adequate conceptual backing. Genuine conflicts of interest are situations in which alternative courses of action are ethically equivalent, decision-making being less a matter of moral deliberation than of personal weighing of interest. In contrast, situations usually thought of as conflicts of interest are mostly temptations to follow an attractive but (...) undue option that causes harm by failing to uphold well-entrenched ethical standards. Examples of moral quandaries that pose as ethically neutral conflicts of interest are healthcare providers enticed to favour certain products; patients being referred to non-therapeutic trials entailing risks and non-optimal healthcare; industry-supported scientists failing to deliver unbiased research results and reports or participating in ghost-writing; and sponsored educators who praise their supporters beyond objective evidence. All these are moral blemishes, where integrity gives way to material incentives at the cost of provoking risky and harm-producing situations, thus constituting false conflicts of interest when they are in fact ethical misdemeanours. Disclosure has been the most widely recommended response to avoid the concealment of conflicting and ethically suspect interests. Regulations regarding disclosure reveal a utilitarian stance that shows more concern for the magnitude of support or sponsorship than for the underlying ethical transgression. Education and oversight should directly address and help correct the moral attitude towards undue influence of inducements and marketing strategies falsely posing as conflicts of interest. (shrink)

Biomedical research is an increasingly multidisciplinary activity bringing together a range of different academic fields and forms of expertise to investigate diseases that are increasingly understood to be complex and multifactorial. Recently the discipline of ethics has been starting to find a place in large-scale biomedical collaborations. In this article we draw from our experience of working with the Malaria Genomic Epidemiology Network and other research projects to reflect upon the integration of ethics into biomedical research. We examine the way (...) in which ethics input may be valuable to research, the forms it tends to take, and also the problems and limitations of such collaborations. (shrink)

Some bioethicists are concerned about other bioethicists being paid by corporations. These concerns make sense if you have a particular view about what the most important role of a bioethicist should be. If you believe that a bioethicist should be a moral critic, attempting to expose wrongdoing, then being paid by corporations might compromise this role. It’s plausible to suppose that this can be a role for bioethicists but it’s unreasonable to insist that all bioethicists should be moral critics.

A decade ago some members of the American Society for Bioethics and the Humanities (ASBH) concluded that the society's reluctance to develop a code of professional ethics, although a tolerable anom...