Hopkins president: No conflict, no interest

William Brody

It was a shocker when the president of a major U.S. university declared Sept. 30 that all researchers “can be bought” and that academic medical centers should ban clinical trials with company ties. The setting made it even more jarring: the president, a founder of three medical device companies, was speaking at the James H. Clark Center, to an audience of scientists and entrepreneurs.

As it turned out, William Brody, MD, PhD, president of Johns Hopkins University, was playing with the crowd. After making these comments, he greeted the sea of surprised faces before him with a smile and a “gotcha.” Brody has a strong view on conflict of interest, but this was not it.

Brody, who was on campus to deliver the medical school’s Thomas J. Fogarty, MD, Lecture, said that conflict of interest is inherent in the research world and not necessarily a bad thing. “It’s not immoral or unethical per se to have this bias,” said Brody, explaining that a bias is born when a scientist has an idea and sets out to make that idea work.

Brody, who received his advanced degrees from Stanford and served on the faculty here, also believes that academic-industry partnerships—the subject of extensive public debate in recent years—are an important way to further science. It’s critical for researchers to help companies keep up with innovation, he said.

Problems arise, Brody explained, when such researchers act in a way that “violates trust” and put their interest before that of the public’s. There is myriad evidence of physicians being swayed by private companies’ money or the potential to profit financially, and Brody referenced a 1998 study that reviewed 70 papers on the effectiveness of calcium-channel antagonists. The researchers found that 96 percent of the favorable studies were from authors who had financial relationships with manufacturers of the drugs.

Brody said this type of bias, or even allegations of such bias, threaten academic medical centers’ “trusted agent status” with the public. For that reason, it’s critical that academic researchers disclose possible conflicts and that institutions oversee such conflicts. He maintained that the issue is too complex to use a single set of guidelines and noted that Johns Hopkins considers each case individually.

“Great institutional judgment is more important than unyielding rules,” he said.

Stanford President John Hennessy, PhD, attended Brody’s talk and said during a Q&A session that his “nightmare scenario” is that a conflict-related tragedy will someday force Congress to prohibit technology transfer from universities to the private sector. “I think this is a time-bomb waiting to happen,” Hennessy said.

Brody acknowledged that such a scenario could occur, and he offered some advice: The most important thing, he said, is to “reduce the chance that [such a tragedy] happens at your own institution.”

The talk was sponsored by the Department of Surgery and the Biodesign Innovation Program.