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by Donald B. Ardell, Ph. D.
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(Don's Report to the World)

Conflicts of Interest - One Of Many Fruitful Areas Of Applied Ethics To Address In Worksite Wellness

Monday December 15, 2008

In the preceding essay, I outlined several benefits of incorporating applied ethics in worksite wellness programming. One benefit would be to add "color" (panache as well as clarifications) to ethical grey areas.

Targeting applied ethics to the goal of boosting good citizenship and healthy communities is recommended. This focus might mitigate concerns about potential "faith-based" controversies, which some might fear when contemplating discussions about "values." The goal of applied ethics is to look for common grounds on secular virtues. Not everyone will agree on the hot button topics that are likely to come up, such as gay rights, euthanasia, access to abortion, stem cell research, global warming and more. But, a consensus on free speech, tolerance, diversity and commonalities of pluralistic life could and should be explored for better common understandings. Other possible value agreements or at least better awareness levels that might be reached with applied ethics training include:

That everyone should be valued and treated with dignity.
That human freedom is precious.
That we are all committed to defending human rights.
That we all seek a fair measure of happiness and rational exuberance.
That self-restraint, temperance, prudence, life satisfaction, excellence and the creative fulfillment of our talents are worthy aspects of a wellness lifestyle.
That we all share a concern for the good life - here and now.

We are guided to a considerable extent by rational self-interest. Everyone cares about his or her health, well-being, children, family, career and other things. But self-interest must be enlightened, for we have responsibilities to others, as well. Paul Kurtz addressed this search for moral balance in a recent "On Faith" commentary in the Washington Post: "There are principles of right and wrong we should live by." In working through differences on moral issues, "there will be difficulties achieving consensus. Negotiation and compromise are essential in a pluralistic society." ("Belief in God Essential for Moral Virtue?" Washington Post, November 20, 2008.)

Conflicts of interest arise in part as a consequence of fuzzy ethics. We read or hear daily about such conflicts. The transgressions of public officials who take payments from interest groups seem self-evidently improper and at odds with public responsibilities to safeguard the commons—to everyone but those with the blatant conflicts. Why? I think it's because we apply ethical standards differently when our own interests are on the line. But, that explanation begs the question: Why does this happen so often?

The deeper answer might lie in the presence of convenient obscurities. If moral issues and values were more frequently discussed in practical ways, ethical conflicts might be more recognizable. Even respectable, esteemed citizens are tempted by ethical quandaries to slant things their way. Conflicts of interest beg for attention; such matters are well suited to discussions in an applied ethics worksite wellness context.

There is one fail-safe precaution anyone can take to mitigate the possibilities of a conflict of interest, and that is to call attention to those associations that might look suspect to others. This seems a moral obligation to everyone affected, from one's employer, sponsor and the general public affected by your advice, work or functioning.

Recently, the doctor host of "The Infinite Mind" on NPR was found to have received well over a million dollars from pharmaceutical companies during a seven-year career as show host. This income was not disclosed, not to the audience and not to the producers of the program. The obvious conflict of interest was uncovered by an investigation by US Senator Charles E. Grassley of Iowa. On occasions, the doctor made statements favorable to drug treatments that were at odds with state of the art medical research. An example was this remark, quoted in the Times article: "... modern treatments - mood stabilizers in particular - have been proven both safe and effective in bipolar children." (Gardiner Harris, "Radio Host Has Drug Company Ties," New York Times, November 21, 2008.)

"The Infinite Mind" programs have been removed from NPR's satellite radio service.

Even the drug companies are embarrassed by revelations of this degree. A spokeswoman for Glaxo commented, "We continue to believe that healthcare professionals are responsible for making disclosures to their employers and other entities, in this case National Public Radio and its listeners." Well, that's good to know. Maybe they need to prod their doctors a bit more to ensure that they do so.

Oddly, the National Institutes of Health and the National Science Foundation have policies requiring full disclosures of potential conflicts. Despite this, the Senator's investigation found researchers had conducted NIH-funded studies without disclosing payments, some in excess of $2.8 million, from drug company consulting arrangements. In one case, NIH suspended a $9.3 million research grant to a prestigious university and the department chairman was forced to resign—all for egregious conflicts of interest of this kind. Similar cases are widespread across leading universities, all of which had responsibilities to conduct scientific studies with impartial scientific rigor for the benefit of taxpayers who paid for the work.

Senator Grassley and others involved in the investigations believe the influence of pharmaceutical interests is so extensive in academic medicine that universities are basically incapable of policing their own doctors.

Naturally, those involved denied conflicts, explaining that they are above being influenced by drug companies that pay for their services. Just the same, many have felt pressured to return large sums of money to drug companies. After all, they would not (any longer) want to give someone, a cynical person to be sure, the wrong impression.

I hope this will convince you that discussions about the nature of conflicts of interest, with specific cases such as noted, would constitute fascinating fodder for applied ethics explorations in REAL worksite wellness.

Don't you think so?

Domain: mental
Subdomain: emotional intelligence

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