{"id":2803,"date":"2014-07-28T15:57:48","date_gmt":"2014-07-28T14:57:48","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=2803"},"modified":"2014-07-31T07:55:32","modified_gmt":"2014-07-31T06:55:32","slug":"on-conflicts-of-interest","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2014\/07\/28\/on-conflicts-of-interest\/","title":{"rendered":"On Conflicts of Interest"},"content":{"rendered":"

It’s only a few days since Richie’s paper<\/span><\/a><\/span><\/span> on providing IVF in the context of global warming was published, but already there’s been a couple of lines of objection to it that have been fairly widespread; I thought it might be worth nodding to one, and perhaps offering an attempt of a defence against the other.<\/p>\n

The first objection is that there’s no justification for the claim about same-sex couples in Richie’s paper – that she shouldn’t have treated homosexuality as a lifestyle choice and as “non-biological” infertility. \u00a0I think that there’s significant merit to this objection to the paper; and though neither Dominic nor I mentioned the objection explicitly, I think that it’s there between the lines of each of our commentaries. \u00a0(It’s certainly an aspect of the paper that’s picked up by the\u00a0Telegraph<\/em>‘s coverage of the paper<\/span><\/a><\/span><\/span>, and it’s been mentioned a couple of times on Twitter and Facebook by people I know and follow. \u00a0(I note that the\u00a0Telegraph<\/em> also gave a highly bastardised version of my post here. \u00a0Ho hum.)) \u00a0I think that Richie’s argument would have been at least as strong if she’d talked about providing IVF to anyone whatsoever – the qualifications about different “sorts” of infertility and lifestyle, I suspect, weakened the paper, inasmuch as that a paper with unnecessary and argumentatively weak aspects is more vulnerable to objections generally than one in which those aspects have been left out. \u00a0So, yeah: I think that that might count as having been – at best – a strategic error on Richie’s part.<\/p>\n

Here’s the other claim that I’ve seen a few times about the paper: that it’s weakened by a conflict of interest because of the author’s affiliation. \u00a0This isn’t directly a claim about the quality of the argument in the same way that the previous objection is. \u00a0Rather, it’s a claim that there’s something unreliable about the very fact of the argument’s having been put. \u00a0(I’m not articulating the distinction very well, but I think you can\u00a0see what I mean.) \u00a0In essence, the worry is this: Richie works for a Jesuit Institution; this isn’t clear from her\u00a0affiliation in the paper; there’s something iffy about this; this iffiness is some form of conflict of interest and her argument is likely to be biased.<\/p>\n

I’m not sure what to make of this. \u00a0I think that\u00a0Ritchie may well have an interest, inasmuch as that she has a position on the topic. \u00a0But this applies to all of us, writing papers on pretty much any topic. \u00a0Does that count as worrisome, or as a source of bias? \u00a0Well, I guess that it might in the broadest sense; but while that might seed objections to parts or all of the argument, I’m not sure that that’s necessarily an objection to the paper itself. \u00a0I mean,\u00a0any paper has certain biases inasmuch as that we all have things that we take to be axiomatic and about which we don’t argue; and we’re all likely to stress the strengths of positions with which we agree and downplay the weaknesses. \u00a0So, at the most, there’s a\u00a0tu quoque<\/em> response available here.<\/p>\n

Is there a conflict of interest, though? \u00a0Again, I’m tempted to think not. \u00a0To see why, start by asking whether it’s possible that Richie’s arguments were made – subconsciously or consciously – because of the nature of her employer.\u00a0\u00a0The answer has to be that it is possible. \u00a0Do we have any evidence of this, though, beyond the paper about which we’re talking? \u00a0Not really. \u00a0So the charge on that front appears to be in danger of collapsing into “This paper can be shown to be dodgy because there’s something dodgy about it”, which is question-begging.<\/p>\n

The problem with conflicts of interest, it seems to me, arises when it’s possible that the writer of a paper has misrepresented or withheld certain data, motivated by a tie to some person or institution that may suffer or lose an opportunity should those data be fully visible. \u00a0Is that a charge that can be levelled at Richie’s paper? \u00a0Again, I think not. \u00a0The reason here is that, in common with most ethics papers, there aren’t data to misrepresent in the way that there might be with (say) pharmaceutical research. \u00a0Very roughly, a person doing pharmaceutical research funded by a big company has a reason to withhold non-favourable results, and thus readers can get a false impression of just how good a drug is because they’re only aware of the favourable\u00a0results. \u00a0Importantly, there might be nothing in the paper as published that would indicate that there’s more to the story than meets the eye.<\/p>\n

Over on the Health Care Ethics and Law FB group, an analogy was drawn with the recent Swiss report into homeopathy, which was fairly favourable, but which was written by homeopaths. \u00a0Could Richie’s paper be a bit like this – a paper that was pretty much in tune with Catholic thinking, written by someone at a Jesuit university, being a little too good to be true? \u00a0Again, possibly – but not definitively. \u00a0I think that the claim that IVF ought to attract more of a particular kind of moral scrutiny doesn’t depend on any particular doctrinal standpoint; the surface detail of the\u00a0way in which the claims and questions are raised might alter, but the essence of thosee claims and questions doesn’t have to.<\/p>\n

Importantly, again, there aren’t any data to misrepresent: Richie wasn’t presenting any claims about the way the world is. \u00a0She was talking about how we ought to act given certain facts about the world – facts that are not (I’m assuming)\u00a0all that contentious. \u00a0That’s the difference from\u00a0the Big Pharma and the homeopathy examples: in both those cases, there’s a reason to worry that the world as it is may not be reflected in the way it’s presented. \u00a0I don’t see that here. \u00a0What’s on show here is an argument about the way the world ought to be. \u00a0The claims therein can be examined without needing any further information – and, as I keep saying, that’s happening already from a number of directions, just as it would with any other paper.<\/p>\n

What about the possibility that Ritchie may have felt pressure to withhold counterarguments? \u00a0I think that this can be dismissed, too. \u00a0One reason for this is that – as I’ve suggested above – it’s possible that the paper would have been stronger if a couple of the details had been left out. \u00a0And those counterarguments are already being presented, informally, on Twitter and messageboards. \u00a0So even if there was pressure, it’s actually backfired for the person applying it. \u00a0Instead of making themselves look better than they are, they’d’ve made their position look worse.<\/p>\n

Finally, we can’t say – not plausibly – that it’s up to the author to avoid\u00a0perceived<\/em> conflicts of interest, because there’s no accounting for what someone might perceive; to make that stipulation puts authors at the mercy of the most cynical or outright tinfoil-hatted.<\/p>\n

So what we’re left with, it seems to me, is a claim that the paper is unreliable because the writer is employed by a certain kind of institution (and may have certain commitments of her own). \u00a0And that seems a little\u00a0ad feminam<\/em> to me. \u00a0A person with different commitments may be less likely to make some of the claims Richie makes; but it doesn’t follow from that that she’s made them because of who pays her wages. \u00a0We’d need independent evidence for that, and I don’t see any.<\/p>\n

It might be that the paper is, on examination, utter bobbins for one reason or another. \u00a0But if it is, then the arguments are already there for the making. \u00a0And I don’t think that that’s attributable to facts about\u00a0who wrote it, or who signs her paycheques.<\/p>\n

 <\/p>\n

(Incidentally – just on the off-chance that this generates comments, I’m about to go away for a fortnight, and won’t be around much (if at all) to engage with them. \u00a0They might be a bit slower to get through moderation, too: it depends on how busy David is.)<\/p>\n","protected":false},"excerpt":{"rendered":"

It’s only a few days since Richie’s paper on providing IVF in the context of global warming was published, but already there’s been a couple of lines of objection to it that have been fairly widespread; I thought it might be worth nodding to one, and perhaps offering an attempt of a defence against the […]<\/p>\n

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