Medical Research Integrity Blog (MedRIB)
Physicians in training are taught that when ordering tests and prescribing drugs, they should do so based on sound medical evidence, which, by and large, comes from medical journals. But what would be the effect if the evidence in these journals were presented in such a way as to mislead readers? If done cleverly, one might believe that an inferior medication or test was the best medical option. Who would benefit from this? Above all, those with a financial stake in the sale of such tests or drugs. And yet, the implications are serious. Not only could this lead to the provision of substandard care, it also puts at risk the credibility of American research. Is this a problem? This is the question that will be explored in MedRIB.
MedRIB: The Medical Research Integrity Blog
By Bruce W. McNulty, MD, Robert E. McNulty, Ph.D.
This article is part of our MedRIB project and was published February 13, 2008.
Today’s medical practitioners are facing a serious problem: the information they depend on to treat patients is sometimes wrong or based on misinformation. Worse still, the problem is not simply a result of the general limitations of human knowledge or the unavoidable variations in practitioners’ knowledge. The problem is more serious because it follows from a systemic breakdown within the current research establishment that generates the information essential to the professional practice of medicine.
The Goal of this Blog
We are not denying that medicine is progressing, but its progress is being undermined because the research on which doctors and other healthcare professionals rely is too often skewed, biased, or misleading in order to support commercial interests. The most prominent example of this pertains to the pharmaceutical industry. Let us be clear, we recognize that the partnership between the medical community and the pharmaceutical industry is vital and symbiotic. But when advances in medical research are subverted for the sake of commercial interests, the consequences can be catastrophic. In the short term, patients may die. In the long term, the effects are deeply corrosive to the medical profession as a whole — the credibility of the research establishment itself is put in question, and with that, the dividing line between science-based medicine and commercially motivated quackery will become blurred. Patients will be fully justified in wondering whether the prescription they are being given represents the treatment most conducive to their health or most conducive to the bottom line.
In this Medical Research Integrity Blog (MedRIB), our goal is to initiate a discussion that focuses on issues pertaining to the integrity of research in those fields that support the medical profession, including pharmaceuticals, medical technology, and services supporting the medical field, etc. — and among these, the greatest attention will be given to pharmaceutical research, since it is here where the problems appear most serious. Besides focusing on problems that we believe deserve greater public attention, we will also look for solutions.
What Do We Mean by “Medical Research Integrity?”
We understand medical research integrity to be found in the intersection of medical ethics, research ethics, and business ethics. When the ethics in these three areas are sound, so too will be the research on which those in the medical field depend. We could go to great lengths to describe the characteristics of ethically sound medical research, but for now at least, this strikes us as unneeded. The essence of what guides us is this:
- Medical decisions should be made to serve the best interests of patients, by contributing to their health and well-being.
- Medical research should be conducted with strict observance to the best scientific practices, adhering rigorously to principles of objectivity and impartiality;
- Business interests should never be allowed to exert any distorting influence on the presentation of medical research that would in any way undermine the guiding principles of sound medical and research ethics.
Medical research integrity is what we take for granted when we read research reports. However, the integrity of medical research is damaged whenever medical and research ethics are compromised for the sake of commercial or related interests. If violations to medical research integrity were rare, there would be no need for this blog. This is not the case. The words in this blog, we hope, will be a prelude to reform and a renewed commitment to research integrity.
Who We Are: Applied Ethics, Inc. and You
For the foreseeable future, in this blog we hope to offer a periodic examination and conversation on the integrity of research pertinent to the medical field. The primary author of MedRIB is Bruce W. McNulty, MD. Bruce received his MD degree from Georgetown Medical School in 1986. After his medical schooling, he attended a residency in Internal Medicine in Boston. He has practiced full time emergency medicine since finishing his residency, first in the Boston area, and for the past 16 years in Chicago. He is board certified in Internal Medicine and Emergency Medicine. He has spent a significant portion of his career in administrative medicine, acting as Chairman of Emergency Departments in Chicago (and currently holds that position at a busy ED in a Chicago hospital). Bruce is also the Vice President of Applied Ethics, Inc.
MedRIB’s editor is Applied Ethics, Inc.’s founder, president, and chair, Robert E. McNulty, Ph. D. After having one career in international business, he returned to graduate school and received a Ph. D. in philosophy and education from Columbia University, Teachers College. The focus of his graduate research was ethics, and after stints at teaching at Columbia, the State University of New York at New Paltz, and at Bentley College, he joined the Center for Business Ethics at Bentley College where he is the director of programs.
Besides Bruce and Bob, MedRIB will enlist the views of other well qualified guest writers. Finally, we welcome your comments, suggestions, and any kind of feedback you would like to give us. Please address these to . For reasons primarily to do with manpower, at least initially, comments will not be posted directly on the blog. However, we will read your comments carefully and, where appropriate, we will respond either by email or through the blog.
In that regard, please do let us know what you think. The need for reform is undeniable – we hope MedRIB can help.