Zerit

Science in the Private Interest: Has the Lure of Profits Corrupted Biomedical Research?

Sheldon Krimsky. Lanham, Md.: Rowman and Littlefield, 2003

Sheldon Krimksy inspires deep discomfort about the state of academic biomedicine in Science in the Private Interest: Has the Lure of Profits Corrupted Biomedical Research? In chapter after chapter, he documents stunning venality, malfeasance, and questionable behavior of all kinds by researchers and their institutions. He links the cases he cites to an overarching concern about commercial endeavors that have transformed the "ethical norms of scientific and medical researchers."

Krimsky believes commercialization distorts the ethical bases of biomedical research by introducing chronic conflicts of interest that drive increasing secrecy, biased findings, and a shrinking knowledge commons. Such outcomes are indeed cause for concern. But Krimsky argues that public-interest science-whose efficacy requires individual and institutional autonomy in support of the disinterested pursuit of knowledge-is the real casualty of academic capitalism.

Ethics warped by the lure of profit and institutional accommodations to commodified science taint our society's wellspring of knowledge, the university, Krimsky writes, endangering our "pure reservoir for dispassionate and independent critical analysis." Moreover, doubts about the autonomy and disinterestedness of the university and its researchers undermine the credibility of scientists when they speak out on matters of public concern.

The university's critical role as agent provocateur "is the sum total of its faculty who choose to exercise academic freedom for the benefit of society." Fiscal interests, corporate pressure, and new standards for commercially viable research make faculty entrepreneurs feel less committed to the public welfare than to the norms of commerce.

Krimsky advocates strict segregation between the academic and the economic roles of faculty researchers and separation of the university and commercial institutions as a means to resuscitate public science. For Krimsky, reestablishing traditional roles and boundaries is the only sure way to prohibit conflicts of interest and to maintain academic autonomy.

I do not believe that the actual situation is as dismal as the picture Krimsky paints. But he does us a service by highlighting the very real perils of commercialization. I worry, however, about the potential consequences of Krimsky's solution. Attempting to enforce a state of affairs that may be idealized could cost the university its relevance and even its ability to generate new biomedical knowledge.

Science, especially cutting-edge biomedical science, draws increasingly on vast resources from both the public and the private sectors. In a recent editorial in Science, Donald Kennedy, the journal's editor-in-chief, notes a growing convergence across the interests, capacities, and practices of public and proprietary science. He calls for the adoption of "a biomedical research strategy combining the creativity and individual skill of traditional publicly funded programs with the technology investment and team tradition of the commercial sector." In the world Kennedy describes, policies that respond to conflicts of interest by prohibiting cross-sector collaboration may dry the well for fear of poisoning it.

Much biomedical science relies on collaboration. The know-how, technologies, skills, and resources needed rarely reside under a single roof. Consequently, the very relationships that threaten Krimsky's public-interest science may be essential to academic research endeavors in basic biomedicine. In fact, I believe that the institutional and organizational arrangements that increasingly support these endeavors can underpin an expanded conception of science for the public good, where efficacy stems from engagement rather than separation.

Krimsky's public-interest science centers on the autonomous researcher dedicated to the disinterested pursuit of truth and buffered from vested parties by academic freedom. By virtue of being beholden to no one, such a scholar can "speak truth to power." Effective public-interest science based on this model depends on individual commitment and strong institutional boundaries between academic pursuits and other endeavors. Where autonomy is the wellspring of critical capacity, separation is necessary to protect the public interest. Yet Science in the Private Interest argues that individual commitments are fragile in the face of personal economic gain, and academic freedom can be shattered by conflicts of interest at the institutional level.

An alternative approach might emphasize the public benefit of academic engagement with commerce. Academic researchers have contributed substantially to the development of new therapies to improve human health. Several universities, for example, hold patents on antiretroviral drugs used to treat HIV/AIDS. In another recent Science editorial, Yale University researchers write that such patents "bring controversy when they ensure power over commodities that are the very currency of life." Yale holds a patent on the antiretroviral drug stavudine and stands in just such a position. Drugs for HIV/AIDS owe much to the academy. This fact suggests that some first-order benefits can result from blurred boundaries between universities and commerce.

The legal power that ownership of intellectual property affords to universities holds out the possibility of further public-interest benefits. But the path is far from clear. Public pressure on Yale in 2001 to facilitate access to stavudine in South Africa sparked intense negotiations between the university and Bristol-Myers Squibb, which holds an exclusive license to Yale's patent. The firm markets stavudine under the brand name Zerit. Those discussions (and undoubtedly the widespread public pressure) led Bristol-Myers to agree not to enforce patent rights in South Africa, paving the way for broad and cheap access to generic versions of Zerit in the underdeveloped world.

Yale's recent attempts to develop best practices for ensuring access to university-developed medications require recourse to the university's legal ownership of intellectual property. This example highlights an important second-order possibility for engaged academic science to serve the public good.

Krimsky has written an important and provocative book. But his work rests on a model of science whose power relies on separation from society. Alternatives exist. Those emphasizing engagement may err by exaggerating the possibilities inherent in an entrepreneurial university. But I contend that Krimsky's book equally overstates the perils.

I concur wholeheartedly with his assertion that universities and academic scientists face a changing institutional and professional environment. I likewise agree that responses to these changes must be systematic and that "subtle policies of management" and simple requirements for disclosure are insufficient to ensure that the university and its science will thrive. Science in the Private Interest should generate fruitful debate about systematic responses to the dangers of research commercialization in the life sciences. I hope that this debate gives rise to a realistic conception of the contemporary models of science upon which possible solutions rest.

Jason Owen-Smith is assistant professor of sociology and organizational studies at the University of Michigan.

Copyright American Association of University Professors Jul/Aug 2004
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