December 4, 2020

The Niche

Knoepfler lab stem cell blog

Real and imaginary conflicts of interest: a helpful guide

What are Conflict of Interests (COI)?

The term COI is sometimes used inappropriately as a weapon by one party to attempt to discredit others.

Conflicts of interest creative commons image
Conflicts of interest. Creative commons image.

We see this more and more frequently in the stem cell field with boosters of for-profit, non-FDA vetted adult stem cell clinics attacking scientists for supposed COIs for what…..apparently for simply being a stem cell scientist.

Onlookers may be confused about this.

Being an interested party or having an interest in a general sense in something like stem cells is not a COI. Knowing about conflicts of interest is not just a bioethics issue, but an everyday practical issue for scientists.

So what is and is not a COI?

Wikipedia largely concurs with the COI training I’ve received for years as a professor with this definition:

conflict of interest (COI) occurs when an individual or organization is involved in multiple interests, one of which could possibly corrupt the motivation for an act in the other.

Some hypothetical examples from the biomedical field below can be instructive.

  • Someone who publicly promotes a biotech stock on a blog or in a newspaper article also owns shares in that stock without disclosing to readers that they own the stock.
  • Someone that promotes a specific medical clinic to patients as safe and effective secretly receives payments from that clinic.
  • A physician who recommends a procedure to patients involving a medical device (e.g. say a special scalpel) does not disclose that she receives money from the company that makes the device.
  • A biotech company (or a scientist working for them) that owns the patent for drug X gives free vacations to doctors who prescribe it frequently.

Conflicts of interest involve an action directly driven by a selfish motivation. Again, having an interest in something does not necessarily equate with a COI.

The word “conflict” is key.

So what kinds of COI are being suggested by pro-dubious clinics proponents against critics of such clinics?

In the stem cell field, we hear about supposed secret plots by the FDA and Big Pharma to slow or kill stem cell therapies (e.g. Dan Ecklund made such a claim on 60 Minutes) and alleged COIs by scientists who are involved in such imaginary nefarious schemes.

Rather than real, these accusations of COIs seem to be used as a tool by fans of unapproved stem cell treatments and for-profit clinics to attempt to discredit critics of such treatments and muddy the waters.

In fact, most stem cell scientists who are involved with biotech companies or have stem cell-related patents (I myself do not fall into either group at the moment, but there is certainly nothing wrong with industry collaborations and who doesn’t want a patent?) want to promote stem cell therapies, not drugs sold by Big Pharma. Therefore the accusations make no sense.

So when academic scientists raise concerns about stem cell treatments or dubious clinics I believe their motivation is not related to some COI, but rather it is because the scientists are genuinely concerned about the lack of proof of safety and efficacy of the treatments.

Patients may get hurt. There is real risk.

Logically what would an academic scientist have to personally gain by pointing out risks and problems associated with the non-FDA vetted, for-profit stem cell industry?

The answer is nothing.

So when you read or hear someone who is a fan of dubious, for-profit stem cell clinics accusing a scientist of a COI, remind yourself what exactly a COI is and what it isn’t and look to see if the accuser provides any facts or logical basis for their accusation.

Ironically, often it is the accuser/fan of for-profit adult stem cell clinics who themselves might have the COI because they receive money from the clinics or from patients.

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