Bioethics, Conflicts of Interest, the Limits of Transparency

The movement in bioethics toward disclosure of financial conflicts of interest is well and good, most of the time. But in some cases, disclosure is not only unnecessary but destructive. When bioethicists advance arguments whose premises and logical moves are open to scrutiny, disclosure--far from clearing the air of bias introduces bias. Over the past several years, there has been growing concern about the commercialization of bioethics. As ever more bioethicists become paid consultants to private industry and paid advocates in court proceedings, many have warned of the dangers such activity can pose to the bioethicist's integrity as a teacher and researcher. (1) This, in turn, has led to increasing demands for disclsure requirements. For the most part, we share the concerns of those who worry about the commercialization of bioethics and we welcome the movement to demand disclosure of possible conflicts of interest. However, as editors of another bioethics journal, Theoretical Medicine and we are concerned that current efforts to broaden the scope of disclosure requirements may result in extending them to contexts in which they are not appropriate. (2) Doing so, we believe, would itself pose a threat to the integrity of bioethics. This threat needs to be understood if editors are to develop reasonable guidelines for disclosure--guidelines that will correctly identify when disclosure is appropriate and when it is not. The threat we have in mind concerns the potential of policies of disclosure to undermine the value of reasoned argument. Bioethics is a reasoned enterprise, one in which Lynn A. Jansen and Daniel P. Sulmasy Bioethics, Conflicts of Interest, and the Limits of Transparency, Hastings Center Report 33, no. 4 (2003): 40-43. scholars and students have a responsibility to think seriously and reflect carefully on the merits of competing arguments. Central to this understanding of bioethics is the presupposition that good arguments can come from any quarter and that no argument should be dismissed or discounted simply because of its source. An uncritical preoccupation with disclosure requirements stands in considerable tension with this key presupposition. It can foster an ad hominem approach to evaluating research, one that shifts attention away from the merits of the work and toward the biography of its author. (3) For this reason, it is important to explain why and where disclosure is needed. We shall argue that it is a mistake to think that if disclosure is a good thing, then more of it is always better. Although transparency is good in some contexts, it may not be good in every context. We shall argue that disclosure requirements should not be extended to cover normative research in bioethics. The Appeal to Authority Disclosure requirements are needed in contexts in which an ethicist is presented as an expert or her research cannot be assessed critically by those to whom it is addressed. In these contexts, the claims of the bioethicist typically are taken as authoritative. Those who hear these claims are not in a good position to assess their cogency and so the only way to estimate the value of what is claimed is to consider the reliability of the source. Here disclosure of financial relationships that might compromise the judgment of the bioethicist is useful in assessing the reliability of what he or she claims. To see this point more clearly, it is helpful to consider three contexts in which disclosure has been widely defended and is a good idea. The first concerns an ethicist's expert testimony in a court proceeding.(4) In court, the ethicist's claims are presented as authoritative. While it is possible that some members of a jury may be able to assess them critically, it is likely that many will not have the analytical skill or the motivation to reflect carefully on the rational value of the claims being presented. Not being bioethicists themselves, they will be inclined to accept the claims on authority. …