Hidden sources of private industry funding.

The target article by Sharp and colleagues (2008) provides some valuable data on the sources of funding for empirical research articles published in bioethics journals. According to the authors, 51% of the articles that acknowledged funding disclosed support from government grants, such as the National Institutes of Health (Bethesda, MD) and the National Science Foundation (Arlington, VA), 37% acknowledged support from private foundations, such as the Robert Wood Johnson Foundation (Princeton, NJ) and the Wellcome Trust (London, England), and only 2% disclosed support from private industry (Sharp et al. 2008). This low rate of industry support helps to dispel the charge that private industry is having a significant influence on bioethics research and practice (Elliott 2005; Turner 2004). Sharp and colleagues (2008) discuss several limitations of the study, including the possibility that some articles had sources of funding they did not disclose and that articles published in scientific or medical journals were not examined. One of the limitations of this study, which the authors do not address, is that their research does not attempt to examine the ultimate sources of funding for bioethics research supported by non-profit organizations, such as private foundations and patient advocacy groups. In recent years, companies that manufacture pharmaceuticals, biologics, or medical devices have established or patronized non-profit organizations to support biomedical research (Brody 2007). Companies can use these organizations to circumvent financial disclosure requirements because biomedical journals do not require authors to disclose ultimate sources of funding. Authors that receive money from one of these industry-supported organizations can report that they have been funded by the organization without mentioning the organization’s relationship to the private company. This subterfuge can prevent editors, reviewers, and readers from discovering that a private company is the ultimate source of funding (Schwartz et al. 2008). A recent case illustrates this problem. The International Early Lung Cancer Action Program ([IELCAP] New York, NY) investigators published a study in the New England Journal of Medicine in October 2006 examining the use of low-dose computed tomography (CT) scanning to detect clinical stage I lung cancer. Lung cancer was detected in 494 out of 31,567 asymptomatic subjects at risk for the disease, 88% of whom survived at least 10 years after diagnosis. The authors interpreted their results as demonstrating that CT scanning can detect lung cancers that are curable (IELCAP 2006). In March 2008, the New York Times investigated the tax records of the Foundation for Lung Cancer: Early Detection, Prevention & Treatment ([LCEDPT] New York, NY), a private foundation that helped to fund the CT scanning study. The Times found that the LCEDPT received most of its funding from a $3.6 million grant from the Liggett Group, a tobacco company that manufacturers several brands of cigarettes (Harris 2008). The IELCAP investigators had not informed the Journal about the LCEDPT’s relationship to the Liggett Group. The Times also revealed that the lead author of the IELCAP study, Claudia Henschke, a professor of radiology at Weill Cornell Medical College (New York, NY), is president of the LCEDPT and that one of her collaborators is the foundation’s secretary-treasurer (Harris 2008). Several weeks after this expose appeared in the Times, Henschke published a letter in the Journal clarifying the Liggett Group’s role in funding the CT scanning study (Henschke 2008). It is possible that private corporations played an important role in financing some of the studies examined by Sharp and colleagues (2008) that acknowledged private foundations, patient groups, or other non-profit organizations as the source of funding. Sharp and colleagues (2008) list some of the non-profits organizations were acknowledged as funding sources. Though it does not appear that any of these organizations were used as vehicles to funnel private money into bioethics research, one cannot be certain of this assumption without examining the financial records of these organizations in more depth. Since private companies have begun to use non-profit organizations to support biomedical research, it is possible that they have also used them to support bioethics research, and that authors of bioethics articles are not disclosing these hidden financial relationships. In any case, this matter warrants additional study.