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Welcome to the nexus of ethics, psychology, morality, technology, health care, and philosophy
Showing posts with label Conflicts of Interest. Show all posts
Showing posts with label Conflicts of Interest. Show all posts

Friday, January 18, 2019

House Democrats Look to Crack Down on Feds With Conflicts of Interest, Ethics Violations

Eric Katz
Government Executive
Originally posted January 3, 2018

Federal employees who pass through the revolving door with the private sector and engage in other actions that could present conflicts of interest would come under intensified scrutiny in a slew of reforms House Democrats introduced on Friday aimed at boosting ethics oversight in government.

The new House majority put forward the For the People Act (H.R. 1) as its first legislative priority, after the more immediate concern of reopening the full government. The package involves an array of issues House Speaker Nancy Pelosi, D-Calif., said were critical to “restoring integrity in government,” such as voting rights access and campaign finance changes. It would also place new restrictions on federal workers before, during and after their government service, with special obligations for senior officials and the president.

“Over the last two years President Trump set the tone from the top of his administration that behaving ethically and complying with the law is optional,” said newly minted House Oversight and Reform Committee Chairman Rep. Elijah Cummings, D-Md. “That is why we are introducing the For the People Act. This bill contains a number of reforms that will strengthen our accountability for the executive branch officials, including the president.”

All federal employees would face a ban on using their official positions to participate in matters related to their former employers. Violators would face fines and one-to-five years in prison. Agency heads, in consultation with the director of the Office of Government Ethics, could issue waivers if it were deemed in the public interest.

The info is here.

Sunday, December 16, 2018

Institutional Conflicts of Interest and Public Trust

Francisco G. Cigarroa, Bettie Sue Masters, Dan Sharphorn
JAMA. Published online November 14, 2018.
doi:10.1001/jama.2018.18482

Here is an excerpt:

It is no longer enough for institutions conducting research to only have conflict of interest policies for individual researchers, they also must directly address the growing concern about institutional conflicts of interest. Every research institution and university deserving of the public’s trust needs to have well-defined institutional conflict of interest policies. A process must be established that will ensure research is untainted by any personal financial interests of the researcher, and that no financial interests exist for the institution or the institution’s key decision makers that could cloud otherwise open and honest decisions regarding the institution’s research mission.

Education and culture are fundamental to the successful implementation of any policy. It is incumbent upon institutional decision makers and all employees involved in research to be knowledgeable about individual and institutional conflict of interest policies. It may not always be obvious to researchers that they have a perceived or real conflict of interest or bias. Therefore, it is important to establish a culture of transparency and disclosure of any outside interests that could potentially influence research and include individuals at the highest level of the institution. Policies should be clear and easy to implement and permit pathways to provide disclosure with adequate explanation, as well as information regarding how potential or real conflicts of interest are managed or eliminated. This will require the establishment of interactive databases aimed at mitigating, to the extent possible, both individual and institutional conflicts of interest.

Policies alone are not sufficient to protect an institution from conflicts of interest. Institutional compliance toward these policies and dedication toward establishing processes by which to identify, resolve, or eliminate institutional conflicts of interest are necessary. Institutions and their respective boards of trustees should be prepared to address sensitive situations when a supervisor, executive leader, or trustee is identified as contributing to an institutional conflict of interest and be prepared to direct specific actions to resolve such conflict. In this regard, it would be prudent for governance to establish an institutional conflicts of interest committee with sufficient authority to manage or eliminate perceived or real conflicts of interest affecting the institution.

Monday, November 5, 2018

Bolton says 'excessive' ethics checks discourage outsiders from joining government

Nicole Gaouette
CNN.com
Originally posted October 31, 2018

A day after CNN reported that the Justice Department is investigating whether Interior Secretary Ryan Zinke has broken the law by using his office to personally enrich himself, national security adviser John Bolton told the Hamilton Society in Washington that ethics rules make it hard for people outside of the government to serve.

Bolton said "things have gotten more bureaucratic, harder to get things done" since he served under President George H.W. Bush in the 1990s and blamed the difficulty, in part, on the "excessive nature of the so-called ethics checks."

"If you were designing a system to discourage people from coming into government, you would do it this way," Bolton said.

"That risks building up a priestly class" of government employees, he added.

"It's really depressing to see," Bolton said of the bureaucratic red tape.

The info is here.

My take: Mr. Bolton is wrong.  We need rigorous ethical guidelines, transparency, enforceability, and thorough background checks.  Otherwise, the swamp will grow much greater than it already is.

Monday, October 22, 2018

Trump's 'America First' Policy Puts Economy Before Morality

Zeke Miller, Jonathan Lemire, and Catherine Lucey
www.necn.com
Originally posted October 18, 20198

Here is an excerpt:

Still, Trump's transactional approach isn't sitting well with some of his Republican allies in Congress. His party for years championed the idea that the U.S. had a duty to promote U.S. values and human rights and even to intervene when they are challenged. Some Republicans have urged Trump not to abandon that view.

"I'm open to having Congress sit down with the president if this all turns out to be true, and it looks like it is, ... and saying, 'How can we express our condemnation without blowing up the Middle East?" Sen. John Kennedy, R-La., said. "Our foreign policy has to be anchored in values."

Trump dismisses the notion that he buddies up to dictators, but he does not express a sense that U.S. leadership extends beyond the U.S. border.

In an interview with CBS' "60 Minutes" that aired Sunday, he brushed aside his own assessment that Putin was "probably" involved in assassinations and poisonings.

"But I rely on them," he said. "It's not in our country."

Relations between the U.S. and Saudi Arabia are complex. The two nations are entwined on energy, military, economic and intelligence issues. The Trump administration has aggressively courted the Saudis for support of its Middle East agenda to counter Iranian influence, fight extremism and try to forge peace between Israel and the Palestinians.

The info is here.

Thursday, October 18, 2018

Medicine’s Financial Contamination

Editorial Board
The New York Times
Originally posted September 14, 2018

Here is an excerpt:

Sloan Kettering’s other leaders were well aware of these relationships. The hospital has said that it takes pains to wall off any employee involved with a given outside company from the hospital’s dealings with that company. But it’s difficult to believe that conflicts of this magnitude could have truly been worked around, given how many of them there were, and how high up on the organizational chart Dr. Baselga sat. It also strains credulity to suggest that he was the hospital’s only leader with such conflicts or with such apparent difficulty disclosing them. After the initial report, but before Dr. Baselga’s resignation, the hospital sent a letter to its entire 17,000-person staff acknowledging that the institution as a whole needed to do better. It remains to be seen what additional actions will be taken — and by whom — to repair the situation.

Financial conflicts are hardly confined to Sloan Kettering. A 2015 study in The BMJ found that a “substantial number” of academic leaders hold directorships that pay as much as or more than their clinical salaries. According to other surveys, nearly 70 percent of oncologists who speak at national meetings, nearly 70 percent of psychiatrists on the task force that ultimately decides what treatments should be recommended for what mental illnesses, and a significant number of doctors on Food and Drug Administration advisory committees have financial ties to the drug and medical device industries. As bioethicists have warned and as journal publishers have long acknowledged, not all of them report those ties when and where they are supposed to.

The info is here.

Wednesday, September 26, 2018

Navigating the Ethical Boundaries of Grateful Patient Fundraising

Collins ME, Rum SA, Sugarman J.
JAMA. Published online August 27, 2018.
doi:10.1001/jama.2018.11655

Here are two excerpts:

There is limited literature examining the ethical issues that grateful patient fundraising raises for physicians. The last American Medical Association report on this topic was issued in 2004.4 The report recognized the value of philanthropy and physicians’ role in it, but rightly emphasized the paramount importance of patients’ rights and welfare in efforts directed at grateful patient fundraising. As such, the report highlighted the need to ensure that gifts are voluntary, that patients should not perceive an obligation to give, and the need to protect privacy. In addition, the report cautioned against physicians initiating discussions about philanthropy during direct patient care. Furthermore, there is also limited literature about the ethical issues grateful patient fundraising poses for development professionals and the health care institutions they represent. Grappling with the ethical issues in grateful patient fundraising necessitates considering them from all of these perspectives.

(cut)

Among the key issues were challenges related to clinicians having discussions about philanthropy with patients who might be especially vulnerable due to their diseases or conditions, the tensions related to conflicts in regard to clinicians’ primary obligations to patient care and a competing obligation to fundraising, the potential effects of fundraising on patient care, possible unintended consequences of concierge services provided to donors, and concerns about privacy.5 The recommendations for clinicians include those concerning when grateful patient fundraising is appropriate (eg, ideally separate from the clinical encounter, not in situations of heightened vulnerability), minimizing conflicts of obligation and commitment, and respecting the donor’s intent of a gift. The recommendations for fundraising professionals and institutions include the need for transparency in relationships, not interfering with clinical care, attending to confidentiality and privacy, appropriateness of concierge services, and institutional policies and training in grateful patient fundraising.

The info is here.

Tuesday, September 4, 2018

Financial Ties That Bind: Studies Often Fall Short On Conflict-Of-Interest Disclosures

Rachel Bluth
Kaiser Health News
Originally published August 15, 2018

Papers in medical journals go through rigorous peer review and meticulous data analysis.

Yet many of these articles are missing a key piece of information: the financial ties of the authors.

Nearly two-thirds of the 100 physicians who rake in the most money from 10 device manufacturers failed to disclose a conflict of interest in their academic writing in 2016, according to a study published Wednesday in JAMA Surgery.

The omission can have real-life impact for patients when their doctors rely on such research to make medical decisions, potentially without knowing the authors’ potential conflicts of interest.

“The issue is anytime there’s a new technology, people get really excited about it,” said lead researcher Dr. Mehraneh Jafari. “Whoever is reading the data on it needs to have the most information.”

The article is here.

Saturday, September 1, 2018

Why Ethical People Become Unethical Negotiators

Dina Gerdeman
Forbes.com
Originally posted July 31, 2018

Here is an excerpt:

With profit and greed driving the desire to deceive, it’s not surprising that negotiators often act unethically. But it’s too simplistic to think people always enter a negotiation looking to dupe the other side.

Sometimes negotiators stretch the truth unintentionally, falling prey to what Bazerman and his colleagues call “bounded ethicality” by engaging in unethical behavior that contradicts their values without knowing it.

Why does this happen? In the heat of negotiations, “ethical fading” comes into play, and people are unable to see the ethical implications of their actions because their desire to win gets in the way. The end result is deception.

In business, with dollars at stake, many people will interpret situations in ways that naturally favor them. Take Bazerman’s former dentist, who always seemed too quick to drill. “He was overtreating my mouth, and it didn’t make sense,” he says.

In service professions, he explains, people often have conflicts of interest. For instance, a surgeon may believe that surgery is the proper course of action, but her perception is biased: She has an incentive and makes money off the decision to operate. Another surgeon might just as easily come to the conclusion that if it’s not bothering you, don’t operate. “Lawyers are affected by how long a case takes to settle,” he adds. “

The info is here.

Thursday, August 16, 2018

Series of ethical stumbles tests NIH’s reliance on private sector for research funding

Lev Facher
STAT News
Originally published August 1, 2018

Here is an excerpt:

Now, the NIH is seeking to bounce back from the hit to its reputation — and to demonstrate that the failures of recent years are isolated incidents and not emblematic of a broader cultural problem. At the same time, some congressional aides have hinted at more aggressive oversight of the foundation through which the NIH takes on many of its partnerships.

NIH officials told STAT this week the agency is completing a plan to ensure better ethical compliance and better delineate the actual process for private-sector collaboration. The officials said the plan will be presented to an advisory committee in December.

Already, as STAT reported in April, the NIH proactively nixed a long-touted plan to accept roughly $200 million from pharmaceutical manufacturers to pursue research on pain and addiction treatment, with an explicit acknowledgement that involving companies being sued for their role in the crisis could taint the perception of the research.

NIH Director Francis Collins acknowledged the setbacks in an interview with STAT this week, but defended his staff’s efforts.

The info is here.

Saturday, June 16, 2018

Ivanka Trump in China: The trademarks raising an ethics firestorm

Aimee Picchi
CBS News - Money Watch
Originally published May 29, 2018

Ivanka Trump this month received trademark approval from China for a broad array of items, including baby blankets, wallpaper and carpets. That wouldn't be unusual for a global business built on consumer goods such as elegant women's clothing and shoes, but it raises numerous ethical issues given that her father is the U.S. president.

The timing appears especially fraught given President Donald Trump agreed to rescue Chinese telecom giant ZTE Corp. shortly after Ivanka Trump's brand was awarded the trademarks.

Ethics watchdogs say the approvals are problematic on a number of levels, including Ivanka Trump's role representing the U.S. at diplomatic events even though her brand's business could be impacted -- for good or bad -- by relations with foreign nations. Then there's also the conflicts that arise from her father's role as president amid rising trade tensions between the U.S. and China.

The article is here.

Wednesday, May 2, 2018

Institutional Research Misconduct Reports Need More Credibility

Gunsalus CK, Marcus AR, Oransky I.
JAMA. 2018;319(13):1315–1316.
doi:10.1001/jama.2018.0358

Institutions have a central role in protecting the integrity of research. They employ researchers, own the facilities where the work is conducted, receive grant funding, and teach many students about the research process. When questions arise about research misconduct associated with published articles, scientists and journal editors usually first ask the researchers’ institution to investigate the allegations and then report the outcomes, under defined circumstances, to federal oversight agencies and other entities, including journals.

Depending on institutions to investigate their own faculty presents significant challenges. Misconduct reports, the mandated product of institutional investigations for which US federal dollars have been spent, have a wide range of problems. These include lack of standardization, inherent conflicts of interest that must be addressed to directly ensure credibility, little quality control or peer review, and limited oversight. Even when institutions act, the information they release to the public is often limited and unhelpful.

As a result, like most elements of research misconduct, little is known about institutions’ responses to potential misconduct by their own members. The community that relies on the integrity of university research does not have access to information about how often such claims arise, or how they are resolved. Nonetheless, there are some indications that many internal reviews are deficient.

The article is here.

Thursday, March 29, 2018

Government watchdog files 30 ethics complaints against Trump administration

Julia Manchester
The Hill
Originally posted March 26, 2018

Here is an excerpt:

"The bottom line is that neither Trump nor his administration take conflicts of interest and ethics seriously," Lisa Gilbert, the group's vice president of legislative affairs, told the network.

" 'Drain the swamp' was far more campaign rhetoric than a commitment to ethics, and the widespread lack of compliance and enforcement of Trump's ethics executive order shows that ethics do not matter in the Trump administration."

NBC News reports Public Citizen filed complaints with the White House Office of Management and Budget, the Environmental Protection Agency, and the departments of Defense, Homeland Security, Housing and Urban Development, Transportation, Health and Human Services, Commerce and Interior, among others.

Trump signed an executive order shortly after he took office in 2017 that was aimed at cracking down on lobbyists' influence in the U.S. government.

The order allowed officials who departed the administration to lobby the government, except the agency for which they worked, and permitted lobbyists to enter the administration as long as they didn't work on specific issues that would impact former clients or employers for two years.

The article is here.

Saturday, March 10, 2018

What swamp? Lobbyists get ethics waivers to work for Trump

Associated Press
Originally posted March 9, 2017

President Donald Trump and his appointees have stocked federal agencies with ex-lobbyists and corporate lawyers who now help regulate the very industries from which they previously collected paychecks, despite promising as a candidate to drain the swamp in Washington.

A week after his January 2017 inauguration, Trump signed an executive order that bars former lobbyists, lawyers and others from participating in any matter they lobbied or otherwise worked on for private clients within two years before going to work for the government.

But records reviewed by The Associated Press show Trump's top lawyer, White House counsel Don McGahn, has issued at least 24 ethics waivers to key administration officials at the White House and executive branch agencies.

Though the waivers were typically signed by McGahn months ago, the Office of Government Ethics disclosed several more on Wednesday.

One allows FBI Director Chris Wray "to participate in matters involving a confidential former client." The three-sentence waiver gives no indication about what Wray's conflict of interest might be or how it may violate Trump's ethics order.

Asked about the waivers, Lindsay Walters, a White House spokeswoman, said, "In the interests of full transparency and good governance, the posted waivers set forth the policy reasons for granting an exception to the pledge."

The article is here.

Tuesday, January 9, 2018

Dangers of neglecting non-financial conflicts of interest in health and medicine

Wiersma M, Kerridge I, Lipworth W.
Journal of Medical Ethics 
Published Online First: 24 November 2017.
doi: 10.1136/medethics-2017-104530

Abstract

Non-financial interests, and the conflicts of interest that may result from them, are frequently overlooked in biomedicine. This is partly due to the complex and varied nature of these interests, and the limited evidence available regarding their prevalence and impact on biomedical research and clinical practice. We suggest that there are no meaningful conceptual distinctions, and few practical differences, between financial and non-financial conflicts of interest, and accordingly, that both require careful consideration. Further, a better understanding of the complexities of non-financial conflicts of interest, and their entanglement with financial conflicts of interest, may assist in the development of a more sophisticated approach to all forms of conflicts of interest.

The article is here.

Friday, November 24, 2017

Trump presidency spurs cottage industry of ethics watchdogs

Fredreka Schouten
USA Today
Originally posted November 23, 2017

Here is an excerpt:

The groups pursuing Trump say they are trying to keep close tabs on a president who is bucking ethical norms by retaining ownership of his businesses and abruptly firing FBI Director James Comey, who was leading the agency’s probe into the Russian government involvement in last year’s election.

“We are in a crisis of ethics,” said Noah Bookbinder, the executive director of Citizens for Responsibility and Ethics in Washington or CREW. “There are ethics a
nd conflicts and influence problems in this administration unlike any we have ever seen. And it began with the president’s decision not to divest from his businesses.”

White House officials this week contended that Trump is operating ethically. As an example, they point to his signing of a far-reaching ethics policy that, among other things, tries to slow the revolving door between government and industry by imposing a five-year cooling-off period before former government appointees can work as lobbyists.

“An organized onslaught from partisan groups committed to undermining the President’s agenda can’t change the fact that he has elevated ethics within this administration,” White House spokesman Raj Shah said in a statement.

The information is here.

Saturday, October 7, 2017

Committee on Publication Ethics: Ethical Guidelines for Peer Reviewers

COPE Council.
Ethical guidelines for peer reviewers. 
September 2017. www.publicationethics.org

Peer reviewers play a role in ensuring the integrity of the scholarly record. The peer review
process depends to a large extent on the trust and willing participation of the scholarly
community and requires that everyone involved behaves responsibly and ethically. Peer
reviewers play a central and critical part in the peer review process, but may come to the role
without any guidance and be unaware of their ethical obligations. Journals have an obligation
to provide transparent policies for peer review, and reviewers have an obligation to conduct
reviews in an ethical and accountable manner. Clear communication between the journal
and the reviewers is essential to facilitate consistent, fair and timely review. COPE has heard
cases from its members related to peer review issues and bases these guidelines, in part, on
the collective experience and wisdom of the COPE Forum participants. It is hoped they will
provide helpful guidance to researchers, be a reference for editors and publishers in guiding
their reviewers, and act as an educational resource for institutions in training their students
and researchers.

Peer review, for the purposes of these guidelines, refers to reviews provided on manuscript
submissions to journals, but can also include reviews for other platforms and apply to public
commenting that can occur pre- or post-publication. Reviews of other materials such as
preprints, grants, books, conference proceeding submissions, registered reports (preregistered
protocols), or data will have a similar underlying ethical framework, but the process
will vary depending on the source material and the type of review requested. The model of
peer review will also influence elements of the process.

The guidelines are here.

Tuesday, October 3, 2017

VA About To Scrap Ethics Law That Helps Safeguards Veterans From Predatory For-Profit Colleges

Adam Linehan
Task and Purpose
Originally posted October 2, 2017

An ethics law that prohibits Department of Veterans Affairs employees from receiving money or owning a stake in for-profit colleges that rake in millions in G.I. Bill tuition has “illogical and unintended consequences,” according to VA, which is pushing to suspend the 50-year-old statute.

But veteran advocacy groups say suspending the law would make it easier for the for-profit education industry to exploit its biggest cash cow: veterans. 

In a proposal published in the Federal Register on Sept. 14, VA claims that the statute — which, according to The New York Times, was enacted following a string of scandals involving the for-profit education industry — is redundant due to the other conflict-of-interest laws that apply to all federal employees and provide sufficient safeguards.

Critics of the proposal, however, say that the statute provides additional regulations that protect against abuse and provide more transparency. 

“The statute is one of many important bipartisan reforms Congress implemented to protect G.I. Bill benefits from waste, fraud, and abuse,” William Hubbard, Student Veterans of America’s vice president of government affairs, said in an email to Task & Purpose. “A thoughtful and robust public conservation should be had to ensure that the interests of student veterans is the top of the priority list.”

The article is here.

Editor's Note: The swamp continues to grow under the current administration.

Saturday, September 30, 2017

Ethics office: Anonymous gifts to legal defense funds are not allowed

Megan Wilson
The Hill
Originally posted September 28, 2017

The Office of Government Ethics (OGE), the federal government’s ethics watchdog, clarified its policy on legal defense funds on Thursday, stating that anonymous contributions should not be accepted.

The announcement comes after a report that suggested the OGE was departing from internal policy regarding the donations, paving the way for federal officials to accept anonymous donations from otherwise prohibited groups — such as lobbyists — to offset their legal bills.

In 1993, the OGE issued an informal advisory opinion that allowed for such donations because the federal employee “does not know who the paymasters are.”

Immediately after, the office acknowledged the problems associated with allowing prohibited individuals to give to legal defense funds anonymously and instead advised lawyers not to accept those contributions.

Then-OGE Director Stephen Potts told a congressional panel in 1994 that the agency “recognized that donor anonymity may be difficult to enforce in practice because there is nothing to prevent a donor disclosing to the employee that he or she contributed to the employee’s legal defense fund,” the advisory published Thursday notes.

The article is here.

Sunday, September 24, 2017

Ethics experts say Trump administration far from normal

Rachael Seeley Flores
The Center for Public Integrity
Originally published September 23, 2017

President Donald Trump’s young administration has already sharply diverged from the ethical norms that typically govern the executive branch, exposing vulnerabilities in the system, a small group of ethics experts and former government officials agreed Saturday.

The consensus emerged at a panel titled “Trump, Ethics and the Law” at the Texas Tribune Festival in Austin, Texas. The panel was moderated by Dave Levinthal, a senior reporter at the Center for Public Integrity.

“There have been untidy administrations in the past, but usually it takes a while to see these things develop,” said Ken Starr, a lawyer and judge who served as solicitor general under President George H.W. Bush and is best known for heading the investigation that led to the impeachment of President Bill Clinton.

Ethics laws are based on the idea that norms will be followed, said Walter Shaub, former director of the U.S. Office of Government Ethics (OGE).

“When they’re not followed, we suddenly discover how completely vulnerable our system is,” Shaub said.

The article is here.

Saturday, July 29, 2017

On ethics, Trump is leading America in the wrong direction

Jeffrey D. Sachs
CNN.com
Originally published July 26, 2017

Here is an excerpt:

So here we are. Bribes are no longer bribes, campaign funds from corporations are free speech, and the politicians are just being good public servants when they accept money from those who seek their favor. Crooked politicians are thrilled; the rest of us look on shocked at the pageantry of cynicism and immorality. Senior officials in law-abiding countries have told me they can hardly believe their eyes as to what is underway in the United States.

Which brings us to Donald Trump. Trump seems to know no limits whatsoever in his commingling of the public interest and his personal business interests. He failed to give up his ownership interest in his businesses upon taking office. (Trump resigned from positions in his companies and said his two sons are in charge.)

Government and Republican Party activities have been booked into Trump properties. Trump campaign funds are used to hire lawyers to defend Donald Trump Jr. in the Russia probe. Campaign associates such as Paul Manafort and Michael Flynn have been under scrutiny for their business dealings with clients tied to foreign governments.

In response to the stench, the former head of the government ethics office recently resigned, declaring that the United States is "pretty close to a laughingstock at this point." The resignation was not remarkable under the circumstances. What was remarkable is that most Republicans politicians remain mum to these abuses. Of course too many politicians of both parties are deeply compromised by financial dependence on corporate campaign donors.

The article is here.