Commentary by Robert Morgan, MD

“The earth is not flat, the earth is not round, the earth is crooked.” While that may describe the sorry state of the world, it is up to all of us to make that world less crooked and more fair. The series of articles in the recent EpiMonitor correctly shone a light on some of the unfairness of the Heath Report in the Pat Buffler matter. Full disclosure: I was Pat’s friend for almost 40 years. The Heath report hardly ranks as investigative journalism. Rather, it is a slanted review of part of the life of a distinguished academician. In his interview, Heath is reported to have said, “Our mission, as with any investigative reporting, is to expose abuses and wrongdoing as a way to curb them.” So what abuse or wrongdoing  is he reporting?

Buffler Membership

Heath implies that Buffler’s membership on the FMC Board of Directors was a shocking and secret conflict of interest.  As a public company, FMC annually publishes the names of the Directors, their compensation, and their stock ownership position.  Hardly secret, hardly shocking that Pat’s name appeared every year of her membership. And as to disclosing that Board membership on publications and grant applications, that would be appropriate only if the topic related to FMC or its products. It is also possible that if she disclosed a possible conflict, the journal did not publish it.  That has happened to me twice (including the New England Journal of Medicine). Did Heath read all her grant applications to support his claim that she never disclosed her FMC relationship?

Criticism in Science

Heath is very critical of Buffler for taking money to critique other scientist’s work. A good scientist welcomes critical review and doesn’t worry about who funded the criticism. In science, the quality of the data and the validity of the criticisms are more important than authorship or funding. The best mechanism for truth in science is peer review.  Dr. Buffler’s papers were subjected to the same peer review process as other submissions. Was there any peer review for the Heath report? Although he criticizes her funding, did he point out that his funding comes from an organization whose Board of Directors is chaired by a famous plaintiff’s lawyer?

Scientists and Industry

The University of California has effectively answered many of Heath’s allegations concerning funding. I agree with their policies and there is no suggestion that she violated any of the rules. Industry has a responsibility to produce safe products and ensure the health of workers, consumers, and the community. One of the ways they can exercise that responsibility is by grants and contracts to the best and brightest academic scientists. The suggestion that scientists are being bought by industry money is grossly unfair to most persons receiving grants or contracts from industry.  That suggestion is also a favorite allegation of plaintiffs’ lawyers when faced with peer-reviewed industry-funded science that weakens or refutes plaintiffs’ claims.

Private Practice

Relevant to the discussion of industry funding is my article of 1982 in the Epidemiology Monitor (June 1982, Vol 3 Number 6 available online) for a discussion of what I have termed the private practice of epidemiology. I have spent over forty years doing research with industry funding.  Like the University of California, we retained all original data in the event that any other competent scientist wished to reanalyze it. Our policies were always clear: we (not the client) designed the studies; we (not the client) decided on publication; we always disclosed funding sources in our research publications; clients did not have the right to edit any of our publications. We submitted our work to peer-reviewed journals. Yet even so, one paper sent to the American Journal of Public Health was rejected outright (without peer review) because the Editor at the time told us he would not publish a negative study funded by industry. Another twist to the well-recognized and continuing problem of publication bias in science.

Outside Consulting

Likely, most academic epidemiologists do some outside consulting. That practice needs no defending. Sometime the consulting is stimulated by litigation or fear of litigation. Both plaintiffs and defendants use experts and both sides pay well. Sometimes, the consulting activity addresses concern over product safety, worker safety, or community health.  Is it wrong for corporations to hire the best possible expertise to address these issues? Is it wrong for a company to place an academic with community health and safety expertise on the Board of Directors?

Government research funds are scarce and tough to get. Industry money is available, and should be used.  Corporations have a responsibility to examine the safety of their products, the health of their workers, and their health effects (if any) on the community. Academics and non-academics (like me) should use those funds for research. Heath’s apparent thesis is that industry should not fund health research.  Does he really wish to remove a major source of funds in a time of federal cutbacks? Who would make up the shortfall in funds?

Funding Source

The Heath report says that, “Buffler co-authored 15 articles in scientific journals paid for by companies or industry groups….” His sentence is amibiguous.  Did the companies pay the journals? Did they pay Buffler to write the articles? Or did they pay for the research that went into the articles? Only Pat Buffler can answer the questions and she is not here.  I suspect the research was funded by industry but Pat wrote the articles on her own time, as I would. And what difference does funding make? Scientific studies should be judged by the research design, data, and interpretations, not funding. The scientific tradition of peer review and repetition of studies provides at least some safeguards against industry buying the science it wants.

Paid Assassins

If Heath wants to do some real investigative reporting, he should look into the funding of the group of self-proclaimed scientists who do no original work, but criticize those who do, and who accept sizeable fees from attorneys to prepare ammunition against legitimate experts. Many of these persons are nothing more than paid assassins hiding behind several “public interest” organizations or publications. Since I am often an expert witness, I know I am a ready target for character assassination. At least I can defend myself. Pat Buffler cannot. In the long run, science will have to discern the truth from conflicting articles.  Meta-analysis, properly done, may provide one of the methods for settling controversy.

It will be unfortunate if Heath’s report discourages scientists from accepting industry grants or contracts out of fear of public attacks on character and credibility.  Let science go forward, whatever the funding source, and continue the usual processes of peer review and further studies to confirm or question published findings. ■
 

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