Tuesday, July 15, 2008

VCU, Philip Morris, and the "Recent Unpleasantness"

While I lived in Richmond, Virginia from 1987 to 1994, one could still find some people who referred to the US Civil War as the "recent unpleasantness." Similarly, we have noted the "anechoic effect," how cases involving deficient ethics, poor leadership, and flawed governance in health care occurs produce few echoes. Many important cases and issues that have been discussed on Health Care Renewal have never appeared in medical or health care journals. Many specific cases have never been publicly discussed at the institutions in which they originated. Some specific cases have never appeared in the national news media. Some specific cases have not been covered even in the relevant local news media.

Here is a case in point, from Richmond, Virginia. The Richmond Times-Dispatch, the only major newspaper in that city, just reported that the President of Virginia Commonwealth University (VCU), Eugene P Trani, is recovering from coronary artery bypass grafting (CABG) surgery. We wish President Trani a speedy recovery. But buried in that article is the only mention that has ever appeared in the Richmond Times-Dispatch of the recent unpleasantness about research contracts between VCU and tobacco company Philip Morris. Here it is:

Trani was scheduled to be on a two-month sabbatical at Harvard University's Taubman Center for State and Local Government through mid-August. In his note to the university community, he said he returned to Richmond after his first month because the university was 'experiencing a number of recent challenges.'

Recent controversies have brought VCU some unwelcome attention.

There have been questions about whether a research agreement with Philip Morris USA was in accordance with traditional accepted research guidelines and policy.

A university Task Force on Corporate Sponsored Research will hold a town-hall meeting tomorrow to hear from faculty and students on the research issue.

We have discussed this "recent challenge" on Health Care Renewal. Briefly, the New York Times reported last month that VCU has been doing research under contract with Philip Morris USA. Contract provisions forbade the university from even revealing the existence of the contract itself. By classifying all products of the research as "proprietary," the contract seemed to bar university faculty from publishing or publicly discussing the research without permission from Philip Morris. Such provisions apparently violated not only the university's stated policies, but its fundamental mission. Furthermore, it appeared that the university's coziness with Philip Morris might relate to its President's leadership role for a company in the tobacco industry. President Trani, it turns out, is on the board of directors of Universal Corp, which buys, processes, and ships tobacco. For a university President who also leads a medical school and academic medical center simultaneously to be responsible to the stock-holders of a tobacco company seems quite a major conflict of interest, given that tobacco products clearly cause much disease, disability, and death in the absence of any health benefits.

But to the Richmond Times-Dispatch, all this seems just to be some recent unpleasantness.

The cone of silence that seems to confine much unethical behavior, poor leadership, and poor governance in health care has disabled medicine's and society's ability to address these problems.


Anonymous said...

I have comment previously that I find it interesting that we in business see more discussion, and identification of conflicts, than those in the medical community. A July 14 WSJ article by Shirley Wang identifies a NIH researcher, Charles Natanson, that did not disclose a financial conflict prior to publication of an article on blood substitutes in the JAMA. Towards the end of this article we find the names Sidney Wolfe and Peter Lurie of Public Citizen being mentioned as co-authors.

Once again we see a business publication putting this information forth with no regard for public stature. Companies also have been forced to put forth product information when giving financial guidance that would, or should, have raised questions in the medical community.

During the early 1970s I was privileged to meet a number of older people from the South. They made it clear that there never was a US Civil War, but a war of Northern Aggression. I guess everything is perspective.

Steve Lucas

Anonymous said...

And he went in for a CABG...

Kind of like the CEO of Smith&Wesson being treated for a gunshot wound.