BMJ  2006;332:1155-1156 (13 May), doi:10.1136/bmj.332.7550.1155-c

Letter

Research for profit

EDITOR—The stumbling block for clinical trials in both the developing and developed world is the same, enrolment.¹ It is difficult to enrol patients into trials, and we rely on consent forms and the investigating doctor to protect patients.

Unknown to most patients, however, is the conflict of interest that exists at the time of enrolment. When I first started in general practice over 10 years ago I was asked to conduct pharmaceutical company research. The motivation to conduct this research was financial with the potential to earn £10 000 (14 500; $18 500) on top of NHS income. This is still common, especially in the most deprived areas of the United Kingdom. I conducted the research and enrolled 10 patients—I told patients that I was being paid but did not disclose the amount.

Later I was again asked to act as an investigator in another trial. On this occasion, however, I decided on complete transparency and disclosed the fee to the patients at the time of enrolment. I was unable to recruit any patients. So ended my involvement in research for profit.

The greatest incentive for doctors to conduct research and enrol patients for pharmaceutical studies is financial, either directly or to their institution. This situation is not ethical. Patients agree to participate in trials for altruistic reasons and put trust in the professionalism of doctors. Ethics committees should recognise this and insist the exact amounts paid to doctors and hospitals be disclosed to patients. Perhaps it is time also that independent non-profit groups and charities oversee and organise clinical trials.

Money, medicine, and research is a heady and seductive cocktail but has the potential for excess, risk taking, and recriminations.

Glasgow G20 9DR destwo{at}yahoo.co.uk

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Competing interests: DS is a member of nofree-lunch.

References

1. Iheanacho I. Drug trials—the dark side: This World. BMJ2006;332: 1039. (29 April.)[Free Full Text]

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