Battle brewing among physicians, JAMA over conflict-of-interest investigations

The Journal of the American Medical Association wants to keep whistleblowers' accusations confidential until conflict-of-interest disputes are thoroughly investigated and resolved, according to a posting on the Wall Street Journal's health blog by Dr. Jonathan Leo, a neuro-anatomy surgeon at Lincoln Memorial Hospital in Tennessee.

Dr. Leo originally informed The New York Times and The British Medical Journal of a suspected, and later confirmed, conflict of interest. JAMA believes that whistleblowers should not use the media as a form for debating suspected conflicts of interest, and rather should wait to make public comment until charges are officially confirmed. Dr. Leo told the New York Times and the BMJ that Dr. Robert Robinson, a psychiatrist at Iowa University had failed to disclose a conflict of interest with Forest Labs, a company whose drug Lexapro, he was studying for use for treating stroke patients.

JAMA published Dr. Robinson's study results last May while he also served on Forest Labs' speaker's bureau creating the conflict of interest, according to Dr. Leo. JAMA believes that whistleblowers, such as Dr. Leo, should report their accusations to the proper authorities but not to the media.

"While the confidential investigation of unreported conflicts of interest is under way, we consider involvement of third parties--such as what Leo has done by his posting on the BMJ site and by contacting the media--to be a serious ethical breach of confidentiality that not only potentially damages our ability to complete a fair and thorough investigation [of the specific issue that Leo had brought to our attention] but also potentially damages JAMA's reputation by the insinuation that we would fail to do so." 

Dr. Leo has taken exception to JAMA's comments and posted them on WSJ's health blog. Both parties are spurring ongoing debate about the rights of whistleblowers and the accused in conflict of interest cases such as Dr. Robinson's with Forest Labs.

For more info:
- here's the blog post
- here's JAMA's take

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