Página 67 - Dimensiones éticas de las regulaciones en salud

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the New England Journal of Medicine found extensive conflict of inter-
est in financial interests among 893 institutional review board members
in American institutions(9). Furthermore, there is a set of non-financial
conflicts of interest related to the growth and association between investi-
gators and industry. These relate more to the need for career advancement
and research publications. These non-financial conflicts of interests are
actually quite extensive (10).
What are the consequences of these forces? As recently as has been docu-
mented, there are concerns with research integrity. Research ethics boards
and institutional review boards cannot monitor individuals who com-
mence their research without ethics approval. Nor can they give oversight
to the sort of scandals such as that by Woo Suk Wang at Seoul National
University in South Korea. In December 2006 on the final issue of Sci-
ence which is usually devoted to the scientific breakthrough of the year,
was in fact called the breakdown of the year(11). The 2005 breakthrough
of the year was related to the claims by Professor Wang to have created
the first ever human embryonic stem cell lines that matched the DNA of
patients. As it emerged, this was a totally fraudulent science and the data
was completely fabricated.
This event had a tremendous impact on Science, one of the major and
most cited journals in all of science. In an editorial in the same issue,
Donald Kennedy, the editor of the journal, documented their response
to the recognition of the fraud that was perpetrated in 2004(12). What
occurred was a complete review of their editorial process, including all
submissions, correspondence amongst editors, review of agreeing editors,
peer reviewers, and agencies responsible for oversight. It is important to
note, however, that a study that gained universal acclaim when published
and massive publicity got through every mechanism and check and bal-
ance and was published in one of the major peer-reviewed journals.
One wonders whether similar non-financial conflicts of interest cloud
decision making at the highest levels of editorial boards. Certainly the