Boston

Back in May, officials at Harvard Medical School gingerly stepped back from a plan to relax the institute's conflict-of-interest policies, which are considered among the strictest in the United States.

At the time, they called for a national forum to establish more uniform standards of conduct for researchers at US academic medical centres (see Nature 405, 497; 2000). Last week, a closed meeting in Washington edged these standards a step closer to reality.

Raising the standard: Harvard's Joseph Martin wants a common policy for conflicts of interest. Credit: GRAHAM RAMSAY/AERO PHOTO

Organized by Harvard's dean of medicine, Joseph Martin, the meeting brought together representatives from eight of the ten largest medical schools in terms of funding from the National Institutes of Health (including Harvard, Yale, Johns Hopkins, and Washington University). Also present were high-profile leaders such as former National Institutes of Health director Harold Varmus, now president of the Memorial Sloan-Kettering Cancer Center in New York.

According to those who attended, the meeting focused on the conflicts of interest that investigators might face when their research offers the potential for personal gain. Recent studies, including one that appeared last week in the New England Journal of Medicine (343, 1621–1626; 2000), have shown a high degree of variation in the ethics policies of medical schools and teaching hospitals. Some have relatively strict rules, whereas others have no stated policies at all.

“This group agreed that it would be good for our community if there were less variability in these policies, while also encouraging the policies to be strengthened overall,” says one attendee, David Korn, vice-president for research at the Association of American Medical Colleges (AAMC). “There was also agreement about the need for absolute and full disclosure, both internally and externally, regarding the possible financial interests of investigators,” he adds.

The group agreed that every institution should have explicit conflict-of-interest policies, clear standards for disclosure of financial ties, and mechanisms for ensuring compliance with the guidelines. “These are broad principles, not detailed rules,” Martin says. “We don't get into the nitty-gritty, as those details should be worked out by the individual institutions.”

A draft statement of principles is now being circulated among meeting participants and could be released before the end of the year, says Dennis Kasper, dean of academic programmes at Harvard Medical School. “We don't represent anyone other than a small consortium of schools that met to talk about this, but we hope other schools will consider these principles.”

Martin says that other institutions may be brought on board through the AAMC. The association has appointed a task force, chaired by William Danforth, former chancellor of Washington University, to review conflict-of-interest issues next year.

And although major medical schools are each likely to adhere to their own sets of conflict-of-interest rules, administrators believe that some commonality between these rules will help to discourage researchers from 'jumping ship' to more lenient institutions.

But Korn warns that there are more important issues at stake. “The critical thing is to maintain the public's confidence in medical research,” he says.