To the Editor:

The medical industrial complex’s compromising of academic medicine’s scientific integrity is one of the most serious issues and problems for current day medical care. Any interested observer can pick out numerous clinical protocols whose design and aims were compromised by the need to come up with a result that would help sell a drug or device. To see the effect on societies such as ASH, one could look at the symposium sensationally titled, “Anemia in the Elderly: A Public Health Care Crisis in Hematology.” Could this emphasis on the issue of mild anemia in the elderly have anything to do with the fact that all the speakers were consultants for companies selling erythropoietin?

There needs to be some way to treat the rampant problem of financial conflict of interest in medical research. Self regulation can never compete with self serving. Thus, as bad as it is, outside regulation or changes in the way research is financed or administratively organized (e.g., the industry’s funding of a truly independent foundation to support clinical research vs. direct industry trial support) is necessary to assure that medical care and medical research are not being perverted by the reality of the profit motive coming before medical need and necessity.

Irwin Nash, MD, Department of Pathology, Hospital of St. Raphael, New Haven, CT