John Paul II´s Address on Conflict of Interests in Medical Research

«Ethical Values Must Be Brought to the Fore»

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VATICAN CITY, APRIL 12, 2002 ( Here is the text of the letter John Paul II sent to Archbishop Józef Kowalczyk, apostolic nuncio in Poland, on the occasion of an international conference on the «Conflict of Interest and Its Significance in Science and Medicine,» held in Warsaw from April 5-6.

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To The Most Reverend Józef Kowalczyk

Apostolic Nuncio in Poland

I am pleased to learn that you will be present at the International Conference to be held at Warsaw on April 5-6, 2002 on the theme: «Conflict of Interest and its Significance in Science and Medicine», and I ask you kindly to convey my heartfelt best wishes to the organizers and participants. The subject of the Conference is well worth bringing to the attention of society as a whole. In fact, this is a question which affects not just the programming and development of medical research and science, but the well-being of peoples and the very dignity and prestige of scientific learning itself. In recent times the issue has emerged as one of the most serious ethical problems facing the international community.

In advanced societies, research, and specifically biomedical research, is one of the most far-reaching and dynamic fields of innovation and progress, drawing investment both from public bodies and from private groups, often of a multinational character.

While it is certainly proper for a firm in the field of biomedical or pharmaceutical research to seek an appropriate return on investment, it sometimes happens that overriding financial interests prompt decisions and products which are contrary to truly human values and to the demands of justice, demands which cannot be separated from the very aim of research. As a result, a conflict can arise between economic interests on the one hand and, on the other, medicine and health-care. Research in this field must be pursued for the good of all, including those without means.

In other words, there is a risk that science-based businesses and health care structures can be set up not in order to provide the best possible care for people in accordance with their human dignity, but in order to maximize profits and increase business, with a predictable lowering in the quality of service for those unable to pay.

In this way there is created in the field of science and medicine a conflict of interest between the investigation and correct treatment of illnesses — which is what scientific and medical research is all about — and the financial objective of making a profit.

Today this conflict is obvious in a number of specific ways. First of all, it can be seen in the selection of research programs, where those programs which hold out the promise of a quick profit are often preferred to other research which involves higher costs and a greater investment of time because it respects the demands of ethics and justice. Driven by the pursuit of profit and catering to what could be called «the medicine of desires,» the pharmaceutical industry has favored research which has already placed on the world market products contrary to the moral good, including products which are not respectful of procreation and even suppress human life already conceived.

Even as biomedical research continues to perfect methods of artificial human fertilization, little funding and little research is directed to the prevention and treatment of infertility. The recent decision in some countries to use human embryos or even to produce or clone them in order to harvest stem-cells for therapeutic purposes has the backing of large investors. Yet ethically acceptable and scientifically valid programs using adult cells for the same therapies, with no less success, draws little support because lower profits are anticipated.

Another example of such conflict of interest is the way in which priorities are set for pharmaceutical research. In developed countries, for instance, huge sums are spent on producing medicines that serve hedonistic purposes, or in marketing different brands of already available and equally effective medicines; while in poorer areas of the world drugs are not available for the treatment of devastating and deadly diseases. In these countries access to even the most basic medicines is almost impossible because the profit motive is absent. Likewise, in the case of certain uncommon diseases the industry offers no financial support for research and the production of medicines, because there is no prospect of profits: these are the so-called «orphan drugs.»

The very ethics of research can be undermined by the conflict of interest of which we are speaking, as for example when financial groups claim the right to permit the publication of research data depending on whether or not such data are in the interest of the groups themselves.

Even medical care in hospitals is increasingly subject to the imperatives of cost-containment. Although it is right to avoid waste in health care administration and in treatment, it is not right to deny proper care or permit the level of treatment to be lowered for the sake of greater financial profits.

The list of such conflicts will undoubtedly expand, if a utilitarian approach is allowed to prevail over the genuine quest for knowledge. This is what happens for example when the media, often financed by the same business interests, provoke exaggerated expectations and spawn a kind of pharmacological consumerism. At the same time they tend to pass over in silence those means of protecting health which require people to act responsibly and with self-discipline.

For science to retain its true independence and for researchers to retain their freedom, ethical values must be brought to the fore. To subject everything to profit involves a real loss of freedom for the scientist. And those who would uphold scientific freedom by appealing to a «values-free science» prepare the way for the supremacy of economic interests.

In a broader view, the pre-eminence of the profit motive in conducting scientific research ultimately means that science is deprived of its epistemological character, according to which its primary goal is discovery of the truth. The risk is that when research takes a utilitarian turn, its speculative dimension, which is the inner dynamic of man?s intellectual journey, will be diminished or stifled.

For scientific research in the biomedical field to be restored to its full dignity, researchers themselves must be fully engaged. It is primarily up to them to guard jealously and, if necessary, to reclaim the essential meaning of that mastery and dominion over the visible world which the Creator entrusted to man as a task and duty. As I wrote in my first Encyclical Letter Redemptor Hominis, this meaning «consists in the priority of ethics over technology, in the primacy of the person over things, and in the superiority of spirit over matter» (No. 16). Consequently, I added, «all phases of present-day progress must be followed attentively. Each stage of that progress must, so to speak, be x-rayed from this point of view» (ibid.).

Public authorities too, as guardians of the common good, have a role to play in ensuring that research is directed to the good of people and of society, and in tempering and reconciling the pressures of divergent interests. By issuing guidelines and by allocating public funds in accordance with the principles of subsidiarity, they should actively support those fields of research not sponsored by private interests. They should be prepared to prevent research which harms human life and dignity or which ignores the needs of the world?s poorest peoples, who are generally less well equipped for scientific research.

In offering good wishes for the success of this important Conference, I wish to reaffirm that the Church looks to scientists and researchers with hope and trust. In this sense I renew the invitation which I addressed to Catholic intellectuals in my Encyclical Lett
er Evangelium Vitae, and I extend it to all researchers of good will: may you «be present and active in the leading centers where culture is formed, in schools and universities, in places of scientific and technological research,» deeply committed to being «at the service of a new culture of life by offering serious and well documented contributions, capable of commanding general respect and interest by reason of their merit» (No. 98). It is in virtue of this broad vision of commitment to the truth and the common good that medical research and learning have written pages of genuine advancement, deserving of humanity?s recognition and gratitude.

With these thoughts, I invoke Almighty God?s assistance upon the work of the Conference and I cordially impart my blessing to all those taking part.

From the Vatican, March 25, 2002

[Original text: English; distributed by Vatican Press Office]

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