Monday, April 11, 2005

UC Academic Council Missing the Point in Tobacco Funding Policy Debate

In May 2004, the faculty of the UC Berkeley School of Public Health voted to adopt a policy that the School would accept no new research grants from the tobacco industry. Three other schools and a total of seven academic units within the UC system have similar policies. The UC Academic Council recently decided that only the Regents, not UC academic units, can make a decision not to accept tobacco industry funding. Now, a coalition of UC faculty and others is attempting to convince the UC Board of Regents to overturn this decision and allow individual Schools to set their own policies. The group is circulating a petition calling on the UC Regents to intervene and allow individual Schools and academic units within the UC system to establish their own policies regarding acceptance of tobacco industry funding.

Two members of the UC Administration - Vice Provost for Research Larry Coleman and Regent Judith Hopkinson - have argued that policies like that adopted by the UC Berkeley School of Public Health violate academic freedom by restricting potential funding sources for faculty researchers. A recent Sacramento Bee article quoted Coleman as stating: "Academic freedom is like the First Amendment. It has to be absolute, or no one has it. If you start making value judgments about the appropriateness of a funder, then there's no place to stop." A San Francisco Chronicle article quoted Hopkinson as stating: "While I abhor the practice of many of the tobacco companies, I do believe this is an issue of academic freedom. I think it is the wrong precedent to set. There are a lot of people who feel strongly about different things. ... Taking such a position universitywide could lead to restrictions on stem-cell research or other controversial research."

In contrast, the coalition defending the right of individual UC Schools to set their own policy regarding tobacco industry funding have argued that the Academic Council's action represents an infringement of the relevant faculty's efforts to protect academic freedom by protecting academic integrity of their faculty and their institutions. In addition, it has argued that "Accepting money from the tobacco industry is inconsistent with the mission of the University of California, Berkeley School of Public Health, ‘the promotion and the protection of the health of the human population.’"

The Rest of the Story

What should, I think, be a relatively straightforward discussion, is, I believe, being obscured by a failure on the part of the UC Academic Council and at least one of the Regents to appreciate the nature of and reasons for the UC Berkeley School of Public Health's decision not to accept research funding from tobacco companies. I believe the actual issue at hand has been distorted by turning the debate into a discourse on academic freedom. And perhaps the arguments offered by some of the proponents of the School's policy have contributed to this distortion of the issue.

I don't see this as properly a debate over academic freedom. But neither do I see it as a debate over the integrity of tobacco industry-funded research. Rather, I see this as a dispute over whether individual schools within the UC system can properly set their own policies to protect the best interests of their faculty and their institutions by guarding against what they perceive to be the most egregious of conflicts of interest in research.

The University of California, Berkeley's Faculty Handbook states, with respect to research conducted by the faculty, that: "The University' s overall policy on conflict of interest is that none of its faculty, staff, managers, or officials shall engage in any activities which place them in a conflict of interest between their official activities and any other interest or obligation." Note that a conflict of interest does not have to be a financial one. Any situation in which a faculty member engages in research which creates a conflict between competing interests of that faculty member may be perceived by a School as representing a conflict of interest, and since the policy stresses that no faculty may engage in such an activity, it is a legitimate interest of the School to adopt policies that, for example, eliminate the possibility of such a conflict of interest.

Now, since helping to fulfill the mission of the School is certainly one of a faculty member's central interests, it follows that any research that is not consistent with the mission of a School (i.e., which conflicts with the School's mission by creating a competing interest on the part of the faculty member or the institution itself) would represent a severe conflict of interest that may be prohibited by University policy. And it would certainly be a legitimate interest of the School to prevent such a substantial conflict of interest from arising by specifying appropriate policies.

Before continuing this argument, two points are critical:

First, there is nothing inherent in the consideration of potential conflicts of interest between funded research and a School's mission that would, on its face, render illegitimate a School's interest in adopting policies regarding the conduct of such research, including policies that relate to the source of funding for that research. So for example, if a School of Public Health researcher sought to study ways in which to re-design automobiles such that they would require less maintenance but would result in far more fatal crashes, no one would likely argue that the School could not prohibit the researcher from accepting funds to conduct such research. In the School's view, there is an inherent conflict between the interests of the research and the interests (specifically, the mission) of the School. I don't see the UC Regents or the UC Academic Council intervening to preempt schools from adopting this type of policy.

Now suppose, instead, that a researcher aimed to do "appropriate" research, but that it was to be funded by an organization whose interests conflicted so greatly with the School's mission that the School had to prohibit such funding in order to prevent such an egregious conflict from arising. Specifically, let us consider a faculty member applying for funding from an organization that promotes the widespread use of marijuana among children. Let us also suppose that the research itself, to study the health effects of marijuana on the respiratory system, was potentially beneficial and that there were to be no strings attached (i.e., no control over the research, its review, its publication, etc.). I doubt that anyone would object to the School of Public Health disallowing that faculty member to accept research funds from such an organization, even under these favorable scientific circumstances.

Indulge me one final step to advance this argument. Suppose that the citizens of California pass an initiative that legalizes marijuana. Does that action immediately make the School of Public Health's policy not to accept research funding from the group promoting marijuana use among children a violation of academic freedom? I think not. If it was not a violation of academic freedom for the School to adopt a policy disallowing funding of research from the Society for the Promotion of Marijuana Use Among Kids before marijuana was legalized, then I do not see how the decision of a majority of California citizens to legalize marijuana would suddenly turn the School's policy into an infringement of academic freedom. After all, the School's consideration of what represents an egregious conflict with its overall mission is dependent on all factors related to the research and funder that are at hand, not only on the legality of the funder's action.

Clearly, a school policy that aims to protect the reputation and integrity of the school and its faculty members by restricting the nature and source of funding of research conducted within that school in order to ensure that the most egregious of conflicts between funded research and the school's mission do not occur is not inherently an infringement of academic freedom. In contrast, that policy is designed to, and in the above situation, would be effective in protecting academic freedom of the school's faculty by helping to preserve the very reputation and integrity of the school and ensuring that the work of the school and its faculty are consistent with its mission. In fact, such a policy would be simply a specific expression of the university's conflict of interest policy.

So if the UC Berkeley School of Public Health setting a policy regarding a source of research funds that the School will not accept is not inherently an infringement of the academic freedom of its faculty members, then the argument against allowing the School to set such a policy relies upon making a distinction between accepting funding from an organization that promotes marijuana use among children and one that promotes tobacco use among children. And the distinction, as I have shown, cannot simply be based on the legality or illegality of the behavior that the relevant organization is promoting.

What we are left with, then, is simply a debate over whether it is legitimate or not for the faculty of the UC Berkeley School of Public Health to view entities that promote cigarette use among kids as being equally egregious a conflict with its mission as entities that promote marijuana use among kids.

And unless the School's reasoning seems entirely illegitimate (and it would be difficult, I think, to make such an argument given the orders of magnitude by which tobacco-related morbidity and mortality exceeds that from marijuana), then the real issue at hand is simply: Who is in the best position to make a decision about how egregious of a conflict with the School's mission it would create to be funded by such an entity - the UC Regents and systemwide Academic Council, or the faculty of the School of Public Health?

This brings us to the second critical point. The decision regarding what constitutes an egregious conflict with a School's mission is going to be different, depending on what specific School one is talking about. The answer for the UC Berkeley School of Public Health and the UCSF Comprehensive Cancer Center will likely be far different than the answer for the Haas School of Business. After all, the missions of these different programs are widely divergent. And that is, in fact, the critical point.

The UC Regents and the UC Academic Council are simply not in a position to usurp the ability of the individual Schools within the UC system to make their own determinations regarding the nature and magnitude of potential conflicts between faculty research activity and the missions of those individual Schools.

By seizing from the individual Schools the ability to set their own policies regarding the nature of the most substantial potential conflict of interest imaginable - activities that conflict with the very mission of a School - the UC Academic Council has severely infringed upon the Schools' abilities to protect the academic freedom of their individual faculty members and their institutions.

It may be worth noting that by delving into the history of tobacco industry misconduct in research, proponents of the UC Berkeley School of Public Health's policy may actually be hurting their cause. Because such an argument sidelines the actual issue at hand, which is not the integrity of the research, but the decision about who is in the best position to judge whether the research funding will conflict with the mission of the UC Berkeley School of Public Health.

In my view, it doesn't matter whether the tobacco industry will or will not attempt to subvert, interfere with, or in any other way compromise the integrity of research grants to UC faculty members. The problem is not the potential lack of integrity in the research itself, it is simply the conflict between the source of the funding and the mission of the School. And it is because that conflict is so substantial, so egregious, and so absolute that a policy that prohibits faculty from accepting such funds is justified.

So when Larry Coleman argues that as long as the research does not violate University rules (e.g., the lack of industry control over the conduct and reporting of the research), schools have no right to deny that funding, he makes a losing argument. Unless he is prepared to overturn any School of Public Health policy that refuses the acceptance of funds from groups that promote marijuana use, binge drinking (an entirely legal activity), or mass suicide.

But perhaps opponents of the UC Academic Council's vote are not doing themselves any favors by focusing the issue on research integrity. Such a focus actually feeds into, rather than debunks, Coleman's argument.

The strongest argument against the UC Academic Council's action is its usurpation of the right of individual Schools at UC to make their own judgments and set their own policies regarding the most egregious of potential conflicts of interests: conflicts with the mission of those Schools. And taking away that right infringes upon the ability of the Schools to protect academic freedom by setting policies to protect the very integrity, reputations, and best interests of their faculty and their institutions.

It may be instructive to close with a quote from the Boston University Faculty Handbook: "Academic freedom is essential in institutions of higher education if they are to make their proper contribution to the common good. The common good depends upon the free search for truth and its free exposition. It is that which justifies academic freedom, not the interest of the individual faculty member or even the interest of a particular university."

It is, indeed, the interest of the faculty of the UC Berkeley School of Public Health (and, I would add, its alumni) in contributing to the common good that led the faculty to adopt its policy on tobacco research funding. It is the compelling and over-riding interest in that same common good that would justify policies preventing School of Public Health researchers from accepting funds from promoters of marijuana and drug use, binge alcohol use, mass suicide, and yes - even the use of the nation's deadliest consumer product - cigarettes.

Michael Siegel, MD, MPH (UC Berkeley School of Public Health '92)

UPDATE (April 11, 9:30 p.m.): It is worth noting that the above argument counters the slippery slope argument advanced by both Coleman and Hopkinson. This is because it makes it clear that the policy in question is not casting personal value judgments. It is simply making an assessment of the degree of conflict with the school's overall mission. This is not a slope. There is a sharp cut-off that is reached at a point where acceptance of research monies from a funder is seen as presenting a conflict with the school's mission so egregious as to require the elimination of any possibility of such a conflict arising. Stem cell research is not a problem, because it is related to personal values, not to a question of conflict with the school's mission. The fact that "different people feel strongly about different things" is not relevant, as it is not intrinsic to the issue of the degree of conflict with a school's mission. The school's mission allows for widely divergent views and different values in many areas; what it doesn't allow is a conflict with the promotion and protection of the health of the human population.

No comments: