The principal investigator of this project is Sheila Kaplan. The EPA has a vast mandate - protecting air, water, land and people from pollutants. But year after year, through both Republican and Democratic administrations and Congresses, strong economies and weak ones, the institution fails the American public in many ways. The evidence abounds. Reports by the Government Accountability Office (formerly the General Accounting Office), EPA's own Inspectors General and the media have long documented EPA's inability to guard Americans from toxic chemicals, mining waste, leaking Superfund sites, greenhouse gas emissions, contaminated water, air pollution and other hazards.... Read more about The Economy of Influence Shaping American Public Health and the Environment

Although all medical specialties have come under scrutiny for financial conflicts of interest, the field of psychiatry has been at the epicenter of this "crisis of credibility" (Fava, 2006). Researchers, investigative journalists, and policy makers have raised questions about the extent of industry influence on the diagnostic and practice guidelines developed by the American Psychiatric Association (APA).... Read more about Anatomy of an Organization: an Ethnographic Approach to Understanding the History and Ethics of the American Psychiatric Association

Professor Marc Rodwin’s project grows out of his previous two books on physicians’ conflicts of interest.¹ One source of these conflicts of interest is physicians’ financial relationship to pharmaceutical firms. As an Edmond J. Safra Research Lab Fellow, Marc Rodwin is analyzing the legal, financial, and organizational arrangements within which the pharmaceutical industry operates. These sometimes create incentives (for drug firms and their employees) that conflict with the development of knowledge, drug safety, the promotion of public health, and innovation. They also make the public depend inappropriately on pharmaceutical firms to perform certain activities and this leads to institutional corruption. In a series of articles he will analyze the pros and cons of various options for reform.... Read more about The Pharmaceutical Industry, Institutional Corruption, and Public Health

Professor Sergio Sismondo has been working to detail the key mechanisms by which which pharmaceutical companies establish dominance over particular areas of medical knowledge. He has been looking at, for example, the ghosting of articles for medical science journals and at drug companies' recruitment and management of physicians to serve as "key opinion leaders". In his project at the Safra Center, he is studying how people justify their work to manage medical knowledge, as well as at how physicians and researchers justify their involvement with the drug industry.... Read more about Corruption and Justification in the Ghost Management of Medical Research

Professor Marc-Andre Gagnon investigates how the innovation system in the pharmaceutical sector is broken. In the last 15 years, fewer new drugs have arrived on the market, and the vast majority of them do not represent any therapeutic advancement as compared to what already exist. However, promotional expenditures surged during that period and, according to dominant pharmaceutical companies' annual reports, they are gaining record profits in spite of the lack of therapeutic innovation.... Read more about The Political Economy of Pharmaceutical Corruption: How to Reconcile Profits and Public Health in the Pharaceutical Sector?

Dr. Susannah Rose's primary project at the Edmond J. Safra Center for Ethics has been to develop an empirical research study aimed at assessing the nature of institutional financial conflicts of interest among patient advocacy groups in the United States. During her first year as a residential Lab Fellow at the Safra Center, Susannah finished a paper that reviews the literature on patient advocacy groups, which describes their significant role in shaping health policy in the U.S. and provides recommendations for helping advocacy groups better manage institutional conflicts of interest. In this paper, she argues that maintaining and enhancing trust and institutional trustworthiness are important targets for policies aimed at managing financial conflicts of interest.... Read more about Patient Advocacy Organizations

Recently, policymakers in the US have become concerned about the relationships between medical trainees and pharmaceutical industry representatives, because such interactions may affect trainees' professional development and their future prescribing practices. Lab fellow Kirsten Austad's project involves investigating the extent of trainees' contacts with pharmaceutical industry representatives, as well as the impact of these interactions on trainees' attitudes about pharmaceutical policy issues and knowledge about evidence-based prescribing.... Read more about Medical Trainees and the Pharmaceutical Industry: a National Survey