Skip to main content

experts shooting themselves in the foot with conflicts of interest

February 22nd, 2018 | 2 min read

By Matthew Loftus

Skepticism of medical authorities is, at least in terms of vaccine refusal, becoming worse and worse. I think this is a bad thing, and have previously commended Ari Schulman’s essay on the politics of medical denialism to help understand why this is the case. In that essay, he mentions that “Vaccines also serve as a proxy for concerns about the nature of Western medicine—its reductiveness, its invasiveness, its emphasis on disease over health, the influence of pharmaceutical corporations in crafting therapeutic techniques”, and I want to highlight the lattermost issue (that is, financial conflicts of interest) there.

From my friend and former colleague Dr. Max Romano:

As a family physician in Baltimore, I use guidelines from professional groups to bring impartial scientific information to my clinical practice — or so I thought. When I read the new blood pressure guideline published by the American College of Cardiology (ACC) and the American Heart Association (AHA) in November, just five minutes of Internet searching exposed that six of the guideline’s authors had financial relationships with corporations that were not mentioned in the publication, as is generally required by the ACC, AHA and the medical journals in which the guideline was published.

Dr. Milton Packer gave a response to Dr. Romano here. I’m personally inclined to call it a lot of question-begging and strawmanning, but you can read it and judge for yourself whether a 2014 payment of $50,000 by a company that makes hypertensive drugs to one of the authors of a guideline may have influenced how that author helped to write that guideline in 2018.

Either way, it still looks bad. And looking bad is half the point: if people have doubts about whether or not a guideline about what they put into their bodies had some nefarious financial interference, then it’s entirely reasonable for them to refuse medical interventions. The physician you see may or may not have gotten anything more than a free pen and lunch from the makers of Progasmozac (and there’s evidence to show that those things do influence prescribing behavior), but when its there’s skeeviness going on with the people setting the guidelines that impartial physicians and savvy patients depend on to make decisions, it undermines the whole system of trust that our medical system depends on.

I’ll do a whole post on sugar and fat sometimes, but the gross negligence of nutrition scientists in pushing “low-fat” diets while allowing the menace of sugar to ravage our bodies unchecked has some ugly history with conflicts of interests. Distrust of medical authorities is fueled by such monumental errors.

You’ll never be able to shut out the quacks entirely. But you can deny them ground to stand on by making sensible disclosures and forthright admissions about conflicts of interest.

Matthew Loftus

Matthew Loftus teaches and practices Family Medicine in Baltimore and East Africa. His work has been featured in Christianity Today, Comment, & First Things and he is a regular contributor for Christ and Pop Culture. You can learn more about his work and writing at