What conflict of interest accusations really mean (with a tie to The Times’s attack on GTNF participants)

by Carl V Phillips

Public health activists are extremely fond of using ad hominem attacks to avoid admitting they have no substantive defense against their critics. They are not alone, of course, with many supporters of other indefensible causes doing the same — e.g., anti-agritech activists, “alternative” energy advocates, alt-right adolescents on Twitter, etc. These attacks most often take the form of claiming “conflict of interest”. Endless ink has been spilled on the fact that resorting to an ad hominem attack is practically an admission that one’s opponent is right. But there is far too little discussion about the actual substantive content of the COI. Basically, what is dressed up as genteel productive discussion is actually a bald accusation that someone is lying, and moreover usually that they are only choosing to lie because of some (often trivial) transfer of funds.

Make no mistake, openly accusing liars of being liars is perfectly reasonable. Sometimes further accusing them of being such a pathetic person as to lie solely to please some financial benefactor is also defensible. If that is what you want to claim, then by all means, man up and say it. But trying to do that without owning it is even more pathetic than being guilty of the accusation.

To unpack that a bit, there are two categories of COI situations: where the actor in question has direct power of some sort, and where he is just providing information. The discussion in the “public health” realm is almost always about the latter. There are exceptions, such as where a decision maker at a government unit — for concreteness, let’s say an agency within the U.S. Department of Health and Human Services — is repaying his past pharma industry patrons or angling for a reward from them when he leaves government. There is a similar problem of decision-maker COI throughout government as well as in many private principal-agent relationships. The key is that the actor is supposed to be serving one interest is actually serving another — that is what the words in “conflict of interest” mean. So the decision is supposed to be what is best for the people the government serves (or the principal that the agent serves), but it is actually serving the interest of himself or a patron.

Despite the fact that the stakes are higher in the real power situation, as compared to the information provider situation, an accusation of COI is actually a rather weaker claim in the former case. Consider a COI accusation against an elected official or a member of the FDA CTP Tobacco Products Scientific Advisory Committee. What does that really even mean? The role of those positions is to advance whatever agenda someone personally thinks is best for the world. So it gets a little fuzzy to try to claim that a particular contributor to that personal opinion is a COI, as opposed to just an I. It is perhaps a bit more clear with the head of FDA or one of its units, but not perfectly clear; after all, they were put in the position to pursue particular goals. Someone might have vile and socially harmful interests, but that does not make them conflicts of interest. Almost all accusations of COI against individuals with direct power really translate into “he is acting based on interests that conflict with my personal view of what is best.”

Contrast that with COI accusations against scientists or journalists whose output is information, not substantive decisions. This also includes those bloggers, pundits, think-tankers, etc. who style themselves as serving as scientists or journalists. (It does not include those who openly identify as trying to bolster a particular corporate or political agenda, like product marketers or those who explicitly position themselves as marketers of an issue.) In that case, the Interest that some other influence might be in Conflict with is trying to provide the most accurate assessment. I.e., it is telling the truth — both in terms of not implying something that contradicts what one knows, and also not endorsing claims in one’s supposed area of expertise that are actually beyond what one knows. There is no other apparent interest to be in conflict with, no mandate to serve the people or fiduciary duty.

Thus, we arrive at the observation that a COI accusation against a researcher or journalist is an accusation that they are lying, in one way or another. Moreover, if the accusation is that some payment is responsible for the lying, there is also the accusation that the individual will sell out his integrity for that (often insignificant) price.

Note that I am not talking about careful measured observations about someone’s affiliations or political ideology, nor about proper “competing interests” disclosures (which is a more accurate phrase, by the way). Those have their own fatal flaws that I have discussed at length — in particular, they lazily ignore the most important COIs (personal political ideology; refusal to admit the error of one’s past positions; the political position of one’s employer) while reporting the trivial ones (who funded an independent research project). I am talking about the COI accusation that effectively are saying “you should ignore this research as being all lies” or “you should not ever trust this person”. These are the clear messages in most COI accusations by “public health” people. Some of those people, like Stanton Glantz and Mike Siegel, spend what seems like most of their time and energy making such accusations. Other anti-tobacco activists are not so prolific, but probably do not go a week without making such an accusation, at least within their own heads to justify their intellectual laziness or to defend their personal biases against the evidence.

Again, if someone is willing to man up and actually say what they are saying, that someone is lying, and perhaps they are doing so because of a particular bit of funding, then they should say it. That is a perfectly legitimate hypothesis that can be offered, openly defended, and then disputed if faulty. But instead, COI accusers always hide behind innuendo, pretending that just saying “COI” about a researcher or journalist is somehow more legitimate, polite, and genteel than saying “liar”. It is not. It is merely less honest.

Of course, it is easy to see why they choose the less honest path. It works and is easy to get away with, without all that pesky effort of actually having to defend one’s claim. Indeed, it often even fools the accused liars into thinking they have not been accused of being liars, even as the dog whistle is clear to everyone else.

That brings us to this week’s chatter about the October 12 attack piece in The Times (London). (Paywalled; if anyone knows of uploaded copy, let me know and I will add a link.) The piece attacked several tobacco product researchers and analysts for giving talks at the GTNF industry conference. It was ostensibly written by reporter Katie Gibbons, but it so clearly parroted tobacco control industry talking points, without any attempt to verify them, that some unacknowledged de facto ghostwriter should probably be considered the real author. (That, by the way, is how you make an honest accusation of dishonesty.) My favorite bit was describing the GNTF meeting as:

last month’s glamorous event, known by insiders as “the Davos of tobacco”

I am pretty sure I am enough of an insider to have heard that if anyone ever said it (I haven’t). And while I have never been to Davos (shocking, right?), I have to say that if it is no more glamorous than GTNF then the world’s robber-barons are definitely not getting their money’s worth. GTNF is no more glamorous than the medical conferences I have been to, and clearly less so than the “public health” boondoggles that its detractors attend.

The main payload of the full page-and-a-half story was trying to smear the particular individuals — Bates, Polosa, Fagerstrom, and others — with innuendo that their research and advice about e-cigarettes are dishonest because they get funding from industry and enjoyed a few days of decent (though presumably not Davos-level) food and drink at industry expense. The phrases “academics making a packet” and “scientists wooed in charm offensive” appear in large type.

As an aside, perhaps the most telling thing about all of this is that the main target of the ghostwritten innuendo seems to be the Nutt et al. paper that is widely misinterpreted (including by its own authors) as showing that e-cigarettes pose 5% the risk of smoking, which was the apparent basis for the Public Health England report that popularized that claim and the Royal College of Physicians report that cemented it. (If you do not recall my analysis of why that claim is bad for the cause, see here.) The story emphasizes the connections of the attacked individuals with the Nutt paper. But the thing is, that paper is junk science from start to finish. It provides evidence of nothing. Calling it junk science may even give it too much credit; it is just a bunch of made-up numbers. It makes Glantz’s cherrypicking efforts look like real science by comparison. But the anti-tobacco zealots are so wedded to ad hominem attacks that they cannot even be bothered to point this out. Instead correctly identifying peak junk science as such, they only know how to make ad hominem attacks on those who endorse it.

Anyway, advancing the clock to this week, The Times published a retraction of some of their claims, supposedly as a result of a threatened lawsuit. You can find a reprint of it here. Pro-ecig activists went gaga over this “victory”. I suggested that perhaps they had not read it. What The Times actually wrote did not in any way soften the accusations of dishonesty they leveled at the individuals in question nor back off of their attack on freedoms of speech and association. Indeed, if anything, they redoubled them.

The content of the “retraction” — apart from some sniveling “you are all great men, so pleeeez don’t sue us” language — was:

[Our story] implied that these experts had received funding for research into e-cigarettes. We accept that this was wrong and their work has not been tainted by the influence of tobacco industry funding.

As a minor point, this is not true. It remains untrue even if we correct the editing error: Obviously most of them they have received funding, but even if we fix that to “received industry funding”, it is still true for some of those smeared in the story. And they all did enjoy the GTNF — with (according to an unretracted assertion) its Davos-style perqs — as claimed. This means that so long as getting any material benefit from tobacco industry money is “tainting”, the accusation has not actually been withdrawn.

That, of course, is the real problem. The Times did not back off on the position that anyone who gets any such funding is a liar. The intimidation remains, with the threat that if any of these guys or anyone else takes such funding, The Times will circle back to smear them for it. Moreover, the “retraction” implicitly redoubles the claim that if one of these individuals did get anything from industry (and, again, they have) they would sell out their integrity and become a liar. Frankly, I would rather be accused of being a liar (for unstated, and thus perhaps noble, reasons) than be accused of having so little intellectual integrity, moral compass, and self-esteem that I would become a liar if offered a few dollars.

I have no doubt, however, that those threatening the lawsuit will consider this a win and back off. Even though the only bit of the damning accusations that were “retracted” were technical details that were actually not entirely false, many consider it vindication (I don’t know if the accused themselves agree, but I would guess yes).

In the ensuing discussion I recalled Chris Snowdon telling me about his effort to get Amazon.com to remove a bunch of personal and defamatory attacks on him in reviews of one of his books. The only one they actually agreed to remove was one that (inaccurately) said he received tobacco industry funding. As he observed from this, you are welcome to call someone a liar and incompetent in a dozen different ways, but saying he got a research grant from the tobacco industry is the one thing that is beyond the pale. (That was a paraphrase summary from memory. I am not sure Chris ever wrote this down. But it is now recalled for your memoirs, Chris — you’re welcome.)

But the ostensible plaintiffs undoubtedly realize that they cannot successfully sue for being called cheap shills who lie about research, and would do so for a few canapes and a chance to get another publication or two. Whereas they might actually win a suit over the technical inaccuracy about who funded those supposedly dishonest research efforts. This is the pervasive anti-scientific illiberalism — denial of the rights of free speech and free association — that The Times‘s ghostwriter took advantage of, and that those who declared the “retraction” a victory are both victims and perpetrators of. That is what the casual acceptance of COI accusations perpetuates.

It is very much like a climate of pervasive racism. It has the same basis — which is to say that the racists and COI accusers can always dig up some rationalization for their attitude (“their nominal forebears lied about something in 1970” is the equivalent of “some of them are rapists”), but none of them stand up to scrutiny. The accusers hide behind words to obscure their accusations (“oh, but I never said they lied, I just put it out there” is the equivalent of “I never use the n-word, so I am not racist”). It is easiest for an individual victim in a particular moment to just surrender to it (“please don’t shoot; I am leaving” rather than “I have as much right to walk down this street as anyone”; “the funding I got is not really that evil funding” rather than “if you are accusing me of lying about something, man up and identify the lie or shut up”).

The latter bit is what ensures that the intimidation, and thus the attitude that motivates it, continues. Appeasement of the accusations of dishonesty and lack of integrity should not be celebrated. Even when it is the pragmatic act for the moment (which is true far less often than the appeasers would like to claim), it should be done with a quiet apology for selfishly not standing up for what is right. Anyone who complains about a particular COI accusation but refuses to condemn the pervasive environment that makes such attacks possible is not part of the solution.

And as for those new victims of the recent rounds of accusations: (a) Welcome to the tobacco wars; funny what happens when you get uppity rather than being an obedient party man like you used to be. (b) Perhaps you should consider refusing to appease the quasi-racists who fling around nasty accusations without hesitation, rather than continuing to empower them.

[Update: Simon Clark has expanded upon this post, here.]

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7 responses to “What conflict of interest accusations really mean (with a tie to The Times’s attack on GTNF participants)

  1. Great post. The Times got itself in trouble because it isn’t as practised at the art of insinuation as the ‘public health’ lobbyists are. Glantz, McKee, Chapman et al. are well skilled in using vague terms like ‘allies’ and ‘ties’ to imply financial relationships without making the – often libellous – claim explicit. You can have ‘ties’ to someone by having ever been in the same room as them and you can be an ‘ally’ by having a similar view of an issue. Thinking that they were dealing with honest people, The Times inferred that money must have changed hands, but they made the mistake of saying this explicitly.

    I was on the radio with someone from Action on Sugar this week. He can’t have felt the interview was going very well because his closing words were ‘You should take everything Mr Snowdon says with a pinch of salt because the IEA is funded by [list of industries that he hopes – but could not possibly know – we’re funded by].’ I was quite amused by the bluntness of the ad hom. It wasn’t in response to a specific point, it was basically ‘ignore everything you’ve heard because… $$$’.

    The black cab drivers are currently annoyed with the IEA because we have called for the ridiculously over-regulated London taxi market to be deregulated. Their killer argument? One of the IEA’s trustees has a daughter who works for Uber!

    And so it goes on and on.

  2. “Their killer argument? One of the IEA’s trustees has a daughter who works for Uber!”

    Upcoming Times headline: “RACIST UBER CORRUPTION SHOCK OUTRAGE!”

  3. Pingback: In the News November 7th | Convicted Vapour

  4. It’s interesting to read your perspective on this important issue. I disagree with the assumption you make in this sentence:

    “we arrive at the observation that a COI accusation against a researcher or journalist is an accusation that they are lying”

    I think this demonstrtes a very limited understanding of this complicated issue. There are a multitude of reasons the commercial sector fund scientific research and a multitude of ways in which this furthers their own commercial goals. Paying for scientific dishonesty is very 20th century (!) and there are many other reasons to be suspicious of any industry-funded research.

    • Carl V Phillips

      Pro tip: You might want to familiarize yourself with the background of who you are talking to before using phrases like “very limited understanding”.

      Anyway, you seem to have some action by researchers in mind, other than lying, to be “suspicious” of. And yet you offer no hint as to what that might be. Care to explain what it is?

  5. Roberto Sussman

    Very through and convincing argumentation on the “conflict of interest” issue as is (ab)used in the context of public health. Interesting parallels can be found in other contexts. In the Public Health Universe the tobacco (cigarette) industry plays the role of the old cold war USSR. So, declaring victory from the withdrawal of an accusation of being a communist during McCarthyism completely misses the point, as what is wrong is not “being a communist”, but McCarthyism’s denial of political liberty by invoking patriotism or some other cause.

    However, what can those opposing this type of public health McCarthyism do? What would be the proper reaction by those accused of being Big Tobacco moles for participating in the GTNF? Perhaps, in my modest opinion, they should start by openly defying this stupid and worn down ideological straitjacket of identifying Big Tobacco as the source of all evil. Of course, they would be ostracized by medical journals, but it seems that they are already ostracized. Also, perhaps it is time for the tobacco industry to close, once and for all, the shame chapter of the “tobacco wars”. I wonder why the tobacco industry has not started to aggressively promote THR research. Why not organizing more GTNF conferences? Perhaps this process is already on the move by the introduction of the new “heated tobacco” technology to be put in the market next year.

    • “In the Public Health Universe the tobacco (cigarette) industry plays the role of the old cold war USSR.”

      The corollaries are so numerous one could almost make a parlor game out of enumerating them.

      1. The domino theory: “If one country falls, the whole world goes Commie”; “If we acknowledge any tobacco product as less harmful, everyone will start smoking cigarettes.”

      2. The ideological litmus test: “Either you love this country or you’re a goddamn Pinko”; “You accede to 100% of the prescribed dogma or you’re a stooge for Big Tobacco.”

      3. Teh Childrinz: “Rock music is a plot to transform your children into godless Communists;” “Everything any tobacco company ever does is basically the moral equivalent of child rape.”

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