The Ethical Barometer

In June 2011, The Spine Journal let loose with its findings on Medtronic’s Infusion, a bioengineered material used in spinal fusion. The special issue of the medical journal concluded that research sponsored by Medtronic resulted in misleading conclusions – overstated benefits and understated risks. So, Medtronic is doing what the Barometer has advocated through years of writing and seven editions of an ethics textbook – let the data speak for itself. Medtronic is giving Yale $2.5 million and the data on Infusion to bring together a panel of experts to study the issue.

There is an inherent conflict when a company with a medical device or drug sponsors the research into the device’s or drug’s efficacy. Liars figure, but figures don’t lie. If the data are out there, the taint of the conflict is removed and folks can figure out the conclusions for themselves. The researchers who did the original work on Infusion could talk themselves blue in defense of their scientific integrity, but that conflict gets in the way. The data may be their exoneration.

Medtronic has proven itself a leader with this move. Other pharmas and medical device manufacturers should follow suit.

Jonathan Mahler, he of the New York Times, and a host of others who crowd the web and bend the Barometer’s ear, wonder why the federal government pursues cases such as those against Roger Clemens, Barry Bonds, and, now, Lance Armstrong. Mr. Clemens’ recent mistrial finds glee among, well, the Barometer is not really sure who to count among those who like to see prosecutors fail, except a goodly portion of defense lawyers employed as commentators on the Casey Anthony case.
Be that as it may, the issue is not that prosecutors failed or the troubling expressions of glee from the ha-ha-you-can’t-catch-and-convict-me crowd, led my Casey Anthony wherever she may be. The issue is one raised by Mr. Mahler, “Is it worth trying to prove?”

When a toddler disappears without explanation by anyone or notification of authorities by cherub’s mother, it is indeed worth a murder trial because we care about innocent victims. Sometimes you win, sometimes you lose, and sometimes you get a jury that finds reasonable doubt in a scenario that requires a willing suspension of all reason. A tot grabbed two Hefty trash bags, couple of Care Bear stickers, and some duct tape, and toddled down to the swamp where she met her fate?

Likewise, when someone such as Mr. Clemens, who was thrown under the bus by everyone except his media constituency, denies use of HGH to the point of a comedy routine, it is worth pursuing. Also, when someone such as Lance Armstrong, who managed to have his media constituency and the gullible all wearing yellow “Live Strong” bracelets, is also under the bus by those swirling around him for crossing a line, well, it is worth it.

So, when and why exactly is it worth it? It’s worth it if the prosecutors and investigators are applying the same standards to Clemens, Armstrong, and even Anthony that they apply in those cases that never see a smidgeon of media coverage. This nation has as a cornerstone, “And justice for all.” Sometimes the justice comes from court proceedings. Sometimes the justice comes from having to be held accountable for actions after a long-term sports existence that found immunity from the rules because, well, “I’m me.” And the latter brings some justice even in mistrials and acquittals.

Mr. Mahler concludes, “Our nation’s values are not at stake.” Actually, yes, they are if investigators and prosecutors do not apply the same standards to all. The Barometer could walk Mr. Mahler threw a few low-profile cases that seemed to be a great deal of work for the end results. Mr. Mahler missed the big picture. Justice is this nation’s grand value. We pursue it even when it proves elusive. Heaven help us when we lose sight of that because we want to move on and “it’s just not that important in this case.” Justice is important in every case. We pursue that goal, regardless of cost, defeat, or, thankfully, the opinion of the masses and media.