A Massachusetts politician once told me, over lunch at Boston's Locke-Ober cafe, that most systems work best when lubricated with a bit of moral ambiguity.
I was reminded of that wisdom this week after the National Institutes of Health, in a fit of ethical repurification, announced that it would no longer allow its researchers to hold significant financial interests in, receive consulting fees from, give paid speeches to or exchange bodily fluids with employees of any drug or biotech companies.
Okay, I'm exaggerating about the bodily fluids part. But I'm not sure I see the wisdom of drawing a "bright line," as my colleague Rick Weiss described it, between NIH scientists doing basic research and commercial enterprises that build upon that research. In fact, I thought the point of the whole exercise out there in Bethesda was to create the breakthrough research that can be used by commercial enterprises to develop products, save lives and create a world-leading biotech industry.
Much of the research done at NIH, of course, is aimed at discoveries that can be published in academic journals or patented and sold for royalties. But there is also a lot of learning that goes on that is much harder to define or quantify, that resides in the heads of NIH scientists and can be put to good use when they participate in commercial ventures. What great public purpose is served by preventing them from making a buck by sharing that informal knowledge with profit-making companies?
There was a time, not so long ago, when people thought the big problem with NIH was not that it had become too cozy with private industry, but that it was too much of an ivory tower that paid scant attention to commercializing its discoveries. This monastic culture was constantly reinforced by attracting scientists who seemed to be missing the entrepreneurial gene. And when someone like Craig Venter happened to come along who did have it, he was repeatedly thwarted in his attempt to try to commercialize his human genome research and ridiculed when he finally left to start a little company. Celera Genomics now has 330 employees and a market value of $965 million.
Since then, various NIH administrators have tried to encourage technology transfer by loosening up some of the rules and setting up formal structures by which NIH could collaborate with private firms. But even those arrangements prevented NIH researchers from receiving any money or company stock in exchange for the work that they do. Those who wanted to divide their time between the NIH and a commercial enterprise, or do some extra work for one on the side, had to disclose it and get approval from the NIH ethics police, to ensure their governmentsponsored research was not compromised by any commercial self-interest.
As it turns out, a surprising number of people violated those rules. But rather than coping with that by dealing harshly and publicly with a few of the worst offenders, the NIH brass have now caved to pressure from Capitol Hill to prohibit drug and biotech-related investments and commercial entanglements by their researchers. In the short term, that is sure to drive some of the NIH's most talented and ambitious scientists -- the ones with the entrepreneurial gene -- into the private sector. In the long term, however, it is sure to be bad news for Washington's biotech industry, one of whose competitive advantages was that it could take best advantage of the easy flow of people and ideas between the NIH and commercial ventures.
Did some NIH employees wander into unethical territory with their commercial involvements? Maybe so. But the right question is not whether we should stomp out every last bit of such "corruption," but whether the price is worth it. Having a fuzzy line, and giving administrators some flexibility in enforcing it, was probably better for medicine, better for the biotech industry and certainly better for the Washington economy.
Update: On Wednesday, just as I was kicking the medical fraternity in the shin for opposing reform of the health care sector, the 116,000-member American College of Physicians issued a report strongly backing the idea of computerizing medical records and tying payments to how well doctors practice evidence-based medicine.
Steven Pearlstein can be reached at firstname.lastname@example.org.