MMR, Conrad Black, and the dilemma of reconciling conflicting interests

While Dr Wakefield didn't have a self interest in the outcome, the distressed parents did

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Conflicts of interest are at the root of many public rows. The reliability of a paper published by the medical journal
The Lancet into links between jabs for MMR (measles, mumps and rubella) and autism has been undermined by accusations of conflicts of interest. As a result
The Lancet now states that the paper should never have been published.

Conflicts of interest are at the root of many public rows. The reliability of a paper published by the medical journal The Lancet into links between jabs for MMR (measles, mumps and rubella) and autism has been undermined by accusations of conflicts of interest. As a result The Lancet now states that the paper should never have been published.

In another example, Lord Black found himself answering a similar charge in a civil action in an American court last week. The outcome will determine the future ownership of The Daily Telegraph. And, to move on, it may be that the misjudgements that led to the recent resignations of the chairman and director general of the BBC were the perverse result of a perceived conflict of interest. Described as Labour cronies, the two went to the opposite extreme in dealing with the Government's complaint about a particular news story.

We also see that Lord Sainsbury is again being called upon to put a greater distance between his business interests and his duties as a government minister. And next Wednesday a different kind of case will surface when a whistle blower working at Government Communications Headquarters, Katharine Gun, will discover whether she is to be tried for offences under the Official Secrets Act. The conflict is between what Ms Gun believes to be her duties as a citizen and her duties as a government employee.

Conflicts of interest can thus be the subject of criminal charges (Ms Gun), civil action in the courts (Lord Black), government guidelines (Lord Sainsbury), hearings in front of a professional tribunal (the MMR case), or they simply come before us in our everyday lives as we try to discern what is best practice and fair dealing.

Conflicts of interest can be hard to pin down. I have sometimes wondered, for instance, whether I could request private financial advice from an investment management firm used by an institution where I am a non executive director. I am sure one of the firm's experts would help me informally on a technical matter to do with my own savings. But I have thus far resisted. For there is a conflict in the transaction. It would eventually present itself when we directors came to review the performance of the firm which had privately assisted me. Would I feel marginally better disposed towards it than I otherwise would?

Sometimes disclosure takes the sting away. In a different institution, I have recently chaired two meetings concerned with the principles that should guide the setting of salaries for some of those present. Everyone at the table knew who had a pecuniary stake in the outcome. At the beginning of the discussion, each of the self-interested was asked to comment and then they left the room while the rest of us made up our minds. The second session was required to finish the business off. As there was no differences of opinion remaining, everybody stayed, and the matter was disposed of within five minutes. Perhaps a sharp-eyed reader will tell me that I wasn't sufficiently rigorous in the way I conducted these meetings.

Each case needs careful analysis. Dr Wakefield, the author of the paper on MMR received funding of about £55,000 from the Legal Aid Board. He didn't disclose this. A group of parents had started court actions to obtain compensation for their children's autism which they believed had developed as a result of MMR jabs and they turned to the Legal Aid Board to fund a piece of research.

Let us stop there for it could be argued that a research commission from a public body such as the Legal Aid Board carries no implication that a particular result would be of financial advantage to the researcher. Whatever the result, once the study was done the matter would be at an end so far as Dr Wakefield was concerned. Thus, there was no conflict. The counter argument would be that nonetheless Dr Wakefield's sympathies had been enlisted by the parents of the autistic children and for this reason he was driven to angle his paper to their advantage. Personally I think this would have been pushing the notion of a conflict of interest too hard except for one further aspect. For the purposes of his study, Dr Wakefield did not use a random group of patients referred to his hospital, the Royal Free in London. Rather he took as the core of the sample some of the children whose parents were mounting the legal action. In other words, the study group of children was unusual to the extent of having a high number of parents who strongly believed in the link. Did this taint the research? Yes, to the extent that interviews with parents on the course of their children's illness was a significant part of the information the study reviewed. For while Dr Wakefield didn't have a self interest in the outcome, the distressed parents did.

Lord Black's conflicts of interest, if the Delaware court so finds, are familiar to observers of the financial markets. They partly arise from the difficulty which many self-made people have in recognising that a company is a legal person separate from themselves. The owner of 100 per cent of a company's shares cannot do what he or she likes with his own creation. This is what some entrepreneurs find hard to take. Actually Lord Black doesn't own 100 per cent of any of the companies represented in the American action. He has constructed a web of interlocking shareholdings which allow his stake to control the rest, or so he has assumed.

There are two points at issue here, the status of certain hefty payments that the companies made to Lord Black and his colleagues, and the sale of The Daily Telegraph to the Barclays Brothers. Lord Black's opponents say that the first represents a form of stealing. If this is plausible, then the matter will eventually reach the criminal courts. The critics say that the second comprises the disposal of an asset for much less than its true worth in order to suit Lord Black's private convenience. Reports from the Delaware court suggest that Lord Black became uncertain about some crucial details during his cross-examination. This forceful, highly intelligent man, with business skills, literary achievements and polemical triumphs in abundance stumbled during one of the most important afternoons of his life. At the end of the morning, he had told the court: "I have been characterised and stigmatised as an embezzler. I am trying to retrieve my reputation as an honest man." Yet The Independent reported that later, when being cross-examined by his opponents' counsel, he seemed "almost befuddled". What happened? Did Lord Black at last begin to see for what they were the conflicts of interest he had previously denied? Did he suddenly realise that all along he had been blind to what was obvious to others?

Conflicts of interest do have a distinct pathology. The Lancet even proposes a test, the embarrassment test. It asks its contributors: "Is there anything ... that would embarrass you if it were to emerge after publication and you had not declared it?" I believe that on Friday afternoon, Lord Black began to feel embarrassed for the first time.

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