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IRS Changes Form 990 to Make Not-for-Profit Organizations More Transparent and Accountable

In the US, many important health care organizations are not-for-profit organizations. Many US medical schools, and other health educational institutions, along with their parent universities are not-for-profit. (Essentially all the exceptions are supported by local or state government.) The majority of US hospitals and hospital systems, including academic medical centers, are not-for-profit. Some managed care organizations are not-for-profit. Medical and professional societies, health care advocacy groups, health care charities, and a variety of other groups are not-for-profit. Not-for-profit health care organizations here have hardly been immune from leadership and governance problems. We have discussed numerous instances of ill-informed, conflicted, and even corrupt leadership of these organizations, and underlying problems with their governance, which may be unrepresentative of key constituencies, unaccountable, secretive and opaque, and not subject to clear ethical rules. There may be some major changes coming, however, affecting leadership and governance of all US not-f0r-profit organizations, including health care organizations. The US Internal Revenue Service (IRS) has long required that not-for-profits that exceed certain minimums file and make publicly available certain information on a form 990. Relatively recent forms from most US not-for-profits are available online from <a href="http://www2.guidestar.org/">Guidestar.org</a>. The old forms provided for some minimal transparency. They displayed, for example, a list of the filing not-for-profit organization's trustees, and the salaries and retirement plans given to their five highest-paid employees. The IRS has revised the forms starting with those to be filed in 2009, which will reflect 2008 data, so as to markedly increase organizational transparency. The actual forms can be found on <a href="http://www.irs.gov/charities/article/0,,id=176613,00.html">this IRS web-page</a>, and a discussion of key points can be found <a href="http://www2.guidestar.org/rxa/news/articles/2009/revised-form-990-a-how-to-guide.aspx">here</a> on the GuideStar.org web-site. For the first time, the forms will include information about certain aspects of leadership and governance. Leadership Conflicts of Interest The new form 990 will require each organization to establish the "independence" of the organizations' trustees, directors, officers, and key employees. Independent individuals would be those without any direct or indirect business relationships with the not-for-profit organization; without any relatives with such business relationships; and who were not serving as an officer, director, trustee, key employee, partner, or member of an organization doing business with the not-for-profit organization. The relationships preventing individuals from being independent would have to be documented. It is likely that perusal of such information on the new form 990 would reveal to some extent the degree the organization's leaders are conflicted. Up to now, it has been very difficult to get information about conflicts affecting the leadership of health care organizations. We have reported numerous cases of seemingly high-level conflicts affecting leaders of not-for-profit health care organizations. It is likely that such conflicts affect the ability and inclination of leaders to uphold their organization's mission, that is, to fulfill their duty of obedience. Leadership Compensation The new form 990 will ask for detailed information about the total compensation given to officers, directors, and trustees, key and the five most highly paid employees, and former officers, directors, trustees, key and most highly compensated employees who continued to receive substantial amounts. This will include not only reportable and other compensation, but whether anyone received unusual compensation such as first-class or charter travel, companion travel, tax indemnification for gross-up payments, discretionary spending accounts, housing allowance or residence for personal use, payments for business use of personal residence, health or social club dues or fees, and personal services (e.g., maid, chauffeur, chef). Also, the form inquires about severance packages and supplemental non-qualified retirement plans. Up to now, little information about the compensation of not-for-profit leaders beyond base salaries, contributions to employee benefit plans and deferred compensation, and expense allowances and the like was available. Clearly, while not reaching the stratospheric levels enjoyed by top leaders of for-profit health care corporations, some leaders of not-for-profit health care organizations have come to be paid enough to make them rich. It is possible that some now regard their positions as first a pathway to wealth, rather than a calling to improve the health of society, or to advance medical education or science. Furthermore, it is possible that some leaders have been receiving additional compensation which has made them even more wealthy, while particular "perks," like staffed houses, chauffeured cars, and first-class travel, has isolated them from the patients, clients, and/or students they are supposed to be serving. Organizational Policies The new form 990 will ask whether the organization has a written conflict of interest policy, and if so, how compliance is monitored and enforced, and a written policy to protect whistle blowers. Summary In my humble opinion, the IRS' new form 990 could make substantial improvements to the transparency and accountability of not-for-profit health care organizations. Review of form 990's filed starting this year could provide important information about conflicts of interest affecting organizational leaders, whether they have been distracted by new-found wealth, or decoyed by luxurious perks, and whether their organizations have clear policies meant to maintain certain ethical standards. However, while the IRS will mandate that such information becomes available, it is not clear what it will do about the information so revealed. Additionally, the wealth of information that will be provided could easily bury the few watchdogs, including the Health Care Renewal bloggers, that have been trying to monitor the governance and leadership of health care organizations. However, the new information provides an important opportunity to other people concerned about these issues. For example, perhaps some health professionals have concerns about how their alma maters are lead and governed. Maybe they will peruse the new information provided, and then try to use it to make their alma maters more accountable. It is at least possible to be optimistic. What Is to Be Done? If you are concerned about a particular not-for-profit health care organization, you can prepare for the availability of more information from the revised form 990 in several ways, by searching for already publicly available information. You can peruse older form 990s, which at least provides the names of trustees and officers, and officers' and key employees' salaries. In addition, the web makes it possible to identify some conflicts of interest affecting current leadership. For example, try first entering each leader's name, surrounded by quotes, into Google, to look for biographical information that could reveal conflicts. Next, try searching on the name plus terms like "board of directors," "board of trustees," "consultant," or "advisory board," which may uncover some additional conflicts. If you find anything of concern, consider making it more public. Remember, the best way to improve health care leadership is to hold it accountable to an activated public, preferably strongly infused with health care professionals who want to uphold their professionalism.

IRS Changes Form 990 to Make Not-for-Profit Organizations More Transparent and Accountable

In the US, many important health care organizations are not-for-profit organizations. Many US medical schools, and other health educational...

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Announcing the 2009 Anita Borg Scholars and Finalists

We're pleased to announce our 2009 Anita Borg Scholars and Finalists. We established the <a href="http://anitaborg.org/about/history/anita-borg/">Anita Borg</a> Memorial Scholarship in 2003 to encourage undergraduate and graduate women completing degrees in computer science and related fields to excel in computing and technology and become active role models and leaders in the field. This year, we're awarding 50 scholars and finalists in the U.S., 18 in Canada and 56 in Europe, the Middle East and North Africa. We'll also be awarding scholarships to female students in Australia and New Zealand later this year. In addition to receiving academic scholarships, all of our winners will be invited to participate in all-expenses-paid networking retreats featuring workshops, speakers, panelists, breakout sessions and social activities at Google offices. For more information on the Anita Borg Memorial Scholarship and other Google scholarship opportunities, visit our <a href="http://www.google.com/jobs/scholarships">scholarships page</a>. Congratulations to all of our winners! The 2009 U.S. Anita Borg Scholars <ul><li> Dana Forsthoefel - Georgia Institute of Technology</li><li> Divya Ramachandran - University of California-Berkeley</li><li> Elaine Short - Yale University</li><li> Isabel Mattos - Massachusetts Institute of Technology</li><li> Jennifer Roberts - Massachusetts Institute of Technology</li><li> Katherine Corner - University of Colorado at Boulder</li><li> Leshell Hatley - University of Maryland College Park</li><li> Manjari Narayan - Rice University</li><li> Mary David - University of Southern California</li><li> Natalie Freed - Arizona State University Main</li><li> Norma Savage - University of California-Santa Barbara</li><li> Ramya Raghavendra - University of California-Santa Barbara</li><li> Saleema Amershi - University of Washington</li><li> Sara Sinclair - Dartmouth College</li><li> Sarah Cooley - Oregon State University</li><li> Sarah Loos - Indiana University Bloomington</li><li> Sheena Lewis - Northwestern University</li><li> Xuexin (Alice) Zhu - Harvey Mudd College</li><li> Yi-Chieh Wu - Massachusetts Institute of Technology</li><li> YoungJoo Jeong - Carnegie Mellon University</li></ul>The 2009 U.S. Anita Borg Finalists <ul><li> Alyssa Daw - California Polytechnic State University-San Luis Obispo</li><li> Angela Yen - Massachusetts Institute of Technology</li><li> Carrie Ruppar - Graduate Program TBD</li><li> Chaitrali Amrutkar - Georgia Institute of Technology</li><li> Cindy Rubio Gonzalez - University of Wisconsin-Madison</li><li> Corey Toler-Franklin - Princeton University</li><li> Ekaterina Gonina - University of California-Berkeley</li><li> Jacinda Shelly - Massachusetts Institute of Technology</li><li> Jennifer Harrison - Arizona State University</li><li> Julia Schwarz - University of Washington</li><li> Kelli Ireland - University of Pittsburgh</li><li> Kristi Morton - University of Washington</li><li>Krystle de Mesa - University of California, San Diego</li><li> Kyle Rector - Oregon State University</li><li>Manasi Vartak - Worcester Polytechnic Institute</li><li> Margaret Leibovic - Massachusetts Institute of Technology</li><li> Maria Kazandjieva - Stanford University</li><li> Pinar Muyan-Ozcelik - University of California-Davis</li><li> Rachel Sealfon - Massachusetts Institute of Technology</li><li> Rachelle Fuhrer - University of California, San Diego</li><li> Sarah Shiplett - Wellesley College</li><li> Shilpa Arora - Carnegie Mellon University</li><li> Sneha Popley - Texas Christian University</li><li> Sonal Gupta - University of Texas at Austin</li><li> Sujatha Nagarajan - University of Illinois at Chicago</li><li> Supriya Vadlamani - Cornell University</li><li> Tracy Chou - Stanford University</li><li> Valerie Yoder - Westminster College</li><li> Wendy Stevenson - Embry-Riddle Aeronautical University</li><li>Xia Zhou - University of California-Santa Barbara</li></ul>The 2009 Canada Anita Borg Scholars <ul><li> April Khademi – University Of Toronto</li><li> Jenna Cameron – University Of Western Ontario </li><li> Jing Xiang – University Of British Columbia </li><li> Pooja Viswanathan – University Of British Columbia </li></ul>The 2009 Canada Anita Borg Finalists <ul><li> Barbara Macdonald – University Of Waterloo</li><li> Fahimeh Raja – University Of British Columbia</li><li> Gail Carmichael – Carleton University</li><li> Kate Tsoukalas (withdrawn) - Simon Fraser University</li><li> Katherine Gunion – University Of Victoria</li><li> Marjorie Locke – University Of Western Ontario</li><li>Melanie Tupper – Dalhousie University</li><li> Michelle Annett – University Of Alberta</li><li>Mona Mojdeh – University Of Waterloo</li><li> Ozge Yeloglu – Dalhousie University</li><li> Phillipa Gill – University Of Toronto</li><li> Sarah Carruthers – University Of Victoria </li><li> Somayeh Moazeni – University Of Waterloo</li><li> Xiaoyuan XU – Simon Fraser University </li><li> Zahra Ahmadian – University Of British Columbia </li></ul>The 2009 Europe, Middle East and North Africa Scholars <ul><li> Anna Magdalena Michalska - University of Warsaw (Poland)</li><li> Bianca Madalina Milatinovici - RWTH Aachen (Germany)</li><li> Chia Ching Ooi - University of Freiburg (Gemany)</li><li> Christiane Lammersen - Technische Universität Dortmund (Germany)</li><li> Christiane Peters - Eindhoven University of Technology (Netherlands)</li><li> Daria Yartseva - Lomonosov Moscow State University (Russia)</li><li> Ekaterina Volkova - Lomonosov Moscow State University (Russia)</li><li>Elisa Rondini - University College London (U.K.)</li><li> Katayon Radkhah - Technische Universität Darmstadt (Germany)</li><li> Keghani Kristelle Kouzoujian - Carnegie Mellon University in Qatar (Qatar)</li><li> Keren Censor - Technion - Israel Institute of Technology (Israel)</li><li> Kira Radinsky - Technion - Israel Institute of Technology (Israel)</li><li> Iulia Ion - Swiss Federal Institute of Technology Zurich (Switzerland)</li><li> Ligia Nicoleta Nistor - University of Oxford (U.K.)</li><li> Maja Temerinac-Ott - University of Freiburg (Germany)</li><li> Marian George - Alexandria University (Egypt)</li><li> Moran Yassour - The Hebrew University of Jerusalem (Israel)</li><li> Regina Bohnert - Universität Tübingen (Germany)</li><li> Selen Basol - Sabanci University (Turkey)</li><li> Suzan Bayhan - Bogazici University (Turkey)</li><li> Tali Treibitz - Technion - Israel Institute of Technology (Israel)</li></ul>The 2009 Europe, Middle East and North Africa Finalists <ul><li> Adrienn Szabo - Eötvös Loránd University (Hungary)</li><li> Anastasia Shakhshneyder - Novosibirsk State University (Russia)</li><li> Andreea Voicu - Eindhoven University of Technology (Netherlands)</li><li> Anna Astrakova - Novosibirsk State University (Russia)</li><li> Anna Sperotto - University of Twente (Netherlands)</li><li> Anna Katarzyna Zych - Swiss Federal Institute of Technology Zurich (Switzerland)</li><li> Birgit Vera Schmidt - Graz University of Technology (Austria)</li><li> Didem Gozupek - Bogazici University (Turkey)</li><li> Elena Smirnova - INRIA Sophia Antipolis (France)</li><li> Franziska Huth - Saarland University (Germany)</li><li> Gaya Nadarajan - The University of Edinburgh (U.K.)</li><li> Irina Calciu - Jacobs University Bremen (Germany)</li><li> Kerstin Bauer - Technische Universität Kaiserslautern (Germany)</li><li> Laia Subirats i Mate - Universitat Politècnica de Catalunya (Spain)</li><li> Limor Leibovich - Technion - Israel Institute of Technology (Israel)</li><li> Lina AL Kanj - American University of Beirut (Lebanon)</li><li> Lu Feng - University of Oxford (U.K.)</li><li> Lucia Fedorova - Czech Technical University (Czech Republic)</li><li> Maria-Camilla Fiazza - University of Verona (Italy)</li><li> Maya Kabkab - American University of Beirut (Lebanon)</li><li> Melinda Toth - Eötvös Loránd University (Hungary)</li><li> Naama Elefant - The Hebrew University of Jerusalem (Israel)</li><li> Nadezda Osadchieva - Bauman Moscow State Technical University (Russia)</li><li> Natalia Criado - Universidad Politécnica de Valencia (Spain)</li><li> Nina Kargapolova - Novosibirsk State University (Russia)</li><li> Noga Zewi - Technion - Israel Institute of Technology (Israel)</li><li> Noura Yousef Salhi - Birzeit University (Palestine)</li><li> Oana Tifrea - Vienna University of Technology (Austria)</li><li> Rehab Khalid Alnemr - Hasso Plattner Institute (Germany)</li><li>Riina Maigre - University of Technology (Estonia)</li><li> Talya Meltzer - The Hebrew University of Jerusalem (Israel)</li><li> Tamar Aizikowitz - Technion - Israel Institute of Technology (Israel)</li><li> Unaizah Hanum Obaidellah - University of Sussex (U.K.)</li><li> Yana Momchilova Mileva - Saarland University (Germany)</li><li> Yimeng Yang - University of Twente (Netherlands)</li></ul>Posted by Meghan O'Farrell, Talent & Outreach Programs Specialist

Announcing the 2009 Anita Borg Scholars and Finalists

We're pleased to announce our 2009 Anita Borg Scholars and Finalists. We established the Anita Borg Memorial Scholarship in 2003 to enc...

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Vote for the national Doodle 4 Google winner

In February we <a href="http://googleblog.blogspot.com/2009/02/doodle-4-google-tell-us-what-you-wish.html">invited</a> U.S. kids to exercise their creativity by participating in our second annual Doodle 4 Google contest. In response, we received more than 28,000 doodles from kids representing all 50 states, a 70 percent increase from last year. Inspired by this year's theme, "What I Wish for the World," kids have expressed a variety of wishes, ranging from a world with a pristine environment to a world where imaginations can run free. We were impressed by the incredible spectrum of artwork we received this year, but even more amazed by the artistic talents of the kids who created them. Thanks to all those who doodled with us! Today, we're pleased to announce the <a href="http://www.google.com/doodle4google/winners_state.html">approximately 400 state finalists </a>and the <a href="http://www.google.com/doodle4google/vote.html">40 regional winners</a>. They were chosen by a <a href="http://www.google.com/doodle4google/judges.html">panel of independent judges</a>, all experts in design, but now it's your turn. We invite you to help us select the four national finalists by voting on your favorite doodle in each grade group. You can place your votes on the <a href="http://www.google.com/doodle4google/index.html">Doodle 4 Google website</a> until May 18 at midnight Pacific time. We'll announce the results — along with the winner — on May 20th, and the winning doodle will appear on our homepage the following day. If you happen to be visiting New York City, you can drop in and see the doodles of all 40 finalists in an exhibit at the Smithsonian's <a href="http://www.cooperhewitt.org/">Cooper-Hewitt, National Design Museum</a>, which will run May 21 - July 5, 2009. So please take a look at our regional winners' inspiring doodles, <a href="http://www.google.com/doodle4google/vote.html">vote</a> on your favorites, and help us decide which of these great doodles will be seen on the Google homepage by millions of people around the world. Update @ 10:00 AM PST: This post was revised to more accurately reflect the number of state finalists.<div> </div><div>Update on May 20, 2009 @ 10:45 AM: We've posted <a href="http://www.google.com/doodle4google/winners_state.html">all of the state finalists</a> — several hundred doodles in all —on the Doodle 4 Google website and we encourage you to take a look at the beautiful artwork created by these very talented young artists. Posted by Marissa Mayer, Vice President of Search Products and User Experience, and Dennis Hwang, Webmaster Manager</div>

Vote for the national Doodle 4 Google winner

In February we invited U.S. kids to exercise their creativity by participating in our second annual Doodle 4 Google contest. In response, w...

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A Mom's Day menu

When I was about three years old, my mom and I had a game. Mom would show me things around the house. "Look, Scotto, this is a picture," she said. "Can you eat it?" I asked. "No, honey," she said. "Look, Scotto, this is a flower." "Can you eat it?" I said. And so the story went: With everything she pointed out, I asked if you could eat it. Now, I'm a chef here at Google. I feel lucky that I fell in love with food and cooking — if not, who knows what I would be having for lunch! This Mother's Day, you could get your mom a bouquet of flowers, or new earrings, but, well, you can't eat those things. Plus, making a gift at home is a nice personal gesture that doesn't break the bank. With that in mind, some of the other Google chefs and I put together a brunch menu full of recipes designed to pamper moms on their special day. You can download all of them in this <a href="http://google.com/googleblogs/pdfs/google_mothersdaybrunch.pdf">PDF</a>, and I've also copied the most mouthwatering recipe below (sure, it's decadent, but isn't that the point?). Molten Chocolate Cakes Ingredients 5 oz chocolate, semisweet 5 oz butter 3 eggs 3 egg yolks 1 ½ cups powdered sugar, sifted ½ cup all-purpose flour 1 tsp vanilla extract Procedure Preheat oven to 325° F. Place chocolate and butter over a double boiler; stir until melted. Let cool slightly. In the meantime, whisk eggs, egg yolks, and vanilla in a large mixer. Slowly add the sugar, then the chocolate mixture and flour. Coat ¾ cup ramekins with butter, then pour the batter into the ramekins up to the rim. Place in oven for 8-10 minutes. Remove from oven; run knife along edges of ramekin; invert onto a plate. Serve with vanilla whipped cream or vanilla bean ice cream. Makes about 6 cakes. We hope your mom — and you — enjoy brunch this Sunday! Posted by Scott Giambastiani, Executive Chef

A Mom's Day menu

When I was about three years old, my mom and I had a game. Mom would show me things around the house. "Look, Scotto, this is a picture,...

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Google Chrome ads on TV

A couple of months ago, the Google Japan team produced a fun <a href="http://www.youtube.com/watch?v=SHZFsJKlsuA" target="_blank">video</a> to demonstrate how clean and simple our <a href="http://www.google.com/chrome">Google Chrome</a> user interface is. After releasing this video on the web, we got lots of positive feedback and thoughtful comments. In order to keep that conversation going, we invited some of our creative friends to make a collection of short films celebrating our browser. We <a href="http://chrome.blogspot.com/2009/04/11-short-films-about-browser.html">released Chrome Shorts</a> last week on our <a href="http://www.youtube.com/user/googlechrome">YouTube channel</a>. At the same time, we talked to our <a href="http://www.google.com/adwords/tvads/">Google TV Ads</a> team to see how we could show the video that our Japan team developed to a wider audience in a measurable way. Using some of the results from our placement-targeted ads on the <a href="http://www.google.com/adwords/contentnetwork/#utm_source=gcn&utm_medium=redirect&utm_campaign=gcn_redirect">Google Content Network</a>, we designed a Google TV Ads campaign which we hope will raise awareness of our browser, and also help us better understand how television can supplement our other online media campaigns. So today, we’re pleased to announce that we're using Google TV Ads to run our Chrome ad on various television networks starting this weekend. We're excited to see how this test goes and what impact television might have on creating more awareness of Google Chrome. Check out the video below if you haven’t already seen it, or wait and you might see it on TV while you’re channel surfing! <object height="295" width="480"><param name="movie" value="http://www.youtube.com/v/SHZFsJKlsuA&hl=en&fs=1"></param><param name="allowFullScreen" value="true"></param><param name="allowscriptaccess" value="always"></param><embed src="http://www.youtube.com/v/SHZFsJKlsuA&hl=en&fs=1" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" width="480" height="295"></embed></object> Posted by Mike Steib, Director, Google TV Ads, and Anna-Christina Douglas, Google Chrome team

Google Chrome ads on TV

A couple of months ago, the Google Japan team produced a fun video to demonstrate how clean and simple our Google Chrome user interface is...

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Attacking "Crusaders" Against Conflicts of Interest with Logical Fallacies

An <a href="http://www.nature.com/nm/journal/v15/n5/full/nm0509-463.html">editorial </a>appeared in the latest edition of Nature Medicine that suggested "crusaders" are making much too much fuss over insignificant "competing financial interests." [Anonymous. A really serious conflict. Nature Medicine 2009; 15: 463-4] The Editorial's Arguments Instead of regarding all conflicts of interest as part of a "monolithic scourge," it suggested we should only attack them in two specific situations. Bad Conflicts of Interest The first is when it leads to falsification of research data: <blockquote>If there is one reason we need to worry about CFIs [competing financial interests], it is because they could lead to misconduct whenever a researcher has a financial incentive to fabricate data. So, if a clinical trial goes ahead on the basis of fraudulent preclinical work or if a drug is approved on the basis of false clinical data, the problem is more profound than can be addressed by the declaration of a CFI. Researchers or clinicians who produce sham data to continue receiving funds from a company must be subject to severe disciplinary actions from their institutions and funding bodies. </blockquote> The second is when it leads to withholding of data in certain circumstances: <blockquote>Companies that conceal negative data from regulators to receive approval for their drug should face not only fines but also penalties as serious as criminal charges. In any case, the focus should move away from CFI declarations and toward exposing and punishing scientific misconduct. </blockquote> Some Conflicts of Interest are Unavoidable On the other hand, the editorial asserted that conflicts of interest are unavoidable in certain situations. <blockquote> But even though a lot has been written about this subject, it is seldom acknowledged that not all CFIs are equally insidious and that some are even necessary for the success of translational research. Scientists who share their expertise with a company and clinicians who agree to conduct a clinical trial have to be compensated for their work in the same way that every other professional ought to be rewarded for his or her labor. To suggest that they should make their contributions freely is disingenuous, and to argue that they should not get involved at all can only slow the development of new medicines. Academic institutions and their employees must be free to benefit financially from the fruits of the advances made in their laboratories, either by independently developing them into products or by selling them to the highest bidder. In the US, the Bayh-Dole Act has protected this right for nearly three decades, and CFIs that result from a university's right to enact this policy should not raise eyebrows. </blockquote> Bad Outcomes of the "Crusade" Against Conflicts of Interest In addition, the editorial argued that because of excess attention paid to minor or unavoidable conflicts of interest, bad things may happen. Clinical trials would be discouraged. <blockquote>However, the fact remains that clinical trials are very expensive, and only the pharmaceutical sector has both the incentive and the deep pockets to pay for them. </blockquote> And innovation would be slowed. <blockquote>A third issue that is rarely acknowledged is that the stridency with which the CFI crusaders fight financial interests has created a milieu in which pharmaceutical firms have increasingly less breathing space to conduct their business, leading to a further slowing of drug development. </blockquote> Finally, the editorial exhorted: <blockquote>Let us instead accept that most financial interests do not represent a conflict as a matter of course and that the influence of money is negative only if it leads to scientific fraud—the one infidel we need to burn at the crusader's stake. </blockquote>Logical Fallacies and Inflammatory Rhetoric It is discouraging to see such sloppy thinking and inflammatory rhetoric appear under the masthead of a prominent journal. How was the thinking sloppy? Let me count the ways, and explain the logical fallacies used by the editorial to support its contention. Arguing that Conflicts are Unavoidable Using False Dilemmas and Appeals to Common Practice The editorial suggests some conflicts of interest may be unavoidable, even necessary for the advancement of science. To do this, it provided a series of <a href="http://www.nizkor.org/features/fallacies/false-dilemma.html">false dilemmas </a>and <a href="http://www.nizkor.org/features/fallacies/appeal-to-common-practice.html">appeals to common practice</a>. A false dilemma is an argument that x and y are mutually exclusive, when they are not. An appeal to common practice is an argument that because something is common practice, it is necessary, moral, correct, or the only course possible. The editorial argued that researchers would not work for free, implying that if drug and device companies could not pay researchers to perform clinical trials, no clinical trials would be done. This is a false dilemma, because it is based on the unstated assumption that there is no other possible source of payment for clinical trial researchers other than the companies whose products the trials evaluate. It may be true that it would be hard to get anyone to conduct clinical trials for free, but there is no law of nature that dictates that all clinical trials must be financed directly by companies whose products are the subjects of these trials, or that prevents clinical trials from being funded by government agencies and/or non-governmental organizations disinterested in whether the results favor one treatment or another. Such disinterested sponsors paying researchers would not create conflicts of interest. The editorial argued that if academic institutions and their employees cannot benefit financially from "the fruits of the advances made in their laboratories," there would be no drug and device development. This is a false dilemma, because it is based on the unstated assumption that the only setting for drug and device development is academic institutions. There is no natural law, however, that restricts drug and device development to academic institutions, or prevents drug development to be done by drug and device companies, or by independent laboratories. The editorial also appended an appeal to common practice. Bayh-Dole may be the current law in the US, but it is hardly natural law. The editorial argued that without the "deep pockets" of the "pharmaceutical sector" and device companies, no one would pay for clinical research. This was a repetition of the false dilemma noted above. There is no natural law that prevents government and non-governmental organizations from sponsoring clinical trials. The editorial again appended an appeal to common practice. Current laws and social conventions have made drug and device companies extremely profitable, but continuation of their profitability is hardly inevitable. Red Herrings to Distract from Other Bad Effects of Conflicts While the editorial identified two particularly bad kinds of conflicts of interest, it ignored other instances that could be equally bad. This was something of a <a href="http://www.nizkor.org/features/fallacies/red-herring.html">red herring</a>. Although the two examples of bad effects of conflicts of interest were undeniably important, they distracted from other bad effects which the editorial chose to ignore. The editorial correctly identified falsification of data as bad, but ignored the entire catalog of ways in which clinical research studies can be manipulated to make them more likely to favor a sponsor's product. See our posts (<a href="http://hcrenewal.blogspot.com/2008/04/another-example-of-manipulation-of.html">here</a> and <a href="http://hcrenewal.blogspot.com/2005/05/medical-journal-are-extension-of.html">here</a>) and the links contained therein for multiple examples of such manipulation. The editorial noted that concealing data from regulators in order to win drug approval is bad, but ignored all the instances in which data has been suppressed outside of the regulatory process to make drugs or devices seem more efficacious or less dangerous than they really are. See <a href="http://hcrenewal.blogspot.com/search/label/suppression%20of%20medical%20research">this link </a>for some of our posts containing relevant examples. If it is bad to fool people who must make regulatory decisions, why is it not so bad to fool physicians and patients who must decide whether to use drugs or devices? The editorial further ignored that conflicts that affect how research is conducted or reported may be linked to conflicts that affect how research is disseminated or used in decision making. The clinical researcher who is paid by a drug or device company to conduct a clinical trial may also be an academic physician paid by the same company as a consultant or through a speakers' bureau to give talks and presentations, and write review articles favorable to the company's product. If it would be bad for the researcher to falsify data to make the product look better, why would it be acceptable for the researcher to act as a huckster for the product while pretending to be a disinterested academic? See <a href="http://hcrenewal.blogspot.com/search/label/stealth%20marketing">this link </a>for posts discussing stealth marketing, and <a href="http://hcrenewal.blogspot.com/search/label/key%20opinion%20leaders">this one </a>for posts discussing the use of key opinion leaders. Ambiguity and Ad Hominem Attacks Inflating the Bad Effects of Fighting Conflicts While the editorial minimized the bad outcomes of conflicts of interest, it resorted to ambiguity and inflammatory language to exaggerate what might happen were conflicts to be reduced. Its most dire prediction of the results of reducing conflicts was that doing so would create a "milieu" in which "pharmaceutical firms have increasingly less breathing space." Literally, this statement was nonsense. Metaphorically, it did not make a clear argument that these highly profitable companies (and even more profitable device companies) could not survive in a "milieu" in which their products were tested by researchers which the companies could not influence. This was not clearly a logical fallacy, but just word-play presented a reasoned argument. Given how prevalent political correctness is, repeatedly characterizing people concerned about conflicts of interest as "crusaders" is inflammatory indeed. Being called "<a href="http://hcrenewal.blogspot.com/2009/04/who-is-now-scolding-pharmascolds.html">pharmascolds</a>" is one thing, but "crusader" in some circles is regarded as equivalent to racist, a nasty term to label those who promote the separation of clinical research and medical education from commercial interests. Thus, the editorial winds up with a rather nasty version of an <a href="http://www.nizkor.org/features/fallacies/ad-hominem.html">ad hominem </a>attack. We have seen numerous <a href="http://hcrenewal.blogspot.com/search/label/logical%20fallacies">examples </a>of the use of logical fallacies in defense of conflicts of interest, often by authors who were themselves conflicted. It is especially sad to see the editors of a scholarly medical journal employ such logical fallacies in the defense of conflicts of interest. ADDENDUM (11 May, 2009) - See also the<a href="http://www.beforeyoutakethatpill.com/index.php/2009/05/11/chowder-headed-nature-editorial-lashes-out-at-conflict-of-interest-crusaders/"> comments </a>by Dr Doug Bremner in the Before You Take That Pill Blog. ADDENDUM (20 May, 2009) - For an example of how the term "crusader" has become politically incorrect in the US context, see <a href="http://www.boston.com/news/local/massachusetts/articles/2009/05/14/college_converts_its_crusader_teams/">this article</a> in the Boston Globe.

Attacking "Crusaders" Against Conflicts of Interest with Logical Fallacies

An editorial appeared in the latest edition of Nature Medicine that suggested "crusaders" are making much too much fuss over insig...

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The power of video

We recently announced the winners of the <a href="http://www.climatesaverscomputing.org/">Climate Savers Computing Initiative</a> (CSCI) Power Down for the Planet video contest. In March, we challenged you to create videos to educate, entertain, and inform others about the importance of energy efficient computing and you did not disappoint. The submissions made us laugh (a lot) and almost cry (okay, just a little). Not only are these videos really creative, but also they help promote a smarter, greener computing future. The global grand prize, $5000 cash and laptops, went to a team from Southern California for their entry "<a href="http://www.youtube.com/watch?v=1GtkBwwF89w">Power Down: One Computer at a Time</a>." Students from the <a href="http://www.powerdownfortheplanet.org/about-the-challenge/participating-universities/">19 participating colleges and universities</a> were also eligible to win the student grand prize. This award goes to a team from Jackson State University for their "<a href="http://www.youtube.com/watch?v=c4U1JloVCDI">Power Down the Planet</a>" entry. They will take home $5,000, <a href="http://www.specialized.com/us/en/bc/SBCBkModel.jsp?spid=40433&eid=178">2009 Specialized Globe Vienna Deluxe 1 bikes powered by Specialized</a>, and software. To all the winners, congratulations! Check out a playlist of some of our favorite video entries: <object height="385" width="480"><param name="movie" value="http://www.youtube.com/p/1B7149EAC1413A24&hl=en&fs=1"><param name="allowFullScreen" value="true"><param name="allowscriptaccess" value="always"><embed src="http://www.youtube.com/p/1B7149EAC1413A24&hl=en&fs=1" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" width="480" height="385"></embed></object> Posted by Alice Ryan, Green Rocket Scientist

The power of video

We recently announced the winners of the Climate Savers Computing Initiative (CSCI) Power Down for the Planet video contest. In March, we c...

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