Book Review

Science for Sale: The Perils, Rewards, and Delusions of Campus Capitalism

N Engl J Med 2008; 358:1643-1644April 10, 2008

Article

Science for Sale: The Perils, Rewards, and Delusions of Campus Capitalism
By Daniel S. Greenberg. 324 pp. Chicago, University of Chicago Press, 2007. $25. ISBN: 978-0-226-30625-4

A recent letter in the journal Science complained that science in the United States might start lagging behind science in other countries because of the burden of regulation. This is a lament that the corporate world also sometimes uses to justify falls in profits. Yet whether the complaint comes from scientists, individual people, or corporations, we must ask what the impetus for the regulations was. In Science for Sale, Daniel Greenberg elegantly explores both the need for and the shortcomings of the growth in attempted ethical regulation of research at various governmental and bureaucratic levels.

The idealistic view of science is the search for truth, just as the ideal of the legal process is the quest for justice. The real world often falls short of ideals, and as a result, professions go through phases of self-regulation and then governmental regulation. Science is new to this process. Science for Sale chronicles nicely the growing pains that science and its traditional institutions (mostly academic) are struggling through as the corporate world begins to overlap with the academic world. In the process, Greenberg dismisses many idealistic notions of “pure science” as an untouchable domain and spells out some of the promises of “technology transfer,” which was conceived as a way to cut governmental costs, provide alternate income to academic institutions, and move more efficiently from discovery to commercial product. He gives some balanced reporting of the successes of this innovation, as well as a reality check in the form of cautionary tales and firsthand accounts of “science for sale” gone wrong.

Greenberg walks the reader briefly but thoroughly through the major failures of what we now generally call “research ethics” and the emergence of ethical standards, which were followed first by internal policing and then by governmental regulation. He then spends the bulk of the book detailing problems that are related to a specific and growing area of ethical concern in science: conflicts of interest. He argues well, but not pedantically, that the emerging entanglement of industry with academic science (which is, after all, the bedrock of the institution of science) has presented a new and dangerous ethical minefield. We have already begun to see the results. Greenberg points out that the 1999 death of Jesse Gelsinger in a gene-therapy trial at the University of Pennsylvania was ultimately the result of a conflict of interest that encouraged investigators to rush to perform clinical trials so that profits could be realized both for the corporation that sponsored the trial and for the university.

The penultimate section of the book involves three interviews that give three different perspectives on the nature and effects of corporate involvement in basic science and technology transfer in general. These interviews are illuminating and reveal the intentions and hopes of those who are on the ground floor of the alliances between industry and academia. Each person who is interviewed offers insights, predictions, and impressions that differ broadly from those of the other interviewees.

Perhaps the only letdown is the final chapter, “What's Right and Wrong, and How to Make It Better,” which I hoped would provide some useful guidance for how to navigate or even avoid the ethical conundrums that were exposed in the preceding chapters. Alas, the chapter is too brief and gives no revolutionary advice. As a research ethics instructor, I have attempted to teach young scientists basic ethical theory through both philosophical ethics and case studies, in the hope that they will carry the lessons in ethical reasoning into the laboratory and through their careers. Greenberg falls far short of suggesting that ethical reasoning should be taught at the outset of medical education and lingers most on the notion of “transparency.” However, all the disclosure and transparency in the world will not thwart unethical behavior if those who are in a position of review and enforcement (generally peers) are not educated in ethics. This education is needed to give these decision-makers the ability to spot ethical problems and to work through moral questions before tragedies happen.

David R. Koepsell, J.D., Ph.D.
State University of New York at Buffalo, Buffalo, NY 14260
koepsell@buffalo.edu