The Edmond J. Safra Research Lab is currently conducting a five year project to study institutional corruption. The Lab currently supports a large number of projects that investigate the nature of institutional corruption through a variety of different contexts. Read more about the projects the Center supports below by clicking on a topic, or read summaries from the 2010-2011 seminar.
MEDICAL TRAINEES AND THE PHARMACEUTICAL INDUSTRY: A NATIONAL SURVEY
Recently, policymakers in the US have become concerned about the relationships between medical trainees and pharmaceutical industry representatives, because such interactions may affect trainees' professional development and their future prescribing practices. Lab fellow Kirsten Austad's project involves investigating the extent of trainees' contacts with pharmaceutical industry representatives, as well as the impact of these interactions on trainees' attitudes about pharmaceutical policy issues and knowledge about evidence-based prescribing. The centerpiece of this project is a national, random-sample survey of first- and fourth-year medical students, as well as third-year residents, conducted in conjunction with Aaron Kesselheim and Jerry Avorn from the Division of Pharmacoepidemiology and Pharmacoeconomics in the Department of Medicine at Brigham and Women's Hospital, as well as Eric Campbell from the Mongan Institute for Health Policy of Massachusetts General Hospital. This survey is novel because of its national scope and its ability to assess differences in attitudes and behaviors among students at 3 stations in their professional training. The project addresses whether institutional factors that shape the professional learning environment-such as a medical school's policies regarding relationships between physicians and pharmaceutical companies-impact how trainees handle personal interactions with industry, view the role of sales representatives in their education, and display knowledge about evidence-based medicine. These results will be applied to the Lab's work more broadly by providing insights into how socialization may be an important component of initiation and maintenance of institutional corruption. Data collection for this project is coming to a close now, and the resulting publications from the project will be posted here once available.
- Austad KE, Avorn J, Kesselheim AS (2011) Medical students' exposure to and attitudes about the pharmaceutical industry: a systematic review. PLoS Medicine 8(5):
- Kesselheim AS and Austad KE (2011) Residents: workers or students in the eyes of the law? New England Journal of Medicine 364(8):697-699.
- Silverman E (2011) Teaching med students about industry influence. Pharmalot.
- HealthDay News (2011) Drug marketing often targets med students: analysis. US News & World Report.
- Nordqvist C (2011) Medical students have substantial exposure to pharmaceutical industry marketing. Medical News Today
OBSTRUCTION TO TRUTH: INSTITUTIONAL CORRUPTION IN ACADEMIA
Academic researchers operate within a unique economy where the goal is to seek and teach the truth about our universe, not to generate profit; indeed, ideas (not money) are the currency of exchange. As such, corruption in this context can be thought of as anything that prevents researchers from discovering the truth or anything that takes away from the public's opinion of the veracity of research findings. Alek Chakroff and Brandi Newell are collaborating to investigate the subtle and often unintentional cognitive biases that can lead researchers away from the truth and, more specifically, towards confirming their own ideas or "pet theories." The aims of the current research project are (i) to establish the public's opinion of academics' trustworthiness, (ii) to empirically demonstrate that corruption exists within academia, and (iii) to make suggestions for ways to address the unveiled corruption.
Abigail Brown's primary project at the Lab is to write a book, using archival firm evidence and other historical methods, to trace the development of the financial statement auditing profession into an entity that could fairly be describes as one suffering from institutional corruption. Parallel to the main book project, she is writing a series of economic articles that develop rigorously the theory that provides the foundation for the book's analysis of qualitative data. She has completed two working papers: one on optimal contracting for auditors and management under conditions that fit that of a public company and one on the conditions under which auditors will agree to collude in both single-period and on-going relationships. Building on the results derived in these papers, she is currently working on a paper that looks at the interaction between reputation and oligopolistic market structure for industries that trade on reputation, such as auditing and credit rating. She is also testing the signaling hypothesis explaining voluntary audits with data from the 1920s. In addition, she is writing a paper with co-author Jacob Klerman on the parallels between the challenges auditors face in remaining independent and those of contractors evaluating the success of government programs.
CONFLICTS OF INTEREST AND THE POTENTIAL AND PITFALLS OF DISCLOSURE
Professionals are often influenced by conflicts of interest when they have a personal, often material, interest in giving biased advice. Although disclosure (informing advisees about the conflict of interest) is often proposed as a solution to problems caused by such conflicts, prior research has found both positive and negative effects of disclosure.
The principal investigator of this project is Sunita Sah. Sunita's interest in disclosure or sunshine policies is to understand when they work and when they do not. In other words, in what situations does disclosure help mitigate the negative effects of conflicts of interest and in what situations do we need to worry that disclosure has enabled advisors to give more biased advice? For example, do advisors behave differently if the conflict of interest is clear or ambiguous? Do advisors give more biased advice in groups or when acting alone? And what rationalizations do professionals use to justify accepting conflicts of interest?
These experiments will provide important information to determine if and when institutional corruption could occur due to conflicts of interest. They will help to identify the psychological factors that contribute to weaken advisors' compunctions about accepting COIs in an effort to create meaningful interventions that work to manage, or eliminate, such conflicts among those who advise us in our most important decisions.
- Sah, S., & Loewenstein, G. (in press). More Affected = More Neglected: Amplification of Bias in Advice to the Unidentified and Many. Social Psychological and Personality Science.
- Loewenstein, G., Cain, D. M., & Sah, S. (2011). The Limits of Transparency: Pitfalls and Potential of Disclosing Conflicts of Interest. American Economic Review: Paper and Proceedings, 101(3), 423-428.
Sah, S., & Loewenstein, G. (2010). Effect of Reminders of Personal Sacrifice and Suggested Rationalizations on Residents' Self-reported Willingness to Accept Gifts: A Randomized Trial. Journal of the American Medical Association, 304(11), 1204.
- Sah, S., Loewenstein, G., & Cain, D. M. (2011). The Burden of Disclosure: Increased Compliance with Distrusted Advice. Working Paper.
SHIFTING THE FOCUS FROM PHARMA TO FOOD: INDUSTRY SPONSORSHIP AND PARTNERSHIP IN HEALTH-RELATED FOOD RESEARCH, NUTRITION EDUCATION AND PRACTICE
The principal investigator is Jonathan H. Marks, associate professor of bioethics, humanities and law, and director of the bioethics program on the main campus at Penn State. Donald B. Thompson, professor of food science (and former department head) at Penn State is a consultant. This project explores the impact and implications of industry-sponsorship on health related food research and on nutrition education and practice. Issues of concern include: the focus on research that explores the health benefits of foods and food components, but neglects the potential adverse effects of consuming those foods or components for their purported health benefits (this might be characterized as a corruption of health-related food and nutrition research); and the regulatory framework governing the use of health to promote foods, in particular, the limited regulation of structure/function claims on food labeling. The project explores a variety of policy solutions including the development of new funding streams for nutrition research, building structures to generate and reinforce reputations based on public interest research, and enhancing regulatory oversight drawing on lessons from comparative regulation. The project will also offer tools to assist the leaders of academic institutions who wish to address industry-related conflicts of interest in a principled manner. Marks and Thompson began working on this project in 2007. It is now a collaborative enterprise between the Edmond J. Safra Center for Ethics at Harvard, and the Rock Ethics Institute at Penn State.
Publications and Working Papers:
- Marks, J.H., "On Regularity and Regulation, Health Claims and Hype," Hastings Center Report, 41(4): xx (forthcoming, July/Aug. 2011 issue)
- Marks, J.H. and D.B. Thompson, "Unhealthy research on the health benefits of food? Industry-sponsorship and the problem of one-sided health-related food research" (draft in progress-for submission summer 2011)
- Marks J.H., "Food for Thought, Menu for Action: A Normative Framework for the Identification and Remediation of Institutional Corruption in Health-Related Food Research, Nutrition Education and Practice" (policy paper in progress-for a symposium in March 2012 to be jointly funded by the Edmond J. Safra Center for Ethics and the Rock Ethics Institute)
- Marks, J.H and D.B. Thompson, "Shifting the Focus: Conflict of Interest and the Food Industry," American Journal of Bioethics, 11(1): 44 (2011)
PATIENT ADVOCACY ORGANIZATIONS
Dr. Susannah Rose's primary project at the Edmond J. Safra Center for Ethics has been to develop an empirical research study aimed at assessing the nature of institutional financial conflicts of interest among patient advocacy groups in the United States. During her first year as a residential Lab Fellow at the Safra Center, Susannah finished a paper that reviews the literature on patient advocacy groups, which describes their significant role in shaping health policy in the U.S. and provides recommendations for helping advocacy groups better manage institutional conflicts of interest. In this paper, she argues that maintaining and enhancing trust and institutional trustworthiness are important targets for policies aimed at managing financial conflicts of interest. This paper services as the background for an empirical research project that Susannah is developing on patient advocacy groups and conflicts of interest, which will be continued during her second year as a non-residential fellow. This study, co-authored with Dr. Steve Joffe at the Dana Farber Cancer Institute, will investigate a random selection of advocacy groups in the U.S. about their financial ties to industry and their conflicts of interest policies. Given that this is a multiple-year research project, data collection and analysis will begin in the fall. In addition to her patient advocacy group study, Susannah is also collaborating with Dr. Christopher Robertson (University of Arizona) and Dr. Aaron Kesselheim (Harvard Medical School) on a randomized trial investigating the impact of different forms of conflicts of disclosure on physicians' perceptions of the methodological rigor of drug clinical trials. This study specifically assesses the impact of including disclosures in the abstracts of drug trials, which may point to improved policies aimed at managing conflicts of interest. During the past year, Susannah and her co-authors refined the methodology and developed the data collection tools, including the survey development, and are planning to start data collection this summer.
THE POLITICAL ECONOMY OF PHARMACEUTICAL CORRUPTION: HOW TO RECONCILE PROFITS AND PUBLIC HEALTH IN THE PHARACEUTICAL SECTOR?
Professor Marc-Andre Gagnon investigates how the innovation system in the pharmaceutical sector is broken. In the last 15 years, fewer new drugs have arrived on the market, and the vast majority of them do not represent any therapeutic advancement as compared to what already exist. However, promotional expenditures surged during that period and, according to dominant pharmaceutical companies' annual reports, they are gaining record profits in spite of the lack of therapeutic innovation. This paradox can be explained if we consider the hypothesis that their main business model is the aggressive promotion of me-too drugs. But what does that mean exactly? If this hypothesis is correct, it means that the profit-motive is not encouraging the development of new drugs. A growing amount of evidences shows, instead, that pharmaceutical companies are trying to re-shape medical knowledge according to their interest in a way that corrupts evidence-based medicine through unethical corporate strategies like ghostwriting, illegal promotion and conflicts of interests. The question before us is thus to understand if the profit-motive is embedded in a market structure encouraging unethical practices instead of innovative therapeutics. And if it is the case, what could be done to re-organize the market structure in order to have a profit-motive serving the interests of patients as well. How can we reconcile pharmaceutical profits and public health?
CORRUPTION AND JUSTIFICATION IN THE GHOST MANAGEMENT OF MEDICAL RESEARCH
Professor Sergio Sismondo has been working to detail the key mechanisms by which which pharmaceutical companies establish dominance over particular areas of medical knowledge. He has been looking at, for example, the ghosting of articles for medical science journals and at drug companies' recruitment and management of physicians to serve as "key opinion leaders". In his project at the Safra Center, he is studying how people justify their work to manage medical knowledge, as well as at how physicians and researchers justify their involvement with the drug industry. For example, the people who ghost-manage medical science articles appear to consider their work justified if: (i) they are producing or communicating sound science; (ii) they are acting according to established protocols; (iii) what they are doing is strategically important or unavoidable within their business context; or (iv) they are promoting health or meeting patient desires. Sismondo's study fills out those categories, and also subjects them to scrutiny. His goal is to better understand the moral economies that allow, and even promote, institutional corruption in medicine, medical research, and the drug industry.
- Ghosts in the Machine: Publication Planning in the Medical Sciences. Social Studies of Science 39 (2009): 171-198.
- Publication Ethics and the Ghost Management of Medical Research (Sergio Sismondo and Mathieu Doucet). Bioethics 24 (2010): 273-283. LINK: http://onlinelibrary.wiley.com/doi/10.1111/j.1467-8519.2008.01702.x/pdf
- Evaluating Solutions to Sponsorship Bias (Mathieu Doucet and Sergio Sismondo). Journal of Medical Ethics, 34 (2008): 627-630. LINK: http://jme.bmj.com/cgi/reprint/34/8/627
- How pharmaceutical industry funding affects trial outcomes: causal structures and responses. Social Science and Medicine 66 (2008): 1909-1914. LINK: http://post.queensu.ca/~sismondo/ssm_6194.pdf
THE PHARMACEUTICAL INDUSTRY, INSTITUTIONAL CORRUPTION, AND PUBLIC HEALTH
Professor Marc Rodwin’s project grows out of his previous two books on physicians’ conflicts of interest.1 One source of these conflicts of interest is physicians’ financial relationship to pharmaceutical firms. As an Edmond J. Safra Research Lab Fellow, Marc Rodwin is analyzing the legal, financial, and organizational arrangements within which the pharmaceutical industry operates. These sometimes create incentives (for drug firms and their employees) that conflict with the development of knowledge, drug safety, the promotion of public health, and innovation. They also make the public depend inappropriately on pharmaceutical firms to perform certain activities and this leads to institutional corruption. In a series of articles he will analyze the pros and cons of various options for reform.
As illustration, consider these examples.
Today, drug firms fund and supervise clinical trials to evaluate drug safety and effectiveness. Their incentive to obtain authorization to market drugs and to promote their use once on the market, can bias the clinical trial design, oversight, conclusions, and reporting of results. What options exist to eliminate this bias?
- The income of drug firms, their key executives, and drug detailers rise as drug sales increase, even if drugs are prescribed for unapproved uses and/ or used inappropriately. This incentive even encourages the illegal promotion of unapproved drug uses. What financial and legal changes could create incentives for drug firms to encourage appropriate drug use and to identify and report problems with drug safety?
- To promote research and development, patent laws protect drug firms from competition and tax subsidies increase their profits. These incentives, however, are not directed to particular kinds of patents (such as new molecular entities) or particular kinds of research, or the development of new therapies and so may not effectively stimulate activities that policymakers seek. What changes could direct incentives more appropriately?
- Drug firms provide substantial discretionary funding for important medical activities such as continuing medical education, medical research, medical journals, and professional medical societies. Pharmaceutical firm funding, however, can compromise these activities and bias their direction. How might changes in the control or direction of funding reduce or eliminate these risks?
Project Publications to Date:
Rodwin, Marc A. 2011. “Reforming Pharmaceutical Industry-Physician Financial Relationships: Lessons from the United States, France and Japan.” Journal of Law, Medicine and Ethics 39(4): 662–670.
Rodwin, Marc A. and John Abramson. 2012. “Clinical Trial Data as a Public Good.” The Journal of the American Medical Association 308(9): 871-872.
Rodwin, Marc A. 2012. “Conflicts of Interest, Institutional Corruption, and Pharma: An Agenda for Reform.” Journal of Law, Medicine and Ethics 40(3): 511-522.
1 Rodwin, Marc A. Conflicts of Interest and the Future of Medicine: The United States, France and Japan. New York: Oxford University Press, 2011; Rodwin, Marc A. Medicine, Money and Morals: Physicians’ Conflicts of Interest. New York: Oxford University Press, 1993
CULTURAL COGNITION AND PUBLIC CAMPAIGN FINANCING
Working in conjunction with the Edmond J. Safra Center for Ethics, the Cultural Cognition Project is conducting an empirical investigation of how cultural cognition influences perceptions of the desirability, efficacy, and importance of public financing of political campaigns. "Cultural Cognition" refers to a set of psychological mechanisms that motivate individuals to fit their beliefs about policy-consequential facts to their preferred visions of the ideal society. Concepts and methods featureing cultural cognition have been used to understand public disagreements over myriad issues, from gun control to climate change. In the research being sponsored by the Center, investigators are testing hypotheses about the impact of cultural outlooks on perceptions of the desirability and efficacy of campaign financing regimes. The goal of the research is to develop guidelines and strategies for promoting attentive and open-minded consideration of information relating to campaign financing by persons of diverse world views.
- Jones, Michael D., and Mark K. McBeth. 2010. "A Narrative Policy Framework: Clear Enough to be Wrong?" Policy Studies Journal, 38 (2): 329-353.
- Kahan, Dan. Forthcoming. Cultural Cognition as a Conception of the Cultural Theory of Risk. In Handbook of Risk Theory, ed. S. Roeser.
- Shanahan, Elizabeth, Michael D. Jones, and Mark K. McBeth. Forthcoming. "Policy Narratives and Policy Processes." Policy Studies Journal, 39 (3): (Forthcoming, August/September, 2011).
- Cultural Cognition Project
FOLLOWING THE MONEY? LOBBYING AND CONGRESSIONAL STAFF CAREERS IN WASHINGTON, 2000-2010
In the last two decades, the lobbying industry has assumed a central role among Washington’s policy-making institutions. Importantly, a large fraction of lobbyists employed in the Federal industry have experience in government positions, especially posts in Congress, the White House and leading executive agencies.
The movement of political staffers from roles in the government to lucrative jobs in the lobbying industry is often described as a ‘revolving door’. This flow of money and staffers towards Washington’s lobbying firms has led to concerns that corporations and other organisations are able to buy influence and acquire privileged access to serving politicians.
This project, led by Mirko Draca, will provide a quantitative analysis of the factors that determine staffer transitions from Capitol Hill to positions in lobbying, the private sector and other types of employment. Practically, the project will be centred on the LegiStorm database of Congressional Staffer Salaries (CSS), which reports the employment and payroll information of Congressional employees since 2000. The LegiStorm data will be matched to information on lobbying industry reports. In turn, demand shocks in the lobbying industry will be linked to turnover patterns among Congressional employees. As the 'outside' demand for particular areas of Congressional expertise shift (for example, recently in legislative areas such as healthcare and financial regulation) then employee turnover patterns could be expected to respond. Hence the main questions here are: how strong is this relationship and has the 'pull' of outside lobbying money been increasing over time?
This research builds on earlier work by Blanes I Vidal, Draca and Fons-Rosen (2010) which measured the value of Congressional connections amongst staffers-turned-lobbyists. This type of quantitative research on economics of political elites in Washington is important for shaping policies that try to reform the 'revolving door' and limit institutional corruption.
Blanes I Vidal, Jordi; Draca, Mirko; and Fons-Rosen, Christian (2010) “Revolving Door Lobbyists”. Centre for Economic Performance Discussion Paper, London School of Economics.
DID CAMPAIGN CONTRIBUTIONS AND CONGRESSIONAL CORRUPTION LEAD TO THE GLOBAL FINANCIAL CRISIS?
Surveys show that the majority of people believe Congress is rife with corruption (e.g. World Values Survey 2000). Despite this public consensus, scholarship on the topic is quite mixed, largely because most studies employ a "market model" in which desired policy outcomes are assumed to be purchased by contributors (Gordon 2005). A "social model" better captures the reality-a reality in which desired policy outcomes are gifted via an ongoing friendly, albeit corrupting, reciprocal relationship (e.g. Clawson, Neustadtl, and Weller 1998; Gordon 2005).
Over the past several years, Clayton Peoples has been building a research program that employs a social model to examine contributor influence on roll call voting across large arrays of bills. The findings show that contributors do, indeed, affect policy decisions across large sets of bills. The most comprehensive paper in this program, published recently in The Sociological Quarterly, shows that this influence is remarkably consistent over more than a decade of policymaking (Peoples 2010). In other words, institutional corruption is, sadly, alive and well in Congress. But the findings do not show how this actually matters.
During the 2011-12 year at the Edmond J. Safra Center for Ethics, Clayton will apply the social model used in his previous work to examine contributor influence on some very important specific pieces of legislation-bills/acts that ultimately led to the Global Financial Crisis. If his research shows that contributors had a significant influence on how lawmakers voted on these specific bills, it will show that the institutional corruption stemming from contributing and contributor-lawmaker relationships does, indeed, have a (catastrophic) impact on society.
Peoples, Clayton D. 2010. "Contributor Influence in Congress: Social Ties and PAC Effects on U.S. House Policymaking." The Sociological Quarterly 51:649-77.
Peoples, Clayton D. 2009. "Reviving Power Structure Research: Present Problems, their Solutions, and Future Directions." Political Power and Social Theory 20:3-38.
Peoples, Clayton D. and Michael Gortari. 2008. "The Impact of Campaign Contributions on Policymaking in the U.S. and Canada: Theoretical and Public Policy Implications." Research in Political Sociology 17:43-64.
POLITICAL MONEY AND THE CRISIS IN POLITICAL REPRESENTATION
In this project, Paul Jorgensen will conduct an empirical and normative project investigating how the industrial structure of the American economy influences the partisan control of Congress and the public policy emanating from this legislative body, from 1990 through 2010. The specific questions guiding this research include: (1) what are and what explains electoral and lobbying coalitions between organized interests and political parties across time, which are defined broadly to include all types of campaign contributions, lobbying contracts, and contents of congressional member stock portfolios, and (2) what are the legislative and economic effects of these coalitions across time?
Answering these questions requires a focus on the influence of political money, the deployment of wealth and money in politics to attain desired goals, in congressional coalition and public policy formation. Investment theory is the predominant research program seeking knowledge of causal links between industrial structure, political-money coalitions, and public policy (e.g., Ferguson 1995), and Paul proposes to use and extend this theory to encompass congressional politics. This theory expects, in political systems reliant on money to operate, public policy outcomes to diverge from the needs of most citizens, and systematically documenting this monetary influence in congressional decision-making would be a significant step towards convincing academics and the public of our representation crisis, the crafting of rules and regulations to benefit the wealthy at the cost of the public good. The normative aspect of this project seeks to develop tools that empower citizens to correct this apparent representation crisis. To begin this empowerment process, Paul proposes to develop a website that would extend the amount of publicly accessible information beyond the existing offerings of other monetary-disclosure sites.
ANATOMY OF AN ORGANIZATION: AN ETHNOGRAPHIC APPROACH TO UNDERSTANDING THE HISTORY AND ETHICS OF THE AMERICAN PSYCHIATRIC ASSOCIATION
Although all medical specialties have come under scrutiny for financial conflicts of interest, the field of psychiatry has been at the epicenter of this "crisis of credibility" (Fava, 2006). Researchers, investigative journalists, and policy makers have raised questions about the extent of industry influence on the diagnostic and practice guidelines developed by the American Psychiatric Association (APA). In 2008, Senator Charles Grassley sent a letter to the APA expressing concerns about the APA's financial relationship with pharmaceutical companies and, concomitantly, undue industry influence. Clearly, much is at stake in terms of profits, institutional reputation, and trust; the APA's Diagnostic and Statistical Manual of Mental Disorders (DSM) is often referred to as the bible of psychiatric disorders because of its enormous influence on clinical practice, affecting such disparate domains as jurisprudence and insurance claims. The APA also produces and disseminates clinical practice guidelines directly tied to DSM diagnoses. The publication of the DSM-V, scheduled for 2013, will not only generate millions in additional revenue for the APA but, along with the practice guidelines, will also affect what health practitioners prescribe to patients. Lisa Cosgrove's work addresses the problems and ethical dilemmas that arise in psychiatry when there are financial ties between the pharmaceutical industry and researchers or professional organizations. Cosgrove and her colleagues (e.g., Harold Bursztajn, Allen Shaughnessy and Sheldon Krimsky) have conducted studies examining the type and extent of financial associations between authors of psychiatric diagnostic and treatment guidelines the pharmaceutical industry. Arguing that transparency is an insufficient solution, she and her colleagues have offered policy-based recommendations based on their empirical work. Cosgrove has published over 30 peer-reviewed journal articles and book chapters and her research on conflict of interest has been discussed in both academic journals and by the media (e.g., The New York Times, the Washington Post, USA Today, U.S News and World Report, the New Scientist, the Boston Globe, and NPR, BBC, and Fox News).
During the Fellowship year 2011-2012, Robert Whitaker and Lisa Cosgrove will produce a monograph on the APA. Robert Whitaker is an award winning investigative journalist who has written extensively about institutional corruption within organized psychiatry. He has written four books, including Mad in America and most recently (2010) Anatomy of an Epidemic. The monograph that will be produced will discuss in detail threats (real and perceived) to APA's independence and trustworthiness as an institution. Possible solutions to these threats will be identified and discussed in terms of their feasibility. Also, and in keeping with the Lab's focus on building "tools" (based on the empirical work of the Lab), another segment of this project will include the development of an empirically-based consumer guide for people considering taking antidepressant medication. Cosgrove and colleagues are currently working on a critical appraisal and quality assessment of APA's practice guidelines on depression and this guide will allow them to disseminate their study results in a format that is accessible to the general public.
Papers and Media:
- Antidepressants and Breast and Ovarian Cancer Risk: A Review of the Literature and Researchers' Financial Associations with Industry
- Diagnosing Conflict-of-Interest Disorder Big Pharma works in subtle but powerful ways inside the pages of the Diagnostic and Statistical Manual of Mental Disorders.
- Researcher urges review of cancer link to antidepressants
- Firms tied to some MDs who set policy: Treatment advice focuses on drugs, researchers findDeveloping Unbiased Diagnostic and Treatment Guidelines in PsychiatryExperts Defining Mental Disorders Are Linked to Drug Firms
LEGAL AMBIGUITY AND ORGANIZATIONAL NONCOMPLIANCE
The principal investigator of this project is Yuval Feldman. The focus of this research is to understand the psychological processes that mediate and moderate the effect of ambiguity in law on rule-following behaviors of individuals in organizations. Although recent research suggests that when people face ambiguity, they may be more likely to rely on their own self-interest to guide their behavior, either deliberately or unknowingly, this project will demonstrate that in an organizational context, the picture is more complex. While it is true that research in areas such as moral disengagement, dishonesty, and self-serving biases suggest that ambiguity will undermine rule-following behavior, there are other theoretical paradigms which are clearly related to the specificity of law, such as the effect of incentives, enforcement (e.g. commodification, crowding out) and the non-instrumental aspects of law (e.g. legitimacy, expressive, intrinsic motivation) that need to be accounted for when attempting to design the optimal specificity of laws that governs the behavior of individuals in organizations.
Given the number of factors involved in this research project, a series of studies using complementary methods (lab/experimental survey and lab experimentation) will be conducted. In the lab context, I plan to focus on understanding the automatic processes involved in giving sense to ambiguous clauses, using methods such as the IAT (Implicit Attitudes Testing) and cognitive loading. In addition, I will attempt to compare the different decision rules people use when asked to interpret ambiguous laws (e.g. self-interest, social norms, morality, fairness, and efficiency). More refined tests could be performed as well for each of these factors (e.g. financial, self- interest, personal, avoiding punishment by boss).
The second method will focus on the importance of the legal and organizational context and will, therefore, be based on an experimental survey of more diverse samples. In this stage of the research, the focus will be on studying variation in interpretation of identical legal clauses, across sectors, industries, legal contexts, and demographics. Examples for legal clauses measured include: 1) What would be considered business-related expenses in a tax context? 2) What would be considered a conflict of interest in an administrative law context? 3) What is a legitimate personal use of organizational means? Lastly, in the third method of web-experimentation, participants will be required to perform various assignments online, manipulating the clarity of legal guidance and, consequently, how incentives will be provided.
While legal compliance and ethical behavior in organizations are different concepts, the inter-relation between them is very important to understanding why there is misconduct in organizations. The optimal specificity of law is highly relevant to illustrating how these two concepts interact in an organizational context. The project will show that it is too simplistic to simply argue that ambiguous laws facilitate corruption. A law that is too detailed and specific may not only be too costly to enact but it may also carry inadvertent effects on people's behavior. Therefore, the normative part of the paper will attempt to model the optimal clarity of law and will attempt to propose taxonomy of legal and organizational contexts where different levels of legal ambiguity are desirable. Such taxonomy will combine the different psychological processes triggered by ambiguity accumulated in the experimental part of the project. Derived from the survey-based part of the project, the proposed taxonomy will identify the areas where ambiguity is more likely to facilitate noncompliance and corruption. Ideally the project could help legal policy makers to design laws whose impact on employees in organization will prevent opportunism without crowding out employees' internal motivation. The implications of optimizing legal ambiguity dealt with in the body of literature on expressive law, and differentiated regulation will be explored as well.
The principal investigator of this project is Sreedhari D. Desai. In this project, Sreedhari and her colleagues use laboratory and field experiments to investigate the role of ethical nudges, or non-coercive ways of leading people down moral pathways. In one segment of this project, they investigated how displaying cues such as moral quotations at the bottom of emails and pictures of moral leaders such as Mahatma Gandhi can trigger implicit psychological processes such that people feel discouraged from behaving unethically. In another segment, they examined how cues related to childhood, such as nursery rhymes and soft toys can activate the construct of moral purity such that after playing with a soft toy or drawing with colored markers, people show less cheating behavior. In a related segment, they found how recollecting childhood memories such as riding your first bicycle can lead to increased generosity toward others. In another segment, they examined how small interventions such as leaving office doors open can cause people to feel more accountable to others and therefore, behave in moral ways. Across the various streams of research described here, Sreedhari and her colleagues identify subtle ways in which policy makers may bring about ethical behavior in individuals and corporations. Sreedhari's research has been covered in a number of publications including the Marker-Haaretz, Outlook Business, and the Harvard Business Review.
- Desai, S. D., & Gino, F. (2011). Mahatma Gandhi, email signatures, and moral decisions: The power of ethical nudges. [Paper available upon request].
Desai, S. D., & Gino, F. (2011). The return to innocence: Nursery rhymes, soft toys, and everyday morality.
Gino, F., & Desai, S. D. (2011). Memory lane and morality: How childhood memories promote prosocial behavior.
- Desai, S. D., & Kouchaki, M. (2011 ). When a little anxiety improves moral health: A story of accountability nudges and honest billing. [Paper available upon request].
THE PERILS OF IMAGINING THE UNETHICAL ROAD NOT TAKEN
In this project, Daniel Effron and his colleagues examine a psychological process that allows people to act unethically without feeling unethical. When people reflect on the unethical road not taken - that is, the misdeeds that they refrained from committing in the past - they feel more justified in acting unethically in the future. Thus, situations that draw people's attention to these unethical roads not taken can inadvertently increase the incidence of unethical behavior. Effron and colleagues use behavioral experiments to examine this psychological process, the situations that give rise to it, and its implications for racial discrimination and conflicts of interest. Initial experiments demonstrate how passing up an opportunity to do something blatantly racist can increase people's willingness to express discriminatory hiring preferences. Ongoing research examines whether people are more likely to allow conflicts of interest to bias their judgment after they have recently passed up an opportunity to commit a more flagrant ethical violation. This project strives to shed light on when and why phenomena like these can become systemic, and what can be done to prevent that from happening.
UNEXPECTED CAUSES AND CONSEQUENCES OF CORRUPTION
Residential lab fellow Celia Moore's research focuses on the unexpected causes and consequences of corruption. In the two projects she is undertaking at the Safra Center, she will be asking questions that target one potential cause (local leadership) and one potential consequence (legitimacy loss) of institutional corruption.
In the first project, Moore will investigate the impact of leadership change in on officer discretion in drunk driving enforcement using a multiyear sample of State Patrol records in Washington. We identify the stringency of DUI enforcement for officers by observing how often they arrest offenders who are clearly over the blood alcohol level limits compared to marginal offenders. Comparing the relative frequency of arrest of marginal offenders relative to borderline offenders thus reflects the individual patroller's decision to punish marginal offenders. Using data on all changes in leadership in Sheriff and Police Chief offices in every Washington State county and municipality over a 17 year period, we will be able to identify whether leadership change at local levels affects to whom and when patrollers treat drivers with undeserved leniency or harshness.
In the second project, Moore will investigate how firms recover in the aftermath of discovered and prosecuted institutional corruption. Using a proprietary sample from the U.S. Sentencing Commission of several hundred firms criminally convicted in federal courts over an 11 year period, Moore and her colleagues will examine how firms endeavor to re-establish their legitimacy after episodes of corruption, and whether those steps are effective.
- Moore, C., Detert, J. R., Treviño, L. K., Baker, V. L., & Mayer, D. M. (In press). Why employees do bad things: Moral disengagement and unethical organizational behavior. Personnel Psychology.
- Moore, C., Stuart, H. C., & Pozner, J-E. (2011). Avoiding the consequences of misconduct: Becoming licensed by and insulated from stigma. [link: http://ebookbrowse.com/moore-stuart-pozner-avoiding-the-consequences-of-misconduct-pdf-d87151427]
- Moore, C. (2009). Psychological perspectives on corruption. In D. De Cremer, (ed.), Psychological Perspectives on Ethical Behavior and Decision Making (pp. 35-71). Charlotte, NC: Information Age Publishing.
- Moore, C. (2008). Moral disengagement in processes of organizational corruption. Journal of Business Ethics, 80(1), 129-139.
REGULATORY CAPTURE AND THE NRC
Observers raised concerns over the effectiveness and the independence of the Nuclear Regulatory Commission long before the nuclear meltdown at Fukushima in Japan this past spring. President Obama, for one, said the agency has "become captive of the industries that it regulates" while on the campaign trail in 2007. But the Japanese nuclear disaster has focused a new spotlight on the commission and its ability to effectively oversee nuclear safety. In this project, investigative journalist Michael Blanding will conduct insider interviews, public records requests, data analysis, and on-site reporting to examine the extent and means of institutional corruption within the agency-as well as possibilities of reform. The NRC poses a unique case study: On the one hand, the chances of a nuclear disaster are admittedly minute, causing complacency among both the public and regulators that weakens incentives for strong oversight. On the other hand, the consequences should a nuclear accident occur are so catastrophic, public interest demands oversight be as rigorous as possible. Recognizing this, recent calls for reform may make this next year a pivotal one. In the wake of the Fukushima, two high-profile commissions were convened: one led by the NRC recommended sweeping policy changes to improve reactor safety, and one by the Energy Department offered a comprehensive solution to the pressing problem of managing nuclear waste. With political pressure to show results before the one-year anniversary of Fukushima next April, this may be the best time in decades to tackle the agency's track record of weak oversight and coziness with the industry it regulates. This project will track the progress and challenges of both of these reform efforts in several feature-length articles for national publications over the coming year.
THE ECONOMY OF INFLUENCE SHAPING AMERICAN PUBLIC HEALTH AND THE ENVIRONMENT: documenting institutional corruption at the Environmental Protection Agency; with emphasis on the intersection of EPA, regulated industries, their lobbyists, Congress and the White House
The principal investigator of this project is Sheila Kaplan. The EPA has a vast mandate - protecting air, water, land and people from pollutants. But year after year, through both Republican and Democratic administrations and Congresses, strong economies and weak ones, the institution fails the American public in many ways. The evidence abounds. Reports by the Government Accountability Office (formerly the General Accounting Office), EPA's own Inspectors General and the media have long documented EPA's inability to guard Americans from toxic chemicals, mining waste, leaking Superfund sites, greenhouse gas emissions, contaminated water, air pollution and other hazards. New problems also continue to appear, from the emergence of untested nanoparticles in consumer goods, to pollution from hydraulic fracking. Polls show that public trust in the EPA is down. In 2010, an advisory panel found that many agency staffers themselves believe that EPA has been hobbled by political pressure; has been forced to ignore relevant science, and is slow to act against known hazards, to avoid damaging industry. EPA has many dedicated employees who truly believe in its mission. So, why has the agency fallen short so often, since it opened its doors in 1970? A close examination of the agency shows that EPA has been corrupted by numerous routine practices, among them: the revolving door between EPA and industry; the large number of former lawmakers now lobbying to weaken environmental regulations or seek exemptions for clients; pressure from current lawmakers who are beholden to donors or who fear opposition in their next race, and other factors, including the "burrowing in" of political appointees, and the influence of the White House Office of Management and Budget.
Lab Fellow Sheila Kaplan will write ethnography of EPA that will use case studies to document how its mission has been distorted and its staffers defanged by this economy of influence. She is also working to develop a way to measure political and corporate influence at EPA, which she hopes will serve as a model to measure corruption at other federal agencies and to promote transparency.
VARIETIES OF CORRUPTION AND THE ARCHITECTURE OF PUBLIC TRUST
Corruption poses two distinct dangers. First, it may prevent institutions from serving their proper ends, as happens when a bribe leads an inspector to overlook a dangerous violation. Second, perceptions of corruption can lead to a lack of trust in institutions themselves, further undermining their public value. Combating corruption, however, is easier said than done. Corruption can take many different forms, depending on the industry or context, and strategies of oversight can sometime be more costly than corruption itself. Moreover, public perceptions of corruption may not reflect the reality on the ground. Bill English's project responds to these broad concerns through three related, but discreet, studies. The first consists of a theoretical examination of the varieties of corruption, which will aim to clarify the economic logic of corruption in different domains (e.g. information asymmetries, principal-agent problems, conflicts of interest, rent seeking) as well as the normative criteria by which particular economies of influence are judged illegitimate. In addition to providing a useful overview of problems of corruption, this study will suggest agendas for research and reform appropriate to different institutional contexts. The second study will use surveys to investigate perceptions of corruption within particular industries (such as finance, medicine, and government) as well as amongst the public at large. These surveys will help establish: 1) what those working within these industries perceive as the greatest challenges of corruption and 2) whether public perceptions accurately reflect concerns expressed by industry insiders. Additionally, the surveys will help characterize public rationales for trust and distrust across different industries, which is an important precondition for addressing deficits in public trust. The third study will examine the comparative advantages of relying on personal ethics versus explicit incentives in addressing particular problems of corruption. Both strategies have strengths and weaknesses, but cultivating and relying on ethical convictions may be especially useful in those areas where incentive design is infeasible. This study will include an experimental component designed to test methods for eliciting costly ethical behavior.
Although these studies respond to specific scholarly debates and will be published independently, their results will ultimately inform a larger book project examining "corruption and the architecture of public trust."
- English, William. "Demystifying Trust: Experimental Evidence from Cambodia and Thailand" Journal of Theoretical Politics (forthcoming) .
- English, William. "The Compartmentalization of Moral Inspiration" in Proceedings of the 36th St. Gallen Symposium. Switzerland: St. Gallen Press, 2006.
CREATIVE OR CORRUPT? HOW WIKIPEDIANS DECIDE IF A NEW CONTRIBUTION IS "GOOD" OR "BAD"
Creativity is the introduction of a novel and appropriate idea or product into a community that transforms the community in some way. Corruption is the decay or redirection of community resources away from a community's purpose toward a self-interested end. Both creativity and corruption alter the possibilities available to later community contributors. In an empirical study of seven contentious Wikipedia pages, Fellow Seana Moran explores: How does the editing community decide, at the time a novel contribution is made, whether it is creative and should be kept, or corrupt and should be removed or blocked? How long does this evaluation take? What evaluative criteria are used? Wikipedia is a conservative environment; the community is concerned about a "wrong" edit staying in the encyclopedia. As a result, it is unwilling to risk inclusion of potentially creative edits for which, at the point the ideas are contributed, it is unsure whether they are "right" or "wrong." Given this policy stance, determining whether a contribution is bad takes a very short time, whereas deciding if a contribution is good can take a long time. Most corrupting vandalism is removed within one day on these pages. Evaluations, on the other hand, may go on for months or years as "edit wars," while contributors argue about the framing and sequencing of information on the page. Evaluations are justified by policy rules, consensus building among the community, and quality judgments of the content itself.
- Moran, S. (forthcoming). How does a group decide which novel contributions to accept as creative or reject as corrupting? The case of Wikipedia.
- Moran, S. (2010). Returning to the Good Work Project's roots: Can creative work be humane?
In H. Gardner (Ed.), Good Work: Theory and practice (pp. 127-145). Cambridge, MA: Good Work Project.
- Moran, S. (2010). The roles of creativity in society. In J.C. Kaufman & R.J. Sternberg (Eds.), The Cambridge handbook of creativity (pp. 74-90). New York: Cambridge University Press.
Elected officials collect large sums of money to run their campaigns, and they often pay back campaign contributors with special access and favorable laws. Fellow Daniel Newman is co-founder and executive director of MapLight, a nonprofit, nonpartisan research organization revealing money's influence on politics. MapLight serves journalists, issue-oriented nonprofit groups, and interested citizens, providing in-depth information about lawmakers, votes, and special-interest influence. MapLight combines campaign contribution data with how every legislator votes, showing patterns of money and influence with unprecedented speed and ease. Prior to MapLight, uncovering connections between money and political influence had been slow and expensive for large groups and near-prohibitive for smaller groups and ordinary citizens, who had to individually research, assemble, and analyze hundreds or thousands of pieces of data on votes and contributions to put together a big-picture view of the influence behind a single bill. Now, information that used to require weeks of work is available at the click of a mouse. By generating widely disseminated, evidence-based findings on the relationship between campaign donations and legislative outcomes, MapLight allows citizens and journalists to explore how money influences government results and empowers the groups in society that hold government accountable.