Public institutions have the responsibility to carry out public affairs with governance mechanisms that keep decisions free of conflicts of interest and the resultant self-dealing by interested parties. As our society has evolved, the influence of well-organized and well-funded interest groups has made avoiding such conflicts of interest more difficult. In the realm of medical science, we have seen the evolution of “economies of influence” that foster inappropriate alliances of government and industry, often euphemistically labeled “public-private partnerships.” We must restore scientific integrity to medicine by rigorously separating industry influence from the scientific process. We need to place the focus of science on its proper mission, that of affirmatively defending consumer interests and well-being, not provider ambitions and profits. This requires fighting back against the most egregious forms of corruption, such as bribery of doctors, censorship of science, and the intimidation of dissident scientists. At the same time, restoring scientific integrity means reducing the medical industry’s economic leverage over politics and journalism by eliminating the roots of its economic power: direct-to-consumer advertising, regulatory capture, and the revolving door between business and government.
