The New England Journal of Medicine, the world's most influential medical journal, recently published three highly controversial essays by cardiologist Lisa Rosenbaum on financial conflicts of interest in medical research. In them, Rosenbaum argued that there is an unreasonable prejudice against researchers who have financial relationships with pharmaceutical companies, because a conflict of interest does not necessarily mean that the researcher is biased. In her view, this prejudice leads to fewer researchers working with industry, thus impeding the progress of research.

Rosenbaum was bold to write these essays, judging by the reaction—one writer called her a “conflict of interest denialist”—and she raised many worthwhile questions about such conflicts. But bad science by biased researchers is a serious problem, and she doesn’t have a solution to it. My answers to Rosenbaum’s questions are that we need more transparency in science, not less, and more scrutiny of all researchers, for all sorts of reasons.

Many readers were shocked not only by the content of Rosenbaum’s essays, but where they appeared. Pharmaceutical companies have certainly made many deceptive claims about their products, bolstered by misleading research conducted by researchers paid by those companies. Because the NEJM helps set standards for the quality of medical science—it was for many years a leading critic of industry influence—some no doubt fear that the NEJM’s defection would be a signal of the cause’s defeat.

And they believe that the NEJM should know better, especially since the journal had itself been the site of the Vioxx scandal in 2000, which served as one of the most damaging cases of a misleading medical research paper. An article about the multibillion-dollar pain medication argued that Vioxx had fewer gastro-intestinal side effects than naproxen, an alternative drug. Each of the authors had financial ties to Merck, Vioxx’s manufacturer. In a 2005 “expression of concern,” the NEJM’s editors said that the study’s authors had wrongly failed to report data on three patients who took Vioxx and suffered heart attacks. Three patients may not seem like much. But tens of millions of people were taking Vioxx, so the difference in risk likely caused tens of thousands of heart attacks and many deaths among patients taking Vioxx.

The four-year delay in that statement deepened suspicions. In an extraordinarily harsh editorial, a former editor of the British Medical Journal argued that the NEJM had known of the problem since 2001 and that the delay in correcting the record “fits with the argument that medical journals are an extension of the marketing arm of pharmaceutical companies.”