Thinking about shelling out $85 for one ounce of serum to improve your skin? Or perhaps you are in the market for "hydra healer maximum strength moisture cream," at $75 an ounce, to help your skin with its hydration and to "restore youthful volume and contours"?
Klinger Advanced Aesthetics, which sells these and similar products as part of its Cosmedicine line, is banking on plenty of people paying such sums. And to make people feel good about it, information about these products boasts that Cosmedicine was "the only skincare line tested for performance and safety in clinical studies designed and analyzed in consultation with JOHNS HOPKINS MEDICINE." If anyone missed the connection to Johns Hopkins University and its top medical school, the phrase Johns Hopkins Medicine is repeated (frequently in all caps) throughout the Web site of Sephora, which sells the items.
By the time you read this article, however, the Hopkins references may be removed or downgraded because of the university's announcement Monday that it was changing its relationship with Klinger. Facing criticism about appearing to endorse a cosmetics line and questions about whether there were conflicts of interest in the Hopkins ties to Klinger, the university downgraded those ties. Since The Wall Street Journal reported on the Hopkins-Klinger relationship last week, experts on research ethics have pounded the university, leaving many there red-faced (and not from rouge).
Hopkins didn't help the company design the new cosmetics, which are part of a trend in which beauty products are made to appear more medical, in theory inspiring purse-opening confidence in would-be purchasers. Rather, Hopkins -- for sums that the university will not disclose -- helped develop methods for testing the safety of the new drugs. Of particular concern to ethicists, Hopkins was to be compensated in part through equity in the company -- an arrangement that shocked observers who noted that the university would then have a vested interest in testing methods that did not uncover any problems.
In a statement, William R. Brody, the president of Hopkins, and Edward Miller Jr., dean of its medical center, defended the university's conduct. But Brody and Miller said that "it has become clear that Johns Hopkins' involvement has been publicly perceived as an endorsement. That perception has led some to wonder, openly, whether we have allowed financial considerations to overcome longstanding policy separating our work from even the appearance of commercial influence."
That isn't the case, Brody and Miller said, but to deal with the appearance, they announced that Hopkins would not take equity or a board seat at Klinger, and that Hopkins and the company have agreed to remove most Hopkins references from materials promoting the cosmetics. A university spokesman said it might be a few days before the Sephora Web site and other promotional materials are changed.
Hopkins also announced that it was starting a review of its policies with regard to business relationships. The review will seek to create "a clear, consistent, comprehensive, universitywide set of principles and criteria for evaluating proposed relationships, especially proposals that envision the use of the Johns Hopkins name."
The announcement Monday satisfied some, but not all, critics of the arrangement with Klinger. Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, said, "I think there were issues about the appearance of endorsement that were very real." Despite Hopkins saying that it never wanted to endorse the company's line of products, "it looked like an endorsement, it just did," Caplan said, so removing most Hopkins references should deal with the problem. In addition, he said that holding equity in the company would have created "a real problem" with the credibility of tests Hopkins helped design. So Caplan said it was correct for the university to simply drop that concept.
Shortly after the arrangement started to get publicity, Caplan attended a meeting of the business officers in the member institutions of the Association of American Medical Colleges. Caplan said that many people there were talking about what Hopkins had done and that he hoped the negative publicity would discourage similar arrangements.
Peter Lurie, deputy director of Public Citizen's Health Research Group, said he was pleased with Monday's announcement, but said he would "like to see Hopkins come clean" on all details about the deal with Klinger. He also "the best option would be for Johns Hopkins to wash their hands of the entire deal," which he said was designed to trade on the Hopkins name.
"If [the cosmetics company] wanted someone to look at their protocol and results, they could have asked me," Lurie said. "The reason a company like this is interested in Johns Hopkins is the appearance of an endorsement."
Lurie also noted what he called "a pattern" of Hopkins devoting resources to cosmetic issues. In 2002, Lurie's group objected to a "Botox Night" at Hopkins -- criticism that the university responded to by saying that while a lecture on the popular treatment could take place, no Botox treatments would be offered.
"Cosmetics are different from drugs. Cosmetics are products for which health claims aren't supposed to be made. This is a health institution. They should focus on those issues related to health," Lurie said. "It's a distraction for all involved and a diversion of researchers could be doing something useful into this trivial task."
Dennis O'Shea, a Hopkins spokesman, said that the company asked for the university's help in measuring the products' safety and the accuracy of claims about it. "Johns Hopkins Medicine concluded that its expertise could help consumers get accurate information, and that's certainly a good thing," he said.
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