Review of Alleged Conflicts-of-Interest in National Institutes of Health Consensus Development Conference on the Treatment of Destructive Behaviors in Person with Developmental Disabilities

EXECUTIVE SUMMARY:

This final report provides the results of our evaluation of potential conflicts-of-interest involving the September 1989 National Institutes of Health (NIH) Consensus Development Conference (Conference) on the "Treatment of Destructive Behaviors in Persons with Developmental Disabilities." Critics claimed that the Conference's "sanctioning" of a controversial pain-inflicting electrical device, called the Self-injurious Behavior Inhibiting System, resulted from "cozy relationships and financial ties" involving Conference officials and promoters of the device. We found no evidence that Conference officials gained financially. We also found no evidence that these associations influenced the Conference officials in their decisions concerning the device. Rather, the Conference concluded that the device and other aversive treatments should be discouraged and used only under restrictive conditions. Our review did, however, disclose that NIH had not implemented effective internal control techniques for identifying, documenting, and evaluating potential conflicts-of-interest for Conference officials. In addition, we found that no internal control review has been conducted of the consensus development conference program as intended under the Federal Managers' Financial Integrity Act (FMFIA). We recommended that an internal control review be periodically conducted of the consensus development conference program in accordance with FMFIA requirements. The Public Health Service concurred with our recommendation.

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