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I. INTRODUCTION
Ten years ago, Jesse Gelsinger died while participating in a human genetherapy trial at the University of Pennsylvania ("Penn"). His death came to signify the corrosive influence of financial interests in human subjects research.1 After Jesse's death, the media reported that one researcher, Dr. James Wilson, held shares in a biotech company, Genovo, which stood to gain from the research's outcome- shares that The Wall Street Journal later valued at $13.5 million, although Wilson maintains he did not make nearly this much.2 At the time Penn authorized Wilson's deal, internal Penn documents implicitly valued Wilson's stake in Genovo at approximately $28.5 to $33 million.3
Jesse's death sparked two separate lawsuits: one by the family, who sued in tort, and one by the federal government, which framed alleged errors in the research trial as a civil False Claims Act violation. Both suits settled, with no public apologies or acknowledgement of wrongdoing in either case.4 The government refused to make public the documents it collected, despite requests from the family.5 Thus, in what is arguably the most famous conflictof-interest case in medicine, we have known for a decade almost nothing about the nature of the financial stakes that Wilson, and Penn, had in the research's outcome, or why Penn authorized a researcher to hold such a substantial stake in that research's outcome. How this web of financial ties came to enmesh Jesse's trial is a subject worthy of exploration because it provides an important lens for evaluating two divergent visions about the role of money in research.
In 2009, the prestigious Institute of Medicine ("IOM") joined a growing chorus of voices that called for significant reforms to the rules governing disclosure of financial conflicts of interest. The IOM and other groups would presumptively bar nearly all equity stakes by researchers like Wilson. Although the IOM's view represents the dominant narrative about financial conflicts of interest, it is not the only one. One influential group urges that financial conflicts can never be removed from medical research and, indeed, should not be.6
This Essay evaluates these polar positions by examining Jesse's participation in human research and his death. Drawing on new evidence from the documents collected in the Gelsingers' lawsuit,7 this Essay asks specifically whether new and...