level—a scientist conducting research—the primary loyalty isn’t always clear. Is it to the scientific community, the public, or policy makers? While this is not an easy question to answer, there is a shared understanding that scientists have profound obligations and therefore need to avoid being improperly influenced by extraneous considerations—most visibly, financial ones.

Types of Conflict

A number of factors can make one type of conflict more significant than others:

  • Intensity of the conflict

  • Expectations and transparency

  • Conflicts of commitment

  • Power and status

  • Financial aspects

The intensity of the conflict—the profound “push or pull” on a person providing the advice—is important. For example, a large sum of money can be a more worrisome source of conflict than a small token. However, there are certain types of conflict that people are known to have and society is willing to accept if these conflicts are both expected and transparent. One such example is the doctor-patient relationship, in which the patient knows a doctor is being paid to give advice and provide an opinion. Because this relationship is open and transparent, it causes less concern about the intensity of the conflict. In other situations, in which a conflict that is expected is not disclosed, this “hidden” nature may take on a greater level of importance and may be seen as an attempt to keep an issue from the public.

While society tends to focus on financial conflicts of interest because they are the most visible and measurable, other types of conflicts can be quite powerful. Conflicts of commitment—being employed by one organization yet having other interests competing for time and attention away from the primary point of employment—have been cited as a concern at the National Institutes of Health and other government agencies. The question was how committed an intramural investigator was to his government job when he was making $150,000 a year above his salary from consulting and other commitments. Another form of conflict, at times overlooked, involves status and power as prime motivators.

Most of the time and effort put into creating rules and guidelines focuses on a larger set of concerns about the influence of power and money on public policy decisions. It is widely agreed that these decisions should be based on an unbiased evaluation of the weight of scientific evidence. Examples range from decisions about the regulation of drugs to the regulation of workplace or environmental toxins.

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