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Conflict of Interest in Medical Research, Education, and Practice
is a critical but limited first step in the process of identifying and respondingto conflicts of interest.
Conflict of interest policies and procedures can be strengthenedby engaging physicians, researchers, and medical institutions in developingpolicies and consensus standards.
Arange of supporting organizations—including accrediting groupsand public and private health insurers—can promote the adoption andimplementation of conflict of interest policies and promote a culture ofaccountability that sustains professional norms and public confidence inmedicine.
Research on conflicts of interest and conflict of interest policies canprovide a stronger evidence base for policy design and implementation.
If medical institutions do not act voluntarily to strengthen theirconflict of interest policies and procedures, the pressure for external regulation is likely to increase.
Physicians and researchers must exercise judgment in complex situations that are fraught with uncertainty. Colleagues, patients, students, and the public need to trust that these judgments are not compromised by physicians’ or researchers’ financial ties to pharmaceutical, medical device, and biotechnology companies. Ties with industry are common in medicine. Some have produced important benefits, particularly through research collaborations that improve individual and public health. At the same time, widespread relationships with industry have created significant risks that individual and institutional financial interests may unduly influence professionals’ judgments about the primary interests or goals of medicine. Such conflicts of interest threaten the integrity of scientific investigations, the objectivity of medical education, and the quality of patient care. They may also jeopardize public trust in medicine.
Surveys show the breadth and diversity of relationships between industry and physicians, researchers, and educators in academic and community settings. For example,
gifts from drug companies to physicians are ubiquitous;
visits to physicians’ offices by drug and medical device company representatives and the provision of drug samples are widespread;
many faculty members receive research support from industry, and industry funds the majority of biomedical research in the United States;
many faculty members and community physicians provide scientific, marketing, and other consulting services to companies; and some serve on company boards of directors or on industry speakers bureaus; and
commercial sources provide about half of the total funding for accredited continuing medical education programs.