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Dermatoethics pp 185-190 | Cite as

No Strings Attached? Managing Conflicts of Interest in Medicine

  • Noah D. Shannon
  • Clifford Perlis
Chapter

Abstract

Conflicts of interest in medicine are common and sometimes unavoidable. While most conflicts involve financial relationships, they may also involve non-financial arrangements such as personal friendships and religious beliefs. Inappropriately influenced decisions, as well as simply the appearance of impropriety, may stem from conflicts of interest. Ethical behavior requires eliminating or managing such conflicts with explicit, formal mechanisms. Appropriate management of these conflicts is illustrated through the use of hypothetical case scenarios.

Keywords

Atopic Dermatitis Professional Judgment Financial Relationship Financial Conflict Secondary Interest 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Lo B, Field M. Conflict of interest in medical, research, education and practice. Washington: National Academies Press; 2009.Google Scholar
  2. 2.
    Thompson DF. Understanding financial conflicts of interest. N Engl J Med. 1993;329:573–6.PubMedCrossRefGoogle Scholar
  3. 3.
    Watson PY, Khandelwal AK, Musial JL, Buckley JD. Resident and faculty perceptions of conflict of interest in medical education. J Gen Intern Med. 2005;20:357–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Bertok J. Managing conflicts of interest in the public service. Paper presented at: Organisation for Economic Co-Operation and Development; March 11, 2004, Washington, DC; 2004.Google Scholar
  5. 5.
  6. 6.
    Keating NL, Green DC, Kao AC, Gazmararian JA, Wu VY, Cleary PD. How are patients’ specific ambulatory care experiences related to trust, satisfaction, and considering changing physicians? J Gen Intern Med. 2002;17:29–39.PubMedCrossRefGoogle Scholar
  7. 7.
    Code for interactions with companies http://www.cmss.org/codeforinteractions.aspx Accessed 28 Sept 010
  8. 8.
    Policy summary: conflict of interest management procedures for clinical practice guidelines. http://www.aad.org/research/guidelines/_doc/COIPolicySummary.pdf. Accessed 22 May 2010.
  9. 9.
    Levinsky NG. Nonfinancial conflicts of interest in research. N Engl J Med. 2002;347:759–61.PubMedCrossRefGoogle Scholar
  10. 10.
    42 CFR Part 50 Subpart F. http://grants.nih.gov/grants/compliance/42_cfr_50_subpart_f.htm. Accessed 28 Sept 2010.
  11. 11.
    Katz D, Caplan AL, Merz JF. All gifts large and small: toward an understanding of the ethics of pharmaceutical industry gift-giving. Am J Bioeth. 2003;3:39–46.PubMedCrossRefGoogle Scholar
  12. 12.
    Campbell EG, Gruen RL, Mountford J, Miller LG, Cleary PD, Blumenthal D. A national survey of physician-industry relationships. N Engl J Med. 2007;356:1742–50.PubMedCrossRefGoogle Scholar
  13. 13.
    Protecting patients, preserving integrity, advancing health: accelerating the implementation of COI policies in human subjects research. Paper presented at: Association of American Medical Colleges; 2008.Google Scholar
  14. 14.
    Steinman MA, Shlipak MG, McPhee SJ. Of principles and pens: attitudes and practices of medicine housestaff toward pharmaceutical industry promotions. Am J Med. 2001;110:551–7.PubMedCrossRefGoogle Scholar
  15. 15.
    Dana J, Loewenstein G. A social science perspective on gifts to physicians from industry. JAMA. 2003;290:252–5.PubMedCrossRefGoogle Scholar
  16. 16.
    Wazana A. Physicians and the pharmaceutical industry: is a gift ever just a gift? JAMA. 2000;283:373–80.PubMedCrossRefGoogle Scholar
  17. 17.
    Bekelman JE, Li Y, Gross CP. Scope and impact of financial conflicts of interest in biomedical research: a systematic review. JAMA. 2003;289:454–65.PubMedCrossRefGoogle Scholar
  18. 18.
    Lexchin J, Bero LA, Djulbegovic B, Clark O. Pharmaceutical industry sponsorship and research outcome and quality: systematic review. BMJ. 2003;326(7400):1167–70.PubMedCrossRefGoogle Scholar
  19. 19.
    Nieto A, Mazon A, Pamies R, et al. Adverse effects of inhaled corticosteroids in funded and nonfunded studies. Arch Intern Med. 2007;167:2047–53.PubMedCrossRefGoogle Scholar
  20. 20.
  21. 21.
    Brennan TA, Rothman DJ, Blank L, et al. Health industry practices that create conflicts of interest: a policy proposal for academic medical centers. JAMA. 2006;295:429–33.PubMedCrossRefGoogle Scholar
  22. 22.
    2995 NIH Financial conflict of Interest Workgroup Report. http://grants.nih.gov/Grants/policy/regulatoryburden/conflictofinterest.htm. Accessed 28 Sept 2010.
  23. 23.
    ICJME uniform requirements for manuscripts submitted to biomedical journals: ethical considerations in the conduct and reporting of research. http://www.icmje.org/ethical_4conflicts.html. Accessed 28 Sept 2010.
  24. 24.
    Cain DM, Loewenstein G, Moore DA. The dirt on coming clean: perverse effects of disclosing conflicts of interest. J Leg Stud. 2005;34:1–25.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 2012

Authors and Affiliations

  1. 1.N.D. Shannon AssociatesNew YorkUSA
  2. 2.Fox Chase Cancer CenterPhiladelphiaUSA

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