Understanding Financial Conflicts of Interest

The problem of conflicts of interest began to receive serious attention in the medical literature in the 1980s1,2. Studies have described a wide range of conflicts involving physicians, medical researchers, and medical institutions (the most comprehensive is by Rodwin3). Among the areas of concern are self-referral by physicians,4,5,6 physicians risk sharing in health maintenance organizations (HMOs) and hospitals,7 gifts from drug companies to physicians,8,9 hospital purchasing and bonding practices,3 industry-sponsored research,10,11 and research on patients12. Yet the concept of conflict of interest itself has been inadequately analyzed, and consequently its elements, the purposes of regulation, and standards for assessment are still often misunderstood. Elements of Conflicts of Interest A conflict of interest is a set of conditions in which professional judgment concerning a primary interest (such as a patients welfare or the validity of research) tends to be unduly influenced by a secondary interest (such as financial gain). [Interessenkonflikt bezeichnet eine Reihe von Zuständen, unter denen professionelles Urteil, dass sich auf ein primäres Interesse bezieht (wie z.B. das Wohl des Patienten oder die Validität von Forschung)