Conflicts of interest (COI) arise when the professional responsibilities of
individuals or organizations are, or have the potential to be, compromised by other, external obligations. The failure of fiduciary responsibility is the key concept in defining conflict of interest situations.
Today, conflicts of interest are recognized in fields as varied as law, medicine, journalism, academia, business and government. In medicine, such compromises are especially threatening, as they can undercut the health and well-being of patients. Physicians and medical organizations may compromise their professional responsibilities by pursuing private financial gain.
Although the pharmaceutical industry and medical device manufacturers have made vital contributions to research and patient care, the ultimate responsibilitiy of for-profit entities is to maximize returns to shareholders. In contrast, the medical profession should put patients’ interests first, regardless of financial considerations. The potential for conflict of interest is, therefore, inherent in industry-medicine relationships. Collaborations must be carefully regulated – and, in some cases, prohibited -- to protect patients' well-being, promote scientific integrity and ensure public trust.
Medical institutions must set conflict of interest policies that recognize these obligations. An effective and responsible conflict of interest policy should clearly specify the relationships and activities that are acceptable, those that are prohibited, and provide clear guidelines on how to make certain all such arrangements are transparent.
Medical Conflict of Interest Policy Areas of Research
The Institute on Medicine as a Profession studies how various health care institutions are addressing the concept of conflict of interest on a policy level. We are currently focused on four key types of organizations: Academic Medical Centers, Professional Medical Associations, Pharmaceutical Companies and Medical Device Manufacturers, and Health Advocacy Organizations. Based upon our research, we have created a variety of resources to help create and implement a sound conflict of interest policy.