Beyond conflict of interest

Transparency is the key

News p 301) Education and debate p 333) Filler p 318) Letters p 344)

Conflict of interest is being taken more seriously by doctors and by society at large. The New England Journal of Medicine has twice recently been heavily criticised for failing to declare authors' conflicts of interest—despite its declared policy of doing so. 1 2 Last week the BBC halted a £360 000, well reviewed television series because of a “potential conflict of interest”: the producer owned commercial property featured in the series.3 Despite the rising concern, medical journals have done an indifferent job in tackling the problem.4 Four years ago I wrote an editorial arguing that we had to do better,5 and we began then to require all authors to sign forms declaring conflicts of interest. Unfortunately authors often fail to declare conflicts of interest. This issue of the BMJ contains a collection of material on the subject, and we are proposing new policies.

A common problem

Conflict of interest has been defined as “a set of conditions in which professional judgment concerning a primary interest (such as patients' welfare or the validity of research) tends to be unduly influenced by a secondary interest (such as financial gain).”6 It is a condition not a behaviour, and there is nothing wrong with having a conflict of interest. It is common.

Some people have taken the view that conflict of interest is a lot of fuss about nothing, or, worse, that identifying people's conflicts of interest is a form of McCarthyism.7 Those who argue against concerns about conflict of interest say that scienceis science, methods are transparent, data either support the conclusions or do not, and it is neither here nor there whether researchers have, for example, shares in a company that manufactures a drug included in …