Has the hunt for conflicts of interest gone too far? YesBMJ 2008; 336 doi: http://dx.doi.org/10.1136/bmj.39493.489213.AD (Published 28 February 2008) Cite this as: BMJ 2008;336:476
- Thomas P Stossel, professor
- 1Department of Medicine, Harvard Medical School, Translational Medicine and Hematology Divisions, Brigham and Women’s Hospital, 1 Blackfan Circle, Karp 6, Boston, MA 02115 USA
Most of us politely ignore street evangelists urging us to repent of our sins. Bizarrely however, academic medical administrators base policy on such preaching by anti-business activists. Their sermons, echoed by medical journals and the news media, warn that medical practitioners, educators, or researchers accepting gifts from or payments for services to companies producing medical products compromise their scientific objectivity and professionalism. Strangely, financial transactions between patients, insurance companies, hospitals, and doctors, encompassing 85% of the medical marketplace, do not count as conflicts of interest.
To be sure, corporations, like everyone else, sometimes behave badly and are punished. The key question, however, is whether detailed disclosure of conflicts of interest and stringent prophylactic management are in the public interest. I believe the answer is a resounding no.
Increasingly, conflict of interest policies exclude conflicted experts, however qualified, from writing reviews or editorials in some journals or from advising regulatory bodies on product approvals.1 They also limit or prohibit financial rewards professionals can receive …