Intended for healthcare professionals

Rapid response to:

Editorials

Disclosure of competing interests

BMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b4144 (Published 12 October 2009) Cite this as: BMJ 2009;339:b4144

Rapid Response:

Conflict of interest document is intrusive and misguided

In reading the document from the ICMJE, I wondered where they would
draw the line on conflict of interest. I was not surprised to find that
there wasn't one. Indeed, the title is the clue: "potential" rather than
"actual" conflicts of interest. The advice to 'err on the side of full
disclosure' is simply wrong-headed.

My reading led me to many observations, a few listed here.

1. Public funding such as from MRC/NIH should not be excluded.

I am not sure why, in the interests of completeness, any source of
funding should be excluded. Public research funding is used for instance
as an indicator of career advancement, as academics in particular show how
much money they have been awarded to further their careers. Employing
institutions may in some countries be under some pressure to demonstrate
academic performance by such measures. This strikes me as a source of
pressure, which ought to be cited as it has an impact on individual
conduct. Given that the awarding of grants is itself peer-based and
conflict-ridden, leaving this out makes no sense.

2. The focus on 3rd party funding could lead to a type of money
laundering.

By focusing on third party funding the guidance could encourage a
type of laundering of institutional funding, to co-mingle third-party
funding to remove potential sources of conflict. The researchers might be
conducting their research in a building funded by a company or patron, or
the institution actively seeking donations from corporate sponsors. Where
does one draw the line?

3. The words "relationships, conditions, circumstances" can mean just
about anything.

There is ambiguity as to what these words might actually apply, which
in the absence of disclosure, offers critics considerable scope to stretch
these words to embrace just about anything they like. Past associations
may come to haunt people, long after they have any relevance or meaning,
despite the inappropriate advice to 'tell all'. As well, one can never be
that certain that a future interest will not emerge that would make past
non-disclosure appear evasive.

4. Asking about children is inappropriate and probably an invasion of
privacy.

The editors do cast the net widely, with an interest in the
activities of children. I believe this should be seen as an invasion of
privacy, and no one should answer such questions; shame on the editors for
even thinking this. But what are we to do with the child (of any age)
studying/working under/with an academic who reviews a grant application
for their parent? Where lies the conflict then? Should the child move to
another institution, the reviewer not review or the academic not seek the
funding?

5. Asking about non-financial associations is intrusive, probably
illegal, and smacks of 'thought police' tactics.

I am really concerned about Section 5 on non-financial associations.
This opens up the risks that Orwell wrote about in his book 1984. The
editors are endorsing collecting information based on the hypothesis that
an individual's beliefs and personal associations may be evidence of
conflict of interest. I see this as inappropriate and potentially
discriminatory, especially if a paper were not published because of the
individual's beliefs; the test for me is whether a reviewer would suggest
rejection of an article based on this information and what consequences
would flow from that. The 'reasonable reader' test is inadequate, as
reasonable readers are not prurient in their interests about other people;
it is the unreasonable people who will misuse this information.

6. In the information age, there is no protection that this
information will not be collated into a database and used against
individuals in the future.

My worry is that the document offers no safeguards against misuse or
'harvesting' of the information for inappropriate use. There is no
indication of what the editors would do if individuals were relentlessly
harassed by readers/critics, or subjected to inappropriately
discriminatory comments based on the disclosure information as the
document places no obligation on the users of this information. It looks
all so very innocent, but underneath is quite sinister.

My fear is the 'thought police' who appear to be at work in the
background of this whole document, and it is they and their lack of
coherent logic and often intrusive zeal that needs to be addressed. It is
they who are using the authority of their position as editors of journals
to coerce authors into inappropriate disclosure, without offering
protection against abuse and misuse. Researchers will in effect be forced
to make disclosures if they want their work to be published, and failure
to disclose will be prima facie evidence of intent to deceive.

Competing interests:
I've been accused of conflict of interest in the BMJ. Is that a conflict of interest?

Competing interests: No competing interests

15 October 2009
Michael Tremblay
policy advisor
none
Tremblay Consulting TN25 6RJ