Intended for healthcare professionals

Head To Head

Has the hunt for conflicts of interest gone too far? No

BMJ 2008; 336 doi: (Published 28 February 2008) Cite this as: BMJ 2008;336:477
  1. Kirby Lee, assistant professor of clinical pharmacy
  1. 1Department of Clinical Pharmacy, University of California, San Francisco, 3333 California Street, Box 0613, San Francisco, CA 94118, USA
  1. leek{at}

Thomas Stossel argues that restrictions on doctors’ and academics’ interaction with commercial companies are damaging research, but Kirby Lee believes it is a price worth paying to maintain public trust

Conflicts of interest occur in health care when clinicians or researchers have personal, professional, or financial interests that could interfere with, or be perceived to interfere with, their professional obligation to act in the best interests of patients or objectively conduct, present, review, or publish research. Although the existence of a conflict does not necessarily mean wrong doing or harm, it does require management to prevent potential bias, or the perception of bias, in medical decision making or research.

Recent attention has focused on conflicts of interest between healthcare professionals and the drug industry. Marketing expenditures for drugs in 2004 was estimated at $57.5bn, nearly twice that spent on research and development.1 Drug and medical device companies have been convicted of criminal violations or have settled civil suits for offering clinicians millions of dollars in kickbacks, bribes, or gifts to get them to use their products. The most notable case illustrating how direct marketing to doctors …

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