Leadership by example: saying no to health industry board membershipBMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h5065 (Published 29 September 2015) Cite this as: BMJ 2015;351:h5065
All rapid responses
While I have no particular anxiety with conflict of interest as long as it is disclosed, we should be mindful of limited suggestions such as this to address it.
Scientists have suppressed research findings which have been at odds with their dominant ways of thinking. We know this from at least Kuhn's work on scientific revolutions. We know that geological plate tectonics was rubbished as a way of understand the dynamics of our planet and as we learn more and become, perhaps more humble, we increasingly accept that the moon and earth may have collided in the past and that there just may be life on Mars. Did I mention H Pylori?
That says to me that conflict of interest, and vested interests are endemic and not easily solved by one-dimensional solutions. My list of equally conflicted arrangements includes:
1. being a government advisor, in any capacity
2. sitting on a research funding review panel, or similar
3. peer reviewing papers where the author's name is known, and maybe even if hidden given the way ideas flow these days
4. sitting on the senate or governing body of any academic body, actually, strike that, sitting on any decision-making or advisory body as one never knows when a conflict will emerge
5. being on the board of any charity
6. being in a close relationship with someone who is involved in 1 to 5 and who may talk about work at home.
I'm sure there are more.
The upshot is that conflict of interest is more likely when two conditions apply, and particularly when both apply together:
1. money is involved (e.g. allocating, approving)
2. decisions are made (e.g. setting goals, priorities, targets).
In my mind, analytical purity in avoiding conflict of interest would lead to intellectual impoverishment and even worse decision-making.
Yes, we need to address the incentives that pervert judgement, but that is a different problem, arising from human fraility, vanity, and self-importance. Honorable people understand this.
Competing interests: No competing interests