Margaret McCartney: Hiding and seeking doctors’ conflicts of interestBMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k135 (Published 22 January 2018) Cite this as: BMJ 2018;360:k135
All rapid responses
I understand the author's concern of doctors' hidden conflicts of interest.<1> I am aware of how undisclosed conflicts of interest, intentional or not, could lead to series of disciplinary investigations.<2> However, I wonder whether it is realistic to have absolutely no conflict of interest.
In academia, researchers benefit by having peer-reviewed articles under their belts, which can lead to more research grant and promotion in their career. Would this be considered another form of conflicts of interest? Similarly, if medical students receive free pens from drug companies during a conference, should it be declared?
What about pharmacists who conduct studies to demonstrate the excellent quality of their service? How about surgeons who publish articles to illustrate the benefit of their surgical methods? These professionals benefit by having high-impact publications, which can convince the government to fund their services.
It is generally assumed that industry-sponsored trials are biased towards their own products.<3> Nevertheless, is it also biased to assume these trials are all biased, when we never even critically appraise each of them ourselves?
I appreciate the effort to ensure conflicts of interest being openly declared. However, I wonder how we can legally and objectively define what "conflict of interest" is without being criticised for having a double-standard.
1. McCartney M. Margaret McCartney: Hiding and seeking doctors’ conflicts of interest. BMJ. 2018;360:k135.
2. Wakefield AJ, Harvey P, Linnell J. MMR—responding to retraction. The Lancet;363(9417):1327-1328.
3. McCartney M. Margaret McCartney: Optional disclosure of payments is pointless. BMJ. 2016;354:i3692.
Competing interests: Competing interests: I have received salaries from working as a paperboy, pharmacy technician, pharmacist, researcher, ice skating marshal, and medical doctor, and free pens given by various commercial and non-commercial organisations. Further conflicts of interest available upon request.