Skip to main content

Part of the book series: Advances and Technical Standards in Neurosurgery ((NEUROSURGERY,volume 32))

  • 804 Accesses

Abstract

It has become more and more apparent that some aspects of current medical practice can no longer be kept solely within the private preserve of the profession. Medical error is now treated in an open fashion because it is clear that frank debate over its incidence, causes and mechanisms are crucial to effective prevention. This has always been one of our worst kept secrets. Equally conflicts of interest [1] assume particular relevance in an occupation whose foundation values demand a robust ethical identity. This is the topic of this essay.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Hazard GC Jr (1996) Conflicts of interest in the classic professions. In: Spece Jr RG, Shim DS, Buchanan AE (eds) Conflicts of interest in clinical practice and research. Oxford University Press, pp 85–104

    Google Scholar 

  2. Medical professionalism in the new millennium: a physicians’ charter. Lancet 359: 520–522, 2002

    Article  Google Scholar 

  3. Rothman DJ(2000) Medical professionalism — focusing on the real issues. N Engl J Med 342: 1284–1286

    Google Scholar 

  4. Swick HM(2000) Toward a normative definition of medical professionalism. Acad Med 75: 612–616

    Google Scholar 

  5. Bloche MG(1999) Clinical loyalties and the social purposes of medicine. JAMA 281: 268–274

    Google Scholar 

  6. Jonsen A(1983) Watching the doctor. N Engl Med 308: 1531–1532

    Google Scholar 

  7. Foster RSJr (2003) Conflicts of interest: recognition, disclosure, and management. J Am Coll Surg 196: 505–517

    Article  PubMed  Google Scholar 

  8. Horrobin DF(1999) Non-financial conflicts of interest are more serious than financial conflicts. BMJ 318: 466

    Google Scholar 

  9. Cohen JJ(2001) Trust us to make a difference: ensuring public confidence in the integrity of clinical research. Acad Med 76: 209–214

    Google Scholar 

  10. Relman AS(1980) The new medical-industrial complex. N Engl J Med 303: 963–970

    Google Scholar 

  11. Moses JW, Leon MB, Popma JJ et al. (2003) Sirolimus-eluting stents versus standard stents in patients with stenosis in a native coronary artery. N Engl J Med 349: 1315–1323

    Article  PubMed  CAS  Google Scholar 

  12. Katz J(1996) Informed consent to medical entrepreneurialism. In: Spece RG Jr, Shim DS, Buchanan AE (eds) Conflicts of interest in clinical practice and research. Oxford University Press

    Google Scholar 

  13. Can you believe what you read? Nature 416: 360–363, 2002

    Article  Google Scholar 

  14. Holden C(2001) Few authors disclose conflicts, survey finds. Science 292: 829

    Google Scholar 

  15. Armour BS, Pitts MM, Maclean T et al. (2001) The effect of explicit financial incentives on physician behavior. Arch Intern Med 161: 1261–1266

    Article  PubMed  CAS  Google Scholar 

  16. Grumbach K, Osmond D, Uranizan K et al. (1998) Primary care physicians’ experience of financial incentives in managed — care systems. N Engl J Med 339: 1516–1521

    Article  PubMed  CAS  Google Scholar 

  17. Mitchell JM(1996) Physician joint ventures and self-referral: an empirical perspective. In: Spece RG Jr, Shim DS, Buchanan AE (eds) Conflicts of interest in clinical practice and research. Oxford University Press

    Google Scholar 

  18. Marshall E(1992) When does intellectual passion become conflict of interest? Science 257: 620–622

    Google Scholar 

  19. Koenig R(2000) Reopening the darkest chapter in German science. Science 288: 1576–1577

    Google Scholar 

  20. Elks ML(1995) Conflict of interest and the physician-researcher. J Lab Clin Med 126: 19–23

    Google Scholar 

  21. Bernstein M(2003) Surgical teaching: how should neurosurgeons handle the conflict of duty to today’s patients with the duty to tomorrows? Br J Neurosurg 17: 121–123

    Google Scholar 

  22. Agnew B(2000) Financial conflicts of interest get more scrutiny in clinical trials. Science 289: 66–67

    Google Scholar 

  23. Alpert JS, Furman S, Smaha L(2002) Conflicts of interest. Science, money and health. Arch Intern Med 162: 635–637

    Article  PubMed  Google Scholar 

  24. Bekelman JE, Li Y, Gross CP (2003) Scope and impact of financial conflicts of interest in biomedical research. A systematic review. JAMA 289: 454–465

    Google Scholar 

  25. Bodenheimer T(2000) Uneasy alliance. Clinical investigators and the pharmaceutical industry. N Engl J Med 342: 1539–1544

    Google Scholar 

  26. Miller FG, Rosenstein DL, De Renzo EG(1998) Professional integrity in clinical research. JAMA 286: 1449–1454

    Article  Google Scholar 

  27. Shamasunder B, Bero L(2002) Financial ties and conflicts of interest between pharmaceutical and tobacco companies. JAMA 288: 738–744

    Article  PubMed  Google Scholar 

  28. Lewinsky NG(2002) Nonfinancial conflicts of interest in research. N Eng J Med 347: 759–761

    Google Scholar 

  29. Stelfox HT, Chua G, O’Rourke K et al. (2000) Conflict of interestin the debate over calciumchannel antagonists. N Engl J Med 342: 1539–1544

    Article  Google Scholar 

  30. Davidson RA (1986) Source of funding and outcome of clinical trials. J Gen Intern Med 1: 155–158

    Article  PubMed  CAS  Google Scholar 

  31. Friedberg M, Saffran B, Stinson TJ et al. (1999) Evaluation of conflict of interest in economic analyses of new drugs in oncology. JAMA 282: 1453–1457

    Article  PubMed  CAS  Google Scholar 

  32. Rochon PA, Berger PB, Gordon M(1996) The evolution of clinical trials: inclusion and representation CMAJ 159: 1373–1374

    Google Scholar 

  33. Rochon PA, Gurwitz JH, Simons RW et al. (1994) A study of manufacturer — supported trials of nonsteroidal anti-inflammatory drugs in the treatment of arthritis. Arch Intern Med 154: 157–163

    Article  PubMed  CAS  Google Scholar 

  34. Montagner JSG, O’Shaughnessy MV, Shetchter MT(2001) Industry sponsored clinical research: a double edged sword. Lancet 358: 1893–1895

    Article  Google Scholar 

  35. Lo B, Wolf LE(2000) Berkeley? Conflict-of-interest policies for investigators in clinical trials. N Eng J Med 343: 1616–1620

    Article  CAS  Google Scholar 

  36. Appelbaum PS, Roth LH, Lidz CW et al. (1987) False hopes and best data: consent to research and the therapeutic misconception. Hastings Cent Rep 17: 20–24

    PubMed  CAS  Google Scholar 

  37. Freedman B (1996) The ethical analysis of clinical trials: new lessons for and from cancer research. In: Vanderpool HY (ed) The ethics of research involving human subjects. Frederick, MD. University Publishing Group

    Google Scholar 

  38. Cho MK, Shohara R, Schissel A et al. (2000) Policies on faculty conflicts of interest at US Universities. JAMA 284: 2203–2208

    Article  PubMed  CAS  Google Scholar 

  39. Gross CP, Gupta AR, Krumholz HM(2003) Disclosure of financial competing interests in randomised controlled trial: cross sectional review. BMJ 326: 526–527

    Article  PubMed  Google Scholar 

  40. Johns MME, Barnes M, Florencio PS(2003) Restoring balance to industry — academia relationships in an era of institutional financial conflicts of interest. Promoting research while maintaining trust. JAMA 289: 741–746

    Google Scholar 

  41. Korn D(2002) Industry, academy, investigator: managing the relationships. Acad Med 77: 1089–1095

    Google Scholar 

  42. Martin JB, Kasper DL(2000) In whose best interest? Breaching the academic — industry wall. N Engl J Med 343: 1646–1649

    Article  PubMed  CAS  Google Scholar 

  43. Schulmann KA, Seils DM, Timbie JW et al. (2002) A national survey of provisions in clinicaltrial agreements between medical schools and industry sponsors. N Engl J Med 347: 1335–1341

    Article  Google Scholar 

  44. Angell M(2000) Is academic medicine for sale? N Engl J Med 342: 1516–1518

    Google Scholar 

  45. Morin K, Ratansky H, Riddick FAJr et al. (2002) Managing conflicts ofinterest in the conduct of clinical trials. JAMA 287: 78–84

    Article  PubMed  Google Scholar 

  46. Blumenthal D, Campbell EG, Causino N et al. (1996) Participation of life science faculty in research relationships with industry. N Engl J Med 335: 1734–1739

    Article  PubMed  CAS  Google Scholar 

  47. Angell M(2000) Disclosure of authors’ conflicts of interest: a follow-up. N Engl J Med 342: 586–587

    Google Scholar 

  48. Davidoff F, DeAngelis CD, Drazen JM et al. (2001) Sponsorship, authorship and accountability. Lancet 358: 854–856

    Article  PubMed  CAS  Google Scholar 

  49. Chaudhry S, Schroter S, Smith R et al. (2002) Does declaration of competing interests affect readers’ perceptions? A randomised trial. BMJ 325: 1391–1392

    Google Scholar 

  50. Steinbrook R(2002) Improving protection for research subjects. N Engl J Med 346: 1425–1430

    Google Scholar 

  51. AAMC Task Force on financial conflicts of interest in clinical research. Protecting subjects, preserving trust, promoting progress I: policy and guidelines for the oversight of individual financial interests in human subject’s research. Acad Med 78: 225–236, 2003

    Google Scholar 

  52. AAMC Task Force on financial conflicts of interest in clinical research. Protecting subjects, preserving trust, promoting progress II: principles and recommendations for oversight of an institution’s financial interests in human subjects research. Acad Med 78: 237–245, 2003

    Google Scholar 

  53. Cech TR, Leonard JS(2001) Conflicts of interest — moving beyond disclosure. Science 291: 989

    Article  PubMed  CAS  Google Scholar 

  54. Coyle SL et al. (2002) Physician — industry relations. Part 1: individual physicians. Ann Intern Med 136: 396–402

    PubMed  Google Scholar 

  55. De Angelis CD, Fontanarosa PB, Flanagin A(2001) Reporting financial conflicts of interest and relationships between investigators and research sponsors. JAMA 286: 89–91

    Article  Google Scholar 

  56. Little M(1999) Research, ethics and conflicts of interest. J Med Ethics 25: 259–262

    Google Scholar 

  57. Beecher HK(1966) Ethics and clinical research. N Eng J Med 274: 1354–1360

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2007 Springer-Verlag/Wien

About this chapter

Cite this chapter

Antunes, J.L. (2007). Conflicts of interest in medical practice. In: Pickard, J.D., et al. Advances and Technical Standards in Neurosurgery. Advances and Technical Standards in Neurosurgery, vol 32. Springer, Vienna. https://doi.org/10.1007/978-3-211-47423-5_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-211-47423-5_2

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-211-47416-7

  • Online ISBN: 978-3-211-47423-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics