Do I have a conflict of interest? No
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EDITORIAL
Do I have a conflict of interest? No Jean‑Louis Vincent1* , Kenneth B. Christopher2 and Anthony McLean3 © 2018 Springer-Verlag GmbH Germany, part of Springer Nature and ESICM
A conflict of interest (COI) can be said to exist when a physician (or his/her company/institution) has an external interest that may appear to alter the way he/ she performs research or practices medicine. Presence of a potential COI can create a perception of diminished investigator independence and thus of decreased research integrity. In recent years, ‘definition creep’ has occurred with definitions of what constitutes a COI becoming increasingly broad, such that almost any interest can be considered as a potential conflict [1], making COI an unhelpful and meaningless concept [2]. Indeed, it is not unethical to have an interest (most of us do), and moneys gained from industry can help expand research facilities, advance important scientific developments, and support postgraduate education [3]. Moreover, the global playing field is not even and industry support may be the only way doctors from less affluent countries can attend postgraduate courses or become involved in research activities, unlike their counterparts in Europe, Australia or North America where institutional support is more readily available. COIs can be divided into financial and non-financial conflicts. We believe there is no reason to disclose an intellectual/academic COI, because that is precisely why a person is invited to write an article or review. We will therefore focus on financial COIs, the most frequent form of conflict. Obviously, large financial interests, such as ownership of substantial equity or regular income from a company, must be declared. It is at the other end of the spectrum that the question really arises. Should we declare having had dinner with an industry representative? Or having received a small gift? And then what *Correspondence: [email protected] 1 Department of Intensive Care, Erasme University Hospital, Université libre de Bruxelles, Route De Lennik 808, 1070 Brussels, Belgium Full author information is available at the end of the article For contrasting viewpoints, please go to https://doi.org/10.1007/s00134018-5285-7 and https://doi.org/10.1007/s00134-018-5298-2.
qualifies as “small”? And what about an invitation by an industry sponsor to give a presentation - this should clearly be recognized at the start of the presentation, but should agreement to give such a talk constitute a COI in any subsequent publications on the topic? Does a single consultation, or even participation in an advisory group, represent a COI? We do not think so. Another difficult question is when to declare financial support that has not been provided directly to a person but to his/her institution or organization. Here, also, the real dilemma is not with large amounts of money, but with smaller sums. If a company sponsors a building or gives a large research grant, it is obvious that such a relationship must be declared. Likewise, any industr
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