Do I have a conflict of interest? Yes
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EDITORIAL
Do I have a conflict of interest? Yes Djillali Annane1* and Bernard Charpentier2 © 2018 Springer-Verlag GmbH Germany, part of Springer Nature and ESICM
Conflict of interest is part of the daily life of human beings since ever. It is a permanent concern in the practice of law, and for instance, an attorney cannot represent a third party whom interests are opposed to those of his/her client. In the field of health science, in the early sixties, the issue of scientific people taking advantages from a government appointment was already a matter of debate [1]. In the past decade, in the number of scientific publications addressing the issue of conflict of interest in medicine increased remarkably (from about 600 in 2008 to roughly 30,000 in 2017) [2]. The observation that a majority of US academic institutions have no or insufficient policies covering the relationship between industries and members of institutional review boards [3] raised public concern [4], and may have contributed to increasing interest for this topic in the medical literature. A conflict of interest can be defined as any situation in which a decision (or an action) taken by a professional in his/her duty (e.g., medical doctor prescribing a drug to his/her patient, or an investigator recruiting a research participant) is influenced by his/her relationship with a third party, providing directly or indirectly to the professional and/or to the third party, personal benefits whether financial or not [5]. Of note, the presence of a conflict of interest is not synonymous of malpractice or professional misconduct. Sometimes there are no consequences on the professional’s duty, and possibly sometimes they may be positive consequences for the patient. For example, a cancer patient may benefit from an innovative intervention before the drug is marketed, *Correspondence: [email protected] 1 Department of Intensive care medicine, School of health science Simone Veil, Raymond Poincaré University Hospital (APHP), University of Versailles SQY University Paris Saclay, 104 boulevard Raymond Poincaré, 92380 Garches, France Full author information is available at the end of the article For contrasting viewpoints, please go to https://doi.org/10.1007/s00134018-5298-2 and https://doi.org/10.1007/s00134-018-5299-1.
by being recruited to participate to an industry driven trial which principal investigator is the patient’s physician. Nevertheless, conflict of interest may also be source of wrongdoing, as illustrated by the so-called “Benfluorex (MEDIATOR)-case” in France [6]. The “MEDIATOR” trial is still on-going. So far, judicial investigations have evidenced that medical doctors acting as experts for health authorities, and politicians, had strong links with and drew individual benefits from the pharmaceutical industry owning the marketing authorization for this drug. As a consequence, there was an unacceptably long delay in drug withdrawal from the market and unduly prolonged exposures of thousands of patients to serious adverse events with some
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