Recently, a French medical organisation initiated legal action against nine doctors for failing to disclose their relationships with drug and other medical industries. At the same time, federal legislators in the United States are moving to enforce mandatory disclosure of industry gifts and payments to doctors on a public website. Indeed, Senator Chuck Grassley of the Senate Committee on Finance is in open conflict with US medical schools over their non-disclosure of drug-firm gifts and payments to faculty members, and is threatening to withhold federal funds. Such developments are testament to an accelerating campaign to confront conflict of interest.
Earlier this year, the US Institute of Medicine (IOM) released a comprehensive report on conflict of interest, covering medical research, education and practice, as well as individual and institutional circumstances. The report advanced wide-ranging recommendations for the handling of conflict of interest in order to “protect the integrity of professional judgment and to preserve public trust”. Closer to home, the National Health and Medical Research Council (NHMRC) is currently reviewing its policy on conflict of interest.
It is perhaps surprising that a profession which prides itself on ethical performance should continue to be plagued by lack of transparency in this one area.
But history repeatedly attests to the lure of financial advantage. The IOM has thus recommended that Congress enact legislation requiring companies and their foundations to publicly report payments and gifts made to both individuals and institutions, whether they be physicians or non-physicians prescribing drugs or using medical devices, biomedical researchers, professional societies, continuing medical education providers, or specific patient advocacy groups.
Sadly, our approach to conflict of interest is hopelessly fragmented. The time has come for rhetoric to give way to binding recommendations based on the US model. To make this happen, we need committed leadership and a national organisation with clout.
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