Ethics framework urged to manage conflicts of interest in medicine

A recent international study led by researchers from McGill University and the McGill University Health Centre (MUHC) examines the complex and controversial interplay of conflicts of interest between physician experts, medicine and the pharmaceutical or medical device industry. The results of the analysis, which are published in the Annals of Internal Medicine, aim to advance the management of conflicts of interest in medical guidelines.

"Over the last decade governments, medical specialty societies and academia have increasingly confronted an in the development of influential, independent, expert ," says lead author, Derek J. Jones of McGill University's Faculty of Law Research Group on Health and the Law.

According to the study, clinical practice guidelines (CPGs) on , mental disorders, flu and diabetes have been criticized, questioned or annulled because of Conflicts of Interest (COIs) issues in the US, Canada, France and . "Should physician experts who have, or had, financial relations with industry be included, excluded, or limited from the development of international clinical practice guidelines," Jones asks. "What if their expertise is rare, unique or essential?"

The interdisciplinary project developed and analyzed the impact of an ethics framework designed to manage COIs in an international CPG on gastroenterology. They found the initiative fruitful, if challenging. "Given the absence of uniform COI definitions, procedures or standards in the international arena, we found that an ethics framework helps to identify COIs, ethics issues, and COI management options in the process," explains Jones.

"We further sought to measure the impact of COIs on voting and discussing the CPG recommendations," explained Dr. Alan Barkun, corresponding author of the study and chief of gastroenterology at the MUHC and professor of medicine at McGill. "Our analysis of the COI management tool used revealed little impact on voting recommendations for the guideline and some impact on discussion. These important issues demand further analysis and initiatives."

The study thus recommends targeted research, the use of ethics frameworks, a financing model, and international and institutional policy initiatives to better manage in the development of future CPGs.

More information: "Conflicts of Interest Ethics: Silencing Expertise in the Development of International Clinical Practice Guidelines," Annals of Internal Medicine.

add to favorites email to friend print save as pdf

Related Stories

Doctoral student develops ethical guidelines for GPs

Nov 04, 2011

Malcolm Oswald, a doctoral student in Bioethics and Medical Jurisprudence in the School of Law, is a co-author of the new guide, entitled, Making Difficult Choices - Ethical Commissioning Guidance to General Practitioners. ...

Recommended for you

Exploring 3-D printing to make organs for transplants

23 hours ago

Printing whole new organs for transplants sounds like something out of a sci-fi movie, but the real-life budding technology could one day make actual kidneys, livers, hearts and other organs for patients ...

High frequency of potential entrapment gaps in hospital beds

Jul 30, 2014

A survey of beds within a large teaching hospital in Ireland has shown than many of them did not comply with dimensional standards put in place to minimise the risk of entrapment. The report, published online in the journal ...

Key element of CPR missing from guidelines

Jul 29, 2014

Removing the head tilt/chin lift component of rescue breaths from the latest cardiopulmonary resuscitation (CPR) guidelines could be a mistake, according to Queen's University professor Anthony Ho.

Burnout impacts transplant surgeons (w/ Video)

Jul 28, 2014

Despite saving thousands of lives yearly, nearly half of organ transplant surgeons report a low sense of personal accomplishment and 40% feel emotionally exhausted, according to a new national study on transplant surgeon ...

User comments