White paper: statement on conflicts of interest

Area of Science:

• Healthcare Ethics
• Medical Professionalism
• Health Policy

Background:

• Conflicts of interest are inherent in social interactions but become critical in healthcare due to trust and power dynamics.
• Unmanaged conflicts can lead to bias, prioritizing professional or organizational interests over patient well-being.
• Increasing reports highlight the damage conflicts cause to trust, patient outcomes, and health system integrity.

Purpose of the Study:

• To identify methods for detecting conflicts of interest in healthcare.
• To propose strategies for mitigating identified conflicts of interest.
• To offer recommendations for minimizing bias in clinical practice and research.

Main Methods:

• A narrative review of the literature was conducted.
• Searches included Medline and reference chaining.
• Iterative discussions informed the review process.

Main Results:

• Conflicts of interest can be financial, professional, or personal, affecting individuals and organizations.
• Unmanaged conflicts introduce bias, compromising patient interests.
• Fifteen recommendations are proposed to minimize conflicts of interest.

Conclusions:

• Establish national open-access registries for disclosing financial, professional, and personal relationships that may cause bias.
• Organizations must govern disclosure through annual appraisals, audited by national research integrity committees.
• Implement clear policies on conflicts of interest in professional societies, journals, and educational programs, including training on misconduct detection and management.