Strengthening conflict-of-interest policies in medicine.
OBJECTIVE
Conflict-of-interest (COI) policies have played a vital role in protecting the integrity of science as well as protecting patients' welfare. However, the usefulness of these policies could be enhanced by addressing gaps in disclosure requirements, especially insofar as these gaps may impede the intended neutrality of COI policies. For example, current COI policies have not addressed potential conflicts created by indirect industry funding, such as when pharmaceutical companies provide general funding to researchers' academic departments or to medical educational programmes. Nor do they address the consequent creation of climates of opinion, which may marginalize important criticisms and undermine progress on this important policy issue.


METHODS
The authors used a critical thinking approach to analyze the gaps in existing COI policies.


CONCLUSIONS
Taking the position that a more adequate system of checks and balances is needed, the authors offer specific recommendations for improving current policies and for addressing the issue of indirect support.
Cosgrove
Lisa
L
Department of Counseling and School Psychology, University of Massachusetts, Boston, MA, USA. lisa.cosgrove@umb.edu
Bursztajn
Harold J
HJ
D016265:Conflict of Interest; D030881:Disclosure / Q000941:ethics / Q000592:standards*; D004502:Education, Medical, Continuing / Q000941:ethics; D032984:Ethics, Research; D019317:Evidence-Based Medicine / Q000941:ethics; D005378:Financial Support / Q000941:ethics*; D006801:Humans; D017410:Practice Guidelines as Topic; D014481:United States