Analyzing a Potential Conflict of Interest

In discussing conflicts of interest, it is important to specify what types of conflicts of interest are impermissible and what types may be permissible with proper management. There are some conflicts that are always impermissible and should be prohibited. For example, a conflict could arise when a sponsor makes it clear that an agreed upon endpoint not be utilized because it is potentially detrimental to the position of that sponsor. The contract language may preclude the sponsor from prohibiting the use of the endpoint, but if the sponsor pressures the researcher to “voluntarily” decide to change his or her mind, perhaps because of the fear of losing future work, such influence can be unethical and constitutes a serious conflict of interest. Similarly, if a sponsor insists on not being disclosed as the source of financial support or if the sponsor specifies certain data sources, outcome measures, or methods of analysis and refuses to include that specification in the contract and disclose it to the appropriate reporting sources, this would remove the work from the realm of research and it would be unethical for the researcher to lead others to believe that it was research.

Other types of conflicts require careful discussion and may be permissible with appropriate management, such as disclosure and oversight. For example:

• A dispute arises over contract parameters. Disputes may arise for any number of reasons, the vast majority of which do not necessarily imply ethical problems.
• A sponsor threatens to withhold future funding unless project design is revised. However, the nature of health services research often requires substantial ambiguity in study design and discretion in implementing a protocol. Thus, rigid adherence to an initial design when new data suggests a change is neither good science nor ethical.
• A researcher also serves in an advocacy role on the subject of his or her research. Constitutional rights to freedom of speech protect a wide variety of advocacy roles that are not necessarily in conflict with good, dispassionate research. Deciding just how to present one’s activities in each realm, however, may require careful thought and negotiation. It is the responsibility of the researcher or advocate to ensure the reasonable observer is informed about the actual role of the presenter.

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Continue to:

• Introduction
• AcademyHealth Ethical Guidelines Committee and Its Objectives
• Conflicts of Interest
  • What is a Conflict of Interest?
  • Conducting Research versus Using Research
• Distinctive Characteristics of Health Services Research
• Guiding Values
• Ethical Guidelines
  • Initiation of Research
  • Conducting Research
  • Reporting Research
• Analyzing a Potential Conflict of Interest
• Implementation and Enactment of the Guidelines
• Conclusion
• Appendix A – AcademyHealth Ethical Guidelines Committee
• Appendix B – Committee Action
• Appendix C – Conflict of Interest Resources