Abstract
A conflict of interests occurs when a doctor is unduly influenced by a secondary interest (i.e., a personal incentive) in his acts concerning one of the primary interests to which he is professionally committed (the welfare of patients, the progress of science, or the education of students or residents). One specific variety of conflicts of interests has monopolized the attention of the scientific and lay press: the financial conflicts of interests arising from the relationships between doctors and drug companies. A large literature has described the many, sometimes subtle, ways by which a psychiatrist can be influenced in his prescribing habits or research activities by his relationships with the industry. Some empirical evidence is now available in this area. On the other hand, it has been pointed out that the current debate on this issue is sometimes "affectively charged" or fails to take into account that the interests of patients, families and mental health professionals and those of the industry may be often convergent. Other types of conflicts of interests are beginning now to be discussed. There is evidence that the allegiance of a researcher to a given school of thought may influence the results of studies comparing different psychotherapeutic techniques, thus colliding with the primary interest represented by the progress of science. Political commitment is also emerging as a source of conflicts of interests. Financial and non-financial conflicts of interests are widespread in psychiatric practice and research. They cannot be eradicated, but must be managed more effectively than is currently the case.
Highlights
A conflict of interests occurs when a doctor is unduly influenced by a secondary interest in his acts concerning one of the primary interests to which he is professionally committed[1,2,3]
Public health sponsors usually have an interest to avoid spending money on the most expensive drugs[25]. This may affect the conduct and the outcome of the studies they fund, especially if the report of results in line with the public sponsor’s interest involves a better chance for researchers to be funded again by that sponsor. Another almost unexplored issue is that of financial conflicts of interests related to the practice of managed care[29]
Conflicts of interests are widespread in medical, and psychiatric, practice and research. Those arising from the relationships of physicians and researchers to the pharmaceutical industry, have a significant impact on the psychiatric field, to some extent documented by research
Summary
Resumen: Se produce un conflicto de intereses cuando un médico se siente indebidamente influenciado por un interés secundario (i.e., un incentivo personal) en relación con sus deberes primarios con los cuales está comprometido profesionalmente (el bienestar de los pacientes, el progreso de la ciencia o la educación de los estudiantes o residentes). Una extensa literatura ha descrito las variadas maneras, a veces sutiles, por medio de las cuales un psiquiatra puede ser influenciado por sus relaciones con la industria al aconsejar hábitos, o en sus actividades de investigación. Existe evidencia de que la cercanía de un investigador a alguna línea de pensamiento puede influenciar los resultados de estudios al comparar diferentes técnicas psicoterapéuticas, chocando, por tanto, con el interés primario representado por el progreso de la ciencia. El compromiso político también está emergiendo como fuente de conflictos de intereses. Palabras clave: conflictos de intereses, industria farmacéutica, sesgo de la publicación, desvelar, efecto de lealtad, compromiso político
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