ABSTRACT
This chapter examines the definitions of conflicts of interest (COIs), their causes, and response to them. First, it defines COIs in the context of physicians’ practice. COIs include financial ties that compromise physician loyalty to patients or the exercise of independent judgment on their behalf. They create a risk that physicians will breach their legal or ethical obligations. COIs do not include a physician's intellectual commitments. Second, it identifies five main sources of COI in medical practice: entrepreneurship, employment, compensation, financial ties to medical providers, and financial ties to insurers. Third, it reviews options to cure or manage COIs. They can be cured (i.e., resolved) by removing the financial interests or ties, or by changing the physician's activity or role that conflicts with their financial interest, and they can sometimes be managed by overseeing the activities of the conflicted physician in order to reduce the risk that the physician will breach his or her duty to serve patients. Finally, it assesses how the disclosure of financial interest can help cope with COI. Disclosure of financial interests is a necessary condition for identifying COI and subsequent remedial responses. However, disclosure alone is insufficient. Many people advocate disclosure and nothing more because it does not require making the difficult changes, and they mistakenly believe that disclosure is itself sufficient to cure COI.
