aaron lee

We worry about conflicts of interest or commitment in research because of the undue influences that they may have on healthcare providers. Since there is clearly an effect upon the care that is delivered, conflicts of interest may impact the care delivered in a positive or a negative way. Positively affecting conflicts of interest motivate healthcare providers to act in the best interest of the patient whereas negatively affecting conflicts of interest motivate healthcare providers to work in the best interest of some entity outside of the patient.

Positively affecting conflicts of interest include situations where the physician or someone close to the physician is the receiver of care such as friends or family. In these cases, the physician has an incentive to provide care above and beyond the average patient. This motivation may have negative consequences when the provider begins work selfishly in the interest of himself over the patient’s own wishes. A common example of this is when providers care for their parents during end of life situations and attempt to exceed the level of care over the patient’s wishes for selfish reasons. Nonetheless in these situations, the care of the provider is for the ultimate benefit of the patient and not a third party, and therefore is less worrisome.

Conflicts of interest which are more worrisome involve cases where the researcher or the provider is not acting solely in the best interest of the patient, but also for a third party entity. These include the cases from drug company provided pens to a researcher’s desire to further their own research. While providers may truly believe that they are acting primarily in the interest of the patient with the additional benefit of a third entity, they must also consider that they are unconsciously or consciously biased toward offering one treatment over another. Given a situation with two possible treatments where both treatments ostensibly benefit the patient, but one additionally benefits a drug company or a researcher’s research, the provider will naturally choose to give the later treatment. Even though this may seem innocuous in its result, the motivation behind the choice may lead to a dangerous situation in which the provider does not prescribe the former treatment even if it is more beneficial for the patient since the provider is no longer acting solely in the interest of the patient. It is precisely these situations that are most dangerous in terms of conflicts of interests, and the reason why we have ethical guidelines to follow.