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Healthy Skepticism Library item: 16665

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Bion J.
Financial and intellectual conflicts of interest: confusion and clarity.
Curr Opin Crit Care 2009 Oct 21;
http://www.ncbi.nlm.nih.gov/pubmed/19851102


Abstract:

PURPOSE OF REVIEW: To examine the literature on competing interests for individuals and organizations involved in healthcare and to determine the nature and extent of the problem, and the most effective methods of management. RECENT FINDINGS: A Medline search from 1950 to August 2009 identified 6803 publications (605 in languages other than English) on the subject of conflict of interest or competing interests. Of these, 1073 were letters, 785 editorials, 434 reviews and 212 referred to competing interests in the context of clinical guidelines. Conflicts of interest (competing interests) and bias are ubiquitous. In medicine, they may have the potential to cause harm to patients or obstruct research and new treatments. Competing interests may arise from financial, academic or personal factors. Most interventions relate to managing competing financial interests derived from relationships with the pharmaceutical industry. SUMMARY: Transparency is a necessary, but not a sufficient component in managing bias. Organizations should develop integrated systems for declaring, monitoring and managing financial interests; insight into other forms of bias could be improved through educational programmes. Marketing masquerading as education should be prohibited for undergraduates and trainees, and by professional organizations. Universities and journals should separate their conflicted roles as regulators and beneficiaries in commercial relationships.

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909