31 August 2010

What is a Conflict of Interest?

Several conversations that I have had off-blog suggest to me that the notion of "conflict of interest" with respect to scientific advisory panels is not well understood.  The IPCC does not presently have any COI policies so it is impossible to judge whether its chairman, or anyone else, has a conflict.  However, under the application of COI policies of other bodies, such as the UN, WMO and NAS, it is indisputable that the IPCC chairman has conflicts of interest.  This is so patently obvious that is not really worth debating.  Whether the IPCC will implement similar policies , and if they do, whether its current chair will be ruled exempt from them are entirely different questions.

Here is how the US National Academy of Sciences defines the concept with respect to financial interests (PDF):
It is essential that the work of committees of the institution used in the development of reports not be compromised by any significant conflict of interest. For this purpose, the term "conflict of interest" means any financial or other interest which conflicts with the service of the individual because it (1) could significantly impair the individual's objectivity or (2) could create an unfair competitive advantage for any person or organization. Except for those situations in which the institution determines that a conflict of interest is unavoidable and promptly and publicly discloses the conflict of interest, no individual can be appointed to serve (or continue to serve) on a committee of the institution used in the development of reports if the individual has a conflict of interest that is relevant to the functions to be performed.

General Principles

The term "conflict of interest" means something more than individual bias. There must be an interest, ordinarily financial, that could be directly affected by the work of the committee. Conflict of interest requirements are objective and prophylactic. They are not an assessment of one's actual behavior or character, one's ability to act objectively despite the conflicting interest, or one's relative insensitivity to particular dollar amounts of specific assets because of one's personal wealth. Conflict of interest requirements are objective standards designed to eliminate certain specific, potentially compromising situations from arising, and thereby to protect the individual, the other members of the committee, the institution, and the public interest. The individual, the committee, and the institution should not be placed in a situation where others could reasonably question, and perhaps discount or dismiss, the work of the committee simply because of the existence of such conflicting interests.

The term "conflict of interest" applies only to current interests. It does not apply to past interests that have expired, no longer exist, and cannot reasonably affect current behavior. Nor does it apply to possible interests that may arise in the future but do not currently exist, because such future interests are inherently speculative and uncertain. For example, a pending formal or informal application for a particular job is a current interest, but the mere possibility that one might apply for such a job in the future is not a current interest.

The term "conflict of interest" applies not only to the personal financial interests of the individual but also to the interests of others with whom the individual has substantial common financial interests if these interests are relevant to the functions to be performed. Thus, in assessing an individual's potential conflicts of interest, consideration must be given not only to the interests of the individual but also to the interests of the individual's spouse and minor children, the individual's employer, the individual's business partners, and others with whom the individual has substantial common financial interests. Consideration must also be given to the interests of those for whom one is acting in a fiduciary or similar capacity (e.g., being an officer or director of a corporation, whether profit or nonprofit, or serving as a trustee).

Financial Interests

The term "conflict of interest" as used herein ordinarily refers to financial conflicts of interest. In assessing potential conflicts of interest in connection with an individual's service on a committee of the institution used in the development of reports for sponsors, particular attention will be given to the following kinds of financial interests if they are relevant to the functions to be performed: employment relationships (including private and public sector employment and self-employment); consulting relationships (including commercial and professional consulting and service arrangements, scientific and technical advisory board memberships, and serving as an expert witness in litigation); stocks, bonds, and other financial instruments and investments including partnerships; real estate investments; patents, copyrights, and other intellectual property interests; commercial business ownership and investment interests; services provided in exchange for honorariums and travel expense reimbursements; research funding and other forms
of research support.
UPDATE:  A colleague remind me of this useful definition, posted long ago on Prometheus:
“A conflict of interest is a set of conditions in which professional judgment concerning a primary interest (such as a patient’s welfare or the validity of research) tends to be unduly influenced by a secondary influence (such as financial gain)… The secondary interest is usually not illegitimate in itself, and indeed it may even be a necessary and desirable part of professional practice. Only its relative weight in professional decisions is problematic. The aim is not to eliminate or necessarily to reduce financial gain or other secondary interests (such as preference for family and friends or the desire for prestige and power). It is rather to prevent these secondary factors from dominating or appearing to dominate the relevant primary interest in the making of professional decisions.”

Reference: Thompson D. F., 1993. Understanding Financial Conflicts of Interest. The New England Journal of Medicine, 329:573-576.