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Integrity
in the face of conflict
Last year Emory’s $525 million profit from the marketing rights
to the HIV drug Emtriva brought into clear focus some of the potential
“dividends” of academic/industry collaboration in health-related
research, product development, and health care. In fact, the Emtriva
partnership is a classic case study in translational research: moving
vital discoveries efficiently from the scientific bench to the bedside
by drawing on the strengths of both the academy and industry. Yet
relationships between health professionals and institutions in the
nonprofit sector and partners and sponsors in the private sector
are fraught with difficulties. An important factor we must recognize
and manage at every step is conflict of interest (COI). COI can
exist where the primary interests of an individual or institution
(for example, the pursuit of knowledge or the education of students)
run up against significant secondary interests (such as pecuniary
gain).
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As
a university and health system, we have special obligations to ensure
the integrity of everything we do. The reliance of students and
trainees on their teachers and mentors requires the commitment of
educators to the best interests of their students. The pursuit of
knowledge and new discoveries requires scientific integrity, collaboration,
and free sharing of information. Human vulnerability in light of
disease and injury creates a moral imperative for the integrity
of caregivers. Even the appearance of COI can undermine a patient’s,
a student’s, or the public’s trust in our vital work.
COI is not new. Longstanding sources
of conflicts requiring management within academia and health care
include hubris, the desire for academic promotion, competition for
sponsored research support and “interesting cases,”
the push to be the first to publish discoveries, an aspiration for
higher pay and revenues, and other competing secondary interests.
The recent growth of collaboration with private industry is only
the latest challenge in earning and maintaining public trust in
the integrity of research, training, and clinical care.
It is vitally important for everyone
in our community to understand COI and be proactive in identifying
and managing conflicts. COI policy and its enforcement have evolved
quickly during the past several years, but they are still works
in progress. Often the issues are complex and far from straightforward
or clear-cut. New ground is broken regularly. Therefore, informed
voices from a variety of perspectives and a continuous and healthy
dialogue are necessary, as is complete compliance in areas where
policies are clear and settled. As always, I hope and expect that
you will find in the pages of Momentum good and useful
information that keeps us moving forward in managing COI and in
all of our work together.
For a related report on conflict of interest from the Blue Ridge
Group, see the Blue
Ridge Report pdf.
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