We applaud CMAJ ’s recent focus on the importance of disclosing conflicts of interest in medical education 1 and research. 2 However, disclosure is only a first step toward mitigating commercial influence, and too often it is viewed as sufficient.
For example, at the last meeting of the American Academy of Child and Adolescent Psychiatry, hundreds of presenters disclosed affiliations with commercial supporters. 3 However, attendees considered the sessions “free of commercial bias,” with a mean rating of 9.17/10 on this item; the result was celebrated as the product of a “strong focus on conflict of interest and disclosure issues.” 4
Simply disclosing a conflict of interest is inadequate because relationships with industry are known to influence physicians’ professional behaviour, 5 and the physician bias mediating the influence is largely unintentional. 6 Furthermore, disclosures alone may provide false reassurance by giving the appearance that physician–industry relationships have been adequately managed. In fact, one study found that when a conflict of interest was disclosed, it had greater, not less, influence. 6
We must move beyond mere disclosure of conflicts of interest toward developing additional regulatory mechanisms aimed at minimizing their pervasive influence. Like George Washington admitting that he chopped down his father’s cherry tree, our willingness to disclose conflicts of interest does not absolve us of further responsibility.
Footnotes
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For the full letter, go to: www.cmaj.ca/cgi/eletters/182/12/1279#594536