Conflicts of interest (COI) in health and medicine have been the source of considerable public and professional debate. Much of this debate has focused on financial, rather than non-financial COI, which is a significant lacuna because non-financial COI can be just as influential as financial COI. In an effort to explore the nature and effects of non-financial, as well as financial COI, we conducted semi-structured interviews with eleven Australian medical professionals regarding their experiences of, and attitudes towards, COI. We found that this group of medical professionals saw non-financial interests—most notably the pursuit of status and respect and the avoidance of stigma—as potentially conflicting with other important interests (such as patient care).
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The term “pharmaceutical industry” in this paper is used to refer to both the pharmaceutical and medical device industries.
There is a close relationship between the concept of non-financial COI and “motivation.” This is because interests are inevitably both motivated (e.g. one might be motivated to hold a particular belief by the fact that one belongs to a particular political organization with which one identifies strongly) and, in turn, motivate other attitudes and behaviours (e.g. one’s desire to preserve life based on a belief in its sanctity would motivate anti-abortion attitudes and corresponding actions). These motivations are, however, often unconscious and are difficult (if not impossible) to assess. Furthermore, it is not motivations but rather interests and their effects that matter when it comes to COI.
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Wiersma, M., Kerridge, I. & Lipworth, W. Status, Respect, and Stigma: A Qualitative Study of Non-financial Interests in Medicine. Bioethical Inquiry 17, 203–216 (2020). https://doi.org/10.1007/s11673-020-09970-1
- Qualitative research
- Non-financial conflicts of interest