CYIL vol. 14 (2023)

HELENA VAN BEERSEL KREJČÍKOVÁ CYIL 14 (2023) judgment or actions regarding a primary interest will be unduly influenced by a secondary interest. 1 Whilst primary interests include values, such as integrity in research, quality of medical education, and welfare of patients, 2 secondary interests are represented by either financial gains or other (non-financial) reasons, 3 such as personal beliefs or well-being of a close family member of the scientist or medical professional concerned. A conflict of interest may appear, for example, in a situation when a Ph.D. candidate conducts a clinical trial whilst receiving their salary from a pharmaceutical company manufacturing the drug subjected to the research (i.e., the candidate might have a secondary financial conflict of interest). Another example could be a doctor with a strong Catholic background who is consulted in an early stage of an unplanned pregnancy (i.e., the doctor might have a secondary non-financial conflict of interest). Currently, there is little doubt about the fact that having a competing financial interest (e.g., receiving gifts from pharmaceutical companies 4 ) is a situation which deserves a transparent disclosure, if not also the further proper management (such as eliminating the financial interest, or additional supervision 5 ). When it comes to potentially competing non-financial interest, 6 the same strategies seem to be less satisfying and the need of finding a different approach is currently discussed intensively within the medical field. 7 Some scholars who attempt to seek a more general cross-disciplinary definition of conflict of interest, prefer to think about conflict of interest more as a collision between a duty (e.g., office/position/ work-related duty) and a tangible or intangible interest, with no further distinction whether the interest is of a financial nature, or not. The duty v. interest collision tempts the person concerned to disregard their duty and constitutes a threat to the interest of someone else. 8 Irrespective of which definition of conflict of interest is taken into consideration, there is a shared understanding that conflict of interest per se shall be considered neither illegal, nor unethical. Having a conflict of interest does not imply that there is in fact an actual unduly influenced professional judgment or action, it merely acknowledges the potential for it. 9 However, unidentified and unmanaged conflicts of interest might have serious consequences and are incompatible with what is understood as the highest standard of research integrity. 1 Institute of Medicine (US) Committee on Conflict of Interest in Medical Research, Education, and Practice. Conflict of Interest in Medical Research, Education, and Practice . (Lo B, Field MJ, eds.). National Academies Press (US); 2009. 2 Ibid. 3 GARATTINI, L., PADULA, A., MANNUCCI, P. M. Conflicts of interest in medicine: a never-ending story. Intern Emerg Med . 2020;15(3):357-359. doi:10.1007/s11739-020-02293-4. 4 RANDALL, T. Ethics of Receiving Gifts Considered. JAMA . 1991;265(4):442-443. doi:10.1001/jama.1991.034600 40016003. 5 LIPTON, S., BOYD, E., BERO, L. Conflicts of Interest in Academic Research: Policies, Processes, and Attitudes. Accountability in Research . 2004;11(2):83-102. doi:10.1080/03050620490512241. 6 SAVER, R. S. Is it Really All about the Money? Reconsidering Non-Financial Interests in Medical Research. J Law Med Ethics . 2012;40(3):467-481. doi:10.1111/j.1748-720X.2012.00679.x. 7 BERO, L. A., GRUNDY, Q. Why Having a (Non-financial) Interest Is Not a Conflict of Interest. PLoS Biol . 2016;14(12):e2001221. doi:10.1371/journal.pbio.2001221. 8 VILLARÁN, A. Conflicts of interest: a moral analysis. Business & professional ethics journal . 2020;39(1):121 142. The reasoning behind this definition is not to diminish the conflicts’ significance. 9 McCOY, M. S., EMANUEL, E. J. Why There Are No “Potential” Conflicts of Interest. JAMA . 2017;317(17):1721 1722. doi:10.1001/jama.2017.2308.

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