Glory as a conflict of interest?

An editorial last week in JAMA – the Journal of the Medical Association  by Anne R. Cappola, and Garret A. FitzGerald about conflicts of interest in medical research notes that “disclosure policies have focused on financial gain. However, in academia, the prospect of fame may be even more seductive than fortune. Thus, the outcome of a study may influence publication in a high-impact journal, invitations to speak at conferences, promotion, salary, and space. Even though an investigator may publicly eschew any direct financial reward from a sponsor, such fiscal and professional benefits may accrue to them indirectly from the institution, if they attract clinical trials with their attendant indirect costs.”

This is, I think, an important point, and its logic goes beyond the context about which the authors write to COIs of many other kinds.  Support for this broader view can be found in a study showing the impact of social, as opposed to purely economic, factors on the conduct of auditing, and a landmark decision in 2003 of the Delaware Chancery Court examining the impact of non-economic factors on possible COIs involving a corporate board. (The study and the case are discussed in this earlier post.)

The JAMA authors’ prescription for addressing this conceptual shortfall is captured in the title of the editorial –  “Confluence, Not Conflict of Interest: Name Change Necessary.”  I find the notion of a “confluence of interest” intriguing but a bit troubling too – in the way that “enhanced interrogation techniques” is. The phrase  also reminds me of a statement by then king-of-the-hill securities analyst Jack Grubman:  “What used to be a conflict is now a synergy.”  (Three years later Grubman was fined $15 million dollars and barred from the industry  for life for what were apparently still considered COIs.)

Many interests really and truly conflict with professional or other duties, as described in this post.   Expanding our recognition of what can have that effect seems like a step forward.  Soft pedaling what that impact can be does not.