Conflicts of Interest Overview

Conflicts of interest (COI) arise when the professional responsibilities of
individuals or organizations are, or have the potential to be, compromised by other, external obligations.  The failure of fiduciary responsibility is the key concept in defining conflict of interest situations.


Today, conflicts of interest are recognized in fields as varied as law, medicine, journalism, academia, business and government.  In medicine, such compromises are especially threatening, as they can undercut the health and well-being of patients.  Physicians and medical organizations may compromise their professional responsibilities by pursuing private financial gain. 

Although the pharmaceutical industry and medical device manufacturers have made vital contributions to research and patient care, the ultimate responsibilitiy of for-profit entities is to maximize returns to shareholders. In contrast, the medical profession should put patients’ interests first, regardless of financial considerations. The potential for conflict of interest is, therefore, inherent in industry-medicine relationships. Collaborations must be carefully regulated – and, in some cases, prohibited -- to protect patients' well-being, promote scientific integrity and ensure public trust.

Medical institutions must set conflict of interest policies that recognize these obligations.  An effective and responsible conflict of interest policy should clearly specify the relationships and activities that are acceptable, those that are prohibited, and provide clear guidelines on how to make certain all such arrangements are transparent.

Medical Conflict of Interest Policy Areas of Research

The Institute on Medicine as a Profession studies how various health care institutions are addressing the concept of conflict of interest on a policy level. We are currently focused on four key types of organizations: Academic Medical Centers, Professional Medical Associations, Pharmaceutical Companies and Medical Device Manufacturers, and Health Advocacy Organizations. Based upon our research, we have created a variety of resources to help create and implement a sound conflict of interest policy.

Academic Medical Centers

IMAP’s Conflict of Interest Policy Database houses over 700 policies on clinical conflicts of interest from the nation's 125 academic medical centers...

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Professional Medical Associations

The Professional Medical Association (PMA) Task Force, which was comprised of ten present and former PMA officers and executive directors along with several biomedical and social scientists, came together in three meetings during 2007 and 2008 in order to identify the major areas of conflict...

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Health Advocacy Organizations

IMAP is now exploring the relationship between health advocacy organizations (HAOs) and the pharmaceutical industry. HAOs are a crucial but relatively unknown participant in health policy...

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Medical Devices

Although considerable attention has been devoted to the relationships between physicians and pharmaceutical companies, relatively little attention has gone to the relationships between physicians and device companies...

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Conflict of Interest Resources

• What is COI and how does it affect modern medicine? Read our definition of conflict of interest.
• How are organizations dealing with COI? Search our conflict of interest policy database.
• What are the best ways to limit COI? Read our Best Practices Toolkits.