Should disclosure of conflict of interests in medicine be public? Medical students' views.
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Open Access
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ArticleAbstract
Background: Conflicts of interest are considered to be ubiquitous in healthcare and biomedicine. Disclosure of relevant interests is a first step in managing conflicts, although its usefulness is contested. While several countries have mandated the public disclosure of doctors’ ...
See moreBackground: Conflicts of interest are considered to be ubiquitous in healthcare and biomedicine. Disclosure of relevant interests is a first step in managing conflicts, although its usefulness is contested. While several countries have mandated the public disclosure of doctors’ financial relationships with the pharmaceutical industry, little is known about medical students’ understanding of mandatory public disclosure. Methods: We conducted six 90-minute focus groups of medical students in a variety of locations in New South Wales, Australia. Participants ranged from first to final year students. We asked about their understanding and experiences of conflict of interest and more specifically for their views and experiences of disclosure in medical education, mandatory disclosure and public registers. Qualitative data analysis was based on a framework approach. Results: Participants were generally not supportive of mandatory public disclosure of financial relationships with industry, principally because of concerns about privacy, control over disclosure, and others’ (mis)interpretations of disclosures. Further, they did not know how to assess the disclosures presented to them as part of their medical education and described a wide range of reactions to disclosed information. Conclusions: Our study suggests that students are currently not well-prepared for mandatory public disclosure of conflicts of interest. We draw on Bourdieu’s doxa to highlight assumptions of altruism in medicine—an assumption that is potentially in tension with recent events that have opened doctors up to moral scrutiny by the public. Medical students could be better prepared them for future obligations by encouraging disclosures, contextualizing and helping students interpret them. Disclosure as a box ticking exercise is unlikely to achieve goals implied by transparency, but a more reflective approach may assist both scrutinizers and the scrutinized.
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See moreBackground: Conflicts of interest are considered to be ubiquitous in healthcare and biomedicine. Disclosure of relevant interests is a first step in managing conflicts, although its usefulness is contested. While several countries have mandated the public disclosure of doctors’ financial relationships with the pharmaceutical industry, little is known about medical students’ understanding of mandatory public disclosure. Methods: We conducted six 90-minute focus groups of medical students in a variety of locations in New South Wales, Australia. Participants ranged from first to final year students. We asked about their understanding and experiences of conflict of interest and more specifically for their views and experiences of disclosure in medical education, mandatory disclosure and public registers. Qualitative data analysis was based on a framework approach. Results: Participants were generally not supportive of mandatory public disclosure of financial relationships with industry, principally because of concerns about privacy, control over disclosure, and others’ (mis)interpretations of disclosures. Further, they did not know how to assess the disclosures presented to them as part of their medical education and described a wide range of reactions to disclosed information. Conclusions: Our study suggests that students are currently not well-prepared for mandatory public disclosure of conflicts of interest. We draw on Bourdieu’s doxa to highlight assumptions of altruism in medicine—an assumption that is potentially in tension with recent events that have opened doctors up to moral scrutiny by the public. Medical students could be better prepared them for future obligations by encouraging disclosures, contextualizing and helping students interpret them. Disclosure as a box ticking exercise is unlikely to achieve goals implied by transparency, but a more reflective approach may assist both scrutinizers and the scrutinized.
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Date
2017-01-01Publisher
WileyLicence
"This is the pre-peer reviewed version of the following article: Williams J, Mayes C, Lipworth W. 2017. Should disclosure of conflicts of interests in medicine be made public? Medical students' views., which has been published in final form at DOI: 10.1111/medu.13383. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions."Citation
Williams, J. , Lipworth, W. , Mayes, C. , Olver, I. and Kerridge, I. (2017), Should disclosure of conflicts of interest in medicine be made public? Medical students’ views. Med Educ, 51: 1232-1240. doi:10.1111/medu.13383.Share