Our society has long sanctioned, at least tacitly, a conflict of interest in medical practice and research as an unavoidable consequence of the different interests of the participants in health care: the physician or clinical researcher, the patient or research subject, insurance companies or research sponsors, the government, and society as a whole. This multidisciplinary effort draws from philosophy, medicine, law, economics and public policy to identify and categorize conflicts of interest in medical practice and clinical research, and, where possible, to offer a mechanism for resolving them. Part I reviews the theoretical background, including basic concepts and analytical frameworks. The second part discusses two topics prominent in current health care policy debates--self-referral and financial incentives to limit care. Part III examines conflicts of interest generated by pharmaceutical industry involvement in clinical practice and research. The final section deals with clinical research in several contexts, including institutional review boards, clinical trials, research agreements between the government and private researchers, brokerage of research subjects by contract research organizations, and cost-effectiveness studies.
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Book Description
Editorial Reviews
Review
"A valuable contribution in an area of growing concern and potential conflict."--Journal of the American Medical Association
"In its 19 chapters, this book examines a broad set of issues involving conflicts of interest in medicine, and it does so from an even broader set of perspectives....The contributions represent a wide range of well-argued views. Every reader is likely to respond to...chapters eagerly....The editors give a coherent and comprehensive look at the issues."--The New England Journal of Medicine
"All readers will benefit enormously from reading this book. The excellent analysis serves not only to heighten awareness of and increase sensitivity to conflicts of interest but also to stimulate further discussion."--Annals of Internal Medicine
"The best book...on the subject of conflict of interest....A distinct American stance."--The Lancet
"Impressive, carefully edited collection of essays....The unity and uniformity of excellence among the contributions is a tribute to the editors' labors..."--The Journal of Legal Medicine
"An important and timely book....This concise and comprehensive book should be read by all oncologists who are seriously involved in clinical trials."--Annals of Oncology
"An in-depth and comprehensive examination...The contributors, experts in the fields of medicine, ethics, philosophy, business, and law, have produced a book that for the first time and in a single volume describes and discusses conflicts of interest COI faced daily by clinicians....Well-organized, well-written, and well-referenced...All will benefit enormously from reading this book. Rating: *****."--Doody's Health Sciences Book Review
"The authors should be commended in coming to grips with a complex subject we and organized medicine have had a difficult time dealing with....An admirable job..."--Radiology
"An extensive conceptual overview provides a strong framework for the understanding of the problem, and is well-grounded in philosophical and ethical theory...This book opens new areas of discussion, and should be of interest to all who care for patients or who are involved in biomedical research."--Annals of the Royal College of Physicians and Surgeons of Canada
"Should be required reading."--Canadian Family Physician
"In its 19 chapters, this book examines a broad set of issues involving conflicts of interest in medicine, and it does so from an even broader set of perspectives....The contributions represent a wide range of well-argued views. Every reader is likely to respond to...chapters eagerly....The editors give a coherent and comprehensive look at the issues."--The New England Journal of Medicine
"All readers will benefit enormously from reading this book. The excellent analysis serves not only to heighten awareness of and increase sensitivity to conflicts of interest but also to stimulate further discussion."--Annals of Internal Medicine
"The best book...on the subject of conflict of interest....A distinct American stance."--The Lancet
"Impressive, carefully edited collection of essays....The unity and uniformity of excellence among the contributions is a tribute to the editors' labors..."--The Journal of Legal Medicine
"An important and timely book....This concise and comprehensive book should be read by all oncologists who are seriously involved in clinical trials."--Annals of Oncology
"An in-depth and comprehensive examination...The contributors, experts in the fields of medicine, ethics, philosophy, business, and law, have produced a book that for the first time and in a single volume describes and discusses conflicts of interest COI faced daily by clinicians....Well-organized, well-written, and well-referenced...All will benefit enormously from reading this book. Rating: *****."--Doody's Health Sciences Book Review
"The authors should be commended in coming to grips with a complex subject we and organized medicine have had a difficult time dealing with....An admirable job..."--Radiology
"An extensive conceptual overview provides a strong framework for the understanding of the problem, and is well-grounded in philosophical and ethical theory...This book opens new areas of discussion, and should be of interest to all who care for patients or who are involved in biomedical research."--Annals of the Royal College of Physicians and Surgeons of Canada
"Should be required reading."--Canadian Family Physician
About the Author
Roy G. Spece, Professor of Law, University of Arizona College of Law. David S. Shimm, Associate Professor of Radiation Oncology, University of Arizona College of Medicine. Allen E. Buchanan, Granger Professor of Business Ethics at the School of Business, Professor of Medical Ethics at the School of Medicine, Professor of Philosophy, University of Wisconsin, Madison.
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