Policy solutions to conflicts of interest: the value of professional norms

2017 ◽  
Vol 1 (2) ◽  
pp. 177-189 ◽  
Author(s):  
SUNITA SAH
Keyword(s):  
Conflict Of Interest ◽  
Conflicts Of Interest ◽  
Unintended Consequences ◽  
Financial Advisors ◽  
Psychological Processes ◽  
Professional Norms ◽  
Good People ◽  
Personal Interests ◽  
And Training ◽  
Policy Solutions

AbstractAdvisors, such as physicians, financial advisors, lawyers and accountants, often face a conflict of interest – that is, a clash between their professional and personal interests. Such conflicts can lead to biased and corrupt advice. In this paper, I focus on how conflicts of interest can cause good people to unintentionally cross ethical boundaries and how we can avoid succumbing to this bias. I first discuss two mechanisms through which advisors may convince themselves to accept conflicts of interest while vehemently believing that they remain unbiased: (1) a sense of entitlement; and (2) a sense of invulnerability created by their belief in their own professionalism. I then discuss several proposed policy solutions to manage conflicts of interest, such as education and training, sanctions, second opinions and disclosure policies. These proposed solutions for dealing with conflicts of interest are largely based on inaccurate intuitions regarding the psychological processes that underlie them; consequently, these policies tend to fail or have unintended consequences. In the absence of eliminating conflicts of interest, solutions that are more likely to be successful consist of identifying and changing the professional norms that exert powerful influences on employee behaviour.

Conflict of Interest and Decision Making

2021 ◽  
pp. 265-282
Author(s):  
Geneviève Helleringer
Keyword(s):  
Decision Making ◽  
Conflict Of Interest ◽  
Cognitive Biases ◽  
Institutional Design ◽  
Conflicts Of Interest ◽  
Self Regulation ◽  
Central Element ◽  
Professional Norms ◽  
The Impact ◽  
Harmful Effects

This chapter looks at conflicts of interest (COI). It first considers tools of analytic philosophy to highlight the notion of COI, and in particular, the connection between COIs, choice and judgment, emphasising why decision making is a central element in the characterisation of COIs. Drawing on these elements, it is clear that any question of regulation and institutional design requires a sophisticated understanding of the capacity of individuals to recognise and resist bias in themselves and others when making judgments and decisions. The chapter then studies two specific mechanisms—bounded rationality and cognitive biases—that affect the behaviour of people in COI situations. It starts by analysing how rationalisation can reframe questionable behaviour as appearing acceptable, and how a sense of invulnerability encourages people to downplay the impact of COIs. The chapter then looks at techniques (policies, procedures, incentives, etc.) used to address COI situations in the light of insights from psychological studies. It concludes that both fiduciary duties and procedural requirements reflect an erroneous understanding of psychology and have led institutions and policies to deal ineffectively—if not indeed counterproductively—with the problems caused by COIs. Finally, the chapter assesses how alternative mechanisms may overcome the highlighted deficiencies. It specifically focuses on the key role that professional norms can play in dealing with unavoidable COIs while preserving trust between the affected parties, and the potential for self-regulation to provide worthwhile tools in combatting the harmful effects of COIs.

scholarly journals Preventing conflicts of i nterest: the policy of giving and accepting gifts in the civil service

2020 ◽  
pp. 279-285
Author(s):  
M. D. Nauryzbek
Keyword(s):  
Conflict Of Interest ◽  
Conflicts Of Interest ◽  
Civil Servants ◽  
Public Officials ◽  
The Public ◽  
The Gift ◽  
The Subject ◽  
The Government ◽  
The One ◽  
Personal Interests

The article raises the issue of conflict of interest and its prevention. The first threat of a conflict of interest in general is a violation of the balance between the personal interests of civil servants and the public interest. And the second risk is that a conflict of interest reduces the level of public trust and confidence in the loyalty and impartiality of public officials. This article analyzes and studies the real form of conflict of interest in Kazakhstan, namely two gift policy options. In particular, the zero gift policy and the limited gift ban policy are the subject of this research. On the one hand, the gift policy may completely prohibit accepting the gifts in order to prevent conflicts of interest. This zero gift policy implies that there is a ban for any gifts, regardless of the price. The establishment of a zero gift policy affects the level of confidence in the government, since citizens know that no factors affect the performance of a civil servant’s work. However, this will significantly restrict the freedom of action of civil servants. On the other hand, the gift policy can determine the rules for accepting the gifts both at workplace and after the work hours. If a gift is permissible, then there is a question of establishing an acceptable price. This means adopting a policy of limited prohibition on gifts and such a policy promotes the development of civil servants' consciousness. As a result, the author suggests a more favorable policy for Kazakhstan.

scholarly journals Bias in the Evaluation of Conflict of Interest Policies

2012 ◽  
Vol 40 (2) ◽  
pp. 368-382 ◽  
Author(s):  
Zachariah Sharek ◽  
Robert E. Schoen ◽  
George Loewenstein
Keyword(s):  
Conflict Of Interest ◽  
Conflicts Of Interest ◽  
Motivated Reasoning ◽  
Decision Makers ◽  
Prior Beliefs ◽  
Process Information ◽  
Medical Institutions ◽  
Wide Range ◽  
Considerable Controversy ◽  
Personal Interests

A wide range of medical institutions have developed and implemented policies to mitigate the adverse consequences of conflicts of interest. These newly implemented policies, which include regulation of industry contact with physicians and hospitals, controls on gifts from industry, and greater transparency in industry sponsored activities, have generated considerable controversy.Formulating and evaluating policies in a neutral, unbiased fashion can be difficult for those personally affected. When people have a stake in an issue, they tend to process information in a selective fashion that supports their personal interests, a phenomenon known as “motivated reasoning.” When decision makers with preexisting opinions are exposed to information, they are inclined to selectively use the information to arrive at conclusions that justify their prior beliefs. When confronted with information that contradicts existing views, people evaluate it with greater skepticism. Additionally, once decision makers have reached a decision, they are likely to evaluate subsequent evidence in a biased manner that supports their decision.

General Particulars Regarding the Conflict of Interest

2020 ◽  
Vol 26 (2) ◽  
pp. 145-149
Author(s):  
Aurelia Teodora Drăghici
Keyword(s):  
Local Government ◽  
Conflict Of Interest ◽  
Conflicts Of Interest ◽  
National Level ◽  
The State ◽  
Role Of The State ◽  
Legal Implications ◽  
Determining Factors ◽  
Changing Role

SummaryTheme conflicts of interest is one of the major reasons for concern local government, regional and central administrative and criminal legal implications aiming to uphold the integrity and decisions objectively. Also, most obviously, conflicts of interest occur at the national level where political stakes are usually highest, one of the determining factors of this segment being the changing role of the state itself, which creates opportunities for individual gain through its transformations.

Preventing and Managing Conflict of Interest in Nutrition Policy: Lessons for Alcohol Control Comment on "Towards Preventing and Managing Conflict of Interest in Nutrition Policy? An Analysis of Submissions to a Consultation on a Draft WHO Tool"

2020 ◽  
Author(s):  
Katherine Severi
Keyword(s):  
Conflict Of Interest ◽  
Conflicts Of Interest ◽  
Nutrition Policy ◽  
Alcohol Policy ◽  
World Health ◽  
Alcohol Control ◽  
Policy Debates ◽  
Food And Nutrition ◽  
Industry Engagement ◽  
Health Organization

Ralston et al present an analysis of policy actor responses to a draft World Health Organization (WHO) tool to prevent and manage conflicts of interest (COI) in nutrition policy. While the Ralston et al study is focussed explicitly on food and nutrition, the issues and concepts addressed are relevant also to alcohol policy debates and present an important opportunity for shared learning across unhealthy commodity industries in order to protect and improve population health. This commentary addresses the importance of understanding how alcohol policy actors – especially decision-makers – perceive COI in relation to alcohol industry engagement in policy. A better understanding of such perceptions may help to inform the development of guidelines to identify, manage and protect against risks associated with COI in alcohol policy.

scholarly journals Addressing Conflicts of Interest in Health and Medicine: Current Evidence and Implications for Patient Decision Aid Development

2021 ◽  
pp. 0272989X2110088
Author(s):  
Rachel Thompson ◽  
Zoe Paskins ◽  
Barry G. Main ◽  
Thaddeus Mason Pope ◽  
Evelyn C. Y. Chan ◽  
...  
Keyword(s):  
Conflict Of Interest ◽  
Decision Aid ◽  
Conflicts Of Interest ◽  
Guideline Development ◽  
Care Delivery ◽  
Quality Standards ◽  
Current Evidence ◽  
Unintended Effects ◽  
Patient Decision Aid ◽  
Patient Decision

Background More stringent policies for addressing conflicts of interest have been implemented around the world in recent years. Considering the value of revisiting conflict of interest quality standards set by the International Patient Decision Aid Standards (IPDAS) Collaboration, we sought to review evidence relevant to 2 questions: 1) What are the effects of different strategies for managing conflicts of interest? and 2) What are patients’ perspectives on conflicts of interest? Methods We conducted a narrative review of English-language articles and abstracts from 2010 to 2019 that reported relevant quantitative or qualitative research. Results Of 1743 articles and 118 abstracts identified, 41 articles and 2 abstracts were included. Most evidence on the effects of conflict of interest management strategies pertained only to subsequent compliance with the management strategy. This evidence highlighted substantial noncompliance with prevailing requirements. Evidence on patient perspectives on conflicts of interest offered several insights, including the existence of diverse views on the acceptability of conflicts of interest, the salience of conflict of interest type and monetary value to patients, and the possibility that conflict of interest disclosure could have unintended effects. We identified no published research on the effects of IPDAS Collaboration conflict of interest quality standards on patient decision making or outcomes. Limitations Because we did not conduct a systematic review, we may have missed some evidence relevant to our review questions. In addition, our team did not include patient partners. Conclusions The findings of this review have implications for the management of conflicts of interest not only in patient decision aid development but also in clinical practice guideline development, health and medical research reporting, and health care delivery.

scholarly journals A cross-sectional study of all clinicians’ conflict of interest disclosures to NHS hospital employers in England 2015-2016

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e019952 ◽  
Author(s):  
Harriet Ruth Feldman ◽  
Nicholas J DeVito ◽  
Jonathan Mendel ◽  
David E Carroll ◽  
Ben Goldacre
Keyword(s):  
Conflict Of Interest ◽  
Conflicts Of Interest ◽  
Current System ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Freedom Of Information ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Gift ◽  
The Uk

ObjectiveWe set out to document how NHS trusts in the UK record and share disclosures of conflict of interest by their employees.DesignCross-sectional study of responses to a Freedom of Information Act request for Gifts and Hospitality Registers.SettingNHS Trusts (secondary/tertiary care organisations) in England.Participants236 Trusts were contacted, of which 217 responded.Main outcome measuresWe assessed all disclosures for completeness and openness, scoring them for achieving each of five measures of transparency.Results185 Trusts (78%) provided a register. 71 Trusts did not respond within the 28 day time limit required by the FoIA. Most COI registers were incomplete by design, and did not contain the information necessary to assess conflicts of interest. 126/185 (68%) did not record the names of recipients. 47/185 (25%) did not record the cash value of the gift or hospitality. Only 31/185 registers (16%) contained the names of recipients, the names of donors, and the cash amounts received. 18/185 (10%) contained none of: recipient name, donor name, and cash amount. Only 15 Trusts had their disclosure register publicly available online (6%). We generated a transparency index assessing whether each Trust met the following criteria: responded on time; provided a register; had a register with fields identifying donor, recipient, and cash amount; provided a register in a format that allowed further analysis; and had their register publicly available online. Mean attainment was 1.9/5; no NHS trust met all five criteria.ConclusionOverall, recording of employees’ conflicts of interest by NHS trusts is poor. None of the NHS Trusts in England met all transparency criteria. 19 did not respond to our FoIA requests, 51 did not provide a Gifts and Hospitality Register and only 31 of the registers provided contained enough information to assess employees’ conflicts of interest. Despite obligations on healthcare professionals to disclose conflicts of interest, and on organisations to record these, the current system for logging and tracking such disclosures is not functioning adequately. We propose a simple national template for reporting conflicts of interest, modelled on the US ‘Sunshine Act’.

scholarly journals Analysis of motivation for acting subjects in diagnostics of occupational diseases

2020 ◽  
Vol 99 (11) ◽  
pp. 1217-1221
Author(s):  
Alexey D. Trubetskov
Keyword(s):  
Occupational Health ◽  
Conflict Of Interest ◽  
Occupational Diseases ◽  
Detection Rate ◽  
Conflicts Of Interest ◽  
Structured Interviews ◽  
Financial Interest ◽  
Medical Institutions ◽  
Professional Longevity ◽  
Detection And Diagnosis

Introduction. There is a shallow detection rate of occupational diseases in Russia. A large number of acting subjects are usually involved in the diagnosis of diseases. There is considered the current cooperation between the acting subjects responsible for diagnostics of occupational diseases in various modes. Material and methods. A search was conducted for data that described the main trends concerning conflict of interest in occupational health. Questionnaires and semi-structured interviews were conducted on issues related to the diagnosis of occupational diseases of specialists working in various branches of this field of medicine Results. The author performed the analysis of existing conflicts of interest in acting subjects in the detection and diagnosis of occupational diseases and established the most significant acting subjects. Among them the most pronounced conflicts of interest were shown to be determined by employers (as institutions, and specific managers and doctors performing examinations of workers in harmful conditions, and the managing stuff of these medical institutions, as well as by the employees themselves, who are subject to these examinations. When analyzing the motivation of acting subjects, the primary and financial interest was shown to have less significance than the secondary one. Mutual connectivity in the implementation of secondary interests adjudicates a persistent configuration, which determines both the low detection rate of occupational diseases, including at early stages, and lack of opportunities for prolonging professional longevity. The existence of a conflict of interest is not evil in itself. Still, its resolution is always associated with obtaining benefits, including the entire country’s level (saving the lives of the working population). Conclusion. To increase staff lifespan and work longevity through the analysis of all acting subjects, it is necessary to improve managing decisions to achieve the predominant primary interests. The study of the conflicts of interest can be an effective method of understanding and improving the health system in occupational health to preserve public health and increase the working population’s longevity.

scholarly journals Problematyka konfliktu interesów w funkcjonowaniu rynku kapitałowego

Ekonomia ◽  
2018 ◽  
Vol 24 (2) ◽  
pp. 73-91
Author(s):  
Agnieszka Parkitna ◽  
Arkadiusz Górski
Keyword(s):  
Capital Market ◽  
Conflict Of Interest ◽  
Conflicts Of Interest ◽  
Good Practice ◽  
Causal Link ◽  
Secondary Market ◽  
Market Practices ◽  
Business Entities ◽  
The One ◽  
The Capital Market

Problems of conflicts of interest in the functioning of the capital marketThe study refers to the occurrence of conflicts of interest on the capital market, which negatively affects the functioning of the capital market, limits its development potential, and may even affect the outflow of investors, particularly those providing liquidity in the market. Today, the social responsibility of business entities becomes something important. It is a specific determinant of the company’s image and the basis of its operation. Word = Institution “brokerage house” should be associated with competence, honesty, or righteousness resulting from observance of the law and ethics principles of conducted business. The existence of a set of regulations the Code of Good Practice for Brokerage Houses, the Act on Counteracting Unfair Market Practices relating to the functioning of brokerage houses, there are situations in business practice that are not used to develop a capital market, based on a conflict of interest. Brokerage firms are obliged, on the one hand, to: sell shares and, on the other hand, recommend buying them. “Manipulation on the market” would mean entering into transactions that give false, misleading signals about supply, demand, and prices of equity instruments. To avoid conflicts of interest, there are special procedures in brokerage offices that prevent co-operation between competing departments: chinese walls.Each office additionally has rules governing the flow and control of confidential information. Such information may not be available, for example, between primary and secondary market forces, between sales departments and analysis departments.The indicated issues were brought together, focusing on the possible consequences of conflicts of interest. It emphasizes the difficulty of bringing justice through the necessity of showing the causal link between the conflict of interest and the possible loss of the investor. Then solutions were identified to protect against the negative aspects of the conflict of interest, and the proposals were presented in their conclusions.

scholarly journals Torture, Impunity, and the Need for Independent Prosecutorial Oversight of the Executive Branch

2017 ◽  
Author(s):  
Fran Quigley
Keyword(s):  
Conflict Of Interest ◽  
Conflicts Of Interest ◽  
Current System ◽  
Attorney General ◽  
Bush Administration ◽  
Executive Branch ◽  
Popular Resistance ◽  
Independent Counsel ◽  
Policy Agendas ◽  
High Level

Fran Quigley, Torture, Impunity, and the Need for Independent Prosecutorial Oversight of the Executive Branch, 20 Cornell J. L. & Pub. Pol'y 271 (2010)Allegations of Executive Branch misconduct present an inherent conflict of interest because prosecutorial discretion is invested in a U.S. Attorney General appointed by – and serving at the pleasure of – the President. Various commentators, including Justice Antonin Scalia, Professor Stephen Carter, and the many critics of the former independent counsel statute have posited that checks on executive power provided by the Legislative Branch, the Judiciary, and political pressure will overcome any potential conflicts of interest. This sanguine view of adequate Executive Branch oversight was put to the test when high-level members of the George W. Bush Administration authorized acts of torture. After widespread public disapproval, Congress and the courts responded with efforts to rein in the Administration’s actions. However, the Department of Justice under the Bush Administration not only refused to investigate and prosecute allegations of sanctioning torture, but its attorneys also led the efforts to overcome congressional, judicial, and popular resistance to the Executive Branch conduct – and did so while explicitly acknowledging that the Executive Branch could expect little or no judicial oversight for its actions. Ultimately, the President who sanctioned torture left office, and the voters elected a President who expressed sharply different views on torture. However, the subsequent Administration of President Barack Obama, although affiliated with a different party and on record as opposed to acts of torture sponsored by the previous Administration, has also declined to pursue prosecution of high-level members of the Bush Administration. This most recent development shows that the conflict of interest presented by presidential control over Executive Branch prosecution transcends predictable concerns of self-preservation. The conflict of interest also highlights the natural desire of a sitting President to avoid prosecutions of previous executive officials when such prosecutions would consume political capital needed for the President’s broader legislative and foreign policy agendas. When it comes to controlling Executive Branch criminal conduct, the current structure designed to provide checks and balances comes up empty and thus must be reformed. The most direct and effective reform would be the direct election of the U.S. Attorney General. Even less precise remedies, such as a revived and improved independent counsel or Congress enacting provisions to break up the current monopoly over Executive Branch prosecution, would be significant improvements over the current system, which mocks the principle of equal justice for all.

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