CONFLICT OF INTEREST

A conflict of interest refers to a situation where a conflict arises for an individual

between two competing interests. These are often, but not exclusively, interests of
public duty versus private interests. This refers to a reasonably perceived, potential
or actual conflict of interest. A conflict of interest involves the abuse -- actual,
apparent, or potential -- of the trust that people have in professionals. The simplest
working definition states: A conflict of interest is a situation in which financial or
other personal considerations have the potential to compromise or bias professional
judgment and objectivity. An apparent conflict of interest is one in which a
reasonable person would think that the professionals judgment is likely to be
compromised. A potential conflict of interest involves a situation that may develop
into an actual conflict of interest. It is important to note that a conflict of interest
exists whether or not decisions are affected by a personal interest; a conflict of
interest implies only the potential for bias, not a likelihood. It is also important to
note that a conflict of interest is not considered misconduct in research, since the
definition for misconduct is currently limited to fabrication, falsification, and
plagiarism. A conflict of interest relates to situations in which financial or other
personal considerations,
circumstances, or relationships
 may compromise,
 may involve the potential for compromising, or
 may have the appearance of compromising a Covered Individual’s objectivity in
fulfilling their University duties or responsibilities,including research, service and
teaching activities and administrative duties.

Common types of conflicts of interest include: self-dealing, family interests or nepotism,

and the giving of gifts. Conflict of interest can be mitigated by several actions including:
removal, disclosure, recusal, third-party evaluations, and establishing codes of conduct.
Conflicts of interest are broadly divided into two categories: intangible, i.e., those involving
academic activities and scholarship; and tangible, i.e., those involving financial
relationships.

COIs REQUIRE PRESENCE OF THREE ELEMENTS

1. Acting in a professional or official capacity or in a position of trust

2. While having a personal interest (usually financial)

3. That interferes with objective decision making (or gives the impression that

decision making is compromised)

Having a conflict of interest is not necessarily a problem or a “bad thing”. Having a

conflict of interest and doing nothing about it is a problem.

INTERESTS COME IN TWO BASIC FORMS

Financial (tangible) Non-Financial (intangible)

• Money • Professional
• Employment Ÿ Personal

• Property/Stock Ownership • Physical

Ÿ Psychological

TYPICAL COIs

• Maintaining roles that conflict

• Accepting personal gratuities

• Influence Peddling

• Use of public property to fulfill private obligations

• Using or disclosing confidential information

 • Conflicting outside employment or other allegiances (i.e.,

boards)

HOW TO HANDLE COIs

Step One: Always disclose

Step Two: Mitigate and manage, where possible

Modify research design

Monitor research by independent reviewers

Step Three: If monitoring is not feasible, you may be required to:

• Discontinue the compensated activity

• Divest self of the financial interest

• Terminate the research

Conflicts of Interest at the Individual Level

Objectivity is the sine qua non (end result or outcome) of scientific discovery. But bias in
judgment is virtually impossible to eliminate. There are often subtle, and not so subtle, pressures
that can influence how we perceive and how we act. All research professionals understand the
pressures to publish, to get funding, appointments, promotions, and to earn respect from peers.
Many strive for the ultimate validation and highest order of recognition -- the Nobel Prize.

In an effort to succeed, there are myriad areas where bias can influence judgment and diminish
objectivity. A desire to validate a pet theory, overconfidence about a particular concept,
overreliance on a belief held by a special group, ruling out data that don't support a hypothesis,
and internal or external pressures to get a specific result are all influences that may lead to
distortions in objectivity. Any of these biases or pressures may lead to what sociologists call
selective inattendance. Your mind-set may cause you to overlook important data or to
misperceive critical observations.

Bias can be too subtle (delicate) to recognize and too difficult to control. It can creep into how
research questions are selected and framed, the choice of research design, the selection of
research participants, and how the data are collected, analyzed, interpreted, and ultimately
published.
Whether you describe the glass as half empty or half full is influenced by what you want your
results to look like. Bias can even influence the sharing of the results of the study.

The bias that such conflicts may impart can affect many University responsibilities,
including:
 decisions about personnel
 the purchase of equipment and other supplies
 the selection of instructional materials for classroom use
 the collection, analysis and interpretation of data
 the sharing of research results, the choice of research protocols the use of
statistical methods
 the mentoring or judgment of student work.

Academic Conflicts of Interest or Intellectual Bias

"Academic scientists have special responsibilities to disseminate knowledge, to
maintain academic standards, to critique the current state of knowledge, to
synthesize existing knowledge, and to apply knowledge to solve basic and applied
problems." The peer-review system is the benchmark of the scientific process. An
academic conflict of interest could occur if an individual interferes with the peer-
review process for some type of intangible personal gain. For example, bias can
cause a reviewer to respond positively to a manuscript because it presents results
favoring a method or production in which the reviewer has a personal interest, or a
reviewer may act to delay the publication of a competitor's manuscript in order to
strengthen his or her own chances for publication or funding.

Financial conflicts of interest are considered tangible conflicts, because they

can be seen and measured. While they appear easier to deal with than intangible
conflicts of interest, they may not be. Financial arrangements with sponsors are
affecting many areas of scientific life. A growing literature is documenting, with
disturbing accounts, how the new entrepreneurial environment is altering the
publication practices and prescribing patterns of investigators and clinicians.
"Subtle (understating or fine) and not-so-subtle perversions of science are very
difficult to detect..."
Intangible conflicts of interest, as previously described, are problematic, but
they are widely recognized and shared. What has captured the attention of the
federal government, the scientific community, and the public are those conflicts
caused by money and financial relationships, the tangible conflicts of interest. Many
fear that the cost of these relationships could be the integrity of science itself.

Conflict of Interest
Examples of Potential Workplace Conflicts of Interest

A conflict of interest arises in the workplace when an employee has competing interests or
loyalties that either are, or potentially can be, at odds with each other.

A conflict of interest causes an employee to experience a struggle between diverging interests,

points of view, or allegiances. Conflicts of interest are generally forbidden in company codes of
conduct and / or employee handbooks.
Conflicts of interest can cause an employee to act out of interests that are divergent from those of
his or her employer or coworkers.

In workplaces, employees want to avoid any behavior or choices that could potentially signal a
conflict of interest. They are bad news for the employee's reputation, integrity, and
trustworthiness in the eyes of management.

Conflicts of interest are difficult to describe in a definition, so the following examples will
illuminate the range of behaviors and actions that can fall within the definition of conflicts of
interest. These examples should serve as a guide to behaviors that you want to avoid as a person
of integrity at work.

Examples of Potential Workplace Conflicts of Interest

These are examples of situations in which an employee might experience a conflict of interest.

 A relative or close friend reports to a supervisor who affects their job responsibilities,
pay, and promotions.
 A male manager dates a female employee who reports to him.
 A lawyer represents a client in a civil dispute while accepting fees from litigants who
hold the opposing point of view.

 A purchasing agent hires his brother-in-law to provide vending services to the company
lunch areas.
 An employee starts a company that provides similar services to similar clients as those of
her full-time employer.
 An employee who is a member of a company employee selection team fails to disclose
that he is related to a job candidate whom the company team is considering for a position.

 A manager provides paid consulting services on the weekend to a company customer or

supplier.
 An employee works part-time in the evening for a company that makes a product that
competes with the products of his full-time employer.
 A member of the company board of directors accepts fees and provides advice to a
company that is in direct competition with the company on whose board of directors he
sits.
 An HR director decides to investigate a charge of sexual harassment, using internal
resources she controls, against a fellow corporate executive whom she has known and
worked with professionally for years.
 A purchasing agent accepts trips and gifts from a vendor and then selects the vendor's
products for purchase by the company.
  An employee accepts free gifts and free products from a training and development
company and then recommends the purchase of these products without comparing them
to comparable products from other vendors.
 A CFO negotiates an agreement in his employer's best interests for a stock option plan
from which he will directly benefit.

Conflicts of interest undermine your reputation and integrity if they are allowed. Your coworkers
and bosses don't know what to believe. They muddy the water and open you up for criticism,
speculation, and doubt.

Description and Examples of Conflicts of Interest

Financial and fiduciary interests, outside activities such as consulting, gifts, and other types of
interactions with industry all have the potential to create real or perceived conflicts of interest or
commitment with one’s patient care, research, teaching, or other responsibilities at Partners.

There are many different definitions of “conflicts of interest.  One that many have found helpful
is the one adopted by the Institute of Medicine, which says:

A conflict of interest is a set of circumstances that creates a risk that professional judgment or
actions regarding a primary interest will be unduly influenced by a secondary interest.

Generally speaking, a conflict of interest tends to occur in one of three ways:

 When an individual has the opportunity to use his or her Partners position for personal financial
gain or to benefit a company in which the individual has a financial interest.
 When outside financial or other interests may inappropriately influence the way in which an
individual carries out his or her Partners responsibilities.

 When an individual’s outside interests otherwise may cause harm to Partners’ reputation, staff,
or patients.

In addition to conflicts of interest, another type of conflict is a conflict of commitment.  This

occurs when there is an outside relationship that may deter an individual from devoting an
appropriate amount of time, energy, creativity, or other personal resources to his or her Partner
responsibilities.

Conflicts of interest and commitment are not in and of themselves unethical or impermissible;
indeed, they are often unavoidable and in many cases can be appropriately managed or reduced
to an acceptable level. However, Partners professionals and staff should be cognizant of the fact
that any outside activity, interest, or interaction with industry has the potential to create conflicts,
whether real or perceived.  Recognition of potential conflicts, and sensitivity to how personal,
financial and other relationships can be perceived by others, are by themselves important parts of
managing conflicts.