Is It Really All about the Money? Reconsidering Non-Financial Interests in Medical Research

Abstract:     
A great deal of attention has been directed toward managing financial conflicts of interest in medical research. Regulations, institutional policies, and guidance from professional bodies and medical journals all primarily focus on financial ties. But why? Concern about financial conflicts crowds out sufficient consideration of other interests that may bias research conduct. Economic gain is not the only powerful influence. Non-economic interests, such as the desire for professional honors and prestige, investigative zeal, and complicating social relationships that arise in the competitive academic research environment, also can negatively impact primary research goals of promoting unbiased investigations, advancing knowledge, and protecting subjects. This article argues that we under-prioritize non-financial interests in the regulation of medical research. It critiques the usual reasons given for regulating financial and non-financial interests differently – that the interests contrast in terms of tangibility, that financial interests are optional, and that financial interests can be efficiently carved out as a discrete area of focus. Moreover, disparate regulatory treatment seems inattentive to the very similar social and psychological forces that animate the bias effect of both financial and non-financial interests and fails to account for how financial and non-financial interests synergistically interact. Under-prioritization of non-financial interests threatens to erode public trust and creates negative spillover effects that weaken financial conflicts regulation. Optimal regulation requires a more integrated, balanced, and proportionate response to secondary interests in medical research. The article concludes by considering possible next steps to more proprtionate regulation and better accounting for the complicating effects of non-financial interests in medical research.

Number of Pages in PDF File: 36

Accepted Paper Series