Competing Interests

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One of the most important elements of research, is for the authors to publicly announce any conflict of interest, i.e., did the company pay for the research conducted, do the researchers own shares in the company, etc. 

An article in the British Medical Journal raised the problem of non-financial interests – summarised as “personal, professional, political, institutional, religious, or other associations”. 

Observations: Competing Interests

When do your politics become a competing interest? 

http://www.bmj.com/content/342/bmj.d269.full

BMJ 2011; 2011; 342:d269 doi: 10.1136/bmj.d269 (Published 25 January 2011)

Cite this as: BMJ 2011; 2011; 342:d269

Gerry McCartney, head, Public Health Observatory Division, NHS Health Scotland, Lisa Garnham, PhD candidate, University of the West of Scotland, Darryl Gunson, lecturer in philosophy, University of the West of Scotland, Chik Collins, senior lecturer in politics, University of the West of Scotland 

Correspondence to: G McCartney gmccartney{at}nhs.net 

Might the declaration of authors’ political affiliations undermine the conditions for rational discourse? 

A recent BMJ article asked, “Would action on health inequalities have saved New Labour?” (BMJ 2010;340:c3294, doi:10.1136/bmj.c3294). Its conclusion leaned heavily towards an affirmative response. An anonymous spokesperson for the Scottish Labour Party subsequently dismissed the article and its conclusions as “political point scoring”—on the basis that its lead author, Gerry McCartney (also lead author of the present article), “is a member of the Scottish Socialist Party”

(www.heraldscotland.com/news/politics/failure-to-tackle-healthinequalities-cost-labour-votes-1.1039889), even though he had declared this membership as a competing interest.  

McCartney’s declaration was in line with the guidance provided to authors by leading journal editors in recent years. In 2009 a group of these editors requested that authors declare relevant “personal, professional, political, institutional, religious, or other associations” (BMJ 2009;339:b4144, doi:10.1136/bmj.b4144). And in the latest iteration of the uniform disclosure form, the question relating to non-financial competing interests has been replaced with: “Are there other relationships or activities that readers could perceive to have influenced, or that give the appearance of potentially influencing, what you wrote in the submitted work?” (BMJ 2010;34:c3239, doi:10.1136/bmj.c3239). To the anonymous Labour spokesperson McCartney’s declaration was clearly important in interpreting and responding to the article in question. Yet the nature of the response it elicited—anonymous, dismissive, ad hominem—might be seen to raise some issues for discussion. 

The objectivity of science has been disputed since its beginnings. The selection of what to observe, where, when, by whom, and how—and how these observations are recorded, analysed, interpreted, and communicated—often requires value judgments. Politics concerns competing values and priorities, and so political views and affiliations can clearly be included in any list of non-financial competing interests. Yet surely all researchers (and editors) have values and priorities—and, even if they do not closely fit a particular party political description or a very coherent ideological category, they remain irreducibly political. How then should editors and readers interpret research where such political views or affiliations seem relevant? If their explicit declaration is desirable, is it also practical? And how does their declaration improve the reporting and interpretation of research? 

One problem is what social theorists call hegemony, where the dominance of a particular political and economic view is such that its uncritical acceptance or advocacy seems to many to be “common sense” and alternatives seem “unrealistic”—or even difficult practically to conceive. Under such circumstances it is easy for researchers to assume that their reflection of the dominant perspective doesn’t constitute a political view or affiliation; only those who stand outside or challenge the dominant view are seen to be “political.” This creates a major problem for those wishing to critique prevailing views or assumptions about the fundamental determinants of health or to pose challenging questions to those in power regarding policy and practice. Their political dispositions will be thought to be of interest to funders, editors, and readers, but the “mainstream” political dispositions—and at times affiliations—of many funders, editors, commentators, and readers can “fly below the radar.” 

A sadly unfortunate consequence of this can be the kind of hegemony that induces self censorship, muted critical engagement, and ultimately a depreciated democracy (BMJ 1994;309:1644-5). Furthermore, some have argued that a simple declaration of competing interests does not resolve the issue at hand—that is, whether the research has been compromised by competing interests—since readers and editors are unable to judge this on the basis of the information provided in any declaration (Journal of Medical Ethics 2010;36:328-32, doi:10.1136/jme.2009.034710).

Is a declaration of interests an admission of likely transgression of accepted standards? Should readers and editors examine research in which a declaration is made more closely with an eye to such? Should they assume that the declaration means that the author has taken particular steps to ensure that there is no such transgression? 

Views and values are often quite private, changeable, and—at times—inconsistent. They may or may not form an important component of personal identity and may or may not have been considered deeply and at length. In contrast to financial interests they can also prove problematically subjective: who could question a declaration of personal political values, even if it did not seem to fit with the public persona? 

Even if declaration of political values and affiliations were to become more common, how far would this add to the advance of science and understanding? Might it tend to undermine the conditions for rational discourse around facts and evidence, by continually foregrounding the differing persuasions from which these get “constructed”? Along this trajectory, rational engagement with the underlying science gives way to, “Well, she [or he] would say that”; and, as the example with which we began demonstrates, this point can in fact be reached very quickly. 

Here we have highlighted three outstanding problems: many researchers fail to recognise their own beliefs as political or feel under pressure to self censor to fit with the dominant hegemony; the simple declaration of interests does not help readers and editors to identify where those interests might unduly have affected an author’s work; and further moves towards declaration may have the unintended consequence of undermining the conditions of rational engagement in pursuit of scientific understanding. 

We offer no easy solutions but are encouraged by the continuing work of the International Committee of Medical Journal Editors to improve when and how non-financial declarations are made. 

Notes

Cite this as: BMJ 2011;342:d269 

Footnotes

Opinions expressed in the paper are those of the authors and do not necessarily reflect the views of NHS Health Scotland. The employing institutions played no role in this work.

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