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Conflicts of Interest and Your Physician: Psychological Processes That Cause Unexpected Changes in Behavior

Published online by Cambridge University Press:  01 January 2021

Sunita Sah
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Extract

The medical profession is under a state of increasing scrutiny. Recent high profile scandals regarding substantial industry payments to physicians, surgeons, and medical researchers have raised serious concerns over conflicts of interest. Amidst this background, the public, physicians, and policymakers alike appear to make the same assumption regarding conflicts of interest; that doctors who succumb to influences from industry are making a deliberate choice of self-interest over professionalism and that these doctors are corrupt. In reality, a myriad of evidence from social science indicates that influence from conflicts of interest often occurs on a subconscious and unintentional level. This poses an important issue, since such conflicts can steer wellintentioned physicians away from their primary professional goal to provide the best medical advice and treatment possible.

Type
Symposium
Information
Journal of Law, Medicine & Ethics , Volume 40 , Issue 3 , Fall 2012 , pp. 482 - 487
Copyright
Copyright © American Society of Law, Medicine and Ethics 2012

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References

Angell, M., “Is Academic Medicine for Sale?” New England Journal of Medicine 343, no. 7 (2000): 1516–1518. Kassirer, J. P., “Commercialism and Medicine: An Overview,” Cambridge Quarterly of Healthcare Ethics 16, no. 4 (2007): 377–386. Dana, J. Loewenstein, G., “A Social Science Perspective on Gifts to Physicians from Industry,” JAMA 290, no. 2 (2003): 252–255.CrossRefGoogle Scholar
See supra note 1. See also Babcock, L. Loewenstein, G. Issacharoff, S. Camerer, C., “Biased Judgments of Fairness in Bargaining,” American Economic Review 85, no. 5 (1995): 1337–1343. Loewenstein, G. Issacharoff, S. Camerer, C. Babcock, L., “Self-Serving Assessments of Fairness and Pretrial Bargaining,” Journal of Legal Studies 22, no. 1 (1993): 135–159. Bazerman, M. H. Morgan, K. P. Loewenstein, G., “The Impossibility of Auditor Independence,” Sloan Management Review 38, no. 4 (1997): 89–94.Google Scholar
Campbell, E. G. Weissman, J. S. Ehringhaus, S. et al. , “Institutional Academic – Industry Relationships,” JAMA 298, no. 15 (2007): 1779–1786.CrossRefGoogle Scholar
Chimonas, S. C. Brennan, T. A. Rothman, D. J., “Physicians and Drug Representatives: Exploring the Dynamics of the Relationship,” Journal of General Internal Medicine 22, no. 2 (2007): 184–190.CrossRefGoogle Scholar
Sah, S. Loewenstein, G., “Effect of Reminders of Personal Sacrifice and Suggested Rationalizations on Residents' Self-Reported Willingness to Accept Gifts: A Randomized Trial,” JAMA 204, no. 11 (2010): 1204–1211.CrossRefGoogle Scholar
Sierles, F. S. Brodkey, A. C. Cleary, L. M. et al. , “Medical Students' Exposure to and Attitudes about Drug Company Interactions: A National Survey,” JAMA 294, no. 9 (2005): 1034–1042.CrossRefGoogle Scholar
Palmer, B., Meeting 3 of the Committee on Conflict of Interest in Medical Research, Education, and Practice, 2008.Google Scholar
See supra note 5.Google Scholar
See supra note 1. Cialdini, R. B., Influence: Science and practice. Foresman Glenview, S., IL; 1985. Wazana, A., “Physicians and the Pharmaceutical Industry: Is a Gift Ever Just a Gift?” JAMA 283, no. 3 (2000): 373–380. Steinman, M.A. Harper, G. M. Chren, M. Landefeld, C. S. Bero, L.A., “Characteristics and Impact of Drug Detailing for Gabapentin,” PLoS Medicine 4, no. 4 (2007): 743–751. Friedman, H. H. Rahman, A., “Gifts-Upon-Entry and Appreciatory Comments: Reciprocity Effects in Retailing,” International Journal of Marketing Studies 3, no. 3 (2011): 161–164.Google Scholar
See supra note 2. Sah, S. Larrick, R., “I Am Immune: A Sense of Invulnerability Predicts Increased Acceptance of, and Influence from, Conflicts of Interest,” Research in Progress, Duke University, 2012; Babcock, L. Wang, X. Loewenstein, G., “Choosing the Wrong Pond: Social Comparisons in Negotiations That Ref*lect a Self-Serving Bias,” Quarterly Journal of Economics 111, no. 1 (1996): 1–20; Thompson, L. Loewenstein, G., “Egocentric Interpretations of Fairness and Interpersonal Conflict,” Organizational Behavior and Human Decision Processes 51, no. 2 (1992): 176–197. Kunda, Z., “The Case for Motivated Reasoning,” Psychological Bulletin 108, no. 3 (1990): 480–498. Pronin, E. Lin, D. Y. Ross, L., “The Bias Blind Spot: Perceptions of Bias in Self Versus Others,” Personality and Social Psychology Bulletin 28, no. 3 (2002): 369–381.Google Scholar
McKinney, W. P. Schiedermayer, D. L. Lurie, N. et al. , “Attitudes of Internal Medicine Faculty and Residents toward Professional Interaction with Pharmaceutical Sales Representatives,” JAMA 264, no. 13 (1990): 1693–1697.CrossRefGoogle Scholar
Kassirer, J. P., “Why Should We Swallow What These Studies Say?” Advanced Studies in Medicine 4, no. 8 (2004): 397–400.Google Scholar
Sah, S. Loewenstein, G., “More Affected = More Neglected: Amplification of Bias in Advice to the Unidentified and Many,” Social Psychological and Personality Science 3, no. 3 (2012): 365–372.CrossRefGoogle Scholar
See supra notes 1 and 10.Google Scholar
See supra note 13.Google Scholar
Cain, D. M. Loewenstein, G. Moore, D. A., “The Dirt on Coming Clean: Perverse Effects of Disclosing Conflicts of Interest,” Journal of Legal Studies 34, no. 1 (2005): 1–25. Cain, D. M. Loewenstein, G. Moore, D. A., “When Sunlight Fails to Disinfect: Understanding the Perverse Effects of Disclosing Conflicts of Interest,” Journal of Consumer Research 37, no. 5 (2011): 836–857. Loewenstein, G. Cain, D. M. Sah, S., “The Limits of Transparency: Pitfalls and Potential of Disclosing Conflicts of Interest,” American Economic Review: Paper and Proceedings 101, no. 3 (2011): 423–428.CrossRefGoogle Scholar
Sah, S. Loewenstein, G. Cain, D. M., “The Burden of Disclosure: Increased Compliance with Distrusted Advice,” Journal of Personality and Social Psychology (forthcoming). Sah, S. Loewenstein, G. Cain, D. M., “Insinuation Anxiety: Increased Pressure to Follow Less Trusted Advice after Disclosure of a Conflict of Interest,” manuscript under review (2012), available at <http://ssrn.com/abstract=197096>(last visited July 9, 2012).(last+visited+July+9,+2012).>Google Scholar
Id.Google Scholar
Id.Google Scholar
Sah, S. Loewenstein, G., “Second Thoughts on Second Opinions: Conflicted Advisors Exaggerate More When They Know They Will Be Second-Guessed,” manuscript under review (2012).CrossRefGoogle Scholar
See supra notes 5 and 10.Google Scholar
See supra note 5.Google Scholar
See supra note 13.Google Scholar
See supra note 20.Google Scholar
See supra note 17.Google Scholar