Medical Conflicts of Interest Similar to Other Fields
Imagine for a moment, while doing work around your home—perhaps lifting a heavy box from the attic to the living room—you feel a sharp pain in your hip and pelvis. The twinge turns into a dull strain over the next few weeks and months. It’s time to see a doctor.
The x-rays come back conclusive. Deteriorating cartilage and bone points to the inevitable: you need a brand new hip.
The doctor does well in convincing you it’s the right time to get an artificial replacement. In the process, the physician tells you that the type of hip he would like to implant into your body is one he had a hand in developing.
What would you do? This is an example of a potential conflict of interest— when the interests of one party is at odds with the other party in which they must unbiasedly serve. This case taps into ethical standards in the workplace, and is an example of a real life case, as told by Dr. Mikkael Sekeres, M.D. in the New York Times.
His 77-year-old mother was a good candidate for hip replacement. Her doctor recommended a specific artificial hip type that he helped create. The doctor did right by disclosing this conflict of interest. By doing so, the patient had the ability to express any concerns about the doctor implanting that specific type of device—especially when the doctor has a vested interest in its success.
When it comes to conflict of interest discussions, issues within the medical field permeate news headlines. But, whether or not we work in the medical field, we all engage in the delicate task of balancing the advancement of our own prerogatives against that of our employers and others. Ethical decision-making is part of the day-to-day responsibilities of all employees.
Sometimes conflicts can be more overt. It’s clearly wrong to be employed by a company and have a duty of loyalty to that organization, while simultaneously working to create a competing business in the same market. However, most conflicts, like the ones people engage in most often are more obscure. For example, being on a hiring committee. What if you’re friends with, or related to someone who is in the running for a position? When is it a good time to disclose the conflict to others? Or, is it right to abstain from the decision-making all together? Should you say anything at all? Not all instances are as cut-and-dry as we’d like them to be.
In Sekeres’ mother’s case, it seemed like disclosure was the right course of action. She did not have a problem with this conflict of interest, and in fact, appreciated his disclosure. However, simply disclosing conflicts of interest of this degree sometimes is not enough.
Sekeres writes, “a doctor may invent a technology, or develop a drug, and receive payments every time that technology or drug is used.” He goes on to say that this doctor in particular didn’t have that specific conflict, but it’s conceivable that others might. Such a conflict may influence the degree to which a physician prescribes or recommends certain treatments. It’s a slippery slope: the doctor-patent relationship becomes less about the well-being of the person being treated, and more about the personal successes of the individual meant to help them.
However, not all disclosures—or lack thereof— go as swimmingly. Take this situation involving psychologist Dan Ariely. He explained, during a recent TED Talk, what it’s like being on the receiving end of a conflict of interest, with his story being a bit more unpleasant.
After suffering from a facial burn on one side, a doctor recommended a new “tattoo treatment” which entailed tattooing tiny black dots on the face that would mimic the look of facial hair, or, 5 o’clock shadow. The doctor told Ariely that his face, as a result of the burn, made him look unbalanced and that his it now lacked symmetry. After refusing the treatment, Ariely says the doctor guilt tripped him, making him feel like he had done wrong.
However, after speaking with some of the doctor’s staff members, it came to light that the doctor was writing a research paper about the procedure, and needed another real-life case study. The recommendation then came from the fact that the doctor needed another test subject, and wasn’t necessarily recommending the treatment in Ariely’s best interest alone.
Though Ariely’s case may be on one extreme, it’s a lesson in what it’s like to be on the receiving end of a bad deal. These are parallels everyone can draw from in many working environments, especially in corporate ones.
Considering ethical conduct in the workplace as a whole is a multifaceted, holistic process. Not all ethical issues are the same— sometimes it involves divulging one’s own conflict of interest, other times it might mean telling on someone else. When it comes to reporting, there are barriers that might prevent one from disclosing ethical transgressions, especially when one fears reprisal or retaliation from the employer or from others.
As employers and employees, it’s a good course of action to foster an environment with high ethical standards. This entails building a space where employees feel a personal responsibility for maintaining the transparency and health of their workplace culture. In this way, ethical issues that effect workplaces of all kinds can be better addressed, such as discrimination and harassment, corporate corruption and bribery, and conflicts of interest.
In addition to establishing a code of ethics within the workplace, another way to prevent conflicts of interest is through compliance training. LawRoom offers courses that deal with ethics, such as bribery, medicare fraud and human trafficking. To see LawRoom courses in action, check out this case study on Namely.