Letter Journal of the Royal Society of Medicine; 2015, Vol. 108(4) 123 DOI: 10.1177/0141076814563246

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If we want things to change, we need to eliminate commercial conflicts of interest Responding to my editorial on transparency, Paolo Vercellini1 argues that disclosure of commercial conflict of interests (COIs) for oral presentations in educational contexts is necessary. I could not agree more. It should be mandatory. But Vercellini’s claim that disclosure can serve to neutralise commercial COIs at the ‘highest levels’ of medical education is wishful thinking. The claim lacks an evidence base and runs up against what is known about the limits of transparency as an accountability tool and its failure to combat commercial COI.2 Even those who have strongly lobbied for greater transparency note that simply declaring a commercial conflict runs the risk of normalising it and that there is a need for medical boards and guideline committees to be free of financial COIs because of their negative effects.3 Disclosure alone will not secure their independence. Indeed, there is a good reason why ‘the Institute of Medicine, the American Medical Association and the Association of American Medical Colleges have all recently issued reports calling for elimination or

limitation of industry sponsored continuing medical education’.4 What is needed is leadership at all institutional levels to carry out this challenging task. Declarations Competing interests: None declared

References 1. Vercellini P. If we want things to stay as they are, things will have to change. J R Soc Med 2014; 107: 386. 2. Wilson M. The Sunshine Act: commercial conflicts of interest and the limits of transparency. Open Med 2014; 8: e10–13. See http://www.openmedicine.ca/article/view/ 628/534 (last checked 19 November 2014). 3. Nagarajan R. Stop corruption or other nations could turn away Indian doctors: Fiona Godlee. Times of India, 5 October 2014. 4. Siwek J. AFP’s conflict of interest policy: disclosure is not enough. Am Fam Physician 2014; 89: 161–167.

Mark Wilson Health Research Associates, Guelph, Ontario N1G 3S4, Canada Email: [email protected]

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If we want things to change, we need to eliminate commercial conflicts of interest.

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