Author Affiliations: Yale School of Management, New Haven, Connecticut (Dr Cain); Departments of Health Policy Management and Evaluation and Medicine, University of Toronto, Toronto, Ontario, Canada; and Departments of Medicine, Mount Sinai Hospital and University Health Network, Toronto (Dr Detsky).
Medical schools and professional medical associations have developed policies and guidelines in response to increasing concerns over potential conflicts of interest.1 While many physicians agree with these concerns, some view conflict-of-interest policies as affronts to their integrity and an indictment of the ethical conduct of the profession as a whole. These individuals believe that their training as scientists and their devotion to professionalism protects them from external influences that might bias their opinions. However, this view may be based on an incorrect understanding of human psychology. Conflicts of interest are problematic, not only because they are widespread but also because most people incorrectly think that succumbing to them is due to intentional corruption, a problem for only a few bad apples. In this Commentary, we argue that succumbing to a conflict of interest is more likely to result from unintentional bias, something common in everyone. We review studies in neuropsychology, behavioral economics, cognitive psychology, and clinical epidemiology to illustrate this point.
Cain DM, Detsky AS. Everyone's a Little Bit Biased (Even Physicians). JAMA. 2008;299(24):2893–2895. doi:10.1001/jama.299.24.2893