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March 2, 1990

Conflicts of Interest, Continued

Author Affiliations

University of Chicago Pritzker School of Medicine Chicago, Ill

University of Chicago Pritzker School of Medicine Chicago, Ill

JAMA. 1990;263(9):1199-1200. doi:10.1001/jama.1990.03440090029015

To the Editor.—  The article by Dr Morreim1 and the accompanying commentaries2,3 on conflict of interest were most interesting. However, she utterly fails to explain why common law principles of the sort she describes have not already been effective at mandating disclosure and enforcing fiduciary duties. What evidence there is suggests that physicians have disregarded even explicit statutory requirements of disclosure (Wall Street Journal. March 1, 1989:A1, A6). The reason the common law approach will never work is that in these entrepreneurial arrangements, there is no potential plaintiff to raise these issues. Unlike an informed consent case, no damages are traceable to the failure to disclose. Thus, there is no incentive to bring suit, and no reason to comply with the common law.Dr Morreim also is mistaken in her assertion that the proposed federal initiatives may "occasion antitrust concerns." It is axiomatic that state action is immune