Multiple facets of conflict of interest.

Abstract

For most physicians, the phrase “conflict of interest” (COI) usually refers to a financial COI, such as physicians receiving payments from a pharmaceutical company. Financial COI is the most frequently discussed COI, and the one disclosed at the end of articles in professional journals. However, financial COI is not the only COI an individual may have. The recent debate about the origin of the virus that causes COVID-19 and the possibility that it escaped from a laboratory in Wuhan, China, revealed another facet of COI—the impact of ideology and personal belief. Some researchers strongly opposed the lab leak theory and attacked those who proposed it. For many, the fact that President Donald J. Trump proposed the virus originated in China was argument enough to label the lab leak theory as yet another conspiracy theory. Additionally, there is what I call “ideological bias” or “ideological COI,” eg, some of the opponents of the lab leak theory were probably impacted by the fact that their reputation would be ruined if it turned out to be true. Unbelievably, Facebook and Wikipedia initially banned any suggestion that the virus may had leaked from the Wuhan laboratory. Interestingly, with President Trump’s departure from office, more people were willing to entertain the possibility that the virus that causes COVID-19 escaped from the laboratory and were willing to investigate this theory. I believe this tale does not paint a very laudatory picture of many scientists and the state of present-day science. It also raises serious questions about nonfinancial COIs. I believe that compared to financial COIs, nonfinancial COIs have a similar, if not worse, impact on scientific conduct. As a profession, psychiatry has focused on discussing and disclosing financial COIs. Yet, there are numerous nonfinancial pressures and COIs. As Korn wrote, “These pressures ... include the desire for faculty advancement, to compete successfully and repetitively for sponsored research funding, to receive academic accolades from professional peers and win Richard Balon, MD Departments of Psychiatry and Behavioral Neurosciences and Anesthesiology Wayne State University Detroit, Michigan, USA