Graduate School of Medicine, Osaka University, Osaka, Japan.
Psychiatry Clin Neurosci. 2014 Jul;68(7):489-97. doi: 10.1111/pcn.12201. Epub 2014 Jun 19.
The relationship between psychiatry and pharmaceutical companies has come under scrutiny during the past decade. Concerns are growing that financial ties of psychiatrists to the pharmaceutical industry may unduly influence professional judgments involving the primary interests of patients. Such conflicts of interest threaten the public trust in psychiatry. The goal of conflict of interest policies is to protect the integrity of professional judgment and to preserve public trust. The disclosure of individual and institutional financial relationships is a critical but limited first step in the process of identifying and responding to conflicts of interest. Conflict of interest policies and procedures can be strengthened by engaged psychiatrists, researchers, institutions, and professional associations in developing policies and consensus standards. Research on conflicts of interest can provide a stronger evidence base for policy design and implementation. Society has traditionally granted the medical profession considerable autonomy and may be willing to continue do so in the case of conflicts of interest. Nevertheless, concern is growing that stronger measures are needed. To avoid undue regulatory burdens, psychiatrists can play a vital role in designing responsible and reasonable conflict of interest policies that reduce the risks of bias and the loss of trust. Psychiatrists and the institutions that carry out research, education, clinical care, and practice guideline development must recognize public concerns about conflicts of interest and take effective measures soon to maintain public trust with a cultural change in the practice of psychiatry, from reactive treatment-seeking for mental illness to proactive advocacy for patients.
在过去的十年中，精神病学与制药公司之间的关系受到了审查。人们越来越担心，精神科医生与制药行业的财务关系可能会不当地影响涉及患者主要利益的专业判断。这种利益冲突威胁着公众对精神病学的信任。利益冲突政策的目标是保护专业判断的完整性并维护公众信任。披露个人和机构的财务关系是确定和应对利益冲突过程中的关键但有限的第一步。通过参与的精神科医生、研究人员、机构和专业协会制定政策和共识标准，可以加强利益冲突政策和程序。关于利益冲突的研究可以为政策设计和实施提供更有力的证据基础。社会传统上赋予了医学界相当大的自主权，在利益冲突的情况下，可能仍然愿意继续这样做。然而，人们越来越担心需要采取更强有力的措施。为了避免不必要的监管负担，精神科医生可以在设计负责任和合理的利益冲突政策方面发挥重要作用，这些政策可以降低偏见风险和失去信任的风险。进行研究、教育、临床护理和实践指南制定的精神科医生和机构必须认识到公众对利益冲突的关注，并尽快采取有效措施，通过改变精神病学实践的文化，从对精神疾病的被动治疗寻求转变为主动为患者辩护，以维护公众信任。
