Pierre is a representative with a company that manufactures devices for use in joint-replacement surgeries. He is often present in surgeries when his company’s products are being used. Recently, as a patient was being wheeled into the operating suite the patient asked the surgeon who Pierre was and why he was there. The nurse explained that Pierre was a with a device manufacturer and was there to provide support if needed. The patient then asked, “But isn’t that a conflict of interest?”
Is there a conflict of interest? How should the nurse respond to the patient? And what should the hospital include in a policy designed to address these types of situations?
A local business owner and philanthropist, whose parent recently died after living with Huntington disease for 15 years, approaches the hospital foundation to offer a significant donation in exchange for creating a new neurological research centre which would be named in memory of the philanthropist’s parent. The hospital has identified its area of greatest need as improving access to primary care for patients in the remote communities it serves, but the donor is not interested in contributing to that mandate.
Is the hospital in a conflict of interest? What is the nature of the potential conflict of interest?
Arya is an occupational therapist who provides support for children with autism spectrum disorder. She frequently recommends sensory integration tools to parents, but most of these are only available online through US-based websites and often that is a barrier for parents. She is considering starting a side business importing and selling these products, but is aware that there will likely be a perceived conflict of interest. Arya approaches her manager for guidance.
If disclosure is not enough to eliminate the perception of conflict of interest, what could Arya do? If the perceived conflict of interest cannot be effectively managed, what should Arya do to meet her patients’ needs?
Alison is a nurse who is working in an endocrine clinic part-time while also working on her Ph.D. She is studying two different approaches to patient education about diabetes management. She is putting together her research ethics application. Alison makes a case for the logistical necessity of her being involved in recruiting patients. Her colleague and friend, Jason, will also help to recruit patients for the study. Alison proposes that she will disclose that the research is for her Ph.D and that the patient’s decision about participation will not affect care, but Alison and Jason aren’t sure about what Jason should tell patients about their relationship.
Do you think that Jason has a conflict of interest? If so, how should it be managed? And does Alison’s disclosure adequately address concerns about her conflict of interest?
David is a patient waiting in a treatment room at a walk-in clinic. He can hear the physician chatting and laughing with someone outside, and from the conversation he guesses that the physician is talking with a pharmaceutical sales representative. David has been waiting for almost two hours with a high fever. As the conversation outside continues, David becomes increasingly angry.
Do you think that the physician might have a conflict of interest? If so, how should it be managed?