Conflicts of interest in the clinical setting

The editor of this journal has invited the ethical committee to reflect and express its opinion about conflicts of interest in the clinical setting. We define "Conflict of Interest" and discuss the effect that mismanagement of a conflict of interest could have on the doctor-patient relationship. We conclude that the basic conflict in the clinical setting is the so-called "double-agent" doctor. This issue has been studied in relation to the development of the North-American system of clinical administration: "managed-care" The name managed care describes the two basic functions of the clinician: his role of "caring" for his patients, and therefore to search for the best for each individual; and his role to manage the resources available and to control costs. This new scenario may radically change the future of the medical profession. Doctors have an undeniable responsibility in the development of what may be a new paradigm in the way medicine is practiced, certainly changing the social contract of our profession. © 2006 Sociedad de Neurología, Psiquiatría y Neurocirugía.