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Our society has long sanctioned, at least tacitly, a conflict of interest in medical practice and research as an unavoidable consequence of the different interests of the participants in health care: the physician or clinical researcher, the patient or research subject, insurance companies or research sponsors, the government, and society as a whole. This multidisciplinary effort draws from philosophy, medicine, law, economics and public policy to identify and categorize conflicts of interest in medical practice and clinical research, and, where possible, to offer a mechanism for resolving them. Part I reviews the theoretical background, including basic concepts and analytical frameworks. The second part discusses two topics prominent in current health care policy debates--self-referral and financial incentives to limit care. Part III examines conflicts of interest generated by pharmaceutical industry involvement in clinical practice and research. The final section deals with clinical research in several contexts, including institutional review boards, clinical trials, research agreements between the government and private researchers, brokerage of research subjects by contract research organizations, and cost-effectiveness studies. This volume represents a multidisciplinary effort, drawing from philosophy, medicine, law, economics and public policy to identify and categorize conflicts of interest in medical practice and clinical research. Where possible, it offers mechanisms for their resolution.

Medical ethics --- Conflict of interests --- Conflict of Interest --- Ethics, Medical --- Referral and Consultation --- Health Maintenance Organizations --- Research --- Ethics, Professional --- Informed Consent --- Physician-Patient Relations --- Conflict of Interest. --- Ethics, Medical. --- Referral and Consultation. --- Health Maintenance Organizations. --- Research. --- Biomedical ethics --- Clinical ethics --- Health care ethics --- Medical care --- Medicine --- Bioethics --- Professional ethics --- Nursing ethics --- Social medicine --- Conflict of interest --- Conflict of interests (Agency) --- Conflict of interests (Public office) --- Conflicts of interest --- Interests, Conflict of --- Ethics --- Laboratory Research --- Research Activities --- Research and Development --- Research Priorities --- Activities, Research --- Activity, Research --- Development and Research --- Priorities, Research --- Priority, Research --- Research Activity --- Research Priority --- Research, Laboratory --- Ethics, Research --- Health Maintenance Organization --- Organizations, Health Maintenance --- Group Health Organizations, Prepaid --- HMO --- Prepaid Group Health Organizations --- Organization, Health Maintenance --- Consultation and Referral --- Health Service Gatekeepers --- Hospital Referrals --- Referral --- Referral, Hospital --- Referrals, Hospital --- Consultation --- Gatekeepers, Health Service --- Hospital Referral --- Second Opinion --- Consultations --- Gatekeeper, Health Service --- Health Service Gatekeeper --- Opinion, Second --- Opinions, Second --- Referrals --- Second Opinions --- Tertiary Care Centers --- Medical Ethics --- Professionalism --- Interest Conflict --- Interest Conflicts --- Morals --- Professional Misconduct --- Moral and ethical aspects --- ethics --- Conflict of interests. --- Medical ethics.