Opinion: Conflicts Of Interest In The Professions And In Public Service

Feb 22, 2017

Credit Abraham Schwab

One of the things that separates professionals, like doctors and lawyers, from other occupations is the additional responsibilities they take on. The nature of these responsibilities depends upon the profession and the particular professional’s role within the profession, but they all fall under the general category of working in the best interest of their client or patient.

Many things can get between a professional and their ability to fulfill their responsibilities. Lacking basic competence or needed resources could contribute to such a failure. And so can conflicts of interest. Any time a professional has a personal or business interest that comes into conflict with their responsibility to work toward the interests of their client or patient, that professional has a conflict of interest. As a result, their ability to fulfill their responsibilities is compromised.

Obviously, as patients or clients, we have an interest in having professionals limit or eliminate their conflicts of interest. We rely on these experts to exercise judgment and discretion and we’re not in a position to judge how well they’re doing. It’s for this reason that we ask professionals to do their own policing. Licensing boards for medicine and the disciplinary boards for lawyers have been established to punish or discipline professionals who are failing to fulfill their responsibilities. These boards are established by public officials, and tend to have non-professional representation. But these boards are primarily constituted by professionals in the field they police.

And, importantly, these boards aren’t always effective. As I’ve written previously, sometimes professionals fail to adequately police themselves. We have only to look at the case of the physician here in Northern Indiana who was reported to the Indiana Licensing Board but was allowed to continue practicing, contributing to the deaths of eight more patients.

It is here that the responsibilities of public servants become important in the policing of professionals. That is, if a profession as a whole, or a particular professional, fails to fulfill their responsibilities to take care of their client’s interests, and the existing mechanisms fail to adequately police these professionals, we, as clients and patients, can only be protected from incompetence or poor judgment if public agencies step in to regulate and address these shortcomings. Only be reconstituting and remaking the relevant regulations and disciplinary boards, can public officials address any shortcoming in the effort to protect patient and client interests.

And so it is important for these public servants to have the public interest in mind. And this circles us back to the question of conflicts of interest. Conflicts of interest are significant in any field, and can undermine the ability to make good judgments. Whenever a public official has a personal, business, or other interest that conflicts with the responsibilities of their office, their judgment will be compromised. And this is not a question of their intentions. Even the most well-intentioned individuals are affected by the unconscious effects of conflicts of interest.

Conflicts of interest can seem to be an obtuse or arcane problem; an issue that is only considered by those who have too much time on their hands. But public servants have responsibilities to act in the public interest, even if it works against that public servant’s personal or business interest. And any conflict of interest undermines their ability to fulfill these responsibilities. When a public servant willingly takes a conflict of interest into a job with them, they indicate that they’re commitment to the public interest will always be limited, if not sidelined, by their private interest. And when we, as the public, shrug about these conflicts, we quietly condone public officials using their public position to serve their own interests instead of the interests of the public.

The same can be said of professionals like doctors, lawyers, and others. When they willingly undertake a conflict of interest that they could avoid, they put their own interests ahead of the interest of those they are supposed to be serving. They prioritize their financial or personal interests ahead of the interests of the health and welfare of their clients and patients. While conflicts of interest may seem to be something that is someone else's concern, when we stand by and allow conflicts of interest in public officials, in medical professionals, and in legal professionals, we simply excuse them from doing the work that they have promised to do.

And if we shrug when medical professionals, legal professionals, and public servants take on conflicts of interest, if we shrug when they prioritize their private and business interests over their responsibilities to their patients, their clients, and the public, we shouldn’t be surprised when our health worsens, our legal protections diminishes, and our government works against us.

Abraham Schwab is a Fort Wayne associate professor of philosophy and medical ethicist.

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