Conflict: A Catalyst for Institutional Change

Introduction Conflict, simply defined, is a state of disharmony between incompatible or opposing persons, ideas, or interests. When asked to close their eyes and envision a recent conflict, most people will experience a disheartening feeling. They may notice physical or emotional signs of distress (e.g., palpitations, rapid breathing, sweaty palms, shaking, tearing, etc.). Therefore they tend to assign a negative connotation to conflict as a general concept. They view conflict as something to be avoided at all costs. But conflict is natural, and even when one acquires the skills to deal with it more effectively it continues to exist (ESR, 1998). It surrounds us on a daily basis, and while it might make us feel stressed, frustrated, angry, scared, or confused, it can offer new and positive opportunities for change, learning, and growth. The same holds true for conflicts of interest and/or commitment within an organization. Again, by simple definition, a conflict of interest and/or commitment exists when there is a state of disharmony between one's responsibilities as an employee/member of a specific institution/ organization and an outside entity. Both the American Association of Medical Colleges (AAMC) and the American Association of Universities (AAU) have adopted this definition: "The term individual conflict of interest in science refers to situations in which financial considerations may compromise, or have the appearance of compromising, an investigator's professional judgment in conducting or reporting research" (Broccolo & Klanica, 2006). Yet, dealing effectively with the conflict of interest situation can also lead to positive opportunities for change, learning, and growth. In essence, a potential conflict of interest or commitment is not inherently a bad thing. Often it means there is good work happening that will contribute to generalizable knowledge and benefit society. External or extramural financial interests often drive the research in ways that internal funding alone cannot by providing a direction to research that will result in the largest possible positive impact on society. Kalichman and Macrina (2001) state that conflicts encountered through the scientific profession are to be expected, it is how they are handled that can lead to untoward, inappropriate, or bad outcomes. Therefore, there is no shame in having external financial relationships, whether as an individual or an institution as a whole. The shame is in allowing those relationships to potentially bias the work, create false presumptions and distort decision-making, or in hiding the fact that they exist in the first place. Maintaining even minimal standards of research integrity is dependent upon protecting and preserving not only the integrity of the science, but that of the researcher and the institution. There is also a fundamental obligation to preserve and sustain the public trust. The public trust is a fragile thing and once shattered it is almost impossible to repair (Schaller-Demers, 2006). Bradley (2005) says there is a concern that an escalating climate of secrecy and economic competition is contributing to the public's loss of confidence in the integrity of science and scientists, if not an actual deterioration in the quality of the science. If one accepts that public trust is what drives public funding, it may be logical to assume that once public trust is eroded, public funding will erode as well (Cohen, 2002). Broccolo and Klanica (2006) state that instances of research misconduct can be motivated by the types of financial and associational (non-financial) interests that give rise to potential conflicts of interest and that the media and the public cannot distinguish the difference between actual conflict and perceptions of conflict. That is why perception and appearances are so important. Hiding is never the answer, because upon close examination, it may be determined that an actual conflict of interest doesn't even exist. …