"I am myself and my circumstances"
José Ortega y Gasset
standard is now widespread, finding scientific publications in the declaration of conflict of interest. Everyone seems logical enough to quarantine the conclusions of a scientific study of a drug that is directly sponsored (financed directly by the research) or indirectly (the research is funded by the sponsor, although such funding is not directly devoted to research in progress) by a laboratory to which you are interested in selling the drug (we call this a direct conflict of interest) or otherwise to assume that competition for their own products (we call this an indirect conflict of interest .) However, not finish be usual to detail everything that could be considered a conflict of interest in this field. When making a declaration of interests, are generally exposed conflicts of interest directly, when it has received direct funding, being much more rare to declare other types of conflicts.
But it's not conflict of interest of what I write, but conflicts of circumstances. These are much more hidden and perhaps more momentous occasion. They are still conflicts in which the end is put into play an income that may not be monetary, but in one way or another can result in economic benefits: prestige that translates into more clients in private practice in contracts as a lecturer in higher sales for a book, and why not a greater number of visits on a blog that translate into higher advertising revenues.
But explain what I mean. Conflict of circumstances when personal circumstances (where you work, fitted with whom you work, number of patients served, help from other professionals, private practice, specialty or possesses and exercises could potentially exercise, family circumstances , political opinion or religious beliefs) could influence the findings of a study or in the statements made in public or what is written in an editorial of a scientific journal. Of course, there are conflicts of circumstances which are legally protected and not have to be declared (political leanings or religious beliefs), even if they miss.
a few examples:
Could be influenced a study on the advisability of circumcision to all newborns, the researchers religion they profess?
Could be influenced a study comparing public and private health systems on the political leanings of the authors?
Could be influenced a study on the healthcare professional to meet a condition, circunstancia fisiológica (embarazo) o una etapa vital (infancia, adolescencia, senectud), por la especialidad que se ejerce o se posee?
¿Podría estar influido un estudio sobre factores de riesgo que precisarán valoración por un médico, por el hecho de que los investigadores tuviesen ejercicio público o privado?
¿Podría estar influida una opinión en una editorial por el hecho de trabajar en atención primaria, secundaria o terciaria?
¿Importaría conocer el número de pacientes que atiende a diario? ¿Si dispone de enfermera? ¿Si tiene una reducción de jornada por liberación sindical o por asunción de otras tareas distintas the directory assistance? If you have an emergency service that attends to all patients not listed? If watchkeeping? The
or asked another way:
Should we take into account the conclusions of a group of cardiologists in private practice on the desirability of specialized cardiological evaluation of all patients before initiating ADHD drug therapy? What if at the time of signing or declare a conflict of interest only place they receive no assistance of any kind of drug lab?
Should we listen to someone who does not work in primary care on how best to organize care pediatric? What if the sign it is as though the primary care pediatrician is in a zone address without basic health care burden?
Should we listen to the gynecologist in private practice defending the need for monthly visits during pregnancy including ultrasound normal? What if he is a pediatrician in private practice who wish to extend childhood to age 21? Should we listen to a trade union cabinet released on private radiological signs of chest radiology in primary care? What if no one declares these circumstances?
Say, I'm quite curious and would like to learn more often the circumstances surrounding those who advocate a particular model of care, for care of a particular age group, by specific diagnostic technique for specific therapeutic technique and, unfortunately, I have an extreme tendency to think badly, perhaps because mixed in me suicidal (thinking is an act quasi-paraphrase autolytic Cioran, "every thought is a thought of more" * or more colloquially "thinking is losing" -) and perfectionists (I do not like mistakes and it forces me wrong thinking - "think wrong and you will succeed," says the English proverb-). 
Hopefully whoever ends or say something that means more to others than himself, was aware of all the bad thoughts that unnecessarily causes ...
And now, is when I clear my conflicts of interest and my circumstances: I am ...
I'm a provocateur.
* "Every word is a word more" EM Cioran
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