Advances in medical and surgical care are hard-won. They require rigorous, carefully interpreted laboratory research. Equally important is the painstaking clinical work to translate basic discoveries into useful diagnostics, drugs, and devices. Despite the odds, the achievements made in the past half century are unmistakable: a 50 percent reduction in cardiovascular mortality despite an epidemic of obesity; a dramatically decreased cancer mortality rate; and the conversion of AIDS from a death sentence to survival with good life quality.
The key to such success has been the growing number and complexity of collaborations between academics, physicians, regulatory agencies, and—not least—industry. Unfortunately, over the past 20 years, a mania has taken hold that discounts the social value of collaboration and has mounted an inquisition against it, encapsulated by the epithet “financial conflict of interest (fCOI).” Critics’ unwarranted allegations that such conflicts cause bias have limited the sources of intellect that can contribute to a given project.