From Purity to Proportionality: Managing Non-Financial Conflicts of Interest in Pain Medicine
Pain Med. 2026 Feb 2:pnag018. doi: 10.1093/pm/pnag018. Online ahead of print.
Modern medicine is built on partnerships—between science and industry, clinicians and regulators, patients and policymakers. Yet our approach to conflicts of interest (COIs) too often treats relationships as contamination rather than collaboration. In the name of purity, we may be undermining both the integrity and the diversity of the scientific enterprise.
The ENTRUST-PE agenda advances essential safeguards—transparent governance, open-science tools, reproducibility checks, and coordinated editorial action. What remains under-specified, however, is how to manage non-financial conflicts with the same rigor as financial ones. This Commentary addresses that gap with concrete, lowcost changes in disclosure language and in committee design that preserve needed expertise while reducing the risk of any single interest—financial or not—dominating pain-medicine policy and practice. In short, the proposals below function as an implementation layer that helps ENTRUST’s trust-building goals succeed in day-to-day editorial and guideline work.
PMID:41629216 | DOI:10.1093/pm/pnag018