Professional societies and health-related industries may establish mutually beneficial relationships. Societies may receive financial or other support from industry for publications, meetings, conferences and educational programs. Industry may, in turn, have the opportunity to showcase their products to a sophisticated and responsive audience. In addition to receiving money directly from industry, societies that allow companies to market products such as credit cards, insurance and stationery might receive royalties from any products sold. Societies might also be paid for the sale of their membership lists and may participate in the marketing of products related to medicine or healthcare. Council and committee members may have shareholdings in companies. All of these arrangements have the potential to create conflicts of interest.

The relationship between the professions and industry raises sensitive professional and public concerns because associations between societies and industry can compromise the societies’ objectives and damage their public standing. Indeed, the mere fact of a society’s association with industry may undermine its standing as an independent, disinterested contributor to debates about health and health policy.

Societies should, therefore, take care to ensure that their objectivity or public standing is not compromised by corporate or other sources of income. Dualities of interests should be disclosed in a transparent, timely and comprehensive manner, as described below.

Detailed disclosure of interactions between individual practitioners and industry are becoming standard in Australia, New Zealand and in many other countries. Typically, responsibility is imposed on industry to provide publicly accessible data regarding direct and indirect payments, or other transfers of value to healthcare professionals. Industry also has a responsibility to provide data about direct and indirect payments to third parties made at the request of, or on behalf of, healthcare professionals. Payments to be reported include:

• consulting fees


• payments for other services, including those of an educational or teaching naturehonoraria, irrespective of whether these are received directly by the individual or are directed to a nominated trust fund, research fund or charity


• provision of food and beverages


• travel and accommodation


• educational expenses


• charitable contributions


• royalties or licence fees


• research and other grants

Professional associations should consider themselves subject to the same requirements of transparency as individual practitioners. That is, receipt of benefits or other transfers of value from industry – including government and non-government sources, by either a society or its individual members, should be fully disclosed and open to adequate public scrutiny.

To meet the requirement of transparency, organisations should establish mechanisms for the detection, management and public disclosure of relevant interests. In the case of individual practitioners, these mechanisms should include sufficient safeguards to ensure the accuracy of the data and the protection of the privacy of individual society members.

Officers of a society, including members of its council and committees and employees and volunteers, may have either pecuniary or non-pecuniary interests relevant to their roles within the society. These interests may take the form of shareholdings or paid consultancies, other commitments in the form of advisory positions, scientific collaborations, or any of the full range of pecuniary or non-pecuniary interests discussed in Interests, dualities of interest and conflicts of interest and Issues affecting health practitioners.

In these cases, the general rules for dualities and conflicts of interest should be applied, that is, that the dual interests should be declared, that an appropriate body should assess whether a conflict exists and, if the latter turns out to be the case, that appropriate action is taken.

If action is required, the nature of this will depend on the circumstances. Action may vary from the mere acknowledgment of the interest to withdrawal from participation in the body in question. Although those who participate in the activities of a society are entitled to privacy, this should be balanced against the need for the society members to be confident that their interests are being appropriately served.

As in other cases of disclosure, appropriate standards of transparency should be applied to ensure both the possibility of adequate scrutiny and protection of the privacy of the individuals involved.

Many health professionals are involved with community-based organisations that deal with specific diseases such as cancer, asthma, diabetes or heart disease, or deal with specific sub-populations, such as Indigenous health organisations. Since many of these organisations are established by industry, work collaboratively with industry, support industry applications for registration and funding, and/or attract significant industry funds, their views and activities might be oriented towards, or influenced by, commercial imperatives.

Clinicians working with community health organisations should therefore be aware of the specific links that these organisations have with industry, clarify the organisation’s policies with respect to industry, encourage the organisation to develop guidelines and policies for involvement with industry and declare its involvement with industry, and ensure that they maintain their own independence when associating with community organisations. Clinicians should also ensure that any community-based educational programs with which they are involved are free of bias.

Membership by clinicians of community organisations may present interests that need to be disclosed in particular settings. The individuals concerned should be aware of this and, where relevant, disclose involvement and implied or incurred obligations.

At times, professional associations and clinical organisations (‘organisations’) might want to arrange research conferences or educational sessions, and are in a position to fund these meetings themselves without external financial support. In these situations, organisers should ensure that the scientific, political or other commitments of the organisation and its office holders do not inappropriately influence the content of the meetings. An organisation’s support of a meeting should be appropriately disclosed to meeting attendees.

Sources of commercial funding should not influence the scientific, educational or public policy decisions of societies. In situations where professional associations and healthcare organisations wish to seek external commercial funding to support their meetings, the association should convene an independent organising committee and adhere to the principles outlined in Issues affecting health practitioners.

In particular, commercial supporters should not be able to influence the planning, content, speaker selection or execution of any program of a society, and commercial sponsorships should not influence the subject matter of any meetings arranged under its auspices. It should be made clear that the display of commercial products or services at society meetings, and advertisements in a society’s journals or social event sponsorship, does not imply warranty, endorsement or approval of the products or services. It should also be made clear that such promotion is in no way an endorsement of effectiveness, quality or safety of the products or services.

There are various special settings in which particularly complex issues of sponsorship may arise. These include conferences convened to discuss specific clinical or scientific issues and meetings of experts to develop clinical and public policy guidelines. These may be sponsored by professional societies or organisations or by external commercial industries.

Because policy and practice guidelines may, by definition, have greater impact on the design and delivery of healthcare than educational or scientific meetings, a greater degree of caution should be exercised regarding any possibility for commercial or political interests to influence these processes.

Nevertheless, the general rules described above apply. Outside funders of an event should have no influence over its content, over selection of speakers or participants, or over the content of reports or other documents, recommendations, guidelines or policies produced as a result. In general, individual societies should review, and accept responsibility for, any such documents.

Clear and rigorous rules for disclosure should be established for all such meetings, and should be publicised in relevant documentation. It is desirable for participants to include a majority with no pecuniary or non-pecuniary conflict of interest in the matter under study. Individuals with conflicts of interest may participate in such events as long as the appropriate public disclosures are made. The disclosures should also be appropriately managed by a planning committee that is independent of influence by commercial sponsors.

It is appropriate that professional associations and healthcare organisations (rather than industry) provide funds for members, students, trainees and staff members to attend or present at educational or scientific conferences, provided that the selection of the recipients is equitable and transparent.

In cases where members of the organisation are offered commercial funding to attend meetings, they should disclose this, and obtain permission from, the organisation, which should have relevant policies and procedures in place. The principles outlined in Issues affecting health practitioners should be applied.

The term ‘endorsement’ is used to refer to a statement of support or approbation from an individual or organisation for a product, recommendation or some other object or course of conduct by which the individual or organisation assumes a degree of responsibility for the ensuing outcomes.

This responsibility includes decisions by a society to approve or participate in a particular activity or to provide public support for a particular event, activity or product that has been planned or developed by an outside entity. These may include participation in consensus conferences to develop clinical guidelines and position statements, to endorse publications or educational activities not developed by the organisation, or to provide links in websites to such publications or educational activities.

The practice of endorsement raises a range of ethical issues, mainly relating to the processes according to which the original activities or products were generated, and how the various interests involved were managed at the time. Endorsement may involve material and other support, such as marketing assistance, and it may result in some benefit or advantage to the society in return for the assistance provided.

Such conferences (previously referred to as ‘consensus events’) include ‘state of the science’ conferences, ‘expert opinion’ conferences and ‘best practices’ conferences.

When endorsing the outcomes of such conferences, societies should consider whether they are satisfied that the processes according to which the conferences were organised and managed conform with the principles outlined in these Guidelines, in particular, whether outside funders have had any influence over the content or conduct of the event, the selection of speakers and participants, or the content of reports or other documents they produced. In addition, societies should consider whether such events have followed the appropriate procedures for disclosure and management of interests relating to each of the issues and topics discussed. These procedures should be fully documented in the body of relevant reports.

A role of professional organisations is to inform and educate the public and government about specific issues concerning medicine, science and clinical practice. From time to time, this may require taking positions in relation to the nature and consequences of particular health problems and treatments. This could include support for specific therapeutic agents or endorsement of clinical guidelines that support particular therapies.

The development of statements of endorsement of guidelines or treatments should be undertaken with great care to avoid compromising the objectivity and credibility of the organisation in the eyes of the broader community. Rigorous policies are needed concerning the processes according to which such statements are generated and reviewed. These policies and processes should ensure that in each case statements are based on relevant evidence, the conditions under which they were prepared included appropriate management of dualities, and any contributions from industry in support of their preparation are provided through arrangements that ensure the processes remain free of influence and are fully disclosed. Conditions should be satisfied where endorsement of statements or policies developed by other societies is considered similar.

Endorsement of clinical guidelines may be appropriate if the following conditions are satisfied:

• the evidence on which the various statements in the guidelines are based was gathered and assessed using methods such as those of the Cochrane Collaboration or an equivalent body


• the guidelines will be reviewed and updated according to a defined schedule


• appropriate processes for disclosure and management of interests will be employed in the production of the guidelines


• in particular, there has been no influence from pharmaceutical or other for-profit industry representatives

The principles described above also apply to materials derived from other sources, including other professional societies, government bodies and community groups.

In all these cases, care needs to be taken to ensure that both pecuniary and non-pecuniary interests have been appropriately managed. Materials generated by religious or political bodies, or community groups advocating for particular issues or points of view, are especially susceptible to biases. Care should be exercised when considering whether to offer support to such organisations.

In general, it is desirable that such materials are produced by committees or groups in which the majority of participants do not have a relevant interest at a level that is likely to compromise their judgments or decisions. Procedures should also be adopted to ensure adequate disclosure and management of interests, and that outcomes are appropriately documented and annotated to advise how this was achieved.