Ms Miriam Wiersma1
1The University Of Sydney, Sydney, Australia
Biography:
Miriam Wiersma is a PhD Candidate at Sydney Health Ethics at The University of Sydney. Her areas of interest include the ethics of clinical innovation—doctors’ use of novel and emerging treatments, as well as conflicts of interest in healthcare and biomedical science. Since 2016 she has been employed as a Research Assistant on several NHMRC grants on access to high-cost cancer medicines, conflicts of interest and commercial influences on assisted reproductive technology.
Abstract:
Aims:
Doctors play a vital role in the development and use of innovative interventions to improve patient care and address health system deficiencies. Ensuring that doctors engage in responsible clinical innovation that is attuned to its inherent risk is important.
Some have claimed that doctors’ interests and conflicts of interest (COI) are particularly problematic in the context of innovative interventions, where the financial and reputational stakes are high. Indeed, recent evidence suggests that individual and institutional COI can impede responsible clinical innovation.
The aim of this study was to explore Australian doctors’ perspectives towards the interests and external factors shaping their use of innovative interventions, to inform the development of oversight mechanisms to encourage responsible clinical innovation.
Methods:
As part of a larger qualitative project, we conducted semi-structured interviews with 33 Australian doctors from surgery, haematology and reproductive medicine. We sought to identify areas of similarity and divergence in doctors’ understanding of, and experiences with, clinical innovation across diverse medical specialties.
Results:
Doctors described how individual interests (e.g. problem solving) and institutional interests (e.g. reputational enhancement) shaped their use of innovative interventions, and how these interests could at times come into conflict with one another and impede responsible clinical innovation.
Conclusions:
By integrating our empirical findings with a historically informed account of interests as well as lessons from virtue ethics, we developed a practical framework to guide responsible clinical innovation for use by doctors and innovation stakeholders (including healthcare managers and policymakers) that is applicable across diverse medical specialties.