AAN/AANPA Policy on Conflicts of Interest

I. Definition

A member of the American Academy of Neurology (AAN) or the American Academy of Neurology Professional Association (AANPA), serving as an officer, committee member, teacher, author, consultant, or other position of official responsibility or leadership, has a conflict of interest if that member has a private interest that may interfere with the member’s official responsibilities to either organization.

II. Importance

Conflicts of interest are a matter of concern for the AAN and the AANPA. Members serving in official capacities have a fiduciary duty to exercise impartial judgments for the best interests of the AAN and AANPA and their members. The presence of a private interest may impair their ability to exercise competent judgment and objectivity in their official capacity. A perceived conflict also diminishes the confidence of members and the public in the quality of the organizations’ products and operations.

III. Examples

Conflicts of interest include these examples: 1) members serving as committee members who are, or within the past five years have been, employed or retained in any capacity by a company doing business with the AAN or the AANPA; 2) members speaking at AAN or AANPA meetings who are, or within five years have been, employed or retained by companies related to the topic of their presentation; 3) members or their immediate families who hold significant economic interests in companies with which the AAN or AANPA conducts business; and 4) members employed or retained by industry who are in a position to influence other members through educational presentations that may benefit the industry.

IV. Resolution of Conflicts

Conflicts of interests can be resolved or lessened through several strategies.

1. Avoidance. Serious conflicts should be avoided altogether by members in official capacities by not participating in situations in which there is a serious conflict of interest.
2. Withdrawal. Members with serious conflicts wishing to retain their official AAN or AANPA responsibility can divest the conflicting interest or withdraw from the conflicting relationship.
3. Disclosure. Members with potential conflicts should disclose them fully to responsible AAN or AANPA officials. Disclosure does not eliminate the conflict but mitigates it insofar as it permits others to become aware of the conflict, to monitor the member’s performance, and to consider its effect when interpreting the member’s official judgments. Disclosure is the appropriate remedy for mitigating most instances of conflicts of interest.

V. Disclosure Statement of Conflict of Interest

Disclosure of conflicts of interest to responsible officials of the AAN or AANPA is an ethical responsibility of the member having the conflict. The AAN and AANPA boards of directors have the ultimate responsibility of determining what limitations or actions may be necessary to protect the organizations. If a member is uncertain whether a conflict of interest exists, it is better to err on the side of disclosure. At the beginning and midpoint of each member’s term of service on the Board of Directors or term as a presidential appointee and before each member gives an educational presentation at an AAN or AANPA meeting, the member must complete or update an appropriate disclosure form. The member must also update the disclosure statement if a change in personal circumstances causes the previously-submitted disclosure to be no longer correct. The boards have approved the disclosure form in the appendix.

VI. Administrative Review and Action on Disclosure Statements

1. The following table explains who is responsible for promptly reviewing submitted conflict of interest disclosure statements:

   Members Submitting Disclosure Statements	Reviewing Authority
   Board of Directors (including Executive Director)	President
   President	Board of Directors
   Appointees to outside organizations	President
   Editor-in-Chief of AAN publications and website	AAN President
   Associate editors of AAN publications and website	Editors-in-Chief
   Chairs of standing committees, task forces, and ad hoc committees	President
   Members of standing committees, task forces, and ad hoc committees	Chairs of standing committees, task forces, and ad hoc committeea
   Chairs of subcommittees and workgroups	Chairs of standing committees
   Members of subcommittees and workgroups	Chairs of subcommittees and workgroups
   Education program directors and faculty	Chair, Education Committee
   Scientific program directors	Chair, Science Committee

   The Reviewing Authority can take one of three possible courses of action with respect to each statement in which a conflict is acknowledged:

   1. There is no serious conflict. No action, short of appropriate disclosure, must be taken. This is the most common action.
   2. There is a serious conflict. The member must be removed from the official AAN or AANPA capacity, must divest the conflicting interest, or must withdraw from the conflicting relationship. Disclosure alone is insufficient to handle the conflict.
   3. There is an intermediate conflict. The presence of such a conflict is compatible with concurrent maintenance of the member’s official AAN or AANPA capacity and the conflicting interest or relationship. The situation should be monitored carefully and appropriate disclosure made.
2. Any disagreement between a member and the Reviewing Authority may be submitted to the AAN or AANPA Executive Committee for resolution. The Executive Committee may consult with the Ethics, Law and Humanities Committee concerning any submitted dispute.
3. Copies of conflict of interest disclosure statements will be provided to the chairs of committees and subcommittees on which the member serves at the beginning of each committee term.
4. Statements of conflicts should be publicized appropriately, by incorporating them into published and spoken AAN or AANPA presentations.
5. AAN and AANPA committees and editors-in-chief may, after first giving notice to the appropriate executive committee, adapt the disclosure statement to best fulfill their mission.

VII. Organizational Conflicts with Industry and Institutions.

1. A complex set of conflicts may accompany relationships of the AAN and AANPA with private industry and other institutions. This policy seeks to recognize and protect the benefits of these relationships while avoiding conflicts of interest that may arise. The AAN and AANPA have functioning policies in several areas where these relationships exist. To reduce possible conflicts of interest, all such relationships should be bound by the following principles:

   1. Gifts from industry should be made as unrestricted grants, or any restrictions should be negotiated with AAN or AANPA officials using the following principles.
   2. The AAN and AANPA should remain independent from commercial sponsors in all substantive program areas by retaining unconditional control of program planning, financing, faculty selection, editorial control, and content.
   3. The AAN and AANPA should ensure balance, objectivity, and scientific accuracy in programs with commercial sponsorship.
   4. The individual AAN or AANPA members producing a program with commercial sponsorship should not benefit materially in any way if such benefit is directly related to their involvement in the program.
   5. The AAN and AANPA should make full disclosure to program participants and the public of industry support and financial relationships.
   6. The AAN and AANPA should retain full control over the methods used to acknowledge industrial support.

VIII. Nonmember Conflicts

The AAN and AANPA recognize the important role played by nonmembers of the AAN and AANPA committees and subcommittees, including service as consultants and staff assistants. At the same time, however, the AAN and AANPA seek to avoid conflicts of interest that arise in this relationship, particularly in situations in which nonmembers are employed by firms that have financial interests in AAN or AANPA affairs, decisions, policies, or products. To minimize these conflicts, the following guidelines should be followed:

1. Nonmembers may serve in clearly defined roles on AAN and AANPA committees at the invitation of the committee or subcommittee chairs. Committee and subcommittee chairs have the responsibility for considering potential conflicts of interest that may arise in such relationships and of executing the provisions of this policy.
2. When conflicts of interest arise, such as when a consultant from industry provides data that concerns the industry’s product to an AAN or AANPA meeting, committee and subcommittee chairs should restrict the nonmember’s role to providing information and answering questions. Nonmembers should not participate in policy formulation or voting. All substantive decision making should be conducted in executive session with the nonmembers absent.
3. Committee and subcommittee chairs should be careful not to share AAN or AANPA proprietary information with nonmember participants because possessing such “inside information” may permit their firms to derive an unfair competitive advantage in seeking AAN or AANPA contracts or other benefits.
4. Observers attending committee and subcommittee meetings purely for educational purposes and who have no conflicts of interest may attend the entire meeting at the discretion of committee or subcommittee chairs.

Policy History:
Initially approved by the AAN Ethics and Humanities Subcommittee April 13, 1997; approved by the AAN Practice Committee August 24, 1997; approved by the AAN Board of Directors October 4, 1997, and published in Neurology (1998;50:332-334). Amended by the AAN and AANPA Executive Committees on February 21, 2008; ratified by the AAN and AANPA Boards of Directors on March 7, 2008 (AAN Policy 2008-06; AANPA Policy 2008-05). Further amended by the AAN Executive Committee on December 11, 2008 (Policy 2008-39) and the AANPA Executive Committee on December 11, 2008 (Policy 2008-21).