Abstract: Conflict of interest and its relevance to medical journals Openness and transparency are vital for the trustworthiness of medical journals and researchers (Gjersvik. Br. J. Dermatol. 2015; 173: 1255–7). Public trust in the scientific process and the credibility of published articles depend in part of how transparency and conflicts of interest are handled during the planning, implementation, writing, peer review, editing and publication of scientific work (http://www.icmje.org/recommendations/browse/roles-and-responsibilities/author-responsibilities--conflicts-of-interest.html). The International Committee of Medical Journal Editors (ICMJE) defines conflict of interest, when professional judgement concerning a primary interest (such as patients’ welfare or the validity of research) may be influenced by a secondary interest (such as financial gain). Perceptions of conflicts of interest are as important as actual conflicts of interest. All participants in the peer review and publication process must consider their conflicts of interest when fulfilling their roles. When authors submit a manuscript, they are responsible for disclosing all financial and personal relationships, and indeed ICMJE provides a disclosure of conflict of interest form to facilitate and standardize authors’ disclosure. Moreover, peer reviewers should be asked at the time they are asked to critique a manuscript to declare their conflict of interest and disclose further to editors any conflict of interest that could bias their opinions. Editors who make final decisions about manuscripts should recuse themselves from editorial decisions if they have conflict of interest or relations that pose potential conflicts. Articles should be published with short statements or supporting documents declaring the author's conflict of interest, sources of supported work and where the author has had access to the study data, with an explanation of the nature and extent of access, including whether access is ongoing. These principles are upheld by this journal. The Journal of the American Medical Association (JAMA) devoted the entire 2 May 2017 issue to the whole concept of conflict of interest (jamanetwork.com/journals/jama/issue/317/17). This theme issue of JAMA includes two editorials and 23 scholarly viewpoints that represent the multifaced aspects and complexity of conflict of interest. In the lead editorial, Stead (JAMA 2017; 317: 1765–7) introduces the concept of a spectrum of professionalism from judgement and integrity at one end to bias and dishonesty at the other end. In this spectrum of professional responsibility, the primary interests of each medical practitioner should be to care for and respect the interests and well-being of patients to the best of their abilities, while making sure that his or her abilities are maintained in new discoveries. In the other editorial, Fontanarosa and Bauchner (JAMA 2017; 317: 1768–71) tackle conflicts of interest in medical journals re-affirming the principles of the ICMJE outlined above and cover a wide range of issues, some of which I will delve into. Editorials and perspective articles represent a particular challenge for editors, and some journals indicate that they do not permit authors with any conflict of interest to write such pieces. Judgement and discretion are necessary and authorship is evaluated on a case-by-case basis. The potential for conflict for editors is dealt with by the inherent hierarchical structure of the editorial board, and whereas the final decision for publication is made by the editor-in-chief, he or she is supported by a deputy editor and members of the editorial board that jointly provide advice to the editor, based on the peer-review process, with recommendations on publication provided by at least two or three reviewers. The conundrum is about how editors themselves are ‘watched’ as they act as ‘watchers’ over authors. Editors exercise substantial control over the biomedical literature, and the literature in turn can have enormous influence on health care. It is important, therefore, that there are clear recusal procedures for editors, a useful list of which is provided by Gottlieb and Bressler (JAMA 2017; 317: 1757–8). The Royal Australasian College of Surgeons has its own policy on conflict of interest and is recommended reading for all fellows, trainees and IMGs (www.surgeons.org/media/295940/2016-04-29_pol_rel-pcs-037_conflict_of_interest.pdf). Competing interests are everywhere but they can be managed! (Dowden. Aust. Prescr. 2015; 38: 2–3). I declare my own conflicts of interests being a member of the Eminent Advisory Group and peer reviewer for this journal.