TMF Conflict of Interest Form

CONFLICT OF INTEREST, CONFIDENTIALITY AND NON-DISCLOSURE POLICY

Adapted from the NIH and Burroughs Wellcome Fund Conflict of Interest Policies

As tax-exempt organizations, private foundations enjoy extraordinary privilege in American society. This carries a great responsibility – to retain the public trust. Hence, The Medical Foundation wishes to avoid any real or perceived conflicts of interest in its grant making and in its business operations. No written policy or guide can cover every situation; responsibility for integrity and fairness must be fulfilled through individual compliance with the spirit as well as the letter of the law governing private foundations.

The Taub Foundation Grants Program for MDS Research is managed by The Medical Foundation at Health Resources in Action, a Boston non-profit organization committed to advancing public health and medical research.

CONFLICT OF INTEREST

It is the policy of The Medical Foundation that a committee member (“Member”) involved in the review of grant applications and awardee progress reports should not have real or potential conflicts of interest.

Potential conflicts of interest would exist if the Member involved in the review process and the applicant had a past association as a thesis advisor/student; mentor/mentee; engaged in a business or professional partnership; collaborated on a project, book, article, report or paper; or have a known family, marriage or other relationship. Any potential conflict of interest must be disclosed prior to the review of grant applications. Once disclosure is made, it is the decision of The Medical Foundation Program Staff and/or Program Chair whether the conflict is sufficient to disqualify the Member from grant application review and scoring. If the conflict is significant, the Member will be asked to leave the discussion and not score the application during the Conference Call or Review Committee Meeting. Please disclose the following:

  • Direct Financial Benefit if application is funded;
  • Institutional Affiliation: an application from the immediate department or division as the committee member; if an applicant within another department or division is not known to the Member, s/he may participate in the grant application review and vote. In addition, if a committee member holds a senior administrative position within that institution, s/he must not participate in the grant application review and vote.
  • Professional Relationships: relationships with any colleague, scientific mentor, student or other scientist with whom the reviewer is currently conducting or has conducted research or other significant professional activities related to the application, within three years of the date of the Scientific Review;
  • Other Relationships: other relationships or situations, both positive and negative that could introduce a bias into the evaluation of an applicant’s grant submission; and
  • Longstanding Disagreement: a situation where a reviewer has had longstanding scientific or personal differences with an applicant.

CONFIDENTIALITY AND NON-DISCLOSURE

It is the policy of The Medical Foundation that the information contained in applications or reports received by the Foundation that is not generally available to the public must be held in strictest confidence. Such information (1) must not be copied or reproduced and (2) must not be disseminated or disclosed to any person other than current members of the Scientific Review Committee, designed Ad Hoc reviewers, and Program staff. Such information must not be used by or for the personal benefit of anyone involved in the review process or made available for the personal benefit of any other individual or organization.

In addition, committee members may not speak to applicants about their grant applications before final approval of funding by the Taub Foundation. All complaints, administrative issues or other inquiries made by applicants directly to committee members should be referred to The Medical Foundation’s Grants Officer.

ACKNOWLEDGEMENT AND ACCEPTANCE OF POLICY

I have read and agree to adhere to The Medical Foundation’s policies on conflicts of interest and confidentiality of information. If a potential conflict of interest exists, I will promptly notify The Medical Foundation Program Staff (listed below) and refrain from participating in the review of a specific application or, if applicable, do everything necessary to resolve the conflict.

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