One of the most harmful adverse consequences of conflicts of interest in research is the potential introduction of bias into the science of medicine and the denigration of the integrity of scientific research. A number of facts support the concerns that financial conflicts influence the integrity of medical research. The potential for conflicts of interest can never be eliminated, but conflicts of interest can be managed and, in some cases, reduced. Strategies for doing so are most useful when they are matters of institutional and editorial policies that are focused on preventing the adverse effects of conflict of interest and are not unduly burdensome. Disclosure is the most common first step in managing conflicts of interest. Public disclosure of raw scientific data and independent monitoring of research are additional mechanisms for managing conflicts of interest. Policies and guidance on conflicts of interest are changing rapidly.