When to Declare a Conflict of Interest in an Investigation

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Introduction

The credibility of an investigation depends on more than the technical quality of the evidence gathered or the analysis undertaken. It also depends on the integrity of the investigation process and the confidence stakeholders can have that the people conducting the investigation are able to approach the evidence objectively. For this reason, actual and perceived conflicts of interest need to be identified, declared and appropriately managed from the outset.

A conflict of interest does not necessarily mean that an investigator has acted improperly, nor does declaring one automatically disqualify a person from participating in an investigation. A conflict exists when a relationship, responsibility, prior involvement, personal interest or other circumstance could influence an investigator's judgement, or could reasonably be perceived by others as having that influence. The distinction is important because an investigator may genuinely believe they can remain impartial while other stakeholders could reasonably question their independence.

Safety Wise investigation principles place considerable importance on the integrity and conduct of the investigator. Effective investigators are expected to maintain high ethical standards, remain neutral, avoid bias towards particular findings, validate information as fact and refrain from reaching premature conclusions. These expectations support a fundamental principle of investigation governance: where circumstances exist that could compromise, or appear to compromise, impartiality, they should be disclosed rather than left to the investigator to manage privately.

The practical threshold for disclosure should therefore be relatively simple. If an investigator becomes aware of a circumstance that could reasonably cause another person to question their independence, objectivity or ability to assess the evidence impartially, the matter should be declared. Disclosure does not determine the outcome. It allows the person responsible for the investigation to assess the circumstances and decide whether the conflict can be managed, whether the investigator's role should be modified, or whether another person should be appointed.

Understanding Actual, Potential and Perceived Conflicts

An actual conflict of interest exists when an investigator's interests or responsibilities directly intersect with a matter being examined. 

For example, a maintenance manager appointed to investigate an incident may discover that the adequacy of the maintenance system for which they are accountable is a significant line of inquiry. Similarly, a supervisor may be asked to investigate an event involving work that they personally authorised or controlled. In both situations, the investigator could effectively be required to assess the adequacy of their own decisions or responsibilities.

A potential conflict of interest exists where the conflict has not yet materialised but could reasonably develop as the investigation progresses. 

This is particularly relevant in systemic investigations because the direction of the investigation cannot always be predicted at commencement. ICAM requires investigators to look beyond the immediate actions associated with an incident and examine the Task/Environmental Conditions, Individual/Team Actions, Absent/Failed Defences and Organisational Factors that contributed to the outcome. An investigator who appears independent when appointed may therefore become connected to an emerging line of inquiry once the evidence identifies deficiencies within an area for which that investigator has responsibility.

A perceived conflict of interest exists when there may be no actual impairment of judgement, but the circumstances could reasonably create doubt about the investigator's impartiality. 

This category is sometimes underestimated because the investigator knows their own intentions and may be confident in their ability to remain professional. The issue, however, is not limited to what the investigator believes about their own objectivity. Investigation credibility also depends on whether witnesses, workers, managers and other stakeholders can have reasonable confidence in the process.

This is why the appropriate question is not simply, "Am I biased?" A more useful question is: "Could my involvement, relationships, previous decisions or interests reasonably cause someone to question whether I can investigate this matter objectively?" If the answer is yes, or there is reasonable uncertainty, disclosure is the appropriate course.

When a Conflict Should Be Declared

Ideally, potential conflicts should be considered before an investigator accepts an appointment. The appointment of the investigation team is an important governance decision. Safety Wise guidance provides that the responsible manager selects and appoints the investigation team and establishes the terms of reference, including the purpose, boundaries, jurisdiction and authority of the investigation. Assessing independence at this stage allows potential problems to be identified before evidence is gathered, witnesses are interviewed or analytical decisions are made.

Direct involvement in the incident is an obvious reason to consider disclosure. An investigator may have participated in the task, supervised the activity, approved a permit, authorised work, completed a relevant risk assessment or made an operational decision connected with the event. The existence of prior involvement does not mean that every person connected with an incident must be excluded from the investigation. Operational and technical knowledge can be extremely valuable. The issue is whether the person's involvement creates a circumstance in which they may be required to assess their own actions or decisions, or where others could reasonably question their ability to do so impartially.

The same principle applies where an investigator has responsibility for the system, control or organisational process being examined. Consider an incident in which a critical item of equipment was unavailable because scheduled maintenance had repeatedly been deferred. If the manager responsible for the maintenance program is also leading the investigation, the investigation may eventually require that person to determine whether maintenance planning, resourcing, prioritisation or management decisions contributed to the event. Even if the manager is highly experienced and genuinely committed to identifying the contributing factors, the circumstances create a clear reason for disclosure.

Personal relationships can create similar issues. A close friendship, family relationship or significant personal connection with someone directly involved in the incident may create an actual or perceived conflict. Importantly, conflicts are not limited to positive relationships. A history of serious disagreement, grievance or hostility may also affect, or appear to affect, an investigator's judgement. In either case, the relevant consideration is whether the relationship could reasonably call the investigator's impartiality into question.

Professional and commercial interests also require consideration. An investigator may have been responsible for selecting a contractor, approving a supplier, developing a procedure, designing equipment, delivering training or recommending a particular system that later becomes relevant to the investigation. The investigator may have done nothing wrong, but they could nevertheless have a professional interest in defending an earlier decision. That circumstance should be disclosed so that the investigation sponsor can determine the appropriate response.

Conflicts Can Emerge During the Investigation

Conflict assessment should not be treated as a one-off administrative exercise completed when the investigation team is appointed. Investigations develop as evidence is gathered, timelines are reconstructed and contributing factors are identified. Information discovered through PEEPO may take the investigation into areas that were not apparent from the initial incident notification.

Safety Wise emphasises gathering relevant information across People, Environment, Equipment, Procedures and Organisation so that investigators can understand the incident and the events leading to it. Relevant information must be supported by evidence, and investigators are expected to look beyond human error to understand why an action or condition existed. That process can reveal connections between an investigator and the subject matter that were not apparent when the team was established.

For example, an investigator may initially believe that an incident concerns an equipment failure. During data gathering, however, evidence may indicate that the equipment had previously been identified as requiring replacement but the capital request was deferred. If the investigator participated in that decision, a conflict issue has emerged. The appropriate response is not to ignore the connection because the investigation is already underway. The investigator should declare it as soon as it becomes apparent so that its significance can be assessed.

This principle should continue throughout the investigation, including during data analysis, development of findings, preparation of recommendations and review of the final report. A conflict discovered late is still a conflict that should be disclosed.

Declaration Does Not Automatically Mean Removal

One reason people may hesitate to declare conflicts is the assumption that disclosure means they will immediately be removed from the investigation. That is not necessarily the case. The appropriate response depends on the nature and significance of the conflict, the person's role, the availability of alternative expertise and the potential effect on investigation credibility.

A relatively minor perceived conflict may be managed through disclosure and oversight. In another situation, the investigator may remain on the team because their technical knowledge is important but be excluded from analysing or determining findings relating to their own area of responsibility. An independent investigator could be assigned responsibility for that part of the investigation. For more significant conflicts, particularly where the investigation will directly examine the decisions or performance of the investigator, replacement may be the most appropriate option.

The important governance principle is that the individual with the conflict should not be the sole decision-maker about how that conflict will be managed. 

Once declared, the circumstances should be assessed by the investigation sponsor, appointing manager or other person with appropriate authority and independence.

This approach protects both the investigation and the investigator. If the matter is challenged later, the organisation can demonstrate that the conflict was identified, disclosed, assessed and consciously managed rather than ignored.

Why Conflict Management Matters in an ICAM Investigation

Conflict management is particularly important in an ICAM investigation because the purpose of the investigation is to understand the system rather than simply identify the person closest to the event. Safety Wise guidance states that the objective of an ICAM investigation is to establish the facts, identify contributing factors and latent conditions, review the adequacy of existing controls, report the findings and develop corrective actions that reduce risk and prevent recurrence. Importantly, it is not the purpose of an ICAM investigation to apportion blame or liability.

This systems-based approach means that an investigation may examine decisions and conditions extending well beyond the immediate workplace. Organisational arrangements, management systems, resources, procedures, training, risk controls and previous decisions may all become relevant. The broader the investigation reaches into the organisation, the greater the possibility that members of the investigation team will encounter areas with which they have some connection.

Managing those connections is essential because an investigator's conflict can subtly change the direction of inquiry. 

It may influence which questions are asked, which evidence is pursued, how inconsistencies are treated, whether a contributing factor is considered significant or how strongly a recommendation is framed. None of this requires deliberate misconduct. Bias can operate without conscious intent, which is precisely why transparency and independent governance are important controls.

A well-managed conflict therefore supports the same principles that underpin a quality ICAM investigation: evidence over assumption, systemic analysis over blame, findings supported by evidence, and recommendations linked to identified contributing factors.

A Practical Example

Consider a high-potential mobile equipment incident at a mine. A light vehicle enters an active operating area and narrowly avoids a collision with a haul truck. The site appoints an experienced operations superintendent as the ICAM Team Leader because of their operational knowledge and previous investigation experience.

At the commencement of the investigation, there appears to be no direct conflict. However, interviews and document reviews establish that the site's traffic management plan had been reviewed six months earlier. Several recommendations concerning light vehicle access controls were proposed during that review but were not implemented. The operations superintendent chaired the meeting at which the implementation was deferred.

At this point the circumstances have changed. The investigation may need to examine whether the decision to defer those controls contributed to the incident. The Team Leader now has a direct connection to a potentially significant contributing factor.

The appropriate action is to declare the conflict.

The declaration does not establish that the superintendent made a poor decision, nor does it mean that the deferred control necessarily contributed to the incident. Those questions remain matters for evidence and analysis. The declaration simply recognises that the Team Leader's previous involvement could reasonably create doubt about their independence when analysing that particular issue.

The organisation may decide to appoint another Team Leader, retain the superintendent as a technical team member, or arrange independent review of the relevant evidence and findings. What matters is that the conflict is visible and consciously managed rather than left unresolved.

The Consequences of Failing to Declare

Failure to declare a conflict can undermine an otherwise technically sound investigation. If the conflict is discovered after findings have been issued, stakeholders may begin questioning whether evidence was selectively interpreted, whether alternative explanations were adequately considered or whether particular findings were avoided.

This can create a problem much larger than the original conflict.

Witnesses may lose confidence in the process. Workers may become reluctant to participate openly in future investigations. Management may question the reliability of the findings. Regulators or other external stakeholders may scrutinise the independence of the process. Recommendations may be challenged not because they are technically unsound but because confidence in the process used to develop them has been damaged.

The quality of the investigation report is also relevant. Safety Wise report-writing guidance requires investigation reports to present facts without opinion, remain bias-free and provide accurate, clear and concise information supported by evidence. If an unmanaged conflict creates doubt about how those facts were selected, analysed or presented, the credibility of the report itself can be affected.

Early declaration is therefore considerably easier to manage than a later challenge to the integrity of the entire investigation.

What Should Be Declared?

Investigators do not need to disclose every workplace acquaintance or insignificant connection. The objective is not to create unnecessary bureaucracy. The focus should remain on circumstances that could reasonably affect, or appear to affect, impartiality.

Relevant matters may include direct involvement in the incident, responsibility for a system being investigated, previous decisions connected with the event, close personal relationships, significant professional relationships, financial interests, previous disputes, involvement in related disciplinary matters, strong pre-existing opinions about the incident, or any circumstance in which the investigator's own performance may become part of the investigation.

When uncertain, disclosure is generally the stronger governance option. The person receiving the declaration can determine that no further action is required. That is preferable to an investigator independently deciding not to disclose a matter that later becomes significant.

How a Conflict Should Be Declared

A declaration should be factual, concise and made to the appropriate investigation authority. It should identify the nature of the relationship or involvement without attempting to argue that the conflict is insignificant.

For example:

"I wish to declare a potential conflict of interest. I participated in the review that approved the current isolation procedure, and the adequacy of that procedure may become relevant to this investigation. I am declaring this so that my continued role in the investigation can be assessed."

That is sufficient to initiate the governance process.

The declaration and the decision about how it will be managed should also be documented. Depending on the circumstances, this may be recorded in investigation planning documentation, team appointment records or another appropriate governance record. If the conflict results in a change to the investigation team or responsibilities, those arrangements should be clear to everyone involved.

The Role of the Investigation Sponsor

Conflict management is not solely an investigator responsibility. The person commissioning or governing the investigation also has an important role.

When establishing the investigation team, the appointing manager should consider competence, technical expertise and independence. The terms of reference should clearly establish the team's authority and boundaries, and governance arrangements should support an investigation capable of following the evidence wherever it reasonably leads. Safety Wise guidance emphasises the importance of clearly defining the purpose, work, stakeholder requirements, confidentiality arrangements, boundaries, jurisdiction and authority of the investigation team.

Where a conflict is declared, the sponsor should assess both actual impairment and reasonable perception. A decision that "we trust the investigator" may not adequately address the issue. Trust is important, but conflict management is about protecting the integrity of the process, not making a judgement about someone's character.

The question should instead be whether the proposed arrangement allows the investigation to remain objective, evidence-led and credible.

Independence Does Not Mean Lack of Knowledge

There is also a danger in treating independence as requiring investigators who know nothing about the organisation or the work. Effective investigations frequently require technical and operational expertise. Someone who understands the equipment, task, work environment or organisational system can provide essential insight into the evidence.

The objective is therefore not absolute separation from the organisation. It is appropriate independence from the matters requiring judgement.

A technical specialist may have extensive knowledge of a system without having responsibility for the decisions being examined. Conversely, a senior manager may have little direct involvement in the incident but still have accountability for the organisational arrangements under investigation.

Investigation team composition should balance competence with independence. Where both cannot be achieved through a single person, a multidisciplinary team can provide the necessary expertise while maintaining appropriate checks on judgement and analysis.

A Simple Decision Rule

Investigators can apply a straightforward rule throughout the investigation:

Declare early, declare when circumstances change, and allow someone independent of the conflict to decide how it should be managed.

The declaration should occur whenever an investigator becomes aware of an actual, potential or perceived conflict that could reasonably call their impartiality into question. It should not be delayed until there is proof that bias has affected the investigation because, by that stage, the integrity of the process may already have been compromised.

This approach is consistent with the wider philosophy of a quality investigation. Investigators gather evidence rather than rely on assumptions. They test information rather than defend predetermined conclusions. They look beyond individual actions to understand the conditions and organisational factors that influenced the event. Conflict-of-interest management applies the same discipline to the investigation team itself.

Conclusion

A conflict of interest is not evidence of wrongdoing. It is a circumstance requiring transparency and appropriate governance.

Investigators should declare a conflict whenever their relationships, responsibilities, previous involvement, interests or decisions could affect, or reasonably be perceived as affecting, their independence and objectivity. The declaration should be made before appointment where possible, but the obligation continues throughout data gathering, organisation, analysis, recommendation development and reporting because new conflicts can emerge as the investigation develops.

The purpose of disclosure is not automatically to remove experienced people from investigation teams. Depending on the circumstances, a conflict may be managed through oversight, changes in responsibilities, independent review or replacement of a team member. What matters is that the conflict is recognised and that the decision about how it will be managed is not left solely to the person affected.

A credible investigation must be capable of following the evidence wherever it leads, including into decisions, systems and controls for which senior or experienced people may be responsible. That is central to systems-based investigation and to the ICAM philosophy of learning from incidents rather than simply finding someone to blame.

If there is reasonable doubt about whether a relationship, interest or prior involvement should be declared, declare it. Transparency at the beginning of an investigation is far easier to manage than a challenge to its credibility at the end.