 |
 |
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
5 March 2002 | Volume 136 Issue 5 | Pages 396-402
This is part 1 of a 2-part paper on ethics and physician-industry relationships. Part 1 offers advice to individual physicians; part 2 gives recommendations to medical education providers and medical professional societies.
Physicians and industry have a shared interest in advancing medical knowledge. Nonetheless, the primary ethic of the physician is to promote the patient's best interests, while the primary ethic of industry is to promote profitability. Although partnerships between physicians and industry can result in impressive medical advances, they also create opportunities for bias and can result in unfavorable public perceptions.
Many physicians and physicians-in-training think they are impervious to commercial influence. However, recent studies show that accepting industry hospitality and gifts, even drug samples, can compromise judgment about medical information and subsequent decisions about patient care. It is up to the physician to judge whether a gift is acceptable. A very general guideline is that it is ethical to accept modest gifts that advance medical practice. It is clearly unethical to accept gifts or services that obligate the physician to reciprocate.
Conflicts of interest can arise from other financial ties between physicians and industry, whether to outside companies or self-owned businesses. Such ties include honorariums for speaking or writing about a company's product, payment for participating in clinic-based research, and referrals to medical resources. All of these relationships have the potential to influence a physician's attitudes and practices. This paper explores the ethical quandaries involved and offers guidelines for ethical business relationships.
Author and Article Information
From the American College of Physicians–American Society of Internal Medicine, Philadelphia, Pennsylvania.
*This paper was written by Susan L. Coyle, PhD, and was developed by the American College of Physicians–American Society of Internal Medicine (ACP-ASIM) Ethics and Human Rights Committee. Members of the ACP-ASIM Ethics and Human Rights Committee were William E. Golden, MD (Chair); David W. Potts, MD (Vice Chair); Harmon H. Davis II, MD; David A. Fleming, MD; Susan Dorr Goold, MD; Vincent E. Herrin, MD; Jay A. Jacobson, MD; Risa Lavizzo-Mourey, MD, MBA (Past Chair); Joanne Lynn, MD; and Daniel P. Sulmasy, OFM, MD, PhD. Lois Snyder, JD, Director of ACP-ASIM's Center for Ethics and Professionalism, provided principal staff support. This paper was approved by the ACP-ASIM Board of Regents on 15 July 2001.
Requests for Single Reprints: Susan L. Coyle, PhD, Center for Ethics and Professionalism, American College of Physician-American Society of Internal Medicine, 190 N. Independence Mall West, Philadelphia, PA 19106-1572. POSITION PAPER
Physician–Industry Relations. Part 1: Individual Physicians
Related articles in Annals:
This article has been cited by other articles:
|
|
 |
|
  D. J. Rothman and S. Chimonas New Developments in Managing Physician-Industry Relationships JAMA, September 3, 2008; 300(9): 1067 - 1069. [Full Text] [PDF]
|
|
|
|
 |
|
 S. L Pinto, E. Lipowski, R. Segal, C. Kimberlin, and J. Algina Physicians' intent to comply with the American Medical Association's guidelines on gifts from the pharmaceutical industry J. Med. Ethics, June 1, 2007; 33(6): 313 - 319. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. S. Ross, J. E. Lackner, P. Lurie, C. P. Gross, S. Wolfe, and H. M. Krumholz Pharmaceutical Company Payments to Physicians: Early Experiences With Disclosure Laws in Vermont and Minnesota JAMA, March 21, 2007; 297(11): 1216 - 1223. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. E. Turton and L. Snyder Physician-Industry Relations Ann Intern Med, March 20, 2007; 146(6): 469 - 469. [Full Text] [PDF]
|
|
|
|
 |
|
 C. M.A. Geppert Medical Education and the Pharmaceutical Industry: A Review of Ethical Guidelines and Their Implications for Psychiatric Training Acad Psychiatry, February 1, 2007; 31(1): 32 - 39. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Bibliography for Ethics, Professionalism, and End of Life Care Focus, January 1, 2007; 5(4): 417 - 419. [Full Text] [PDF]
|
|
|
|
|
|
M A Morgan, J Dana, G Loewenstein, S Zinberg, and J Schulkin Interactions of doctors with the pharmaceutical industry. J. Med. Ethics, October 1, 2006; 32(10): 559 - 563. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Day Industry gifts to healthcare providers: are the concerns serious? Am. J. Crit. Care., September 1, 2006; 15(5): 510 - 513. [Full Text] [PDF]
|
|
|
|
|
|
M. D. Jibson Medical Education and the Pharmaceutical Industry: Managing an Uneasy Alliance Acad Psychiatry, February 1, 2006; 30(1): 36 - 39. [Full Text] [PDF]
|
|
|
|
 |
|
 S. Chimonas and D. J. Rothman New Federal Guidelines For Physician-Pharmaceutical Industry Relations: The Politics Of Policy Formation Health Aff., July 1, 2005; 24(4): 949 - 960. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. C. Mohl Psychiatric Training Program Engagement With the Pharmaceutical Industry: An Educational Issue, Not Strictly an Ethical One Acad Psychiatry, June 1, 2005; 29(2): 215 - 221. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Snyder, C. Leffler, and for the Ethics and Human Rights Committee, America Ethics Manual: Fifth Edition Ann Intern Med, April 5, 2005; 142(7): 560 - 582. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. B. Frye Disclosing conflicts of interest involving clinicians who prepare therapeutic guidelines Am. J. Health Syst. Pharm., February 15, 2005; 62(4): 361 - 362. [Full Text] [PDF]
|
|
|
|
 |
|
 H. Brody The Company We Keep: Why Physicians Should Refuse to See Pharmaceutical Representatives Ann. Fam. Med, January 1, 2005; 3(1): 82 - 85. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Blumenthal Doctors and Drug Companies N. Engl. J. Med., October 28, 2004; 351(18): 1885 - 1890. [Full Text] [PDF]
|
|
|
|
|
|
D. M. Studdert, M. M. Mello, and T. A. Brennan Financial Conflicts of Interest in Physicians' Relationships with the Pharmaceutical Industry -- Self-Regulation in the Shadow of Federal Prosecution N. Engl. J. Med., October 28, 2004; 351(18): 1891 - 1900. [Full Text] [PDF]
|
|
|
|
 |
|
 L. E. Ferris and C. D. Naylor Physician remuneration in industry-sponsored clinical trials: the case for standardized clinical trial budgets Can. Med. Assoc. J., October 12, 2004; 171(8): 883 - 886. [Full Text] [PDF]
|
|
|
|
|
|
D. A. Davis CME and the pharmaceutical industry: two worlds, three views, four steps Can. Med. Assoc. J., July 20, 2004; 171(2): 149 - 150. [Full Text] [PDF]
|
|
|
|
 |
|
 S. Packer and D. W. Parke II Ethical Concerns in Industry Support of Continuing Medical Education: The Con Side Arch Ophthalmol, May 1, 2004; 122(5): 773 - 776. [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. Diaz and M. J. Stamp Primer on Medical Professionalism J Am Podiatr Med Assoc, March 1, 2004; 94(2): 206 - 209. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Sullivan, D. M. Perry, W. Grimes, and H. Wetherbee Benefit Coverage of Novel Antipsychotics in Medicaid Programs and the Veterans Health Administration American Journal of Medical Quality, January 1, 2004; 19(1): 37 - 40. [Abstract] [PDF]
|
|
|
|
 |
|
 A. S. Brett, W. Burr, and J. Moloo Are Gifts From Pharmaceutical Companies Ethically Problematic?: A Survey of Physicians Arch Intern Med, October 13, 2003; 163(18): 2213 - 2218. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Grande and K. Volpp Cost and Quality of Industry-Sponsored Meals for Medical Residents JAMA, September 3, 2003; 290(9): 1150 - 1151. [Full Text] [PDF]
|
|
|
|
|
|
S. S. Chopra Industry Funding of Clinical Trials: Benefit or Bias? JAMA, July 2, 2003; 290(1): 113 - 114. [Full Text] [PDF]
|
|
|
|
 |
|
 E. Wager How to dance with porcupines: rules and guidelines on doctors' relations with drug companies BMJ, May 29, 2003; 326(7400): 1196 - 1198. [Full Text] [PDF]
|
|
|
|
|
|
J. E. Bekelman, Y. Li, and C. P. Gross Scope and Impact of Financial Conflicts of Interest in Biomedical Research: A Systematic Review JAMA, January 22, 2003; 289(4): 454 - 465. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. J. Masters Resident Stress Ann Intern Med, January 7, 2003; 138(1): W14 - W14. [Full Text] [PDF]
|
|
|
|
|
|
S. Sollitto, S. Youngner, and M. M. Lederman Nonfinancial Conflicts of Interest in Research N. Engl. J. Med., December 26, 2002; 347(26): 2173 - 2173. [Full Text] [PDF]
|
|
Article
