Ethical issues concerning the relationships between medical practitioners and the pharmaceutical industry
Paul A Komesaroff and Ian H Kerridge
RELATIONSHIPS INVOLVING medical practitioners and the pharmaceutical industry raise serious concerns and The Medical Journal of the medical profession and the controversy within bothAustralia ISSN: 0025-729X 4 February 2002 176 2 118-121 broader community.1,2 Within the profession itself views differ sharply, from the conviction 2001 www.mja.com.au ©The Medical Journal of Australia that the risks associated with such relationships are minimal to a concern that all Clinical Ethics contact between doctors and industry involves compromise and should therefore be avoided as far as possible.3 The relationship between the pharmaceutical industry and the medical profession includes clearly desirable aspects (eg, the cooperative efforts of industry, government and prescribers in trying to achieve quality use of medicines) and less clearly ethically justifiable ones (eg, acceptance of lavish gifts and money for entertainment expenses by doctors).
Sources of concern
• Medical practitioners and the pharmaceutical industry serve interests that sometimes overlap and sometimes conflict. • There is strong evidence that associations between industry and doctors influence the behaviour of the latter in relation to both clinical decision making and the conduct of research. • In view of the risk of compromising relationships with patients and the integrity of the research process, doctors must exercise care in their dealings with industry. • The basic principles underlying the conduct of doctors with respect to pharmaceutical companies should be openness and transparency. • Clearly articulated procedures should be developed to deal with specific issues such as travel subsidies, receipt of gifts, sponsorship of conferences and continuing education activities, and dualities of interest