The most useful ethical discussions are those that force us to examine our values, motives, and behaviors, that highlight the conflicting values and goals inherent in most real-life situations, and that lead us to make changes based on what we discover. Although there are some cases in which black-and-white thinking is appropriate ("Should I seduce this patient?" "Should I send some fraudulent billings to Medicare today?"), most cases are less useful when reduced to that paradigm. In discussions of the interactions between clinical or academic medicine and the pharmaceutical industry, black-and-white thinking leads to two tempting but indefensible endpoints. The first is that physicians are immune to marketing and are at liberty to engage in whatever activity they wish without regard for possible conflicts of interest. This position is at odds with a substantial body of evidence showing that marketing clearly affects physician practice (1), even when they do not believe it is occurring (2). The counterposition is that industry is inherently corrupt and corrupting to any who have contact with it. Thus, the ethical stance is to maintain total separation of physicians from industry. This position is both implausible and unwise, failing to acknowledge the importance of
Medical Education and the Pharmaceutical Industry: Managing an Uneasy Alliance
Abstract
The most useful ethical discussions are those that force us to examine our values, motives, and behaviors, that highlight the conflicting values and goals inherent in most real-life situations, and that lead us to make changes based on what we discover. Although there are some cases in which black-and-white thinking is appropriate ("Should I seduce this patient?" "Should I send some fraudulent billings to Medicare today?"), most cases are less useful when reduced to that paradigm. In discussions of the interactions between clinical or academic medicine and the pharmaceutical industry, black-and-white thinking leads to two tempting but indefensible endpoints. The first is that physicians are immune to marketing and are at liberty to engage in whatever activity they wish without regard for possible conflicts of interest. This position is at odds with a substantial body of evidence showing that marketing clearly affects physician practice (1), even when they do not believe it is occurring (2). The counterposition is that industry is inherently corrupt and corrupting to any who have contact with it. Thus, the ethical stance is to maintain total separation of physicians from industry. This position is both implausible and unwise, failing to acknowledge the importance of
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Medical Education and the Pharmaceutical Industry: Managing an Uneasy Alliance
Jibson, Michael D.
Follow Academic Psychiatry
, Volume 30 (1): 36
American Psychiatric Publishing, Inc (Journal) – Feb 1, 2006
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