Virtual Mentor. January 2005, Volume 7, Number 1.
Case 6.1: Gifts from Industry—The Cost of Lunch
Throughout this discussion, "industry" refers to all "proprietary health-related entities that might create a conflict of interest." While relationships between industry and the medical community have resulted in important benefits for patient care, there has been growing concern about the potential negative consequences of the relationship. In particular, commentators have increasingly questioned the appropriateness of some of the gifts and other subsidies that are given to physicians by companies in the pharmaceutical, device, and medical equipment industries. Some of these gifts and subsidies may have inappropriate effects and are therefore cause for concern. Accordingly, Opinion 8.061, "Gifts to Physicians from Industry" addresses the appropriateness of gifts given to physicians by health care industries.
Some of the gift-giving practices by industry are ethical and beneficial to patients. Nonetheless, the practice of gift giving raises a number of ethical concerns. First, industry invests in promotional activities because promotions increase sales. There is no evidence that physicians knowingly or intentionally compromise their patients' care as a result of gifts from industry. Nevertheless, the practice of gift giving may subtly influence practice patterns such that they are based on considerations other than scientific knowledge and patient needs. Moreover, gifts may also affect a physician's continuing education because physicians only have time to attend a limited number of conferences, and industry can make their conferences more attractive by subsidizing the costs of attending.
Second, even if gifts from industry have no effect on a physician's practices, there may be a public impression of impropriety, especially if the gifts are of substantial value. Public trust in physicians may be undermined if it appears that the choice of a drug, device, or other product is influenced by the fact that the physician received a gift from the company that manufactures the product.
Finally, the costs of gifts from industry to physicians are ultimately passed on to the public. In effect, patients pay for a benefit that may be experienced primarily by their physicians.
For further discussion of this topic, see also the "Clarification of Opinion 8.061, Gifts to Physicians from Industry" in the Code, and see <www.ama-assn.org/go/ethicalgifts>, especially module 4.
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