Academic Medicine: Journal of the Association of American Medical Colleges
The pharmaceutical industry's wide range of interactions with physicians, trainees, and other medical professionals--interactions that include information transfer and financial incentives--has been the source of undue influences, especially on physicians' prescription behavior. Current literature has mainly been focused on the financial element of these influences, and the problems in medical professional-pharmaceutical industry interactions are mainly viewed in terms of conflicts of interest.
A conflict of interest in scientific and medical research "between the investigation and correct treatment of illness ... and the financial objective of making a profit" was addressed in a papal message to an April 5-6 international conference on conflicts of interest in science and medicine sponsored by the Polish Academy of Sciences. The Vatican released the papal message April 11, which was addressed as a letter to Archbishop Jozef Kowalczyk, apostolic nuncio to Poland.
A Christian analysis of the moral conflicts that exist among physicians and health care institutions requires a detailed treatment of the ethical issues in managed care. To be viable, managed care, as with any system of health care, must be economically sound and morally defensible. While managed care is per se a morally neutral concept, as it is currently practiced in the United States, it is morally dubious at best, and in many instances is antithetical to a Catholic Christian ethics of health care.
Medical bribery seems to be a global problem from Eastern Europe and the Balkans to China, a diffuse phenomenon, starting with morally acceptable gratitude and ending with institutional bribery. I focus my attention on Romania and analyze similar cases in Eastern European and postcommunist countries. Medical bribery can be regarded as a particular form of human transaction, a kind of primitive contract that occurs when people do not trust institutions or other forms of social contract that are meant to guarantee their rights and protect their interests.
In this article we will examine the relation between physicians and (representatives of) the pharmaceutical industry. More in particular we want to discuss the appropriateness of some of the gifts that are given to physicians by companies in the pharmaceutical (and medical equipment) industry, since there has been growing concern about the potential negative consequences of these so-called 'gift-giving practices'.
Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
Referral patterns of physicians have a direct impact upon the care of patients, particularly in obstetrics and gynecology. The choice of referral is influenced by the history of specialization, physician altruism, and intricate patterns of financial conflicts of interest. The conflicts of interest are further obscured by the lack of clear definition of roles and responsibilities for generalist, specialist, and subspecialist. Alternate patterns for referral based on financial incentives or directed referral care plans are reviewed to examine the potential conflicts of interest.
The Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
While engaged in interviewing stroke patients, nurses found their research responsibilities conflicting with traditional patient care values. At the termination of the pilot project, the nurses, doubting their role, shared their concerns with the research team. They made recommendations regarding the appropriateness of tools and training needs of research assistants. Unresolved role conflict motivated the nurses to review the literature, seeking answers to the issue. Other nurses have experienced this same conflict.
Annals (Royal College of Physicians and Surgeons of Canada)
With increasing economic, political, and bureaucratic involvement in research, there is little focus on the medical researcher's idealistic and benevolent intentions. Benevolence is a pillar of ethical human-subjects research, and altruism is a form of benevolence that is difficult to quantify. It is interest in the welfare of others without personal benefit. This article examines the extent of altruism in medical research from philosophical, psychological, and practical points of view.
The Journal of Law, Medicine & Ethics: A Journal of the American Society of Law, Medicine & Ethics
We seem to prefer that medicine and medical care be provided through altruistic motives. Even the pharmaceutical industry justifies its behavior in terms of altruistic purposes. But economists have known since Adam Smith that self-interested behavior can create large and growing social benefits. This is true for medical care as well as for other goods. First, I consider specifically the case of pharmaceutical promotion, both to physicians and to consumers. I argue that such promotion is highly beneficial to patients and leads to health improvements.
This paper reflects on some amendments to the Declaration of Helsinki in 2008. It focuses on former paragraphs 5 (now 6) and 19 (now 17). Paragraph 5 suggested that the wellbeing of research participants should take precedence over the interests of science and society. Paragraph 6 now proposes that it should take precedence over all other interests. Paragraph 19, and the new paragraph 17, suggest that research involving the members of a disadvantaged population is only justified if the clinical trial is likely to benefit them.