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Healthy Skepticism Library item: 16469

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Van Der Weyden MB
Confronting conflict of interest
eMJA 2009; 191:(5):241
http://www.mja.com.au/public/issues/191_05_070909/martin_070909.html


Abstract:

Recently, a French medical organisation initiated legal action against nine doctors for failing to disclose their relationships with drug and other medical industries. At the same time, federal legislators in the United States are moving to enforce mandatory disclosure of industry gifts and payments to doctors on a public website. Indeed, Senator Chuck Grassley of the Senate Committee on Finance is in open conflict with US medical schools over their non-disclosure of drug-firm gifts and payments to faculty members, and is threatening to withhold federal funds. Such developments are testament to an accelerating campaign to confront conflict of interest.

Earlier this year, the US Institute of Medicine (IOM) released a comprehensive report on conflict of interest, covering medical research, education and practice, as well as individual and institutional circumstances. The report advanced wide-ranging recommendations for the handling of conflict of interest in order to “protect the integrity of professional judgment and to preserve public trust”. Closer to home, the National Health and Medical Research Council (NHMRC) is currently reviewing its policy on conflict of interest.

It is perhaps surprising that a profession which prides itself on ethical performance should continue to be plagued by lack of transparency in this one area.

But history repeatedly attests to the lure of financial advantage. The IOM has thus recommended that Congress enact legislation requiring companies and their foundations to publicly report payments and gifts made to both individuals and institutions, whether they be physicians or non-physicians prescribing drugs or using medical devices, biomedical researchers, professional societies, continuing medical education providers, or specific patient advocacy groups.

Sadly, our approach to conflict of interest is hopelessly fragmented. The time has come for rhetoric to give way to binding recommendations based on the US model. To make this happen, we need committed leadership and a national organisation with clout.

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909