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Healthy Skepticism Library item: 1917

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

Wall LL, Brown D.
Pharmaceutical sales representatives and the doctor/patient relationship.
Obstet Gynecol 2002 Sep; 100:(3):594-9
http://www.greenjournal.org/cgi/content/full/100/3/594


Abstract:

As marketing efforts by drug companies become more aggressive, physicians are being asked to provide clinical “preceptorships” to pharmaceutical sales representatives. During a “preceptorship” of this type, the company representative spends a day with the physician seeing patients “as an educational experience,” and the physician receives an “honorarium” from the drug company in return. We explore the implications of this practice. First, we examine the nature of the doctor/patient relationship and the fiduciary obligations incumbent upon physicians in their role as healers. Second, we examine four interlocking ethical principles-nonmaleficence, beneficence, respect for patient autonomy, and justice-that should govern doctor/patient encounters. Third, we critique several hypothetical scenarios involving individuals who might put forth a claim to enter the doctor/patient relationship (ie, a pharmacist, a social scientist, the husband of the patient, and a pharmaceutical sales representative). We conclude that the practice of providing clinical “preceptorships” to pharmaceutical sales representatives is unjustifiable, is unethical, and should not be permitted.

Keywords:
Beneficence Commerce Drug Industry/standards* Drug Industry/trends Economics, Pharmaceutical Humans Interprofessional Relations* Physician's Practice Patterns Physician-Patient Relations Prescriptions, Drug/statistics & numerical data* United States

 

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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