Physicians, scholars call for medical ethics reform

Doctors should not accept drug samples, junkets or even ballpoint pens from drug or medical-device companies, says a group of leading physicians and scholars in a sweeping new call for ethical reform in medicine.

In today’s Journal of the American Medical Association, 11 experts warn that the financial ties between physicians and drug and device vendors are undermining scientific integrity and patient care.

The authors labeled existing guidelines ineffective, and called on university-affiliated hospitals to take the lead in establishing stricter policies that would bar gifts, restrict corporate financial ties and require transparency in medical research contracts.

The recommendations mark the first high-profile effort from within the medical profession to broadly limit financial entanglements between doctors and companies. Authors said doctors must embark on reforms or face increased government regulation.

“If you don’t do it, it’s going to be done to you,” warned David Rothman, a co-chairman of the group who also is president of the Institute on Medicine as a Profession at Columbia University.

The pharmaceutical industry alone spends about 90 percent of its $21 billion marketing budget on efforts aimed at physicians, the JAMA article’s authors said. That’s an average of $13,000 a year per doctor – an outlay that the authors contend drives up the cost of medications and affects what gets prescribed.

“It’s clear that voluntary disclosure is not working and even small gifts can influence behavior,” said group co-chairman Dr. Troyen Brennan, a Harvard professor of medicine who last week was appointed chief medical officer of Aetna Inc.

Concerns about the influence of marketing on medical decisions have been on the rise, fueled recently by courtroom revelations about Merck &Co.’s lobbying of physicians for its now-banned blockbuster pain reliever Vioxx.

JAMA editor Dr. Catherine DeAngelis said she expects the new recommendations to stir controversy but views the debate as vitally important to patients.

“There’s some recommendations in there that I think are excellent,” she said. “Whether all or some of them will be enacted … I don’t know. I certainly hope that they would be.”

Among other recommendations, the authors said teaching hospitals should:

* Bar doctors from serving on manufacturers’ speakers bureaus or participating in articles ghostwritten by industry-paid authors.

* Exclude physicians who have ties to manufacturers from committees that decide what drugs and devices will be allowed at hospitals.

* Prohibit open-ended grants and gifts to physician researchers and post all consulting and research contracts on a public Web site.

Drug industry officials say doctors should be careful not to go too far. Pharmaceutical sales representatives provide information that ensures medications are used correctly and answer questions about how their drugs work and side effects, they say.

And a voluntary code adopted by the Pharmaceutical Research and Manufacturers of America three years ago works fine, said Ken Johnson, a senior vice president with the trade group.

“The code states that entertainment, expensive meals and gifts that are for personal use by the physician are not appropriate,” he said in a statement. “Only practices that do not compromise independent judgments of health providers, such as modest working meals, gifts of minimal value that support medical practice and distribution of free samples, are permitted.”

Talk to us

> Give us your news tips.

> Send us a letter to the editor.

> More Herald contact information.

More in Local News

Customers enter and exit the Costco on Dec. 2, 2022, in Lake Stevens. (Olivia Vanni / The Herald)
Costco stores could be impacted by looming truck driver strike threat

Truck drivers who deliver groceries and produce to Costco warehouses… Continue reading

Two Washington State ferries pass along the route between Mukilteo and Clinton as scuba divers swim near the shore Sunday, Oct. 22, 2023, in Mukilteo, Washington. (Ryan Berry / The Herald)
Ferry system increases ridership by a half million in 2024

Edmonds-Kingston route remains second-busiest route in the system.

A view of a homes in Edmonds, Washington on Friday, Sept. 8, 2023. (Olivia Vanni / The Herald)
Snohomish County to mail property tax statements this month

First half payments are due on April 30.

Ticket and ORCA card kiosks at the Lynnwood Light Rail station on Thursday, April 4, 2024 in Lynnwood, Washington. (Olivia Vanni / The Herald)
Beginning March 1, Community Transit to reduce some fares

Riders eligible for reduced fares will pay $1 for a single ORCA card tap and $36 for a monthly pass.

The amphitheater at Deception Pass during the 2021 concert series. (Photo provided by Deception Pass Park Foundation Facebook page.)
Deception Pass Foundation seeks Adopt-A-Trail volunteers

If you’re looking for a way to get outside and… Continue reading

Robin Cain with 50 of her marathon medals hanging on a display board she made with her father on Thursday, Jan. 2, 2025 in Lake Stevens, Washington. (Olivia Vanni / The Herald)
Running a marathon is hard. She ran one in every state.

Robin Cain, of Lake Stevens, is one of only a few thousand people to ever achieve the feat.

People line up to grab food at the Everett Recovery Cafe on Wednesday, Dec. 4, 2024 in Everett, Washington. (Olivia Vanni / The Herald)
Coffee, meals and compassion are free at the Everett Recovery Cafe

The free, membership-based day center offers free coffee and meals and more importantly, camaraderie and recovery support.

Devani Padron, left, Daisy Ramos perform during dance class at Mari's Place Monday afternoon in Everett on July 13, 2016. (Kevin Clark / The Herald)
Mari’s Place helps children build confidence and design a better future

The Everett-based nonprofit offers free and low-cost classes in art, music, theater and dance for children ages 5 to 14.

The Everett Wastewater Treatment Plant along the Snohomish River on Thursday, June 16, 2022 in Everett, Washington. (Olivia Vanni / The Herald)
Everett water, sewer rates could jump 43% by 2028

The rate hikes would pay for improvements to the city’s sewer infrastructure.

The bond funded new track and field at Northshore Middle School on Thursday, Oct. 24, 2024 in Bothell, Washington. (Courtesy of Northshore School District)
Northshore School District bond improvements underway

The $425 million bond is funding new track and field complexes, playgrounds and phase one of two school replacements.

A pedestrian is struck and killed by vehicle Wednesday in Everett

The pedestrian was a man in his 60s. The collision happened at 5:30 a.m. Wednesday.

Want coffee? Drink some with the Marysville mayor.

A casual question-and-answer session between mayor and constituents is planned for March 24.

Support local journalism

If you value local news, make a gift now to support the trusted journalism you get in The Daily Herald. Donations processed in this system are not tax deductible.