Is it ethical for doctors to work in cahoots with big pharma?
Depends on how you frame it. Many of the restrictions have been placed on doctor/pharma collaborations in recent years – and critics are now asking, have we gone too far?
Julia Belluz at Vox has analyzed how this conflict-of-interest debate is playing out these days.
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The case for curtailing pharma’s influence on doctors has been well-established: The ski trips and the swag have a dubious ethical edge. The past 15 years have heralded many new rules to keep this behavior in check, and increase transparency.
But as Belluz points out:
Now experts are debating whether these measures have gone too far. There’s an interesting back-and-forth between doctors in the New England Journal of Medicine and the British Medical Journal on whether conflicts of interest are actually a huge problem in medicine — and whether efforts to regulate them do more harm than good.
The other side of the coin, Belluz writes, is “whether these conflict-of-interest policies are rational — or simply driven by moral outrage and knee-jerk anti-Pharma attitudes that aren’t evidence-based.”
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Cardiologist Lisa Rosenbaum penned a three-part series (here’s part 1, part 2, and part 3) that centers on this conflict-of-interest debate – and how we’ve come to a point where any collaboration between pharma and physicians is viewed as suspect. She wrote in NEJM:
“Recently, for the first time, I was asked to consult for a medical products company. My first thought was, ‘This would be fascinating.’ My second was, ‘There’s no way.’ I would have to disclose the relationship, my credibility would suffer, and I would be defenseless. That I immediately succumbed to this fear reflects our failure to manage industry relationships effectively.”
The idea is that doctors and drugmakers should theoretically have similar goals and similar ends, Belluz points out. This stigma could delay a drug’s entrance to market, if doctors aren’t willing to test its efficacy. Or that research projects that would require physician/private sector collaboration don’t ever get off the ground for fear of crossing these ethical boundaries.
But the British Medical Journal piece rebuts this opinion – suggesting that journalists and judges are barred from having financial relationships with the private sector so as to keep them unbiased. Doctors are no different, it says, and that having credibility eroded by ties to pharma just isn’t worth it.
