Members of the Council on Ethical and Judicial Affairs include Robert M. Tenery, Jr, MD (chair), Dallas, Tex; Herbert Rakatansky, MD (vice chair), Providence, RI; Alan Hartford, MD, PhD (resident), Boston, Mass; John C. Madden III (student), Brentwood, Mo; Leonard J. Morse, MD, Worster, Mass; John M. O'Bannon III, MD, Richmond, Va; Frank A. Riddick, Jr, MD, New Orleans, La; Victoria Ruff, MD, Columbus, Ohio; George T. Wilkins, Jr, MD, Culver, Ind; Charles W. Plows, MD (former chair), Santa Ana, Calif; Linda L. Emanuel, MD, PhD (vice president, ethics standards), Chicago, Ill; Stephen R. Latham, JD, PhD (acting council secretary and staff author), Chicago; H. Nina Kim (staff associate), Chicago; Blaire S. Osgood (staff associate), Chicago.
A number of physicians are engaged in the sale, from their offices,
of such non–health-related goods as household products and magazine
subscriptions.1 This report addresses certain
important ethical problems with such sales and sets guidelines for the sale
of such goods in those few circumstances when it is appropriate.
The for-profit sale of goods to patients by physicians inherently creates
a conflict of interest. Physicians engaging in this activity have a direct
financial interest in selling the goods to patients, but the sale may or may
not be in the best interests of the patients. Physicians may be tempted to
sell items for profit even though their patients do not need the products.
Even if most physicians are capable of resisting such temptation, the ethical
course is for professionals to avoid placing themselves in temptation's way.
This conflict of interest is particularly troubling in the office setting,
where most patients appear because they need medical attention. In the ordinary
market setting, consumers can be trusted not to purchase items they do not
want; thus, a voluntary sales transaction is taken to be in the best interests
of both parties. But the voluntariness of any sale to a patient in a medical
office setting is open to serious question.
Council on Ethical and Judicial Affairs, American Medical Association . Sale of Non–Health-Related Goods From Physicians' Offices. JAMA. 1998;280(6):563. doi:10.1001/jama.280.6.563