To the Editor.
—Dr Westfall and colleagues1 seem to be in an unnecessary quandary over the ethical implications of the personal use of drug samples by physicians. The practice is unethical because it violates at least 3 duties of physicians.2 The duty to do no harm—primum non nocere—is violated because samples raise the cost of care to patients, in that samples generate cost, ultimately paid for by patients, beyond the accepted cost of research, production, and marketing. Presumably patients have other uses for the resources that pay for physician samples. Another possible harm is through the possible improper use of medicines, as suggested by Westfall et al. The duty of fidelity—the obligation to serve the interests of the patient—is transgressed because the acceptance of samples for personal use makes the physician an agent of the pharmaceutical companies that provide them. The conflict of interest between serving
Margolis LH. Personal Use of Drug Samples by Physicians and Office Staff. JAMA. 1997;278(19):1567. doi:10.1001/jama.1997.03550190031021