May 2004

Ethical Concerns in Industry Support of Continuing Medical EducationThe Con Side

Author Affiliations



Copyright 2004 American Medical Association. All Rights Reserved.Applicable FARS/DFARS Restrictions Apply to Government Use.2004

Arch Ophthalmol. 2004;122(5):773-776. doi:10.1001/archopht.122.5.773

The American Medical Association (AMA), Chicago, Ill, has led the wayin alerting physicians to the ethical concerns that relate to industry supportof educational activities.1,2 Weagree with their analysis and are realistic as to the benefits that can accrueto patients from constructive interactions between physicians and for-profithealth care corporations. Many different types of activities fall under theumbrella of such professional interactions. This article focuses on the ethicalconcerns that may arise when there is financial support from industry forcontinuing medical education (CME). We would like to state clearly that weare not a priori against industry support of medical education, rather thatit raises many concerns. These concerns arise in part from the dilemmas posedby the commercialization of medicine. Stated another way, the best interestsof corporate shareholders are the fiduciary responsibility of corporations,whereas the best interests of patients are the fiduciary responsibility ofphysicians. This does not place corporations and physicians necessarily inconflict but all parties must remain vigilant to ensure that they retain thetrust of their constituencies. This vigilance historically has not alwaysbeen uniformly exercised. For officers and directors of a corporation, thereis a direct legal obligation to act in the best interests of stockholders,and if they do not, they may incur a substantial civil liability. For physicians,there are not only the legal responsibilities of care but also the ethicalobligations of the profession. The pharmaceutical industry has recently raisedthe level of commitment to patients with the new PhRMA (Pharmaceutical Researchand Manufacturers of America, Washington, DC) code.3