This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Mary-Margaret Chren, MD; C. Seth Landefeld, MD; Thomas H. Murray, PhD

JAMA. 1989;262(24):3448-3451.

Abstract
Doctors often accept gifts from drug companies. We analyze this practice and conclude that accepting a gift has complex practical and ethical repercussions. Gifts cost patients money, and they may change society's perception of the profession as serving the best interest of patients. Also, accepting a gift establishes a relationship between the physician and the drug company that obliges a response from the physician. Accepting gifts and the resulting relationship have ethical implications as well. First, the use of patients' money to pay for gifts can be unjust. Second, the fiduciary relationship between physician and patient may be threatened if prescribing practices are affected (as intended by the drug company). Third, physicians' characters may be altered by a practice that fosters self-interest at patients' expense. We discuss the need for guidelines for the profession to help physicians promote their patients' well-being.

(JAMA. 1989;262:3448-3451)

Author Affiliations
From the Department of Dermatology (Dr Chren); the Division of General Internal Medicine and the Clinical Analysis Project, Department of Medicine (Dr Landefeld); and the Center for Biomedical Ethics (Dr Murray), Case Western Reserve University School of Medicine and University Hospitals of Cleveland (Ohio).

Footnotes
Reprint requests to the Department of Dermatology, University Hospitals of Cleveland, 2074 Abington Rd, Cleveland, OH 44106 (Dr Chren).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Corporate influences on epidemiology
Pearce
Int J Epidemiol 2008;37:46-53.
ABSTRACT | FULL TEXT  

Is continuing medical education a drug-promotion tool?: YES
Steinman and Baron
cfp 2007;53:1650-1653.
FULL TEXT  

La formation medicale continue est-elle un outil de promotion pharmaceutique?: OUI
Steinman and Baron
cfp 2007;53:1654-1657.
FULL TEXT  

The Role of the Pharmaceutical Industry in Teaching Psychopharmacology: A Growing Problem
Brodkey
Acad. Psychiatry 2005;29:222-229.
ABSTRACT | FULL TEXT  

The Company We Keep: Why Physicians Should Refuse to See Pharmaceutical Representatives
Brody
Ann Fam Med 2005;3:82-85.
ABSTRACT | FULL TEXT  

Ethical Concerns in Industry Support of Continuing Medical Education: The Con Side
Packer and Parke
Arch Ophthalmol 2004;122:773-776.
FULL TEXT  

Are Gifts From Pharmaceutical Companies Ethically Problematic?: A Survey of Physicians
Brett et al.
Arch Intern Med 2003;163:2213-2218.
ABSTRACT | FULL TEXT  

Policies to Regulate Gifts to Physicians From Industry
Tsai
JAMA 2003;290:1776-1776.
FULL TEXT  

Predictors of Broad-Spectrum Antibiotic Prescribing for Acute Respiratory Tract Infections in Adult Primary Care
Steinman et al.
JAMA 2003;289:719-725.
ABSTRACT | FULL TEXT  

Physician-Industry Relations. Part 1: Individual Physicians
Coyle and for the Ethics and Human Rights Committee, America
ANN INTERN MED 2002;136:396-402.
ABSTRACT | FULL TEXT  

Accepting commercial sponsorship
Bero
BMJ 1999;319:653-654.
FULL TEXT  

Advertising Policies of Medical Journals: Conflicts of Interest for Journal Editors and Professional Societies
Orentlicher and Hehir
J Law Med Ethics 1999;27:113-121.
 

Personal Use of Drug Samples by Physicians and Office Staff
Westfall et al.
JAMA 1997;278:141-143.
ABSTRACT  

Physicians, Pharmaceutical Sales Representatives, and the Cost of Prescribing
Caudill et al.
Arch Fam Med 1996;5:201-206.
ABSTRACT  

A Food-Borne Outbreak of Expensive Antibiotic Use in a Community Teaching Hospital
Shorr and Greene
JAMA 1995;273:1908-1908.
ABSTRACT  

Professional Boundaries in the Physician-Patient Relationship
Gabbard and Nadelson
JAMA 1995;273:1445-1449.
ABSTRACT  

Patient Perceptions of Physician Acceptance of Gifts From the Pharmaceutical Industry
Mainous et al.
Arch Fam Med 1995;4:335-339.
ABSTRACT  

Independent Investigators and For-Profit Companies: Guidelines for Biomedical Scientists Considering Funding by Industry
Chren
Arch Dermatol 1994;130:432-437.
ABSTRACT  

Physicians' Behavior and Their Interactions With Drug Companies: A Controlled Study of Physicians Who Requested Additions to a Hospital Drug Formulary
Chren and Landefeld
JAMA 1994;271:684-689.
ABSTRACT  

Genetic Testing and the Social Responsibility of Private Health Insurance Companies
Jecker
J Law Med Ethics 1993;21:109-116.
 

The Many Ways of Marketing Artificial Baby Milk
Auerbach
J Hum Lact 1992;8:61-62.
 

Pharmaceutical Advertisements in Leading Medical Journals: Experts' Assessments
Wilkes et al.
ANN INTERN MED 1992;116:912-919.
ABSTRACT  

Impact of Pharmaceutical Company Representatives on Internal Medicine Residency Programs: A Survey of Residency Program Directors
Lichstein et al.
Arch Intern Med 1992;152:1009-1013.
ABSTRACT  

Gifts to Physicians From Industry
Goldstein
JAMA 1991;266:61-61.
ABSTRACT  

Gifts to Physicians From Industry-Reply
Randall
JAMA 1991;266:63-63.
ABSTRACT  

Cost-Benefit Issues in the Practice of Internal Medicine
Friedman and Katt
Arch Intern Med 1991;151:1165-1168.
ABSTRACT  

Of Mugs and Marketing
Goldstein
JAMA 1991;265:2391-2392.
ABSTRACT  

Editors and Advertisements: What Responsibility Do Editors Have for the Advertisements in Their Journals?
Rennie
JAMA 1991;265:2394-2396.
ABSTRACT  

Exhibitor "Giveaways": A Curmudgeon's View
BERGER
Arch Pediatr Adolesc Med 1991;145:427-428.
ABSTRACT  

Physicians, Lenses, and Myopia
Packer
Arch Ophthalmol 1990;108:1671-1671.
ABSTRACT  

Attitudes of Internal Medicine Faculty and Residents Toward Professional Interaction With Pharmaceutical Sales Representatives
McKinney et al.
JAMA 1990;264:1693-1697.
ABSTRACT  

Physicians and the Pharmaceutical Industry
Goldstein
ANN INTERN MED 1990;113:407-408.
ABSTRACT  

Doctors, Drug Companies, and Gifts
Gorski
JAMA 1990;263:2177-2177.
ABSTRACT  

Doctors, Drug Companies, and Gifts
Gelbart
JAMA 1990;263:2177-2177.
ABSTRACT  

Doctors, Drug Companies, and Gifts
Hume
JAMA 1990;263:2177-2178.
ABSTRACT  

Practice Policies--What Are They?
Eddy
JAMA 1990;263:877-880.
ABSTRACT