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To the Editor: It was gratifying to read the American Medical Association's statement on the sale of non–health-related goods from physicians' offices, generally condemning this practice. However, the sale of certain "health-related" items should also be scrutinized.

Anecdotally, I have noticed the sale of high-dose vitamin and mineral supplements from physicians' offices. The excess mortality observed in the Alpha-Tocopherol Beta Carotene Cancer Prevention Study² and the Beta-Carotene and Retinol Efficacy Trial³ in groups receiving vitamin supplementation for chemoprevention should give pause not only to physicians who recommend supplements in the absence of demonstrated benefit from well-designed randomized controlled trials but also to those who peddle these products.

Andrea Lyman, MD, MSCM
New York, NY

1. Council on Ethical and Judicial Affairs, American Medical Association. Sale of non–health-related goods from physicians' offices. JAMA. 1998;280:563. FREE FULL TEXT 2. The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. The effects of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med. 1994;330:1029-1035. FREE FULL TEXT 3. Omenn GS, Goodman GE, Thornquist MD, et al. Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease. N Engl J Med. 1996;334:1150-1155. FREE FULL TEXT

In Reply: Dr Lyman raises an issue about which the Council on Ethical and Judicial Affairs is also concerned. In fact, the council is currently drafting guidelines that will address the practice of selling health-related goods. . . . [Full Text of this Article]

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Sale of Non–Health-Related Goods From Physicians' Offices
Council on Ethical and Judicial Affairs, American Medical Association
JAMA. 1998;280(6):563.
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