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To the Editor: The majority of the recommendations made by Dr Brennan and colleagues¹ are necessary if somewhat overdue. Their discussion mirrors the conclusion of Healthy Skepticism in Australia—that at the present state of medical knowledge, we cannot "manage" gifts and financial exchanges with the pharmaceutical industry in such a way that we insure a greater likelihood of benefit than harm to patients.²

However, I dissent from their acceptance of industry grants directly to AMCs, and their confidence in the ability of those centers to effectively manage the financial pressures those grants represent so long as there is sufficient publicity and transparency. The track record is not optimistic for academic institutions' ability to adhere to the values of public health and good science when large amounts of cash are at stake.^3-4

A better solution would be to first demand a mandatory public registry of clinical trials, and then to move . . . [Full Text of this Article]

Howard Brody, MD, PhD
brody@msu.edu
Department of Family Practice
Michigan State University
East Lansing

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