Weekend reading: doctors pitching drugs, ethics in med school, and East-West divides over biotechnology

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NYT Mag: Dr. Drug Rep
Daniel Carlat, a psychiatrist, recount his year as a “Lunch and Learn” speaker for Wyeth:

Was I swallowing the message whole? Certainly not. I knew that this was hardly impartial medical education, and that we were being fed a marketing line. But when you are treated like the anointed, wined and dined in Manhattan and placed among the leaders of the field, you inevitably put some of your critical faculties on hold. I was truly impressed with Effexors remission numbers, and like any physician, I was hopeful that something new and different had been introduced to my quiver of therapeutic options.

At the end of the last lecture, we were all handed envelopes as we left the conference room. Inside were checks for $750. It was time to enjoy ourselves in the city.

Lancet Student: Letter to a new medical student
Daniel Sokol encourages medical students to keep ethics in mind:

Throughout your training, you will be exposed to the scientific and technical components of medicine. You will wonder at, and on occasion curse, the sheer volume of medical and biochemical knowledge acquired over the centuries. We have come a long way from the days of supernatural explanations of disease, and Galens long-standing belief that illness was caused by an imbalance of four humours. The ethical aspect will not feature as much as the technical and the temptation will be to dismiss ethics as irrelevant, unimportant or inconvenient to the immediate task of helping the patient.

My message is this: do not yield to this temptation, however strong, but take the ethical issues in medicine as seriously as you do the technical ones. This doesnt mean devouring textbooks on medical ethics. It means simply seeing ethics as integral to the proper care of your patients. Just as you want to increase your understanding of the factual aspects of medicine, so should you want to deepen your moral understanding. Your ability to perceive moral issues, to reason through ethical problems in search of a solution, and to act upon your decision is inextricably linked to your future success as a doctor

NYT: Are Scientists Playing God? It Depends on Your Religion
John Tierney looks at religious — and geographical — differences in how people view biotechnology:

Asia offers researchers new labs, fewer restrictions and a different view of divinity and the afterlife. In South Korea, when Hwang Woo Suk reported creating human embryonic stem cells through cloning, he did not apologize for offending religious taboos. He justified cloning by citing his Buddhist belief in recycling life through reincarnation.

When Dr. Hwangs claim was exposed as a fraud, his research was supported by the head of South Koreas largest Buddhist order, the Rev. Ji Kwan. The monk said research with embryos was in accord with Buddhas precepts and urged Korean scientists not to be guided by Western ethics.

Asian religions worry less than Western religions that biotechnology is about playing God, says Cynthia Fox, the author of Cell of Cells, a book about the global race among stem-cell researchers. Therapeutic cloning in particular jibes well with the Buddhist and Hindu ideas of reincarnation.

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