Hot Topics: Conflict of Interest

Blog Posts (13)

April 29, 2016

BioethicsTV: Boundaries are Black and White on Grey’s

by Craig Klugman, Ph.D.

Reaching back to its roots, Grey’s Anatomy in its 12th season has been investigating more professional and ethical challenges in medicine.…

March 1, 2016

Code Black Ends the Season on Bioethics

BioethicsTV is an occasional bioethics.net feature where we examine bioethical issues raised in televised medical dramas.

by Craig Klugman, Ph.D.

The season finale of Code Black (season 1; episode 18 – February 24, 2016) presented a plethora of ethical challenges for the hard working doctors and nurses of Angels Memorial Hospital’s emergency department.…

January 20, 2016

Putting Patients Before Publicity

by Craig Klugman, Ph.D.

Imagine if 5 million people learned about your hospital in a week. Would you want your hospital to be featured in a television reality show?…

October 12, 2015

An F.D.A. Commissioner With Ties to the Pharmaceutical Industry? Heaven Forbid?

<p style="font-size: 11.2px; line-height: 19.04px;"><span style="font-size: 11.2px; line-height: 19.04px;">On September 16, 2015, </span><a style="font-size: 11.2px; line-height: 19.04px;" href="http://www.nytimes.com/2015/09/16/health/cardiologist-nominated-to-be-head-of-fda.html">President Obama nominated</a><span style="font-size: 11.2px; line-height: 19.04px;"> the internationally known Duke University cardiologist-researcher </span><a style="font-size: 11.2px; line-height: 19.04px;" href="https://medicine.duke.edu/faculty/robert-m-califf">Robert M. Califf, MD</a><span style="font-size: 11.2px; line-height: 19.04px;">, to be Commissioner of Food and Drugs. He will replace</span><a style="font-size: 11.2px; line-height: 19.04px;" href="http://www.nytimes.com/2015/02/06/health/margaret-hamburg-fda-commissioner-stepping-down.html">Margaret Hamburg, MD</a><span style="font-size: 11.2px; line-height: 19.04px;">, who left the agency last March. Dr. Califf – a registered Democrat but well regarded by Senate Republicans – has served as </span><a style="font-size: 11.2px; line-height: 19.04px;" href="http://www.fda.gov/AboutFDA/CentersOffices/ucm452317.htm">Deputy Commissioner at the F.D.A.</a><span style="font-size: 11.2px; line-height: 19.04px;"> since February. The Senate must confirm the commissioner.</span></p> <p style="font-size: 11.2px; line-height: 19.04px;">Immediately prior to joining the F.D.A., Dr. Califf was professor of medicine and vice chancellor for clinical and translational research at Duke. While at Duke, he founded the Duke Clinical Research Institute and served as director of the Duke Translational Medicine Institute. A highly esteemed expert in cardiovascular medicine, health outcomes research, healthcare quality, and clinical research, Dr. Califf has led many landmark clinical trials and authored or co-authored over 1,200 publications in the peer-reviewed literature. He is one of the American Medicine’s most frequently cited authors in the biomedical sciences. His credentials are unimpeachable. Two of Dr. Califf’s area of interests are improving the design of drug research projects and streamlining the regulatory process to bring innovative drugs to market more quickly.</p> <p><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.04px;"><strong>The Alden March Bioethics Institute offers a Master of Science in Bioethics, a</strong> </span><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.04px;">Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="http://www.amc.edu/Academic/bioethics/index.cfm">website</a>.</strong></p>
September 25, 2015

Drug Price Hikes and the Misguided Profit Imperative

by Craig Klugman, Ph.D.

Headlines this past week were abuzz with news that Daraprim—a drug that has fought parasitic infections such as toxoplasmosis for 62 years—saw its price hiked by 5500%, nearly overnight.…

April 8, 2015

Is a gift of ribs “slightly unethical” in the physician-patient relationship?

by Craig Klugman, Ph.D.

In an editorial in the Chicago Tribune, a physician tells the story of an underserved patient who owned a rib joint.…

December 8, 2014

Marketing Extremes That Even Give Big Pharma Supporters Pause

<p class="MsoNormal" style="line-height: 22.3999996185303px;"><span style="line-height: 22.3999996185303px;">On November 28, 2014, </span><em style="line-height: 22.3999996185303px;">The New York Times</em><span style="line-height: 22.3999996185303px;"> broke another story about Big Pharma marketing extremes. Reported by Katie Thomas and titled “<a href="http://www.nytimes.com/2014/11/28/business/drug-maker-gave-large-payments-to-doctors-with-troubled-track-records.html">Using Doctors With Troubled Pasts to Market a Painkiller</a>”</span><span style="line-height: 22.3999996185303px;">, the article reveals that one drug manufacturer is taking usual and customary sales strategies beyond the reasonable.</span></p> <p class="MsoNormal" style="line-height: 22.3999996185303px;"><span style="line-height: 22.3999996185303px;">It is </span><a style="line-height: 22.3999996185303px;" href="http://www.pewtrusts.org/en/research-and-analysis/fact-sheets/2013/11/11/persuading-the-prescribers-pharmaceutical-industry-marketing-and-its-influence-on-physicians-and-patients">independently reported</a><span style="line-height: 22.3999996185303px;"> that pharmaceutical manufacturers spent as much as $27 billion in 2012 to promote their products.  (Curiously during the same year, Big Pharma itself reported spending about $48 billion on the research and </span><a style="line-height: 22.3999996185303px;" href="http://www.phrma.org/sites/default/files/pdf/PhRMA%20Profile%202013.pdf">development of new drugs</a><span style="line-height: 22.3999996185303px;">.  However, some believe the research and development </span><a style="line-height: 22.3999996185303px;" href="http://www.sciencedaily.com/releases/2008/01/080105140107.htm">costs are overstated</a><span style="line-height: 22.3999996185303px;"> because government grant support and marketing and other expenses are included in the totals.)</span></p> <p class="MsoNormal" style="line-height: 22.3999996185303px;"><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="text-decoration: underline; color: #000099;" href="/Academic/bioethics/index.cfm">website</a>.</strong><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;"> </span></p>
December 2, 2014

Marketing Extremes That Even Give Big Pharma Supporters Pause

<p style="line-height: 19.0400009155273px;"><span style="line-height: 19.0400009155273px;">On November 28, 2014,The New York Times broke another story about BigPharma marketing extremes. Reported by Katie Thomas and titled “<a href="http://www.nytimes.com/2014/11/28/business/drug-maker-gave-large-payments-to-doctors-with-troubled-track-records.html">Using Doctors With Troubled Pasts to Market a Painkiller</a>”, the article reveals that one drug manufacturer is taking usual and customary sales strategies beyond the reasonable.</span></p> <p style="line-height: 19.0400009155273px;">It is independently reported that pharmaceutical manufacturers spent as much as <a href="http://www.pewtrusts.org/en/research-and-analysis/fact-sheets/2013/11/11/persuading-the-prescribers-pharmaceutical-industry-marketing-and-its-influence-on-physicians-and-patients">$27 billion in 2012</a> to promote their products. (Curiously during the same year, Big Pharma itself reported spending about <a href="http://www.phrma.org/sites/default/files/pdf/PhRMA%20Profile%202013.pdf">$48 billion</a> on the research and development of new drugs. However, some believe the research and development costs are overstated because government grant support and marketingand other expenses are <a href="http://www.sciencedaily.com/releases/2008/01/080105140107.htm">included in the totals</a>.)</p> <p><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="/Academic/bioethics/index.cfm">website</a>.</strong></p>
September 30, 2014

Dollars to Doctors: Sun Rises on Sunshine Act’s Open Payments Database

by Craig Klugman, Ph.D.

Today, Tuesday, September 29, the Centers for Medicare and Medicaid Services will release most of the Open Payments database.…

March 7, 2014

GlaxoSmithKline and Conflicts of Interests

<p class="MsoNormal" style="line-height: 22.399999618530273px;">A <em><a href="http://www.nytimes.com/2013/12/17/business/glaxo-says-it-will-stop-paying-doctors-to-promote-drugs.html">New York Times</a></em><a href="http://www.nytimes.com/2013/12/17/business/glaxo-says-it-will-stop-paying-doctors-to-promote-drugs.html"> article</a> by Katie Thomas published on December 16, 2013 led with this sentence: “The British drug maker GlaxoSmithKline will no longer pay doctors to promote its products and will stop tying compensation of sales representatives to the number of prescriptions doctors write, its chief executive said Monday, effectively ending two common industry practices that critics have long assailed as troublesome conflicts of interest.” Might one ask: Are these really conflict of interests problems?</p> <p class="MsoNormal" style="line-height: 22.399999618530273px;">A <em>conflict of interest</em> (so sometimes, <em>conflict of interests</em>) is <a href="http://www.nejm.org/doi/full/10.1056/NEJM199308193290812">often defined as</a>: “a set of circumstances that creates a risk that professional judgment or actions regarding a primary interest will be unduly influenced by a secondary interest.”  In a short introduction to conflicts of interests, written for a business ethics class at the McCombs School of Business at the University of Texas at Austin, Dr. Lamar Pierce (Associate Professor of Strategy, Olin Business School, Washington University, St. Louis) said:</p> <p class="MsoNormal" style="line-height: 22.399999618530273px; padding-left: 60px;"><span style="color: #434343;">Incentives are pervasive in every aspect of society. People are rewarded for taking certain actions, and not rewarded for taking others. Workers are paid for their effort and productivity, salespeople are paid for their sales, and small business owners are rewarded with profits for successful ventures. So long as these incentives are well-understood by everyone, they work reasonably well. They motivate effort, performance, and social welfare. But sometimes, individuals have incentives that conflict with their professional responsibilities, often in ways that are not transparent to the public or in their own minds. These conflicts of interest produce serious economic and social problems.</span></p> <p class="MsoNormal" style="line-height: 22.399999618530273px;"><span style="color: #434343;"></span><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 20px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="/Academic/bioethics/index.cfm">website</a>.</strong></p>

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News (41)

January 15, 2016 3:59 pm

Heart doctors outraged Florida dumps hospital standards after big gifts to GOP

The state of Florida is putting thousands of children with heart defects at risk, a group of cardiac doctors say, because of a change in policy that came after Tenet Healthcare contributed $200,000 to Florida Republicans.

November 12, 2015 3:51 pm

Coca-Cola Spends Millions Of Dollars Funding Research That—Surprise!—Says Soda Is Just Fine

Last week, the University of Colorado announced that it would return a $1 million gift from Coca-Cola—news that came after a New York Times article in August revealed that the soda company funded a group of scientists called the Global Energy Balance Network that downplayed the relationship between soda and obesity, emphasizing instead the importance of exercise.

March 12, 2015 6:31 pm

FDA proposal to allow drug reps to circulate data draws protests

Consumer watchdog Public Citizen has called on U.S. health regulators to withdraw a proposal that would allow pharmaceutical companies to distribute medical literature suggesting a drug’s risk is less than stated on the label.

June 30, 2014 6:15 pm

Facebook responds to criticism of its experiment on users

Facebook is unapologetic about the “emotional contagion” experiment it was conducting on customers.

April 23, 2014 1:40 pm

UC OKs paying surgeon $10 million in whistleblower-retaliation case

The settlement ends a case brought by the ex-head of UCLA’s orthopedic surgery department, who says the medical school allowed doctors to take industry payments that may have compromised patient care.


April 17, 2014 5:37 pm

Free samples of prescription drugs are costly to patients, study says

Free samples of prescription drugs may seem like a great deal for patients. But even when doctors think they’re doing patients a favor by handing out the freebies, the real beneficiaries are the drug manufacturers, according to new research in the journal JAMA Dermatology.

March 21, 2014 2:46 pm

Hawaii police urge lawmakers to let undercover cops have sex with prostitutes

December 17, 2013 6:00 pm

GlaxoSmithKline To Stop Paying Doctors To Promote Drugs

GlaxoSmithKline will stop paying doctors for promoting its drugs and scrap prescription targets for its marketing staff – a first for an industry battling scandals over its sales practices, and a challenge for its peers to follow suit.

November 8, 2013 1:41 pm

Feds Have Beaten Pharma Into Submission Over Off-Label Drug Use, But At What Cost?

Regulatory policy should be based on rules that are clear, with a process that is transparent, and on decisions that are accountable and reviewable, and that are congruent with other public policy imperatives.

November 6, 2013 4:37 pm

U.S. directed medical professionals to ignore ethics, abuse detainees, report says

A new report accuses the U.S. government of directing doctors, nurses and psychologists to participate in the abuse of detainees in Afghanistan, Guantánamo and Iraq.

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