An Engelhardtian Analysis of Interactions Between Pharmaceutical Sales Representatives and Physicians
Peppin, John F.
Journal of Medicine and Philosophy. 1997 Dec; 22(6): 623-641.
Physician conflict of interest has been of concern since Hippocrates and rarely is this concern more evident than in the relationship between pharmaceutical sales representatives (PSR) and physicians. Given the acrimonious public debates concerning this issue a careful exploration of the concerns at sake and the conceptual arguments which support such concerns is called for. In this piece I will take as heuristic the conceptual philosophical framework argued for by H. Tristram Engelhardt. This framework would sanction interactions between PSRs and physicians given that such relationships are free and without coercion. Further, patients must be informed, uncoerced and free in choosing such relationships with physicians who engage in interactions with PSRs. I consider four major criticisms which claim that PSR-physician interactions are morally impermissible: 1) influence, 2) "patients do not choose, but they pay," 3) violation of ethical principles, and 4) erosion of the patient-physician relationship. Each is shown to be unpersuasive under Engelhardtian philosophy. As long as the principle of permission and informed consent obtain without coercion than the interaction between PSRs and physicians would be construed to be morally permissible.
Advertising; Autonomy; Beneficence; Coercion; Conflict of Interest; Consent; Democracy; Disclosure; Drug Industry; Drugs; Ethics; Financial Support; Freedom; Gifts; Industry; Informed Consent; Justice; Moral Policy; Organizational Policies; Organizations; Patient Care; Patients; Philosophy; Physician Patient Relationship; Physicians; Principle-Based Ethics; Professional Organizations; Secularism; Standards; Trust;
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Peppin, John F. (1996-02)Since their appearance in 1850, Pharmaceutical Sales Representatives (PSR) interactions with physicians have engendered intense emotional responses. The controversy has continued unabated since that time. Arguments in favor ...