Filed at 5:47 p.m. ET
CHICAGO (AP) -- The American Medical Association is spending a big chunk
of drug-company money to tell doctors not to accept large gifts from drug
companies in a campaign that critics say smacks of hypocrisy.
The AMA is contributing about $400,000 to the $1 million effort, but most
of the balance comes from payments between $50,000 and $100,000 from nine
major drug companies.
The AMA says it makes sense to involve the industry in a campaign that's
also designed to inform drug makers about what is considered unethical
behavior. But critics question that logic.
``How can anyone believe that they're engaging in some kind of campaign to
fight the perception of unethical behavior by engaging in unethical
behavior?'' Dr. Sidney Wolfe, director of the consumer-oriented Public
Citizen Health Research Group, said Wednesday. ``It's just outrageous.''
Some medical ethicists agree.
``It's symbolically endorsing the very behavior that they're trying to caution
against,'' said Dr. John Lantos, associate director of the University of
Chicago's MacLean Center for Clinical Medical Ethics.
At issue are the myriad freebies, ranging from pens and notepads to free
dinners and trips, that some drug makers shower on doctors. Ethicists say the
gifts could encourage doctors to prescribe medications that may not be in
patients' best interests.
``Overall they spend billions of dollars trying to influence physicians'
prescribing behavior, and it works,'' Lantos said.
AMA policy suggests a limit of about $100 on such gifts and says they
should not include things like free trips, hotel accommodations and other
personal expenses for doctors attending conferences. Things like work-related
pens and notepads are considered acceptable.
``Any gifts accepted by physicians individually should primarily entail a
benefit to patients and should not be of substantial value,'' the policy
says.
Dr. Randolph Smoak, the AMA's immediate past president, said the campaign
was prompted in part by concern that many younger doctors may be unaware of
the decade-old policy.
``We're attempting to not only re-educate physicians but also the
marketing forces,'' Smoak said, ``so that all those people understand the
rules of engagement.''
The Pharmaceutical Research and Manufacturers of America, a trade group
for most of the nation's brand-name prescription drug makers, supports the
policy, but believes ``it is entirely appropriate to educate physicians about
new treatments,'' spokeswoman Jackie Cottrell said.
She said her group is informing industry representatives about the policy
as part of the campaign.
The AMA on Monday began mailing informational material to doctors, which
includes a list of the drug-company sponsors. The campaign also includes a new
Web site about the guidelines.
Critics support limiting pharmaceutical industry influence, but question
the funding source for the campaign and say it might backfire by influencing
doctors to favor the nine companies that are participating.
``Whoever is making decisions over there seems to be just brain-dead,''
Wolfe said of the AMA.
He likened the controversy to the AMA's botched 1997 deal with Sunbeam
Corp., in which the association was forced to
abandon an agreement to endorse Sunbeam products after an outcry from members
and ethicists.
Dr. Jay Jacobson, an AMA member and chief of the medical ethics division
at LDS Hospital and University of Utah medical school, agreed that the
funding ``seems absolutely paradoxical.''
But Jacobson said, ``You have to suspend judgment'' and see if the
campaign works at curbing unethical behavior.
``This may actually be better than nothing,'' he said.
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On the Net:
American Medical Association: http://ama-assn.org