Gifts from Industry
Many gifts to physicians by companies in the pharmaceutical, device and
medical equipment industries serve an important and socially beneficial
function. For example, companies have long provided funds for educational
seminars and conferences. However, there has been growing concern about
certain gifts from industry to physicians. Some gifts that reflect
customary practices of industry may not be consistent with principles of
medical ethics. To avoid the acceptance of inappropriate gifts, physicians
should observe the following guidelines:
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Any gifts accepted by physicians individually should primarily entail a
benefit to patients and should not be of substantive value. Accordingly,
textbooks, modest meals and other gifts are appropriate if they serve a
genuine educational function. Cash payments should not be accepted.
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Individual gifts of minimal value are permissible as long as the gifts
are related to the physician's work (e.g., pens and notepads).
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Subsidies to underwrite the costs of continuing medical education
conferences or professional meetings can contribute to the improvement
of patient care and therefore are permissible. Since the giving of a
subsidy directly to a physician by a company's sales representative may
create a relationship which could influence the use of the company's
products, any subsidy should be accepted by the conference's sponsor who
in turn can use the money to reduce the conference's registration fee.
Payments to defray the costs of the conference should not be accepted
directly from the company by the physicians attending the conference.
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Subsidies from industry should not be accepted to pay for the costs of
travel, lodging or other personal expenses of physicians attending
conferences or meetings, nor should subsidies be accepted to compensate
for the physicians' time. Subsidies for hospitality should not be
accepted outside of modest meals or social events held as a part of the
conference or meeting. It is appropriate for faculty at conferences or
meetings to accept reasonable honoraria and to accept reimbursement for
reasonable travel, lodging and meal expenses. It is also appropriate for
consultants who provide genuine services to receive reasonable
compensation and to accept reimbursement for reasonable travel, lodging
and meal expenses. Token consulting or advisory arrangements cannot be
used to justify compensating physicians for their time or their travel,
lodging and other out-of-pocket expenses.
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Scholarships or other special funds to permit medical students,
residents and fellows to attend carefully selected educational
conferences may be permissible as long as the selection of students,
residents or fellows who will receive the funds is made by the academic
or training institution.
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No gifts should be accepted if there are strings attached. For example,
physicians should not accept gifts if they are given in relation to the
physicians' prescribing practices. In addition, when companies
underwrite medical conferences or lectures other than their own,
responsibility for and control over the selection of content, faculty,
educational methods and materials should belong to the organizers of the
conferences or lectures. (JC Rpt B, A-93) (Reaffirmed A-23)
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Abbreviations for House of Delegates report origination:
EC – Executive Committee; BT – Board of Trustees; CPA – Council on
Professional Affairs; JC – Judicial Council; CHS – Community and Health
Services