의사-제약산업체 상호작용에서의 이해상충 관리
Management of Conflicts of Interest in Physician-Pharmaceutical Industry Interaction
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Physician-pharmaceutical industry interaction (PPII) is ubiquitous in medical research, education, and clinical care. Conflicts of interest, which occur in the interaction, are to be properly managed at the level of the health care institution as well as at the level of individual health care personnel. The purpose of that management is to control conflicts of interest to the maximum extent possible, thereby preserving the value of public trust. Public trust is founded on the principle of prioritizing patients’ interests. Founding principles of COI management are based on public trust, professional integrity, and publicity. With these founding principles the relevant stakeholders (the pharmaceutical industry, physicians, medical care institutions, and the general public) should make continuous efforts to manage COI appropriately. Above all, the awareness of influences is essential among those stakeholders. This article argues that medical professionals should appreciate and protect the value of professional integrity and that medical organizations and institutions should establish reasonable policies of COI management, including the constitution of COICs (conflicts of interest committees) and education programs. Furthermore, it is claimed that society as a whole shares the responsibility of providing an appropriate health care environment by compensating heath care providers with adequate payment in order to avoid inappropriate PPII development. Without providing reasonable health care reimbursement, legal restrictions designed to control inappropriate PPII maAy not achieve their goal.
Abstract
Physician-pharmaceutical industry interaction (PPII) is ubiquitous in medical research, education, and clinical care. Conflicts of interest, which occur in the interaction, are to be properly managed at the level of the health care institution as well as at the level of individual health care personnel. The purpose of that management is to control conflicts of interest to the maximum extent possible, thereby preserving the value of public trust. Public trust is founded on the principle of prioritizing patients’ interests. Founding principles of COI management are based on public trust, professional integrity, and publicity. With these founding principles the relevant stakeholders (the pharmaceutical industry, physicians, medical care institutions, and the general public) should make continuous efforts to manage COI appropriately. Above all, the awareness of influences is essential among those stakeholders. This article argues that medical professionals should appreciate and protect the value of professional integrity and that medical organizations and institutions should establish reasonable policies of COI management, including the constitution of COICs (conflicts of interest committees) and education programs. Furthermore, it is claimed that society as a whole shares the responsibility of providing an appropriate health care environment by compensating heath care providers with adequate payment in order to avoid inappropriate PPII development. Without providing reasonable health care reimbursement, legal restrictions designed to control inappropriate PPII maAy not achieve their goal.
참고문헌 (11)
- ACCME, "Standards For Commercial Support - Standards to Ensure the Independence of CME Activities", 1~3 (2007)
- AMA, "Ethical Opinion E-8.061, Gifts to Physicians from Industry", ~
- Canadian Medical Association Policy, "Guidelines for Physicians in Interactions with Industry", 44~ (2007)
- "Conflicts of interest", Nature, 340, pp.664~ (1989)
- "General Medical Council Opinion of 2006", ~
- Hurst SA, "A question of method", EMBO Reports, 9(2), pp.119~123 (2008)
- Institute of Medicine, "Conflict of interest in medical research, education, and practice", pp.53~ (2009), The National Academies Press
- Kmietowicz Z, "WMA sets rules on how doctors handle industry sponsorship", BMJ, 329(7471), pp.876~ (2004)
- Reich WT, "Encyclopedia of Bioethics", pp.503~508 (2004), Simon & Schuster Macmillan
- Rodwin M, "Medicine, money and morals" (1993), Oxford University Press