Huddle Thomas S
Division of General Internal Medicine, University of Alabama at BirminghamSchool of Medicine, FOT 720, Birmingham AL 35294, USA.
Perspect Biol Med. 2008 Spring;51(2):251-60. doi: 10.1353/pbm.0.0012.
Abstract:Academic physicians and bioethicists are increasingly voicing objections to "drug rep" detailing. Leaders in academic medical centers are considering proposals to ban the small gifts of detailing within their walls. Such bans would be a mistake, as the small gifts are unlikely to act as bribes and do not create unacceptable conflicts of interest for physicians. Drug rep detailing does influence physician behavior, but this influence has not been shown to be harmful. Calls for a ban are premised on empirical evidence for harm that is inconclusive at best, and emerging literature in economics suggests that detailing may well be socially beneficial. A preponderance of harm over benefit is not, however, the primary source of the animus against detailing, which stems from moral considerations that are independent of its social consequences. However, pharmaceutical advertising, including detailing, is a morally legitimate aspect of the world of medical practice that we in academic medicine ought to be preparing our trainees to encounter and properly sift.
学术医生和生物伦理学家越来越多地对“医药代表的产品详细介绍”提出反对意见。学术医疗中心的领导们正在考虑在其机构内禁止这种带有小礼物的产品详细介绍的提议。这样的禁令将是一个错误，因为这些小礼物不太可能起到贿赂的作用，也不会给医生造成不可接受的利益冲突。医药代表的产品详细介绍确实会影响医生的行为，但这种影响尚未被证明是有害的。要求禁令的呼声是基于充其量只是不确定的危害实证证据，而新兴的经济学文献表明产品详细介绍很可能对社会有益。然而，危害大于益处并非反对产品详细介绍的主要敌意来源，这种敌意源于与社会后果无关的道德考量。然而，包括产品详细介绍在内的药品广告是医疗实践领域中道德上合法的一个方面，我们学术医学领域的人应该让我们的实习生做好准备去面对并正确筛选它。
