Rothman David J, McDonald Walter J, Berkowitz Carol D, Chimonas Susan C, DeAngelis Catherine D, Hale Ralph W, Nissen Steven E, Osborn June E, Scully James H, Thomson Gerald E, Wofsy David
Institute on Medicine as a Profession, Columbia College of Physicians and Surgeons, 630 W 168th St, New York, NY 10032, USA.
JAMA. 2009 Apr 1;301(13):1367-72. doi: 10.1001/jama.2009.407.
Professional medical associations (PMAs) play an essential role in defining and advancing health care standards. Their conferences, continuing medical education courses, practice guidelines, definitions of ethical norms, and public advocacy positions carry great weight with physicians and the public. Because many PMAs receive extensive funding from pharmaceutical and device companies, it is crucial that their guidelines manage both real and perceived conflict of interests. Any threat to the integrity of PMAs must be thoroughly and effectively resolved. Current PMA policies, however, are not uniform and often lack stringency. To address this situation, the authors first identified and analyzed conflicts of interest that may affect the activities, leadership, and members of PMAs. The authors then went on to formulate guidelines, both short-term and long-term, to prevent the appearance or reality of undue industry influence. The recommendations are rigorous and would require many PMAs to transform their mode of operation and perhaps, to forgo valuable activities. To maintain integrity, sacrifice may be required. Nevertheless, these changes are in the best interest of the PMAs, the profession, their members, and the larger society.
专业医学协会（PMA）在界定和推进医疗保健标准方面发挥着至关重要的作用。它们的会议、继续医学教育课程、实践指南、道德规范定义以及公共宣传立场在医生和公众中具有重大影响力。由于许多专业医学协会从制药和器械公司获得大量资金，因此其指南妥善处理实际和潜在的利益冲突至关重要。对专业医学协会诚信的任何威胁都必须得到彻底有效的解决。然而，目前专业医学协会的政策并不统一，且往往缺乏严格性。为应对这种情况，作者首先识别并分析了可能影响专业医学协会活动、领导层和成员的利益冲突。然后，作者进而制定了短期和长期指南，以防止不当行业影响的表象或实际发生。这些建议十分严格，将要求许多专业医学协会改变其运作模式，甚至可能要放弃一些有价值的活动。为维护诚信，可能需要做出牺牲。尽管如此，这些变革符合专业医学协会、该行业、其成员以及更广泛社会的最佳利益。
