Assistant Professor of Business Ethics at Georgetown University and a Research Fellow at the Ethics Center at Harvard University. Associate Professor in the Department of Pharmacology and Physiology and the Department of Family Medicine at Georgetown University Medical Center (GUMC).
J Law Med Ethics. 2013 Fall;41(3):665-72. doi: 10.1111/jlme.12076.
Pharmaceutical and medical device companies apply social psychology to influence physicians' prescribing behavior and decision making. Physicians fail to recognize their vulnerability to commercial influences due to self-serving bias, rationalization, and cognitive dissonance. Professionalism offers little protection; even the most conscious and genuine commitment to ethical behavior cannot eliminate unintentional, subconscious bias. Six principles of influence - reciprocation, commitment, social proof, liking, authority, and scarcity - are key to the industry's routine marketing strategies, which rely on the illusion that the industry is a generous avuncular partner to physicians. In order to resist industry influence, physicians must accept that they are vulnerable to subconscious bias and have both the motivation and means to resist industry influence. A culture in which accepting industry gifts engenders shame rather than gratitude will reduce conflicts of interest. If greater academic prestige accrues to distant rather than close relationships with industry, then a new social norm may emerge that promotes patient care and scientific integrity. In addition to educating faculty and students about the social psychology underlying sophisticated but potentially manipulative marketing and about how to resist it, academic medical institutions should develop strong organizational policies to counteract the medical profession's improper dependence on industry.
制药和医疗器械公司将社会心理学应用于影响医生的处方行为和决策。由于自利偏差、合理化和认知失调，医生未能认识到自己易受商业影响。职业道德几乎没有提供保护；即使是最有意识和真诚地遵守道德行为，也不能消除无意识的、潜意识的偏见。影响的六个原则——互惠、承诺、社会认同、喜欢、权威和稀缺——是行业常规营销策略的关键，这些策略依赖于这样一种错觉，即行业是医生慷慨的叔叔般的伙伴。为了抵制行业的影响，医生必须接受他们容易受到潜意识偏见的影响，并有动机和手段来抵制行业的影响。一种接受行业礼物会引起羞耻而不是感激的文化，将减少利益冲突。如果与行业的关系是遥远的而不是亲密的，会带来更大的学术声誉，那么一种新的社会规范可能会出现，促进患者护理和科学诚信。除了教育教师和学生关于复杂但潜在的操纵性营销背后的社会心理学以及如何抵制它之外，学术医疗机构还应该制定强有力的组织政策，以对抗医学界对行业的不当依赖。
