Chren M M, Landefeld C S, Murray T H
Department of Dermatology, Case Western Reserve University School of Medicine, University Hospital of Cleveland, Ohio 44106.
JAMA. 1989;262(24):3448-51.
Doctors often accept gifts from drug companies. We analyze this practice and conclude that accepting a gift has complex practical and ethical repercussions. Gifts cost patients money, and they may change society's perception of the profession as serving the best interest of patients. Also, accepting a gift establishes a relationship between the physician and the drug company that obliges a response from the physician. Accepting gifts and the resulting relationship have ethical implications as well. First, the use of patients' money to pay for gifts can be unjust. Second, the fiduciary relationship between physician and patient may be threatened if prescribing practices are affected (as intended by the drug company). Third, physicians' characters may be altered by a practice that fosters self-interest at patients' expense. We discuss the need for guidelines for the profession to help physicians promote their patients' well-being.
医生经常接受制药公司的礼物。我们分析了这种行为，并得出结论：接受礼物会产生复杂的实际和伦理影响。礼物让患者花钱，还可能改变社会对该职业为患者的最大利益服务的看法。此外，接受礼物会在医生和制药公司之间建立一种关系，这就要求医生做出回应。接受礼物以及由此产生的关系也有伦理方面的影响。首先，用患者的钱购买礼物可能是不公正的。其次，如果处方行为受到影响（正如制药公司所期望的那样），医生与患者之间的信托关系可能会受到威胁。第三，一种以牺牲患者利益来促进自身利益的行为可能会改变医生的品格。我们讨论了该行业制定指导方针的必要性，以帮助医生增进患者的福祉。
