Disclosing Non-research Payments
Moral Question
Do physicians have an obligation to inform their patients on non-research funding received from pharmaceutical companies?
Moral Argument
Moral Principle
According to the AMA Code of Ethical Opinions 11.2.4, physicians are obliged to notify patients on appropriate treatment interventions, dangers and advantages of alternatives, and any other pertinent data, including financial incentives or guidelines that could alter the quality and delivery of care (AMA, 2016).
Facts
The facts about the current situation in the medical field is that; (a) Doctors are legally required to disclose any information that could jeopardize patients’ health outcomes. (b) The conflict of interest in violating doctor-patient obligations by over-prescribing drugs like opioids is relatively unclear. (c) The power to curb the distribution non-research payments is beyond the control of physicians.
Options
One, doctors shouldn’t disclose the payments to patients, as they are trusted to put the latter’s best interest above personal gain. In this sense, the issue of non-research payments is beyond the control of the physicians and their best input is to ensure the safety of their customers. Second, doctors can inform patients about the payments from pharmaceutical companies, which could ultimately birth chaos and mistrust between all the stakeholders in the healthcare industry.
Moral Conclusion
Indeed, the first option of concealing the information from patients seems to have an overall advantage for all players in the industry. In truth, the decision would be morally wrong for physicians, but on the other hand, they should take the rap for something beyond their control. The issue of distributing non-research payments is relatively bureaucratic stakeholders should find a firm and amicable solution, rather than depending on the moral obligation of physicians.
Objections
First, there is a clear conflict of interest when doctors receive non-research payments from pharmaceutical companies to over-prescribe opioids. One could argue that the behavior utterly violates doctor to patient obligations, which is unethical. In this context, physicians are inherently obliged to disclose the information to patients.
Second, there seems to be a lack of a profound connection between increased prescription rates and non-research payments. Meetings between pharmaceutical representatives and physicians still serve the traditional purpose of education, and thus doctors who miss the interactions could be disadvantaged. From this perspective, physicians seem to be personally connected to the malpractices in the healthcare industry.
First Reply
While it seems accurate to judge doctors about their moral judgements, the situation in the medical field is way beyond their control. On one hand they are obliged to protect patients at all cost, but on the other hand they face pharmaceutical giants, who are reinforced with bureaucracy, world-class marketing, public relations. Thus, no argument pins the practices entirely on untoward motivations from doctors.
Response from Opponent
However, if doctors fail to take charge, malpractices like the distribution of non-research payments could be unending. Physicians are the only reliable link between pharmaceutical companies and patients, that could streamline the application of ethics in the healthcare industry. They need to fulfil their obligation of information transparency to patients.
Reply to Response
Indeed, doctors play an integral role in engaging all stake holders, patients and pharmaceutical companies, but their reaction to the situation should be gradual. The healthcare industry is relatively sensitive and physicians should conceptualize a comprehensive strategy to streamline the malpractices in the field. Disclosing information to patients directly could have detrimental consequences.
Second Reply
In some cases, studies have proved the lack of a proper connection between increased non-research payments and over-prescriptions of opioids. Nonetheless, the statistics don’t blame the situation entirely on the motivations of physicians. They could be victims of informed marketing techniques from pharmaceutical companies, like the rest of society. Their interaction with pharmaceutical representatives could be just for fulfilling their professional obligations.
Response from Opponent
Physicians who don’t attend educational meetings with pharmaceutical representatives are bad professionals who lack essential information and are motivated by money. They could be central to the whole issue.
Reply to Response
The assumption merely highlights one aspect of the situation and it’s not sufficient to conclude the intentions of physicians. There lacks sufficient evidence and statistics not only to identify the motivations of doctors, but also to implement interventions like oversite policies and banning non-research payments. Conclusively, the ultimate solution is to streamline the perception of all stakeholders to the interconnection between professional obligations and conflicts of interest.
References
AMA. (2016, November 14). Transparency in Health Care. Retrieved from American Medical Association: https://www.ama-assn.org/delivering-care/ethics/transparency-health-care