Gifts to physicians from industry

Article Abstract:

Gifts to physicians from industry, particularly pharmaceutical, medical device and medical equipment companies, are controversial. After a year of meetings, the Council on Ethical and Judicial Affairs of the American Medical Association issued its opinion on the subject. This opinion has been incorporated into the association's code of ethics for the medical profession. There are six guidelines for accepting gifts. First, gifts given to individual physicians should also benefit patients, and should not be valuable; thus, textbooks or modest meals might be considered appropriate in the service of education. There should be no cash payments. Second, individual gifts of minimal value (e.g., pens and notepads), related to the physician's work are acceptable. Third, subsidies for continuing medical education conferences or professional meetings are permissible, but should be accepted by the conference's sponsor rather than the physicians attending the conference. Fourth, subsidies should not pay for the costs of travel, lodging, or other personal expenses of attendees, nor should they compensate the physician for his or her time. Modest meals and social events are acceptable as long as they are a part of the meeting. Honoraria and reimbursement of expenses are appropriate for legitimate consultants and faculty. Token consulting or advisory positions are not eligible for reimbursement of expenses. Fifth, scholarships and other funds to allow medical students, residents, and fellows to attend educational conferences are permitted, provided the selection of attendees is made by the academic institution. Sixth, no gift is acceptable if any quid pro quo is expected. Gifts tied to a physician's prescribing practices should never by accepted. Also, when companies underwrite medical conferences or lectures outside of the company, all selection of content, faculty, and other decisions should be made by the organizers of the conference. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drugs, Marketing, Ethical aspects, Business gifts, editorial

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Mandatory parental consent to abortion

Article Abstract:

The American Medical Association's Council on Ethical and Judicial Affairs recommends that doctors encourage - but not require - their pregnant teenage patients to consult with their parents before having an abortion. Federal constitutional case law gives pregnant minors the right to have an abortion without getting parent advice or consent, unless state law specifies otherwise. At least 40 states have laws requiring parental consent, but many of these laws are not enforced because of court orders or local enforcement decisions. The number of minors seeking abortion in Massachusetts declined after the state passed a parental consent law, but this was compensated by a corresponding increase in those seeking abortion outside the state. Minors generally have the same privacy rights as adults. Physicians must obey the laws regarding parental consent in the states where they practice, but should otherwise respect the confidentiality of communications with minors. Teenagers should be allowed to decide whether they want to involve their parents in their decision.

Laws, regulations and rules, Confidential communications, Physician-patient privilege, Parental consent, Teenage abortion

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Physicians and domestic violence: ethical considerations

Article Abstract:

Some medical ethicists think that physicians should be more involved in diagnosing abuse in their female patients and referring them to the appropriate social service agency. Several studies have found that physicians correctly diagnose abuse in only a small percentage of cases. Many physicians are not trained to deal with domestic violence, and they also believe that it is rare, does not occur in normal relationships and should be resolved within the relationship. There may be few social service programs to which the woman can be referred. The American Medical Association is developing tests that physicians can use to diagnose and treat domestic violence. Medical students and residents should be trained to deal with domestic violence. Physicians should routinely ask their female patients about abuse, and should be aware of community agencies that can deal with it.

Care and treatment, Abused women

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