Thursday, April 18, 2013

Whose ethics code is this anyway?

The Times of India reports that the Medical Council of India (MCI) is contemplating changing its Code of Medical Ethics (2002; updated 2010) to permit physicians to accept travel and hospitality sponsorship from pharmaceutical companies. This proposed amendment is aimed directly at Article 6.1.8., which excludes the acceptance of gifts, travel support, accommodation, and cash or monetary grants (unless the latter is in the context of working in pharma-funded medical research).

It should not be a surprise that pressure to change this part of the code comes from ... pharmaceutical companies. Representatives of the pharmaceutical industry argue that they are merely trying to help: Indian doctors do not earn very much, often not enough to attend domestic and international conferences, and it is crucial that they are kept up to date with the latest medical advances.  The amendment is merely meant to improve medical education. Detractors recast the 'sponsorship' as bribery: pharma's interest in hosting such conferences is not to improve physician's knowledge, but to enhance brand recognition among (and prescribing practices of) doctors.

These struggles between pharmaceutical companies and professional medical associations are familiar in developing countries, but in countries like India the power relationships are somewhat different: the pharmaceutical companies wield significant economic and political power, and underpaid doctors would be understandably tempted by their siren's song. The MCI is supposed to regulate a responsible relationship between these two. Whether it is able or inclined to do so remains to be seen.

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