Dana Katz

All Gifts Large and Small Toward an Understanding of the Ethics of Pharmaceutical Industry Gift-Giving

Much attention has been focused in recent years on the ethical acceptability of physicians receiving gifts from drug companies. Professional guidelines recognize industry gifts as a conflict of interest and establish thresholds prohibiting the exchange of large gifts while expressly allowing for the exchange of small gifts such as pens, note pads, and coffee. Considerable evidence from the social sciences suggests that gifts of negligible value can influence the behavior of the recipient in ways the recipient does not always realize. Policies and guidelines that rely on arbitrary value limits for gift-giving or receipt should be reevaluated.

All Gifts Large and Small

Much attention has been focused in recent years on the ethical acceptability of physicians receiving gifts from drug companies. Professional guidelines recognize industry gifts as a conflict of interest and establish thresholds prohibiting the exchange of large gifts while expressly allowing for the exchange of small gifts such as pens, note pads, and coffee. Considerable evidence from the social sciences suggests that gifts of negligible value can influence the behavior of the recipient in ways the recipient does not always realize. Policies and guidelines that rely on arbitrary value limits for gift-giving or receipt should be reevaluated.

A "Fix" of Reality

paired. If one argues that this incompetence is speciacally related to heroin, then addicts cannot be charged with any crime related to the procurement or use of the drug. But if a heroin addict murders his dealer, is he mentally incompetent at the time of the murder? Further, if one gives in to the author’s argument, then one must assume that a heroin addict’s incompetence is permanent, since, as in all clinical trials, consent can be withdrawn at any time and there is no evidence that this happened in the Swiss trial. This brings us not to Cynthia’s dilemma but to the dilemma of Cynthia. Was Cynthia competent to enter into a discussion with the author? Would we all be in a state of incompetence because we love something too much? Mea culpa. The lesson here, it would appear, is that it is generally a bad idea to enter into a philosophical discussion with an addict whose competency may be in doubt.