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Hooked: Ethics, the Medical Profession, and the Pharmaceutical Industry

Rowman & Littlefield Publishers (2007)

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  1. The commercialization of the biomedical sciences: (mis)understanding bias.Inmaculada de Melo-Martín - 2019 - History and Philosophy of the Life Sciences 41 (3):34.
    The growing commercialization of scientific research has raised important concerns about industry bias. According to some evidence, so-called industry bias can affect the integrity of the science as well as the direction of the research agenda. I argue that conceptualizing industry’s influence in scientific research in terms of bias is unhelpful. Insofar as industry sponsorship negatively affects the integrity of the research, it does so through biasing mechanisms that can affect any research independently of the source of funding. Talk about (...)
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  • Patenting and the Gender Gap: Should Women Be Encouraged to Patent More? [REVIEW]Inmaculada de Melo-Martín - 2013 - Science and Engineering Ethics 19 (2):491-504.
    The commercialization of academic science has come to be understood as economically desirable for institutions, individual researchers, and the public. Not surprisingly, commercial activity, particularly that which results from patenting, appears to be producing changes in the standards used to evaluate scientists’ performance and contributions. In this context, concerns about a gender gap in patenting activity have arisen and some have argued for the need to encourage women to seek more patents. They believe that because academic advancement is mainly dependent (...)
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  • A Duty to Participate in Research: Does Social Context Matter?Inmaculada de Melo-Martín - 2008 - American Journal of Bioethics 8 (10):28-36.
    Because of the important benefits that biomedical research offers to humans, some have argued that people have a general moral obligation to participate in research. Although the defense of such a putative moral duty has raised controversy, few scholars, on either side of the debate, have attended to the social context in which research takes place and where such an obligation will be discharged. By reflecting on the social context in which a presumed duty to participate in research will obtain, (...)
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  • Pharmaceutical Sales Representatives in the United States and China: The Need for Professional Public Space.Xiaoying Chen - 2021 - Health Care Analysis 30 (1):35-56.
    Pharmaceutical sales representatives (PSRs) are one of the most frequently used drug information sources for physicians in both the United States and China. During face-to-face interactions, PSRs use various promotional strategies to impact the prescribing behavior. In the United States, PSRs provide physicians small gifts, free drug samples, and “sincere friendships”, whereas in China, they played an indispensable role in medical corruption over the past three decades. To cope with the undue influence of PSRs, both these countries have taken positive (...)
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  • What’s it to me? Self-interest and evaluations of financial conflicts of interest.Samuel V. Bruton & Donald F. Sacco - 2017 - Research Ethics 14 (4):1-17.
    Disclosure has become the preferred way of addressing the threat to researcher objectivity arising from financial conflicts of interest. This article argues that the effectiveness of disclosure at protecting science from the corrupting effects of FCOIs—particularly the kind of disclosure mandated by US federal granting agencies—is more limited than is generally acknowledged. Current NIH and NSF regulations require disclosed FCOIs to be reviewed, evaluated, and managed by officials at researchers’ home institutions. However, these reviewers are likely to have institutional and (...)
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  • Responses to Peer Commentaries on “Clarifying Conflict of Interest”.Howard Brody - 2011 - American Journal of Bioethics 11 (1):W4 - W5.
    As the debate over how to manage or discourage physicians’ financial conflicts of interest with the drug and medical device industries has become more heated, critics have questioned or dismissed the concept of “conflict of interest” itself. A satisfactory definition relates conflict of interest to concerns about maintaining social trust and distinguishes between breaches of ethical duty and temptations to breach duty. Numerous objections to such a definition have been offered, none of which prevails on further analysis. Those concerned about (...)
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  • Pharmaceutical Industry Financial Support for Medical Education: Benefit, or Undue Influence?Howard Brody - 2009 - Journal of Law, Medicine and Ethics 37 (3):451-460.
    Presently, the pharmaceutical industry funds about half of the costs of continuing medical education programs in the U.S. This contributes to the ethical problems that pervade the relationship between medicine and the pharmaceutical industry: trustworthiness and conflicts of interest. The problems are exacerbated by rationalizations prevalent on both sides that deny the ethical concerns. Commercialism and commercial bias are highly visible at large CME gatherings, and available data, while scanty, back up the view that physician attendees' subsequent prescribing practices are (...)
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  • Pharmaceutical Industry Financial Support for Medical Education: Benefit, or Undue Influence?Howard Brody - 2009 - Journal of Law, Medicine and Ethics 37 (3):451-460.
    As early as the 1960s and 1970s, astute commentators began to call into question the degree of influence that the pharmaceutical industry was exercising over all aspects of medical research, education, and practice in the U.S. More recently, a spate of books and articles demonstrates that the issue has only become more serious in the last decade or two.My focus in this paper will be on the industry’s influence on medical education. The influence that the industry exerts on undergraduate and (...)
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  • Drug Detailers, Professionalism, and Prudence.Howard Brody - 2010 - American Journal of Bioethics 10 (1):9-10.
    Huddle (2010) claims that the Association of American Medical Colleges (AAMC), in advocating the exclusion of pharmaceutical detail representatives from academic medical centers, erred in placing t...
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  • Clarifying conflict of interest.Howard Brody - 2011 - American Journal of Bioethics 11 (1):23 - 28.
    As the debate over how to manage or discourage physicians? financial conflicts of interest with the drug and medical device industries has become more heated, critics have questioned or dismissed the concept of ?conflict of interest? itself. A satisfactory definition relates conflict of interest to concerns about maintaining social trust and distinguishes between breaches of ethical duty and temptations to breach duty. Numerous objections to such a definition have been offered, none of which prevails on further analysis. Those concerned about (...)
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  • Ask your doctor if this genetic test is right for you.Howard Brody - 2008 - American Journal of Bioethics 8 (6):1 – 2.
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  • Big Pharma: a former insider’s view. [REVIEW]David Badcott - 2013 - Medicine, Health Care and Philosophy 16 (2):249-264.
    There is no lack of criticisms frequently levelled against the international pharmaceutical industry (Big Pharma): excessive profits, dubious or even dishonest practices, exploiting the sick and selective use of research data. Neither is there a shortage of examples used to support such opinions. A recent book by Brody (Hooked: Ethics, the Medical Profession and the Pharmaceutical Industry, 2008) provides a précis of the main areas of criticism, adopting a twofold strategy: (1) An assumption that the special nature and human need (...)
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  • Misapplying Moral Hazard in Bioethics.Denis Arnold - 2016 - American Journal of Bioethics 16 (7):41-42.
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  • Better Regulation of Industry-Sponsored Clinical Trials Is Long Overdue.Matthew Wynia & David Boren - 2009 - Journal of Law, Medicine and Ethics 37 (3):410-419.
    Regulating clinical trials for testing new drugs is fraught with risk. Misregulation can slow development of innovative and useful new drugs, but in other ways misregulation can foster trials that are inefficient and unethical, driven by commercial rather than scientific ends, and that can harm patients. In this paper, we argue not for more but for better regulation, based on the goal of rapidly producing innovative and safe products that represent significant advances in medical care. Data on industry-funded, late-stage clinical (...)
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  • Better Regulation of Industry-Sponsored Clinical Trials is Long Overdue.Matthew Wynia & David Boren - 2009 - Journal of Law, Medicine and Ethics 37 (3):410-419.
    There is an old saw in health policy that everyone wants health care that is good, fast, and cheap — but it’s impossible to have more than two of these at one time.A similar bit of folk wisdom seems intuitively true for the development and testing of new pharmaceutical products. The public is in a bind. We want breakthrough drugs, and fast. But we also want these drugs to be affordable, thoroughly tested, safe, and effective. It seems we can’t have (...)
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  • Drug Reps Off Campus! Promoting Professional Purity by Suppressing Commercial Speech.Lance K. Stell - 2009 - Journal of Law, Medicine and Ethics 37 (3):431-443.
    In the name of restoring professionalism, an influential group of physician-educators have urged academic medical centers to take the lead in purging the house of medicine of the conflicts of interest created by industry's marketing. I argue that this revivalist movement is misguided, uses “conflict of interest” as an epithet, creates counter-productive incentives, and fails the duty to prepare physicians for ethical engagement with their commercial partners in patient care.
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  • Drug Reps off Campus! Promoting Professional Purity by Suppressing Commercial Speech.Lance K. Stell - 2009 - Journal of Law, Medicine and Ethics 37 (3):431-443.
    In purity and holiness I will guard my life and my art.Every physician-patient encounter is a conflict of interest. Every physician-payer encounter is also a conflict of interest.Wide-spread criticism of the pharmaceutical industry’s extravagant marketing practices and some doctors’ undignified, even appalling eagerness to stuff themselves, their pockets and their offices with the industry’s “stuff,” prompted physician groups, the drug and device industry itself to institute reforms designed better to limit industry influence on physicians.But according to Troyen Brennan and his (...)
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  • A Christian Physician: Combining Conscience, Philanthropia, and Calling.Michael J. Sleasman & Gregory W. Rutecki - 2016 - Christian Bioethics 22 (3):340-362.
    When physicians today appeal to “conscience,” it has been alleged such exercises pejoratively reflect “conscience without consequence” as contemporary practitioners are said to be insulated from the consequences of such decisions. It has also been implied these physicians avoid traditional professional responsibilities—including providing charity care and making house or night calls. The assertions demand clarification. Fundamentally, what traits constitute an integrated professionalism specific to Christian physicians? Historical evidence verifies sanctity-of-life affirmations by Christian physicians throughout Church history. However, surveying Christian medical (...)
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  • The Details Are in the Field.Abraham P. Schwab - 2010 - American Journal of Bioethics 10 (1):19-21.
    The article reviews the article "The Pitfalls of Deducing Ethics From Behavioral Economics: Why the Association of American Medical Colleges Is Wrong About Pharmaceutical Detailing," by T. S. Huddle in the January 1, 2010 issue of "American Journal of Bioethics.".
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  • Huddle Gets It Right, Most Docs Don't.Paul H. Rubin - 2010 - American Journal of Bioethics 10 (1):17-19.
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  • Hidden Sources of Private Industry Funding.David B. Resnik - 2008 - American Journal of Bioethics 8 (8):60-61.
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  • Patenting and the Gender Gap: Should Women Be Encouraged to Patent More?Inmaculada Melo-Martín - 2013 - Science and Engineering Ethics 19 (2):491-504.
    The commercialization of academic science has come to be understood as economically desirable for institutions, individual researchers, and the public. Not surprisingly, commercial activity, particularly that which results from patenting, appears to be producing changes in the standards used to evaluate scientists’ performance and contributions. In this context, concerns about a gender gap in patenting activity have arisen and some have argued for the need to encourage women to seek more patents. They believe that because academic advancement is mainly dependent (...)
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  • On the fragility of medical virtue in a neoliberal context: the case of commercial conflicts of interest in reproductive medicine.Christopher Mayes, Brette Blakely, Ian Kerridge, Paul Komesaroff, Ian Olver & Wendy Lipworth - 2016 - Theoretical Medicine and Bioethics 37 (1):97-111.
    Social, political, and economic environments play an active role in nurturing professional virtue. Yet, these environments can also lead to the erosion of virtue. As such, professional virtue is fragile and vulnerable to environmental shifts. While physicians are often considered to be among the most virtuous of professional groups, concern has also always existed about the impact of commercial arrangements on physicians’ willingness and capacity to enact their professional virtues. This article examines the ways in which commercial arrangements have been (...)
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  • Declarations, accusations and judgement: examining conflict of interest discourses as performative speech-acts.Christopher Mayes, Wendy Lipworth & Ian Kerridge - 2016 - Medicine, Health Care and Philosophy 19 (3):455-462.
    Concerns over conflicts of interest in academic research and medical practice continue to provoke a great deal of discussion. What is most obvious in this discourse is that when COIs are declared, or perceived to exist in others, there is a focus on both the descriptive question of whether there is a COI and, subsequently, the normative question of whether it is good, bad or neutral. We contend, however, that in addition to the descriptive and normative, COI declarations and accusations (...)
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  • Moral Hazards Over Narrative Methods in Pediatrics? Not Worth the Risk.Kellie R. Lang & D. Micah Hester - 2016 - American Journal of Bioethics 16 (7):42-44.
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  • Are Corporations Re-Defining Illness and Health? The Diabetes Epidemic, Goal Numbers, and Blockbuster Drugs.Linda M. Hunt, Elisabeth A. Arndt, Hannah S. Bell & Heather A. Howard - 2021 - Journal of Bioethical Inquiry 18 (3):477-497.
    While pharmaceutical industry involvement in producing, interpreting, and regulating medical knowledge and practice is widely accepted and believed to promote medical innovation, industry-favouring biases may result in prioritizing corporate profit above public health. Using diabetes as our example, we review successive changes over forty years in screening, diagnosis, and treatment guidelines for type 2 diabetes and prediabetes, which have dramatically expanded the population prescribed diabetes drugs, generating a billion-dollar market. We argue that these guideline recommendations have emerged under pervasive industry (...)
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  • Moral Psychology and the Intuition that Pharmaceutical Companies Have a ‘Special’ Obligation to Society.James M. Huebner - 2014 - Journal of Buisness Ethics (3):1-10.
    Many people believe that the research-based pharmaceutical industry has a ‘special’ moral obligation to provide lifesaving medications to the needy, either free-ofcharge or at a reduced rate relative to the cost of manufacture. In this essay, I argue that we can explain the ubiquitous notion of a special moral obligation as an expression of emotionally charged intuitions involving sacred or protected values and an aversive response to betrayal in an asymmetric trust relationship. I then review the most common arguments used (...)
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  • Moral Psychology and the Intuition that Pharmaceutical Companies Have a ‘Special’ Obligation to Society.James M. Huebner - 2014 - Journal of Business Ethics 122 (3):501-510.
    Many people believe that the research-based pharmaceutical industry has a ‘special’ moral obligation to provide lifesaving medications to the needy, either free-of-charge or at a reduced rate relative to the cost of manufacture. In this essay, I argue that we can explain the ubiquitous notion of a special moral obligation as an expression of emotionally charged intuitions involving sacred or protected values and an aversive response to betrayal in an asymmetric trust relationship. I then review the most common arguments used (...)
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  • The Pitfalls of Deducing Ethics From Behavioral Economics: Why the Association of American Medical Colleges Is Wrong About Pharmaceutical Detailing.Thomas S. Huddle - 2010 - American Journal of Bioethics 10 (1):1-8.
    The Association of American Medical Colleges (AAMC) is urging academic medical centers to ban pharmaceutical detailing. This policy followed from a consideration of behavioral and neuroeconomics research. I argue that this research did not warrant the conclusions drawn from it. Pharmaceutical detailing carries risks of cognitive error for physicians, as do other forms of information exchange. Physicians may overcome such risks; those determined to do so may ethically engage in pharmaceutical detailing. Whether or not they should do so is a (...)
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  • Philosophers on drugs.Bennett Holman - 2019 - Synthese 196 (11):4363-4390.
    There are some philosophical questions that can be answered without attention to the social context in which evidence is produced and distributed.ing away from social context is an excellent way to ignore messy details and lay bare the underlying structure of the limits of inference. Idealization is entirely appropriate when one is essentially asking: In the best of all possible worlds, what am I entitled to infer? Yet, philosophers’ concerns often go beyond this domain. As an example I examine the (...)
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  • Answering Brody's challenge from a pharmapologist perspective.Thomas D. Harter - 2011 - American Journal of Bioethics 11 (1):29 - 30.
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  • Financial Conflicts of Interest are of Higher Ethical Priority than “Intellectual” Conflicts of Interest.Daniel S. Goldberg - 2020 - Journal of Bioethical Inquiry 17 (2):217-227.
    The primary claim of this paper is that intellectual conflicts of interest (COIs) exist but are of lower ethical priority than COIs flowing from relationships between health professionals and commercial industry characterized by financial exchange. The paper begins by defining intellectual COIs and framing them in the context of scholarship on non-financial COIs. However, the paper explains that the crucial distinction is not between financial and non-financial COIs but is rather between motivations for bias that flow from relationships and those (...)
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  • Eschewing Definitions of the Therapeutic Misconception: A Family Resemblance Analysis.D. S. Goldberg - 2011 - Journal of Medicine and Philosophy 36 (3):296-320.
    Twenty-five years after the term "therapeutic misconception’ (TM) first entered the literature, most commentators agree that it remains widespread. However, the majority of scholarly attention has focused on the reasons why a patient cum human subject might confuse the goals of research with the goals of therapy. Although this paper addresses the social and cultural factors that seem to animate the TM among subjects, it also fills a niche in the literature by examining why investigators too might operate under a (...)
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  • Concussions, Professional Sports, and Conflicts of Interest: Why the National Football League’s Current Policies are Bad for Its Health. [REVIEW]Daniel S. Goldberg - 2008 - HEC Forum 20 (4):337-355.
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  • More Regulation of Industry-Supported Biomedical Research: Are We Asking the Right Questions?Sigrid Fry-Revere & David Bjorn Malmstrom - 2009 - Journal of Law, Medicine and Ethics 37 (3):420-430.
    There is no doubt that industry-sponsored biomedical research is under the microscope. Unfortunately, this new era of skepticism prematurely rushes in doubts of the ethos of science. Skepticism can lead to positive changes, but only when timely and supported by sound reasoning. Snapshot views and theories, especially those that result in costly new regulations and inefficient policies often do more harm than good. Many critics would have the reader doubt scientific integrity because they believe that the relationship between the pharmaceutical (...)
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  • More Regulation of Industry-Supported Biomedical Research: Are We Asking the Right Questions?Sigrid Fry-Revere & David Bjorn Malmstrom - 2009 - Journal of Law, Medicine and Ethics 37 (3):420-430.
    Industry-sponsored biomedical research is under the microscope. In an attempt to achieve just results in extraordinary cases, critics are suggesting regulations that would pervert the U.S. clinical trial process. However, the arguments made to justify such regulation are weak at best. All the proposals to regulate industry sponsorship of clinical trials that we surveyed suffer from some form of fallacious reasoning. In the interest of advocating sound policy, this article points out some of the most common reasoning errors found in (...)
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  • The Physician-Patient Relationship and a National Health Information Network.Leslie Pickering Francis - 2010 - Journal of Law, Medicine and Ethics 38 (1):36-49.
    The growing use of interoperable electronic health records is likely to have significant effects on the physician-patient relationship. This relationship involves two-way trust: of the physician in patients, and of the patients in their providers. Interoperable records opens up this relationship to further view, with consequences that may both enhance and undermine trust. On the one hand, physicians may learn that information from their patients is — or is not — to be trusted. On the other hand, patients may learn (...)
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  • The Physician-Patient Relationship and a National Health Information Network.Leslie Pickering Francis - 2010 - Journal of Law, Medicine and Ethics 38 (1):36-49.
    The United States, like other countries facing rising health care costs, is pursuing a commitment to interoperable electronic health records. Electronic records, it is thought, have the potential to reduce the risks of error, improve care coordination, monitor care quality, enable patients to participate more fully in care management, and provide the data needed for research and surveillance. Interoperable electronic health records on a national scale — the ideal of a national health information network — seem likely to magnify these (...)
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  • Considerations for applying bioethics norms to a biopharmaceutical industry setting.Wendell Fortson, Kathleen Novak Stern, Curtis Chang, Angela Rossetti, Ariella Kelman, Michael Turik, Donald G. Therasse, Tatjana Poplazarova & Luann E. Van Campen - 2021 - BMC Medical Ethics 22 (1).
    BackgroundThe biopharmaceutical industry operates at the intersection of life sciences, clinical research, clinical care, public health, and business, which presents distinct operational and ethical challenges. This setting merits focused bioethics consideration to complement legal compliance and business ethics efforts. However, bioethics as applied to a biopharmaceutical industry setting often is construed either too broadly or too narrowly with little examination of its proper scope.Main textAny institution with a scientific or healthcare mission should engage bioethics norms to navigate ethical issues that (...)
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  • Progressive and degenerative journals: on the growth and appraisal of knowledge in scholarly publishing.Daniel J. Dunleavy - 2022 - European Journal for Philosophy of Science 12 (4):1-27.
    Despite continued attention, finding adequate criteria for distinguishing “good” from “bad” scholarly journals remains an elusive goal. In this essay, I propose a solution informed by the work of Imre Lakatos and his methodology of scientific research programmes (MSRP). I begin by reviewing several notable attempts at appraising journal quality – focusing primarily on the impact factor and development of journal blacklists and whitelists. In doing so, I note their limitations and link their overarching goals to those found within the (...)
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  • Experimental Design: Ethics, Integrity and the Scientific Method.Jonathan Lewis - 2020 - In Ron Iphofen (ed.), Handbook of Research Ethics and Scientific Integrity. Cham, Switzerland: pp. 459-474.
    Experimental design is one aspect of a scientific method. A well-designed, properly conducted experiment aims to control variables in order to isolate and manipulate causal effects and thereby maximize internal validity, support causal inferences, and guarantee reliable results. Traditionally employed in the natural sciences, experimental design has become an important part of research in the social and behavioral sciences. Experimental methods are also endorsed as the most reliable guides to policy effectiveness. Through a discussion of some of the central concepts (...)
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