Public policy tries to promote appropriate drug use by allowing firms to market drugs in interstate commerce only for uses that the Food and Drug Administration has found to be safe and effective. Because of their medical knowledge, physicians are authorized to prescribe drugs even for uses unapproved by the FDA. Nevertheless, physicians have relied on drug firms for information on appropriate prescribing despite the inherent tension between drug firm dissemination of information to promote sales and rational prescribing. In the (...) past, physicians often relied particularly on drug firm advertising for information on drug use. Today, physicians rely on drug firms to finance continuing medical education. A historical review reveals connections between these two different ways commercial interests have influenced the information that physicians receive and points the way to needed reforms. (shrink)

The article addresses the topic of “group agency” with respect to large organizations. It undertakes to analyze some of the concrete micro- and meso-level processes (microfoundations) through which large organizations arrive at collective “knowledge” and “action.” The article makes use of the theory of strategic action fields to analyze processes of knowledge and the implementation of organizational intentions. The article describes some of the dysfunctions and disunities that should be expected from these individual-level processes, including principal–agent problems, conflicts of interests (...) and priorities among organizational actors, loose coupling among subunits, and outcomes that are influenced by powerful outsiders. It argues for a limited conception of “ bounded localistic organizational rationality” in which organizations have limited coherence, unity, and consistency over time in their beliefs and actions. (shrink)

Resistance by physicians, medical researchers, medical educators, and medical students to pharmaceutical industry influence in medicine is often based on the notion that physicians and the industry are in conflict. This criticism has taken the form of a professional movement opposing conflict of interest in medicine and medical education and has resulted in policies and guidelines that frame COI as the problem and outline measures to address this problem. In this paper, I offer a critique of this focus on COI (...) that is grounded in a broader critique of neo-liberalism, arguing it individualizes the relationship between physicians and industry, too neatly delineates between the two entities, and reduces the network of social, economic, and political relations to this one dilemma. (shrink)

Physicians, scholars, and policymakers continue to be concerned about conflicts of interests among health care providers. At least two main types of objections to conflicts of interest exist. Conflicts of interests may be intrinsically troublesome if they violate providers’ fiduciary duties to their patients or they contribute to loss of trust in health care professionals and the health care system. Conflicts of interest may also be problematic in practice if they bias the decisions made by providers, adversely impacting patient outcomes (...) or wastefully increasing health care costs. This latter objection may be observed in differences in the prescriptions written, procedures performed, or costs billed by health care professionals who have conflicting interests, when compared to those that do not have such financial relationships. (shrink)

Essay Review: Medicine To Make You Mad Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America by Robert Whitaker Henry H. Bauer Essay Review: Apparitions of the Living: The Views of William H. Harrison and Gabriel Delanne Spirits Before Our Eyes by William H. Harrison Les Apparitions Matérialisées des Vivants & des Morts. Vol. 1: Les Fantômes de Vivants [Materialized Apparitions of the Living and of the Dead. Vol. 1: Phantoms of the (...) Living] by Gabriel Delanne Carlos S. Alvarado Phantasms of the Living by Edmund Gurney, Frederic W. H. Myers, and Frank Podmore Bryan J. Williams Nonsense on Stilts: How To Tell Science from Bunk by Massimo Pigliucci Constantin Cranganu Nonsense on Stilts: How To Tell Science from Bunk by Massimo Pigliucci Hannah Jenkins The Logical Leap: Induction in Physics by David Harriman Michael Davidson Paranormal America: Ghost Encounters, UFO Sightings, Bigfoot Hunts, and Other Curiosities in Religion and Culture by Christopher D. Bader, F. Carson Mencken, and Joseph O. Baker Mark Rodeghier Loch Ness, Nessie, & Me: The Truth Revealed by Tony Harmsworth Karl P. N. Shuker Conscious Connections: About Parapsychology and Holistic Biology by Göran Brusewitz Michael Nahm Science & Spirit by Hernani Guimarães Andrade Wellington Zangari & Fatima Regina Machado The Sixth Sense Reader edited by David Howes Patric Giesler. (shrink)