Medical Ethics—Industry and Realism-Reply

Abstract

Gallagher's letter makes four points: (1) that ethics in regard to physicians and pharmaceutical companies is a new and exaggerated issue; (2) that he is personally insulted that his decision making could be influenced by marketing strategies; (3) that the editorial message implied that association with drug or medical device companies is a crime; and (4) that we should instead look at more important issues, which have larger impacts than dinner with drug representatives. The first three points deserve response. The fourth does not. Doctors are parties to a social contract, and they practice in a profession that should be protected from outside influence. Evidence abounds that the medical-industrial complex is threatening that contract. Rules or standards that govern the conduct of individuals in a profession is the definition of ethics. How can one argue that this relationship is not an ethics one? Second, that Gallagher could not be influenced