Healthy Skepticism Library item: 14650

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Publication type: news

Carlat D.
AMA's U-Turn on Industry Funding
The Carlat Psychiatry Blog 2008 Nov 21
http://carlatpsychiatry.blogspot.com/2008/11/amas-u-turn-on-industry-funding.html

Full text:

As reported in Medical Meetings (http://meetingsnet.com/medicalmeetings/news/ceja_commercial_support_1108/), the AMA’s Council on Ethical and Judicial Affairs (CEJA) will reverse its earlier position, and will recommend that industry support of CME be allowed to continue. Just last May, CEJA had prepared this report urging the AMA to adopt a stance against allowing commercial support of CME, concluding that:

“To promote continued innovation and improvement in patient care, medicine must sustain ongoing, productive relationships with the pharmaceutical, biotechnology, and medical device companies. However, industry support of professional education has raised concerns that threaten the integrity of medicine’s educational function….Existing mechanisms to manage potential conflicts and influences are not sufficient to address these concerns. Recognizing the profession-defining importance for medicine of achieving its educational goals, the Council recommends that:
Individual physicians and institutions of medicine, such as medical schools, teaching hospitals, and professional organizations (including state and medical specialty societies) must not accept industry funding to support professional education activities.”

That report was debated in an AMA reference committee (a committee which debates issues before bringing them before the full house of delegates), and after hearing from a slew of medical education companies, the committee recommended tabling the proposal for further review. Since then, Dr. Mark Levine, the chairman of the committee, ended his term and was replaced by Dr. Regina Benjamin. Apparently, one of the committee members (not Dr. Benjamin) told journalist Dave Kovaleski that while the next version of the report will not be released until next June, an interim report makes it clear that industry funding will continue in some fashion or other. That’s clear enough. But in a strange twist, CEJA is now calling for comments as they prepare the final report. They’ve already given us the punchline, and now they want input?

At any rate, it appears that CEJA is working on this report jointly with the AMA’s Committee on CME, and this may explain why CEJA has changed its mind. The ethics of the issue have not changed over the last 6 months—after all, ethics rarely change at all. The core ethics of this issue were summarized in the original report’s abstract thusly:

“Medicine’s autonomy and authority to regulate itself depends on its ability to ensure that current and future generations of physicians acquire, maintain, and apply the values, knowledge, skills, and judgment essential for quality patient care. To fulfill this obligation, medicine must ensure that the values and core commitments of the profession protect the integrity of professional education.”

In May, this ethical core struck CEJA as being inconsistent with industry funding of medical education. What appears to have happened is that ethics (CEJA) has married expediency (the CME Committee.) The final report will therefore be a moral compromise. This does not make me proud of my profession.