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Healthy Skepticism International News

August 2002

AN UNHEALTHY ALLIANCE: A discourse analytic study of General Practitioners and Pharmaceutical…

August - October 2002 Vol 20 No 8-10


A discourse analytic study of General Practitioners and Pharmaceutical Representatives, Gifts and Samples


ABSTRACT                                                                    iv

DECLARATION                                                                vi

ACKNOWLEDGEMENTS                                                       vii

CHAPTER ONE: INTRODUCTION                                            1         Pharmaceutical Promotion

1.1.1.      General Overview

1.1.2.      The Influence of Pharmaceutical Promotion on Prescribing

1.2         Medical Ethics

1.3         Ethical Dilemmas

CHAPTER TWO: METHODOLOGY                                        22

2.1         Discourse Analysis

2.2         Collection of Data

2.3         Analysis Procedure

2.4         Methodological Issues

2.5         Analysis Outline


3.1         The ‘Business’ Repertoire

        3.2         The ‘Information/Knowledge’ Repertoire

        3.3         Discussion

REFERENCES                                                                  59

APPENDICES:                                                                67

A:        Information Letter                                                    

B:        Consent Form                                                        

C:        Focus Group Information Sheet                                  

D:        Focus Group Questions and Issue Statements                    

E:        Transcript Notation                                                  

F:        MaLAM                                                            

G:        AMA Position Statement: Code of Ethics                        

H:        ‘Business’ Repertoire Extracts                                        

I:        ‘Information/Knowledge’ Repertoire Extracts



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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909