AMA CEJA – How Did We Get Here

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Thomas Stossel, MD, Chairman of the Division of Translational Medicine at Harvard has written a very insightful editorial published today in the Medscape Journal of Medicine: Response to AMA’s Council on Ethical and Judicial Affairs Draft Report on "Ethical Guidance for Physicians and the Profession With Respect to Industry Support for Professional Education in Medicine" around the origins of controversies surrounding The CEJA Report 1 of The Council on Ethical and Judicial Affairs: Industry Support of Professional Education in Medicine and conflict of interest and the wholesale ethnic cleansing associated with it.

Enactment of these regulations will have profound practical consequences for medical education, and stakeholders concerned about these effects should address them in detail. My intention here, however, is to challenge the fundamental beliefs underlying The Report that transcend medical education to affect medical practice and medical research in general. These beliefs are that commerce in general is detrimental to medical professionalism and that "medicine" and "commerce" have sufficiently misaligned interests to justifying their segregation from one another. Such segregation is increasingly becoming policy in academic medical centers in the form of severe prophylactic laws impinging on physicians’ freedom of association and action, and similar rules are under consideration in state legislatures and in the Congress.

His insightful editorial challenges the concept of “professionalism free of any commercialism”.  He goes right to the start of this recent controversy in the Brennan report Health Industry Practices That Create Conflicts of Interest published in JAMA in 2006.

I first show that Brennan and colleagues and the derivative Report failed to place their "concerns" in terms of a balanced risk-benefit assessment, and that such an analysis does not support their assumptions or the recommendations. I then argue that Brennan and colleagues and The Report based their conclusions on an arbitrary, obsolete, and frankly untenable definition of professionalism.

He outlines a realistic view of medical education: "absence of bias," is impossible and therefore inappropriate as a criterion for professionalism.

This article promises to be a foundational report to helps us understand the value of collaboration.

By working together with industry colleagues, we can explain to the public that the contributions of corporations to medicine are on balance more beneficial than harmful and that both medicine and the industries that provide it with its technologies are worthy of public support. Cooperation, instead of antagonism, can help industry market its products with the highest integrity, keep physicians current on the best available evidence, and provide excellent patient care. This plan, not woolly ethical generalities, is the proper model of medical professionalism.

We challange those who disagree with our position to read his editorial .  This article may change the way you think.  Enjoy…

Medscape Journal of Medicine Stossel Commentary

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