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For decades, medical professionals have been betraying the public's trust by accepting various benefits from the pharmaceutical industry. Drug company representatives and doctors alike have promulgated creative rationalizations to portray this behavior positively, as if it really serves the interest of the public. In Hooked: How Medicine's Dependence on the Pharmaceutical Industry Undermines Professional Ethics, Howard Brody claims that we can neither understand the problem, nor propose helpful solutions until we fully recognize the many levels of activity that connect these two industries. Then, for real improvement to occur, the doctors themselves need to not only change their behavior, but also change how they view the actions of their peers and colleagues. We can pass laws and enact regulations, so that those physicians that do choose to focus on ethics won't be in an environment where they feel as if they are swimming against too strong a current to make meaningful change, but ultimately a profession has to take responsibility for its own integrity.
The relationship between the medical profession and the pharmaceutical industry is an ethical minefield. Brody (director, Inst. for the Medical Humanities, Univ. of Texas Medical Branch, Galveston; The Placebo Response) traces the gradual intertwining of the two, showing how it has led to a climate in which research, prescribing practices, government regulation, and even journal articles are influenced by dollars and marketing in ways seldom questioned. From medical school on, he writes, physicians encounter pharmaceutical representatives and receive favors that start small and grow, causing doctors to develop a sense of entitlement. They see others as being compromised by grants, gifts, and other enticements, yet deny that they themselves are influenced. Brody offers suggestions for achieving divestiture rather than continuing to try to manage the status quo. Thoroughly documented, logically structured, and well written, his book offers a good starting point for discussing ethical issues that impact us all. There is some overlap with Leonard J. Weber's Profits Before People?: Ethical Standards and the Marketing of Prescription Drugs, but Brody's work is more focused on medical ethics. Recommended for all medical and public libraries.
—Dick Maxwell Copyright 2007 Reed Business Information
Chapter 1 Introduction: The Tipping Point Part 2 I. Overview Chapter 3 1. The Good, the Bad, and the Ugly: A Story of Two Medications Chapter 4 2. An Ethical Framework Part 5 II. Specific Issues and Problems Chapter 6 3. The Pharmaceutical Industry and the Free Market Chapter 7 4. Patents, Generic Drugs, and Academic Science Chapter 8 5. Research and Profits Chapter 9 6. Suppression of Research Data Chapter 10 7. The Quality of Pharmaceutical Research Chapter 11 8. The Drug Rep: Historical Background Chapter 12 9. The Drug Rep Today Chapter 13 10. The Influence of Drug Reps: What the Data Show Chapter 14 11. Continuing Medical Education Chapter 15 12. Professional Organizations and Journal Advertising Chapter 16 13. The Industry and the Consumer Chapter 17 14. The FDA: From Patent Medicine to AIDS Drugs Chapter 18 15. The FDA and the Industry, 1990-2004 Part 19 III. Toward Solutions Chapter 20 16. Solutions: The Management and Divestment Strategies Chapter 21 17. Solutions Requiring Enhanced Professionalism in Medicine Chapter 22 18. Solutions Requiring Regulatory Reform Chapter 23 Epilogue: Industry Woes and Professional Opportunities