Shrink Choice, Patient Tough Titty & Only living dog to see Bunuel's "Un Chien ..."

21-item questionnaire ethical issues Practitioner Acronym Table

i was to say my first NY apt. ... but, in retrospect, your tweet does not support it; untenable expiation, impossible correction, failing future motility through recursive, penance or obfuscatory effort, transforms into palimpsest

The only living dog to have seen Bunuel's famous classic film, "Un Chien ...".

 

Including the famous scene.

... An animal eye is cut with a razor.

Designed and filmed by artist Salvador Dali. He and Gala and some dogs attend the only Cannes Filme Grande Première - north by northwest of Cannes.

The dog saw “Dog,” with the same eyes “we humans,” see horror in movies like “Psycho” and “Jaws”.

The dog is suffering from post-traumatic stress disorder.

• A drug company representative gives a practicing physician a box of golf balls (value about $40). Is this scenario ethically problematic?

• A drug company representative gives a practicing physician several large medical textbooks (total value, about $500). Is this scenario ethically problematic?

• Same basic scenario as scenario 4, but the recipient of the textbooks is a first-year medical resident. Is this scenario ethically problematic?

• A drug company sponsors a dinner for practicing physicians at a nice restaurant. Dinner is followed by a speaker on a medical topic. The speaker receives an honorarium from the drug company, and his lecture includes a favorable discussion of a drug made by the company. Is this scenario ethically problematic?

• Same basic scenario as scenario 6, but the lecture mentions no products made by the company sponsoring the dinner. Is this scenario ethically problematic?

• A drug company pays the honorarium for a speaker at medical Grand Rounds at your institution; this sponsorship is disclosed to the audience. The lecture includes a favorable discussion of a drug made by the company. Is this scenario ethically problematic?

• Same basic scenario as scenario 8, but the lecture mentions no products made by the company sponsoring the Grand Rounds. Is this scenario ethically problematic?

• A drug company offers a practicing physician an all-expenses-paid weekend trip to a resort hotel (includes airfare, hotel, meals, and entertainment). The physician's only obligation is to spend several hours in seminars focusing on the company's products. Is this scenario ethically problematic?

• A drug company representative provides free samples of newly marketed drugs for a physician's office. Is this scenario ethically problematic?

• A drug company provides free lunch for a noon conference for residents and medical students; the conference is taught by one of the medical school faculty. At the beginning of the session, the drug company representative gives a 3-minute presentation on his company's newest drug. Is this scenario ethically problematic?

• Same drug representative does not give a formal presentation; instead, he chats informally with residents and students before and after the session. Is this scenario ethically problematic?

• Same12 and 13 (the drug company buys the lunch), but no company representative is present at the session. Is this scenario ethically problematic?

• A drug company provides an unrestricted monetary gift ($1000) to the department of medicine; it can be used for any educational purpose. Is this scenario ethically problematic?

• A medical clinic staffed by residents has a small vacant office in which drug representatives are permitted to sit during clinic hours. Sometimes they bring new drug product information and snacks. During clinic hours, the residents can stop in to chat if they wish. Is this scenario ethically problematic?

• A drug company pays for  (eg, a "happy hour" at a local bar); several drug representatives attend. Is this scenario ethical?

• Do physicians with reliable information on the indications for, and effectiveness of, newly marketed drugs?

  
  

• Do drugs provide physicians with reliable newly marketed drugs similar already on the market?

  (Please respond on a scale of 0-3, where 0 indicates not at all reliable and 3 indicates very reliable.)

• Do you think that the drugs in a physician's office (provided at no charge by the drug company) influences a physician's choice of drugs? 

   (Please respond on a scale of 0-3, where 0 indicates not at all influential and 3 indicates very influential.)

Conclusions

We found that physicians at a single institution tended to hold fairly lenient views on the ethical propriety of a wide range of gifts and activities sponsored by the pharmaceutical industry. The views of physicians-in-training and experienced physicians were similar. Many physicians did not seem troubled by gifts and activities that are considered problematic by professional organizations such as the AMA and ACP. Nevertheless, some physicians appeared to believe that even gifts of minimal monetary value might pose ethical problems. In our view, the medical profession should focus more attention on the underlying rationale for personalized marketing to physicians by the pharmaceutical industry and less attention on fine distinctions among the specific gifts and activities themselves.