Several medical professional associations have adopted guidelines, codes or other statements on physicians` relationship with industry, but the Committee did not find a complete overview of the statements (or lack thereof) of professional societies. A selective review of social policy suggests that statements about gifts are quite common, while statements about advertising speech, ghostwriting and consultation agreements are not. A number of professional groups have signed a Charter for Medical Professionalism, which identifies “maintaining trust through conflict of interest” as the 1 in 10 key tasks for physicians (ABIM Foundation et al., 2002, p. 245). Box 6-1 contains excerpts from the general WADA and ACP opinions on industry gifts to physicians. The WADA Declaration, first adopted in 1990, has been endorsed or used as a model by a number of other professional societies, including the American Academy of Pediatrics (Fallat & Glover, 2007), the American College of Obstetricians and Gynecologists (Morgan et al., 2006) and the American College of Rheumatology (ACR, 2007). WADA has also issued specific recommendations for representatives of medical devices. It emphasizes that the information provided by these representatives or the training provided by these representatives should not replace adequate training of physicians and should be subject to institutional policies governing the presence of these representatives (e.g., patient information, privacy and credentials) (AMA, 2007). Disarmament, in mutual honour and trust, is a constant imperative. Together, we must learn to deal with differences, not with weapons, but with decent intelligence and determination.

Because this need is so acute and obvious, I confess that I resign from my official responsibilities in this area with a certain sense of disappointment. As a witness to the horror and lingering sadness of war – as someone who knows that another war could completely destroy this civilization that has been built so slowly and painfully over thousands of years – I wish I could say tonight that lasting peace is in sight. As described in this chapter, the relationship between practising physicians and drug and medical device companies is extensive and has resulted in a number of responses from professional societies, government officials and other stakeholders. The community medical practice environment presents different challenges than the academic and research communities. In particular, physicians in group practice often have a lower attachment to institutions than academic physicians and a higher degree of autonomy. While Chapters 3 and 5 mention issues related to the implementation of conflict of interest policies by academic institutions, these institutions are generally better able to enforce compliance with conflict of interest policies by employees than professional societies in enforcing their members to enforce their policies and codes of ethics. Like all other citizens, I wish the new president and all those who will work with him well. I pray that the years ahead will be blessed with peace and prosperity for all. Megan Maixner, Elizabeth Meshes, in Evidence-Based Treatment for Children with Autism, 2014 This document is available on DocsTeach, the online tool for teaching with documents from the National Archives. Search for teaching activities that include this document or create your own online activities.

From a legal system perspective, the more relevant information a judge or jury considers in a court case, the fairer the decision. In order to obtain these documents, the court may issue subpoenas (lawful orders to appear witnesses) or subpoenas of ces tecum (legal instructions to appear and bring certain documents). A court may also make an order requiring a party to make a statement or produce documents. There is a difference between morality, ethical principles and a code of ethics. Morality refers to the “personal values, character, or behavior of individuals within communities and societies.” [11] An ethical principle is a general guide, fundamental truth, or hypothesis that can be used with clinical judgment to determine a course of action. Four common ethical principles are charity (doing good), non-malevolence (doing no harm), autonomy (individual control) and justice (equity). A code of ethics is established for a profession and explains its main commitments, values and ideals. Other researchers have approached risk from a social psychology perspective, wondering why lay observers often diverge from experts in their judgments about the relative importance of different types of risk. This question has given rise to a considerable number of experiments and examinations of risk perception (Slovic 2000), as well as theoretical critiques of this work, which have revealed problems in both the formulation and characterization of secular attitudes (Irwin and Wynne, 1994).

While some social scientists were concerned with identifying and measuring “real” risks or their perceptions, others treated risk itself as a new organizing principle in social life, noting that vulnerability to risk was not clearly mapped to previous divisions of society along race, class, or economic status (Beck 1992). In contrast, the American environmental justice movement produced data suggesting that social inequality still played a role in the distribution of industrial risks, which disproportionately affected the poor and minorities (Bullard, 1990). This strategic research, while controversial, led to an executive order in 1994 requiring U.S. federal agencies to consider the impact of their actions on justice. Fairness analysis thus emerged as an offshoot of existing risk assessment methods and provided a formal justification for legal claims of environmental injustice. The scientific study of risk is the result of governments` efforts to manage the dangers of industrial production and a growing reliance of modern governments on formal decision-making tools to streamline difficult policy decisions. Uncertainty about the risks and benefits of technology has increased throughout the twentieth century, as has the size and complexity of production systems. From the village economy, where victims assumed to know the agents and the causes of the damage inflicted on them, the global economy has attracted consumers into networks of relationships that spread both knowledge of risks and responsibility for regulation and compensation.