Does money or patient welfare drive our profession?

An extremely well-written and thought provoking book is The Truth About The Drug Companies: How They Deceive Us And What To Do About It, by Marcia Angell. Dr. Angell is a former editor of the New England Jounrnal of Medicine and a respected authority in the field of medical and pharmaceutical matters. Her book tackles what she has termed the takeover of the pharmaceutical field by 'big pharma'

Dr. Angell opines that the massive profits generated by the leading pharmaceutical companies are no longer morally justified and sustainable. She argues that truly innovative and socially profitable drugs are now few and far between, and that the current system of patent protection and profit taking is being manipulated by pharmaceutical companies, to the detriment of the general public. Her arguments are well reasoned and backed up by fact and lead one to give a certain credence to her thesis.

In this light, an introspective view at the manner in which we conduct our profession is warranted. Do we, as Dr. Angell so well describes in her writing, take every word and advertised fact proposed by drug companies as being incontrovertibly right? Do we question research we are quoted and probe the efficacy of newer and more costly medicinal products? Do we consider the financial implications that pharmaceuticals have on the daily well-being of our patients? Are we placing our own motives for profit, financial or otherwise, before those of the public we are obliged to treat impartially?

The above questions are not easily answered, and as in most situations in life, the pragmatic response is a grey line somewhere down the moral middle. Considering them and applying the consequent thoughts to our daily professional practice can only lead to better application and patient benefit. The above mentioned book is also worth a read as it portrays the pharmaceutical industry in a manner few have had the courage to.