Questionable ethics: a textbook case


When Chris Thompson received a free textbook in his Eyes, Nose and Throat class he took a look at the logo in the corner and rolled his eyes.

The symbol was for Daiichi Pharmaceutical Corporation, which distributes an ear infection solution called FLOXIN Otic. The company gave a grant for the book to be updated and distributed.

“Primary Care Otolaryngology” was given to second-year medical students on Oct. 19 and is part of a much bigger problem – the unhealthy collusion of medical education and the pharmaceutical industry, Thompson said.

The University of Minnesota does not have guidelines in place to restrict such gifts, Dr. Mark Paller, executive vice dean of the Medical School, said. A draft of a conflict of interest policy will be finished in the next couple of weeks which probably would not allow gifts to be given to students, Paller said.

He said the textbook is an attempt by the industry to curry favor with future prescribing physicians.

“If [the company] really wanted to do it for educational purposes, they would give a donation to the University and allow the curriculum committee to decide how to use the money,” Paller said.

Center for Bioethics professor Dr. John Song was a member of the conflict of interest task force created by former Medical School Dean Deborah Powell. The task force’s final report from August 2008 recommended against gifts like this, Song said.

But the report was condensed into a two-page document which left out the suggested policy.

Song said pharmaceutical influence in education has become less common in the past few years.

Thompson said he has not received any other textbooks with pharmaceutical logos or heard of any other instances of gift-giving.

Third-year medical student Hannah Shacter said to her knowledge she never received any gifts from pharmaceutical companies.

Paller said the students can choose not to take the book.

“Medical students are mature adults, they can make their own decision,” he said. “It’s not as if their diploma has a pharmaceutical logo on it or something like that.”

Thompson said it is difficult to tell whether the material in the book is unbiased.

The basis of the book was written by Dr. Gregory Staffel in 1996 and was revised and edited by members of the American Academy of Otolaryngology – Head and Neck Surgery. The educational content does not mention Daiichi.

But the beginning of each chapter says Daiichi Pharmaceutical Corporation distributes FLOXIN Otic solution and gave a grant to the American Academy of Otolaryngology for the revisions and distribution of the book.

“The authors and editor had sole responsibility for the subject matter and editorial content,” the introduction by Daiichi Pharmaceutical says.

Although the textbook’s content may not push the pharmaceutical company’s product, having the mark of the company creates an “unfavorable impression,” Thompson said.

It’s important to convey that “we are professional people, and the medicine we practice is not biased, is not influenced by the industry,” he said.