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Opinion 9.6.2

Gifts to Physicians from Industry

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Relationships among physicians and professional medical organizations and pharmaceutical, biotechnology, and medical device companies help drive innovation in patient care and contribute to the economic well-being of the community to the ultimate benefit of patients and the public. However, an increasingly urgent challenge for both medicine and industry is to devise ways to preserve strong, productive collaborations at the same time that they take clear effective action to prevent relationships that damage public trust and tarnish the reputation of both parties. 

Gifts to physicians from industry create conditions that carry the risk of subtly biasing—or being perceived to bias—professional judgment in the care of patients. 

To preserve the trust that is fundamental to the patient-physician relationship and public confidence in the profession, physicians should: 

  1. Decline cash gifts in any amount from an entity that has a direct interest in physicians’ treatment recommendations. 
  2. Decline any gifts for which reciprocity is expected or implied. 
  3. Accept an in-kind gift for the physician’s practice only when the gift:
    1. will directly benefit patients, including patient education; and 
    2. is of minimal value. 
  4. Academic institutions and residency and fellowship programs may accept special funding on behalf of trainees to support medical students’, residents’, and fellows’ participation in professional meetings, including educational meetings, provided: 
    1. the program identifies recipients based on independent institutional criteria; and 
    2. funds are distributed to recipients without specific attribution to sponsors.
AMA Principles of Medical Ethics: II
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Related Opinions

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Opinion 1.1.1

Patient-Physician Relationships

At the heart of medicine lie relationships founded in a “covenant of trust” between patient and physician in which physicians commit themselves to responding to the needs and promoting the welfare of patients.
Opinion 1.2.8

Gifts from Patients

Some gifts are offered to physicians as an expression of gratitude or a reflection of the patient’s cultural tradition. Accepting these gifts can enhance the patient-physician relationship; Some patients offer gifts or cash to secure or influence care or to secure preferential treatment. Such gifts can undermine physicians’ obligation to provide services fairly to all patients.
Opinion 7.1.4

Conflicts of Interest in Research

Minimizing and mitigating conflicts of interest in clinical research is required in order to justify and maintain trust in the medical research community.
Opinion 9.2.6

Continuing Medical Education

Physicians should strive to further their medical education throughout their careers, to ensure that they serve patients to the best of their abilities and live up to professional standards of excellence. Participating in certified continuing medical education (CME) activities is critical to fulfilling this professional commitment to lifelong learning.
Opinion 9.2.7

Financial Relationships with Industry in Continuing Medical Education

Financial or in-kind support from pharmaceutical, biotechnology, or medical device companies that have a direct interest in physicians’ recommendations creates conditions in which external interests could influence the availability or content of continuing medical education (CME). When possible, CME should be provided without such support or the participation of individuals who have financial interests in the educational subject matter.
Opinion 11.2.2

Conflicts of Interest in Patient Care

Under no circumstances may physicians place their own financial interests above the welfare of their patients. Treatment or hospitalization that is willfully excessive or inadequate constitutes unethical practice.