Physicians understand that to maintain their professional objectivity they must be mindful of potential biases in medical information. In fact, the entire infrastructure of science and much of physician education is built on the fundamental notion of eliminating, or at least controlling for, the many and powerful biases inherent in generating and interpreting scientific data.
Ethically and professionally, the objective evaluation of medical information is critical for deciding on best clinical practices (beneficence) and avoiding risks to patient safety (Stryer, 1996). Thus, physicians have an obligation to themselves, their profession, and society to evaluate, correct for, and eliminate potential bias in medical information from all sources and disclose relationships with drug companies.
Physicians also have an ethical obligation, based on the principle of patient autonomy and informed choice, to disclose their commercial ties to patients who are prospective study participants. Physicians who involve their own patients in office-based trials must also be aware of potential conflicts between what is best for the patient-subject and what is optimal for the conduct of the research. In weighing the two interests, clinicians must consider their role as physician first and as investigator second.
It is reasonable for the clinician to receive compensation commensurate with time and expenses incurred in study recruitment (Ziegler, 1995). However, physicians may not accept compensation simply for referring their patients to an industry study, regardless of whether the physician directly participates in the trial. Known as "finder’s fees," such arrangements represent pure profit and create an inherent conflict with the best interests of the patient.
Participation in practice-based research can contribute to our understanding of the benefits and risks of a new product, thereby promoting medicine’s underlying principles of beneficence. Still, physicians are responsible for ensuring that any clinical research in which they participate is potentially of significant value.......
