Letters Web of industry, advocacy, and academia

Medical schools should prohibit financial ties between individual academics and industry

BMJ 2015; 351 doi: http://dx.doi.org/10.1136/bmj.h4301 (Published 11 August 2015) Cite this as: BMJ 2015;351:h4301
  1. Paolo Vercellini, associate professor of obstetrics and gynaecology1
  1. 1Department of Clinical Sciences and Community Health, Università degli Studi di Milano, and Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
  1. paolo.vercellini{at}unimi.it

The web of financial interests involving industry, advocacy, and academia in the management of osteoporosis described by Grey and Bolland is typical in many medical specialties.1 2 However, the ethical implications for each component of the web are different. Industry is a private enterprise, its goal is profit, and its managers are accountable to shareholders. Advocacy organisations are morally accountable to patients but are supported mainly by private funds.3 Conversely, most European academics are public employees paid from citizens’ taxes and are accountable to society at large. Academics seem to have the highest ethical liability, because without their compliance neither industry nor advocacy organisations could catch medicine so effectively in the web.

Because academics influence prescription practices they affect citizens’ health and healthcare resources. Therefore, citizens should not only have the right to know which academics are paid by whom and how much but also be allowed to decide whether these financial ties are permissible. Collaboration between industry and academics is necessary, but should not imply payments to individual investigators. Money deriving from industry supported research could be centralised in anonymous institutional funds. Academics have the moral duty to educate young people according to the highest ethical standards. Medical students are intellectually vulnerable and it must be ensured that all teachers enable their medical students to objectively appraise the evidence. Thus, universities should prohibit the establishment of financial ties between academics and private enterprises, including medical communication companies.4

In his last published words, Arnold Relman warned: “now, more than ever, it is important that leaders in academic medical centers set an example for students and faculty by concentrating on advancing the non-for-profit social purposes of these institutions. They cannot do this if they also have ties to pharmaceutical businesses.”5


Cite this as: BMJ 2015;351:h4301


  • Competing interests: None declared.


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