Intended for healthcare professionals

Rapid response to:


Pharmaceutical industry sponsorship and research outcome and quality: systematic review

BMJ 2003; 326 doi: (Published 29 May 2003) Cite this as: BMJ 2003;326:1167

Rapid Response:

Uneasy interactions just around the corner

“Here is no water but only rock … amongst the rock one cannot stop or


The Waste Land

I welcome the article by Lexchin et al. published in the current
issue of the journal. It is common place that the progress of medical
science has become increasingly dependent on pharmaceutical industry and
this seems to have direct implications for public health affairs. The link
between medicine and pharmaceutical industry has directly affected the way
that medicine is practiced and also the quality of medical care. In an
increasingly globalised world, if medical research and practice is
dictated by the needs of industry, this suggests crisis. I really wonder
if there is still enough space for some independent research in academic
laboratories. On the other hand, it is dangerous when medical research
narrows its concentration into areas directed by the profit motive of
pharmaceutical industry. I think this, finally, underlies the
helplessness of the individual.

The medical community itself knows better than anyone else how deeply
these ties traumatise the integrity of medical profession, and also, if
efforts and codes of practice failed, what the potential consequences
might be. I believe that the central question is not whether someone
should tell clinicians and researchers what to do or not to do, but who
impose such limits and directions and by what criteria. And if there will
not be a clear distinction between medicine and pharmaceutical industry
the results of this entwinement cannot be predicted. It is a matter of
medical culture and, indeed, if doctors learn to shrug their shoulders
about these issues the future of medicine seems dull, and, then, perhaps
the price for patients and society may be high.

Competing interests:  
None declared

Competing interests: No competing interests

03 June 2003
Konstantinos E. Paparounas
Consultant Neurologist
Department of Neurology, Hatzikosta General Hospital of Ioannina, 45001 Ioannina, Greece