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Medicine and Bribery

A Short Explanation of Medicine and Bribery

A Short Explanation of Medicine and Bribery

Bribery can crop up easily in the medical world, but there are no Federal rules preventing many of the forms of bribery that might be used since doctors are not Government employees. That, coupled with doctors’ importance to the general public of America, makes bribery in the medical world an entirely different, dangerous beast than is bribery in the Government.
Just like any other system in which individuals are given power and knowledge over others, the medical world is ripe for bribery. The form of bribery primarily seen in America is a relatively recent development,  however, as there weren’t major drug manufacturers with the power or desire to bribe doctors to endorse their products. In the past, and in developing countries, bribery of doctors likely instead took the form of patients bribing doctors to ensure better care.
Currently, doctors being bribed by major medical companies forms a much more insidious, and potentially dangerous, kind of bribery. This form of bribery is difficult to detect and even more difficult to eliminate. For more on the general background of bribery and how it relates to the medical profession, click the link. 
In the medical world, aside from bribes for medical service which are mostly restricted to developing nations, most bribery originates with pharmaceutical companies. Pharmaceutical companies’ primary purpose is to make money. Often the most apparent way for them to do so is by bribing doctors and other individuals with power over the medical world. Doctors can be bribed to prescribe certain drugs more often, which increases the pharmaceutical companies’ profit and exposure. 
Food and Drug Administration officials can be bribed to expedite the process of drug approval to ensure that drugs are approved quickly, regardless of dangers. Such bribery represents a major danger to the overall health of America and any country with similar problems. Follow the link for a more in-depth discussion of the problems surrounding bribery and pharmaceutical companies. 
One of the semi-innocuous forms of “bribery” used by pharmaceutical companies to influence doctors is that of free samples of drugs. Free samples are a very difficult issue to talk about because they have both advantages and disadvantages. More free samples will allow doctors to give drugs to patients without the patient needing to spend money on full prescriptions. Free samples will give doctors the option to see if the drug works for the patient at no cost to the patient. 
However, free samples often influence doctors’ judgment in unfortunate ways. A doctor becomes more likely to reach for his free samples when prescribing medicine for a patient than he is likely to give the patient a known medicine that might do more good than the medicine the doctor assigns out of his drawer of free samples. To learn more about the dangers and benefits of free samples, click the link. 
Doctors and medical professionals have a very important role in the world. That role affords them a great deal of power over their patients. It is all too easy to abuse that power by requesting bribes from patients in order for the patients to receive improved treatment or by accepting a bribe from a pharmaceutical company who would prefer doctors to recommend their drugs to patients, whether those drugs merit recommendation or not.
The code of medical ethics that all doctors swear to follow bears a number of principles at its forefront, such as “do no harm” and “the patient comes first.” Performing either of the above bribery-based actions would cause the doctor to come into conflict with that code of ethics. For more information on the ethics of doctors and how it relates to bribery, click the link.
Most bribery between pharmaceutical companies and medical professionals comes in less blatant forms. At least this is true of most known bribery. It is possible that more traditional bribery takes place under the table, unknown to most, but it is safe to say that this is likely rarer than the more open, seemingly innocuous methods of gifting from the pharmaceutical companies. 
These gifts, however, can come in many forms, and can greatly affect the judgment of doctors, as much as if the doctors had made an agreement to act in certain ways. To learn more about some of the many ways in which doctors can be influenced by gifts from pharmaceutical companies, follow the link.

How Is Bribery Involved in the FDA

How Is Bribery Involved in the FDA

In the world of medicine, it is the role of such organizations as the Federal Drug Administration and the role of doctors in general to act as a discerning body, determining whether or not any drug manufactured by a pharmaceutical company is effective, too dangerous, or anything else of note. Bribery intrudes on this system, warps it, and corrupts it until it is no longer able to fulfill its intended purpose. 
It is too easy for a pharmaceutical company to bribe an FDA official simply in order to gain approval for one of the company’s drugs. Instances of such bribery have been discovered many a time and likely continue today.
Bribery of FDA officials is criminal, as FDA officials are Government employees. Bribing an FDA official is no different than bribing a senator. Pharmaceutical companies also often bribe doctors, outside of the FDA, in order to gain those doctors’ endorsements for their drug products or to get those doctors to prescribe their drugs more often. Technically, this form of bribery would not fall under the purview of Federally illegal bribery, as these doctors are not Federal employees.
The American Medical Association has its own rules for punishing doctors who accept such bribes, however, as behavior of the sort is deemed unethical. Bribery from pharmaceutical companies can often be even more dangerous than bribery in Government, as it can lead to the approval of drugs which are dangerous or ineffective.
When pharmaceutical companies dole out bribes, they do so under the traditional guise of “giving gifts,” as gifts are supposedly different from bribes in one substantial way: bribes are attempts to make the bribed individual perform a certain service or action in response to the bribe, whereas gifts supposedly have no strings attached. 
This is obviously a fabrication, as doctors receive outrageous “gifts” from pharmaceutical companies in order to influence the judgment of those officials. These gifts may not come with a clear, specific request for a particular action, but almost certainly the doctor receiving the gifts is expected to alter his practices to better accommodate the gifting pharmaceutical company’s desires.
Giving such gifts to an FDA official would, under Federal law, be considered a form of bribery, as no Federal employee can receive gifts for performing their duties. However, this does not mean that bribery of the FDA or similar agencies is curtailed, as is evidenced by examples such as the investigation performed by a pharmaceutical company, Mylan, in order to determine if FDA employees were accepting bribes from Mylan’s competitors.
Mylan hired private investigators who found evidence that FDA officials were often bribed. FDA officials took bribes from pharmaceutical companies, and in return, expedited the approval process for Mylan’s competitor’s drugs. 
Bribery from pharmaceutical companies is perhaps the most directly dangerous form of bribery for the public of America. Such bribery allows for the bypass of rules and regulations specifically implemented to keep the public aware of, and safe from, harmful drugs. If the system continues to be so easily circumvented through the use of bribe after bribe, then the future of America’s health is grim.

Significant Examples of Bribery

Significant Examples of Bribery

Bribery in the medical profession can lead to terrible consequences, undermining the legitimacy of any given doctor’s medial decisions. Even more innocuous gifts from pharmaceutical companies to doctors can have the effects of full-fledged bribery in influencing doctors towards making different, and perhaps worse, decisions.
This is part of the reason why providing direct examples of pharmaceutical companies bribing doctors is difficult. Though it assuredly happens, pharmaceutical companies do not wish to be charged with bribery, so they search for alternate means to achieve the same results. Non-obvious forms of bribing, like small gifts, can be used for much the same purpose. 
As an example of such “bribing” and its effects, consider a situation in which a doctor has been given all sorts of small gifts from pharmaceutical companies. These are not major gifts, not valued highly in cash, or otherwise. They cannot be considered “bribing” from the more traditional point of view, especially because they really are gifts: the pharmaceutical company simply gave the doctor a free pen, no strings attached. 
But then, when he goes to write a note, he’s writing it with a pen that blares the name of a pharmaceutical company on the side. He’s writing on a pad with the name of a drug watermarked into the paper. He reaches for his mouse and sees the mousepad underneath, emblazoned with the logo and curly font of another pharmaceutical company’s cash cow drug. It’s not hard to believe, then, that when this doctor goes to write a prescription, his mind is going to drift to the names he sees on the objects he uses every day. 
While the pharmaceutical companies cannot be charged with bribery for giving out these objects, they are assuredly given out with the intent of influencing doctors, almost as a form of constant marketing, aimed at the physicians themselves. 
If the pharmaceutical companies give out free samples, then the doctors are likely to be all the more influenced. A doctor who has a number of free samples to give out to his patients is entirely likely to prescribe those, first, as he will be saving his patients the cost of buying a drug, and the free sample may very well work. 
But at the same time, often enough doctors will prescribe from their supply of free samples instead of necessarily making the best decision and prescribing a drug that is more likely to help the doctor’s patient. So even if the doctor is not actively making decisions to act improperly, as he would be if he were complicit in out and out bribing, the doctor can still be doing exactly what the pharmaceutical company would want him or her to do without ever once having had to take the chance of being charged with bribery. 
Essentially, pharmaceutical companies use such methods in order to achieve the effects of bribery, without the risks. Practices such as these need to be, at the very least, examined and, at the very worst, eliminated. Such procedures have already begun, as the Pharmaceutical Research and Manufacturers of America has issued a voluntary code of conduct for pharmaceutical companies to follow which would eliminate the distribution of such small, branded trinkets. 
But many of the other forms of non-bribery bribing still remain, such as free samples, bought meals, and expensive consultations, nor does the new code apply to medical device manufacturers. A first step has been taken, but a long way is left to go.

The Truth About Free Samples

The Truth About Free Samples

Many pharmaceutical companies give free samples to doctors in an attempt to increase the overall pervasiveness of their drug brands. It is, in its own way, a form of marketing to give these free samples to doctors for the simple reason that free samples are inherently alluring to consumers. If someone can avoid paying for a drug sample, then he or she would love to do so. Doctors and patients alike know this. As a result, free samples are a highly effective way to ensure that a given pharmaceutical company's drug will find its way into consumer hands and will, therefore, lead to a greater prevalence for that drug. 
 
 
To call taking free samples the same thing as accepting bribes is perhaps a little strong, at least at first glance. After all, the free samples being given out by the pharmaceutical companies are free and seem oriented towards helping the consumer, not necessarily the doctor being given the free samples. One of the most important elements to successfully mounting bribery charges is to clearly determine that element of quid pro quo, "this for that," that defines bribery. In the case of free samples, the quid pro quo element appears absent. But is this enough to save doctors who take free samples from accusations of accepting bribes? 
 
 
The problem with free samples is that too often their effect is similar to that of a bribe, without necessarily looking like a bribe. Doctors will reach first for their supply of free samples to give to patients both because the sample is readily available and because it is free. 
 
 
This is especially true of doctors who want to help patients, who understand the rising costs of drugs and realize the boon that a free sample of a drug might be to a patient. As such, these doctors reach for the free samples first. But some have argued that this is exactly the source of the problem. 
 
 
As David J. Rothman, president of the Institute on Medicine as a Profession, said, "The question to the doctor is: If you didn't have it in your drawer, would that have been your drug of choice?" Similarly, a study showed that the number of doctors who used the drugs recommended by national guidelines increased greatly when these doctors no longer had free samples. If they had free samples, then instead of using these "first line" drugs, they were giving out those free samples.
 
 
The acceptance and use of free samples skirts dangerously close to accepting bribes on the part of the doctor and deserving of bribery charges on the part of the pharmaceutical company. All evidence points to the fact that free samples greatly benefit the pharmaceutical companies, simply by making their drugs more commonly used and prescribed, whether or not doctors mean to do so illegitimately.
 
 
But there are benefits to the use of free samples, not the least of which is that the samples allow doctors to determine if an individual can be helped by a given drug before he or she goes out and buys a full supply of that drug. 
 
 
In the end, however, even if the practice does not necessarily fall into the same category as bribery charges, it seems to be more trouble than it may be worth, as the entire practice is designed to manipulate doctors, if not outright bribe them. 
 
 
The drugs being given as free samples are often new drugs which the doctors do not have much experience with and cannot judge as accurately. This, combined with the fact that doctors seem to almost subconsciously dispense the free samples more often, paints the entire practice in a starkly negative light.