Attitudes of physicians and public to pharmaceutical industry 'gifts'

Background: Few studies have reported the attitudes of both individual doctors and members of the public toward the appropriateness of 'gifts' from pharmaceutical companies. Aims: To investigate the attitudes of both doctors and members of the public toward the appropriateness of receiving particular 'gifts' from pharmaceutical companies, and to consider whether public acceptability is a suitable criterion for determining the ethical appropriateness of 'gifts'. Methods: A survey questionnaire of medical specialists in Australia and a survey questionnaire of members of the public itemised 23 'gifts' (valued between AU$10 and AU$2500) and asked whether or not each was appropriate. Results: Both medical specialists and members of the public believe certain 'gifts' from pharmaceutical companies are appropriate but not others. There was a tendency for members of the public to be more permissive than medical specialists. Conclusion: Although some professional guidelines place importance on the attitudes of the general public to 'gift' giving, and other guidelines give importance to a need for transparency and public accountability, we question whether public acceptability is a suitable criterion for determining the ethical appropriateness of 'gifts'. We suggest that more weight be given to the need for independence of clinical decision making, with empirical evidence indicating that even small 'gifts' can bias clinicians' judgments, and to important values such as the primacy of patient welfare, autonomy and social justice. We conclude that it is time to eliminate giving and receiving of promotional items between the pharmaceutical industry and members of health professions.