Conflict of Interest

The pharmaceutical industry has produced many drugs that have benefited man. Political frameworks designed to govern the industry must maintain these benefits. However, regulation needs to be sufficiently robust to protect public health from drugs that are unsafe, ineffective, or unnecessary. The extent of industry influence over drug regulation, at the expense of other interested parties, suggests that the current system could be more robust. The many ways in which the pharmaceutical industry can influence governments and regulatory agencies are discussed, and methods by which this influence can be curbed are suggested.

Mutualisms are of fundamental importance in all ecosystems but their very existence poses a series of challenging evolutionary questions. Recently, the application of molecular analyses combined with theoretical advances have transformed our understanding of many specific systems, thereby contributing to the possibility of a more general understanding of the factors that influence mutualisms.

High rates of addiction, overdose, and death make the opioid epidemic one of the most urgent public health issues in the United States, with more than 47,000 opioid related deaths in 2017. Evidence from the United States shows that opioid manufacturers' strategies to deceive the medical community about the safety and efficacy of opioids played a pivotal role in the American opioid epidemic. This paper investigates how pharmaceutical promotion practices in the United States influenced health professionals, the regulator and the public, and contributed to the opioid crisis. The study focuses on the approval of OxyContin (an opioid) in 1995 and the aggressive and misleading marketing campaign that followed its approval by its manufacturer, Purdue Pharma. This paper argues that drug companies' strategies to influence the medical community represent a significant public health concern. Identifying the influence of drug companies on the medical community can help prevent similar public health crises.

Conflicts of interest (COIs) cloud vaccine safety research. Sponsors of research have competing interests that may impede the objective study of vaccine side effects. Vaccine manufacturers, health officials, and medical journals may have financial and bureaucratic reasons for not wanting to acknowledge the risks of vaccines. Conversely, some advocacy groups may have legislative and financial reasons to sponsor research that

The question of whether clinical ethics consultants may engage in patient advocacy in the course of consultation has not been addressed, but it highlights for the field that consultants' allegiances, and the boundaries of appropriate professional practice, must be better understood. I consider arguments for and against patient advocacy in clinical ethics consultation, which demonstrate that patient advocacy is permissible, but not central to the practice of consultation. I then offer four recommendations for consultants who engage in patient advocacy, and consider the implications of this issue for the field.

Riassunto. Vi sono molti modi di pensare alle mète future della ricerca clinica. Lascian- do ad altri contributi il compito di occuparsi delle frontiere conoscitive della ricerca cli- nica, ci concentriamo in questo articolo su questioni di metodologia e di policy. Le finalità etico/scientifiche e la realtà della ricerca clinica sembrano infatti marciare in direzione opposta. Per i pazienti, una

In this case study from litigation, we show how ghostwriting of clinical trial results can contribute to the manipulation of data to favor the study medication. Study 329 for paroxetine pediatric use was negative for efficacy and positive for harm. Yet the ghostwritten publication from this study concluded that paroxetine provided evidence of efficacy and safety and continues to be influential. Despite the role of named authors in revisions of the manuscript, the sponsor company remained in control of the message.

To explore a number of issues related to boundary violations in psychiatry, including the relationship between the individual physician and his or her patient and broader issues related to various dilemmas arising in academic departments of psychiatry. Several potentially troublesome scenarios are presented and discussed in the contexts of 1) the doctor-patient relationship, 2) sexual boundary violations, and 3) nonsexual forms of exploitation, such as finances, confidentiality, dual relationships, and relationships with industry. A number of examples of boundary problems involving psychiatrists have been explored, and although some of these behaviours are clearly forbidden and harmful, others are less clear and require careful consideration if the profession is to arrive at a thoughtful consensus.

Concerns about legal implications affect many decisions of the average radiologist, and physicians do not always appreciate the validity of these concerns. However, such concerns often influence radiologists' decisions more than is warranted. An improved understanding of the law and its ramifications may serve to prevent adverse legal effects found in the everyday practice of radiology. Legal issues influence radiology in many ways. Two important ways the law affects the practice of radiology relate to the business affairs of radiologists and to the radiologist's duty to perform to a standard of care. Legal issues relate to the business aspects of radiology through radiologists' relationship to their group practice and the radiology group's relation to the outside world. Radiology groups use legal services for issues such as employment contracts, hospital privileges, group relations, and bylaws. They make decisions with major legal implications when they establish th...

This paper integrates elements from the theory of agency, the theory of property rights and the theory of finance to develop a theory of the ownership structure of the firm. We define the concept of agency costs, show its relationship to the 'separation and control' issue, investigate the ...