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Contemporary bioethics is concerned with qualitative decisions rather than quantitative decisions. Several examples are discussed including the role of patients as decision makers in their treatment and in their assignment within clinical trial groups.
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Advertising of drugs and other preparations with an impact on human health is an integral part of the present time. The presented paper deals with different types of advertisements and legal and ethical problems associated with them. The authors in more detail discuss principles laid down in directive 92/28/EEC, which are mandatory from January 1993 for countries of the EEC.
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Physicians may receive various gifts and incentives from companies that make pharmaceuticals and medical devices. Although such incentives may benefit patients and physicians, they often pose serious conflicts of interest that violate a physician's professional responsibility. The physician-patient relationship is predicated on the physician acting in the best interest of the patient. The application of medical knowledge to complex clinical circumstances is difficult, even without biased sources of information and internal conflicts attributable to financial incentives. Yet, industry resources often are dedicated to the dissemination of information and incentives aimed to influence decisions not necessarily aimed at the goals of the patient. Physicians often are unaware of the nature of the incentives and commonly deny their demonstrated impact. Any incentive that is designed to impede, rather than enhance, the clinician's ability to make optimal patient care decisions is unethical for a physician to accept. These incentives should play no role in the practice of orthopaedic surgery.
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