Earlier this year, EyeNet announced that the Academy had sold sponsorship of its publication The Ethical Ophthalmologist to a pharmaceutical company (“New Residents Primed on Ethics,” Academy Notebook, January). Although there is nothing wrong with corporate good citizenship, the wisdom of accepting money from a for-profit business to subsidize the training of physicians in medical ethics is questionable. This transaction conveys the wrong message—that the cost of teaching ethics has become too high for our profession to afford.

The pharmaceutical and health care technology industries have been taking a growing interest in physician education through support of educational activities. The scope of this financial investment is enormous and contributes to the higher cost of medicines and devices. Because the monetary outlay for education from private industry is done for commercial benefit, physicians, by accepting these services, create a conflict of interest.

Industry support is not inherently bad, but the conflicting goals of business and medicine must always be understood. The primary purpose of a corporation is to serve its stockholders, not patients.

At a time when pharmaceutical companies spend an average of $8,000 to $13,000 per physician each year,¹ it may be appropriate to consider what the perception of selling our professional duty to teach ethics might cost us in return. Irony is not lost on a pharmaceutical company that decides to invest in teaching medical ethics to physicians when the industry itself is criticized for the practice of gift giving.

The teaching of ethics to new members of our profession illustrates to society our commitment to abide by the moral rules that govern our work. The importance of The Ethical Ophthalmologist goes beyond its printed words. The work is a symbol of our professional commitment to patients and society.

No degree of disclaimer can appropriately distance the implications of financial sponsorship of The Ethical Ophthalmologist and related programs from their purpose to educate and positively influence the professional conduct of ophthalmologists. We must encourage persons and institutions outside of medicine to engage us in dialogue about how to best serve patients. Pharmaceutical companies are important allies in health care and their participation in the didactics of continuing medical education is appropriate, but medical ethics is not pharmacology. While medical ethics is no longer the exclusive domain of doctors, the responsibility of teaching medical ethics still belongs to physicians and should not be sold to the highest bidder.

Curtis E. Margo, MD, MPH
Lakeland, Fla.